@article{ref1,
title="Belt-positioning booster seats and reduction in risk of injury among children in vehicle crashes",
journal="JAMA journal of the American Medical Association",
year="2003",
author="Winston, Flaura Koplin and Elliott, Michael R. and Durbin, Dennis R.",
volume="289",
number="21",
pages="2835-2840",
abstract="CONTEXT: Although more than a dozen states have ratified laws that require booster seats for children older than 4 years, most states continue to have child restraint laws that only cover children through age 4 years. Lack of booster seat effectiveness data may be a barrier to passage of stronger child restraint laws. OBJECTIVES: To quantify the association of belt-positioning booster seats compared with seat belts alone and risk of injury among 4- to 7-year-old children and to assess patterns of injury among children in booster seats vs seat belts. DESIGN, SETTING, AND POPULATION: Cross-sectional study of children aged 4 to 7 years in crashes of insured vehicles in 15 states, with data collected via insurance claims records and a telephone survey. A probability sample of 3616 crashes involving 4243 children, weighted to represent 56,593 children in 48,257 crashes was collected between December 1, 1998, and May 31, 2002. MAIN OUTCOME MEASURE: Parent report of clinically significant injuries. RESULTS: Injuries occurred among 1.81% of all 4- to 7-year-olds, including 1.95% of those in seat belts and 0.77% of those in belt-positioning booster seats. The odds of injury, adjusting for child, driver, crash, and vehicle characteristics, were 59% lower for children aged 4 to 7 years in belt-positioning boosters than in seat belts (odds ratio, 0.41; 95% confidence interval, 0.20-0.86). Children in belt-positioning booster seats had no injuries to the abdomen, neck/spine/back, or lower extremities, while children in seat belts alone had injuries to all body regions. CONCLUSION: Belt-positioning booster seats were associated with added safety benefits compared with seat belts to children through age 7 years, including reduction of injuries classically associated with improper seat belt fit in children.",
language="",
issn="0098-7484",
doi="10.1001/jama.289.21.2835",
url="http://dx.doi.org/10.1001/jama.289.21.2835"
}