Connecticut Department of Public Health National Highway Traffic Safety Administration (NHTSA) Crash Outcome Data Evaluation System (CODES) Grand Rounds.

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 :

justin.peng@ct.gov

Marian Storch : marian.storch@ct.gov

Mukhtar Mohamed : mukhtar.mohamed@ct.gov