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Abstract
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Decker notes that the disparity between earlier findings1 of car seat effectiveness and those from our study2 may have resulted from interstudy variability or from progress made in other risk factor areas over the past 25 years. We agree with these assertions and add the following comments.
It seems likely that variability between study samples would account for some of the disparity, particularly given the limited data of the earlier study, which used 6 years of police data from 1 state. The estimated odds ratio for death (11) was based on 2 deaths of children using child restraints and would thus have been quite unstable. The findings from Partyka3 suggest that the Decker et al. data may have deviated from other data at the time. Partyka used national police reported collision data for years 1982 to 1987 to estimate death risk ratios of 3.2 for infants and 1.9 for toddlers, comparing unrestrained children to those sitting in safety seats.
Regardless, significant progress has been made in designing safer vehicles and in trauma care over the past 25 years. If the overall risk of severe or fatal injury to infants and toddlers during collision has been reduced over time, we agree that the observed effectiveness of safety seats would be lower today than it was in the past.
Rice TM, Anderson CL. The effectiveness of child restraint systems for children aged 3 years or younger during motor vehicle collisions: 1996 to 2005. Am J Public Health. 2009;99:252-257
Language: en |