Rear seat safer: Seating position, restraint use and injuries in children in traffic crashes in Victoria, Australia

Lennon, Alexia; Siskind, Vic; Haworth, Narelle · 2007 · OpenAlex-citations

DOI: 10.1016/j.aap.2007.09.024

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Summary

This study investigates the relative risks of death and serious injury for children aged 0–12 years in traffic crashes, specifically examining the effects of seating position and restraint use. The research was motivated by the prevalence of US-based safety data, which may not accurately reflect the Australian context due to differences in airbag prevalence, airbag design specifications, and higher restraint compliance rates. The authors aimed to determine if rear seating is safer for children in Australia and to inform ongoing reviews of road rules regarding child passenger safety. The researchers analyzed official police crash records from Victoria, Australia, covering two time periods (1993–1998 and 1999–2004) and three geographic regions. The dataset included 30,631 children under 13 years old involved in crashes where injuries occurred, focusing exclusively on sedans and station wagons. Outcomes were categorized as serious (fatal or hospitalized), minor, or uninjured. Statistical analyses included maximum likelihood estimation of relative risks (RR) for injury severity and logistic regression for fatalities, stratified by age groups (0–3, 4–7, and 8–12 years), seating position (front vs. rear), and restraint status. The results indicated that 92% of children were restrained, while 20.6% were seated in the front seat. For children under four years old, front seating significantly increased risk even when restrained; the relative risk of serious injury was 1.59 times higher than for rear-seated peers, and for infants under one year, the risk was 3.28 times higher. Front seating also doubled the risk of fatality for children under four. In contrast, seating position had no significant effect on injury risk for children aged four and older. Restraint use was critical across all ages; unrestrained children faced relative risks of serious injury ranging from 2.49 to 3.65 compared to restrained children. The risks associated with front seating and non-restraint use were multiplicative, with unrestrained children in the front seat facing nearly ten times the risk of serious injury compared to restrained rear-seat passengers. The study concludes that rear seating is significantly safer for children under four years old, particularly infants, and recommends mandating rear seating for this demographic. While the lack of significant risk for older children in the front seat contrasts with some US findings, the authors attribute this to lower airbag prevalence and less severe crash types in the Australian dataset. The findings reinforce the critical importance of restraint use and suggest that Australian road safety regulations should prioritize rear seating for young children to minimize injury and fatality risks.

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• child passenger safety

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• Empirical Findings: crash risk outcomes