Updated population-level estimates of child restraint practices among children aged 0-12 years in Australia, ten years after introduction of age-appropriate restraint use legislation.

ObjectiveTo determine child restraint practices approximately 10 years after introduction of legislation requiring correct use of age-appropriate restraints for all children aged up to 7 years. MethodsA stratified cluster sample was constructed to collect observational data from children aged 0-12 years across the Greater Sydney region of NSW. Methods replicated those used in a similar 2008 study. Population weighted estimates for restraint practices were generated, and logistic regression used to examine associations between restraint type, and child age with correct use accounting for the complex sample. ResultsAlmost all children were appropriately restrained (99.3%, 95% CI 98.4-100). However, less than half were correctly restrained (No error = 27.3%, 95% CI 10.8-43.8, No serious error = 43.8%, 95% CI 35.0-52.7). For any error, the odds of error decreased by 39% per year of age (OR 0.61, 95% 0.46-0.81), and for serious error by 25% per year (OR 0.75 95% CI 0.60-0.93). ConclusionThe findings demonstrate a substantial increase in appropriate child restraint, but no real change in correct use. Implications for Public HealthGiven the negative impact incorrect use has on crash protection, continuing high rates of incorrect use may reduce effectiveness of legislative change on injury reduction.