Are restrained children under 15 years of age in cars as effectively protected as adults?

AIM To compare the injury distribution between children and adults, injured as restrained car passengers. METHODS Population based study of data from a French road trauma registry in 1996-2002. Children under 15 years old were compared with adult casualties according to the distribution of serious injuries in three distinct body regions (head, chest, and abdomen) when they were restrained car passengers. A multivariate logistic regression was performed to quantify the risk of AIS2+ injury (Abbreviated Injury Scale of 2 or more). RESULTS Among the 7568 casualties who were injured as restrained car passengers in car accidents, 1033 were less than 15 years old. Overall, 35.4% of children and 25.2% of adults were unrestrained. For children and adults, the risk of fatality was significantly reduced when they were restrained, but the percentages of children with Injury Severity Score (ISS) > or =16, were not significantly different between restrained and not restrained casualties. Compared to adults, restrained children aged 5-9 were 2.7 times (OR 2.74; 95% CI 1.17 to 6.43) as likely to sustain an AIS2+ abdominal injury, and tended to be more at risk of AIS2+ head injuries, but were less at risk of AIS2+ chest injuries. CONCLUSIONS Children aged 5-9 years injured in road accidents as restrained car passengers were more likely to sustain an AIS2+ abdominal injury than adults. This emphasises the need to reinforce educational campaigns aimed not only at getting children into restraint systems, but also insisting on their correct use.