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Connecticut Department of Public Health
National Highway Traffic Safety Administration (NHTSA)
Crash Outcome Data Evaluation System (CODES)
Grand Rounds
February 9, 2011
Promoting back seat travel for children < 13 years old in Connecticut
Connecticut CODES Project The CT CODES Project is
located in the CT Department of Public Health’s Health Education, Management and Surveillance Section (HEMS)
CT CODES Project Staff Supervising Epidemiologist
for Epidemiology Unit Injury Epidemiologist Unintentional Injury
Prevention Coordinator
Currently have 1997-2007 linked crash, inpatient and emergency dept data.
E p id e m io lo gy U n it In ju ry P re ve n tion P ro g ram
H E M S S e c tion
P u b lic H e a lth In itia t ives
C T D ep t o f P u b lic H e a lth
CT CODES Advisory Board Membership CT Dept of
Transportation*Transportation Safety DivCrash Analysis Unit
CT Hospital Association* CT Dept of Public Health*
Office of Emergency Medical Services
CT Dept of Public Safety/ Crimes Analysis Unit
CT Dept of Motor Vehicles
NHTSA Region 1 Safe Kids Connecticut A regional planning agency Yale School of Medicine
Section of Emergency Medicine
Researcher on older drivers Yale New Haven Hospital
Injury Program Coordinator University of CT
Dept of Engineering & Transportation Institute
A hospital trauma manager
*Data Owners
Reason for the study:
Safe Kids Connecticut requested state specific data To enhance child passenger safety for
children < 13 years old To promote back seat travel for children < 13
years old
Target audiences: Parents Care givers Traffic safety decision makers
Reason for the study:
CT law (2005) :Children should ride in a car seat or booster
until they reach 7 years old and 60 poundsChildren who ride in a booster seat must use
a lap and shoulder belt
Recommendation:Children should ride in the back seat until they are 13 years old
Methods: Data
Linked imputed CT crash, inpatient & ED data (2000 – 2006)
Restraint use of None Shoulder belt only Lap belt only Shoulder and lap belt Child safety seat
Vehicle type: Passenger car Light truck
Passengers only
Methods (continued): Injury severity score (ISS)
i. < 9 = Minorii. 9 - 15 = Moderateiii. >15 = Severe
Analysis Severe injury – Front seat vs. back seat Control for restraint use Examine 0-6y and 7-12y separately
Odds ratio/relative risk
Results
Slightly higher one-third of 0-12 year old sat at front seatMajority of other age groups sat at front seat
Severe injuries for <13 year old were significantly higher by 2.5 times at the front seat than at back seat
No significant risk or protection for other age groups
Restraint use by seating position and severe injuries
Restraint use did not change results for 0 – 12 year old (OR=2.56, 95% CL 1.04-6.04)
Further analyses:
0 – 6 year old
7 – 12 year old
Restraint use by seating position0 – 6 year age group
Severe/moderate injuriesFor kids who used shoulder & lap belt, those
who sat in the front seat were 1.67 times more likely to suffer severe or moderate injuries when compared to those who sat in the back (OR=1.67, 1.02-2.74)
Restraint use by seating position7 – 12 year age group
Severe/moderate injuriesFor kids who used shoulder & lap belt, those
who sat in the front seat were three and half times more likely to suffer severe or moderate injuries when compared to those who sat in the back (OR=3.46, 2.19-5.47)
Key findings:
Children <13 years of age seated at the front seat are 2.5 times more likely to suffer severe injuries compared to children at the back seat
The risk remained pretty much the same even if they had some type of restrain use
For those restrained with lap & shoulder belt, seated at the front increased the risk of severe/moderate injury by 1.7 times for 0 – 6 years old and by 3.5 times for 7-12 years old
Limitations Due to smaller sample size
hard to produce comparable hospital medical charges
confidence limits of risk ratio/odds ratios are wide
Our plan is to add three more years of linked data and see if results change.
CT CODES ProgramCT Department of Public Health
Injury Prevention Program Justin Peng :
Marian Storch : [email protected]
Mukhtar Mohamed : [email protected]