@article{ref1,
title="The effect of correct cross-chest clip use on injury outcomes in young children during motor vehicle crashes",
journal="Traffic injury prevention",
year="2018",
author="Woodford, Evangeline and Brown, Julie and Bilston, Lynne E.",
volume="19",
number="4",
pages="371-377",
abstract="OBJECTIVE: Traffic crashes have high mortality and morbidity for young children. While many specialised child restraint systems improve injury outcomes, no large-scale studies have investigated the cross-chest clip's role during a crash, despite concerns in some jurisdictions about the potential for neck contact injuries from the clips. This study aimed to investigate the relationship between cross-chest clip use and injury outcomes in children between 0-4 years of age. <br><br>METHODS: Child passengers between 0-4 years of age were selected from the Crashworthiness Data System of the US National Automotive Sampling System (NASS) datasets (2003-2014). Multiple regression analysis was used to model injury outcomes while controlling for age, crash severity, crash direction and restraint type. The primary outcomes were overall Abbreviated Injury Score (AIS) 2+ injury, and the presence of any neck injury. <br><br>RESULTS: Across all children aged 0-4 years, correct chest clip use was associated with decreased AIS 2+ injury (OR 0.44, 95%CI 0.21-0.91), and was not associated with neck injury. However, outcomes varied by age. In children <12 months old, chest clip use was associated with decreased AIS 2+ injury (OR 0.09, 95%CI 0.02-0.44). Neck injury (n = 7, all AIS 1) for this age group only occurred with correct cross-chest clip use. For 1-4 year old children, cross-chest clip use had no association with AIS 2+injury, and correct use significantly decreased the odds of neck injury (OR = 0.49; 95%CI 0.27-0.87) compared to an incorrectly used or absent cross-chest clip. No serious injuries were directly caused by the chest clips. <br><br>CONCLUSIONS: Correct cross-chest clip use appeared to reduce injury in crashes, and there was no evidence of serious clip-induced injury in children in 5 point harness restraints.<p /> <p>Language: en</p>",
language="en",
issn="1538-9588",
doi="10.1080/15389588.2017.1410545",
url="http://dx.doi.org/10.1080/15389588.2017.1410545"
}