Principal Investigator: Rachel Myers, PhD, MS, Children’s Hospital of Philadelphia

This project builds on prior CChIPS-supported work, in which New Jersey police crash report and hospital discharge (ED/inpatient/outpatient) data of child occupants were successfully linked. These data were used to describe restraint use and injury outcomes among children. Year 2 work aims to complete linkage of 2018 and 2019 administrative data sources to supplement existing 2017 NJ Safety and Health Outcomes (NJ-SHO) data, to examine restraint use for select child occupant characteristics as well as driver and vehicle characteristics, and to comprehensively describe injuries for select child, driver, vehicle, and crash characteristics.

WHAT WAS THE PURPOSE OF THIS PROJECT?

This project builds upon prior CChIPS work using the New Jersey Safety and Health Outcomes (NJ-SHO) Data Warehouse in which we successfully linked NJ police crash report and hospital discharge data of child passengers across one year (2017) and demonstrated the potential use of these data for child-focused research. This preliminary work led to several critical questions related to child crash-related injury outcomes.

HOW WAS THE RESEARCH CONDUCTED?

In the current project, we included two additional years (2018 and 2019) of crash and injury outcome data to conduct analyses across multiple years of motor vehicle crashes (MVCs). We described prevalence of child restraint use by child characteristics (age, sex, seating location, and crash injury) and driver characteristics (age, sex, restraint use, and alcohol use). We examined the frequency of injuries to child passengers documented on crash reports and in hospital discharge data.

WHAT DID YOU FIND?

We identified a sample of 87,229 child passengers ages 0 to 12 in MVCs in NJ from 2017-2019. While most children were seated in the rear rows of the vehicle, among children under 2, only 60% were riding in rear-facing CRS at the time of the crash, which goes against CPS best practices and NJ state law. We also found limited use of belt-positioning booster seats with potentially premature graduation to vehicle belt use, as shown by the proportion of 4-to 7-yearold’s restrained by the vehicle belt at time of a crash (36%). We observed that younger (<21 years) and older (>65 years) drivers had greater proportions of improperly restrained children. With regards to injuries among child passengers, we found 12% of children noted to be uninjured on the crash report had an injury documented in the hospital data.

WHAT’S NEXT?

Our findings indicate that opportunities may exist for specific educational and behavioral interventions to address child restraint practices among certain potentially vulnerable groups, namely children under age 2, younger adult drivers, and drivers who engage in potentially unsafe behaviors. We are beginning to leverage the integrated data of the NJ-SHO to examine injury outcomes among child passengers using integrated hospital data to understand the types and severity of injuries associated with use of child restraints.

These graphs show the proportion of children using each restraint type by age. The bars in pink within each age category reflect the optimal restraint use by age per NJ statute and minimum best practice recommendations.

Co-Investigator

Allison Curry, PhD, MPH, Children’s Hospital of Philadelphia

Project Team Members

Leah Lombardi, MPH, Children’s Hospital of Philadelphia; Melissa Pfeiffer, MPH, Children’s Hospital of Philadelphia; Emma Sartin, PhD, MPH, Children’s Hospital of Philadelphia

IAB Mentors

Emily Thomas, Consumer Reports; Suzanne Johansson, General Motors Holdings LLC; Mark LaPlante, Graco Children’s Products Inc.; Marianne Le Claire, Graco Children’s Products Inc. Emily Burton, American Honda Motor Co., Inc.; Bill Lanz, American Honda Motor Co., Inc.; Russ Davidson, Lear Corporation; Steve Gerhart, Nuna Baby Essentials, Inc.; Guy Nusholtz, Stellantis; Schuyler St. Lawrence, Toyota USA; Uwe Meissner, Technical Advisor