Effectiveness of child safety seats vs safety belts for children aged 2 to 3 years

Arch Pediatr Adolesc Med. 2007 Jan;161(1):65-8. doi: 10.1001/archpedi.161.1.65.


Objective: To compare the effectiveness of child safety seats and lap-shoulder belts in rear passenger vehicle seats for 2- to 3-year-old crash survivors.

Design: Cohort study.

Setting: The January 1, 1998, to December 31, 2004, US data on a nationally representative sample of crashes that resulted in at least 1 vehicle being towed away.

Participants: Toddlers who were sitting in rear vehicle seats and using lap-shoulder belts or child seats when involved in highway crashes.

Intervention: Child safety seat vs safety belt.

Outcome measure: Presence of any injury after a crash.

Results: The adjusted odds of injury were 81.8% lower (95% confidence interval, 58.3%-92.1% lower) for toddlers in child seats than belted toddlers.

Conclusions: Child safety seats seem to be more effective rear seat restraints than lap-shoulder safety belts for children aged 2 to 3 years. Laws requiring that children younger than 4 years travel in child safety seats have a sound basis and should remain in force.

MeSH terms

  • Accidents, Traffic / mortality
  • Accidents, Traffic / prevention & control*
  • Child, Preschool
  • Confidence Intervals
  • Follow-Up Studies
  • Humans
  • Infant Equipment / standards*
  • Odds Ratio
  • Retrospective Studies
  • Seat Belts / standards*
  • Survival Rate
  • United States / epidemiology