Rear seat safer: Seating position, restraint use and injuries in children in traffic crashes in Victoria, Australia

Car crashes are a major cause of death and serious injury to children but most analyses of risk are based on US data. The Australian context is different in at least three ways: (1) the proportion of passenger-side airbags, a potential risk to children in front seats, is much lower; (2) unlike in the US, Australian airbags are designed to work with restrained passengers; (3) restraint use for children 0–12 years is high (>90%). Official data drawn from Victorian crash records (n = 30,631) were used to calculate relative risks of death or serious injury for children (0–3 years, 4–7 years; 8–12 years) traveling in passenger cars during 1993–1998 and 1999–2004. Over 90% were reportedly wearing a restraint, and 20% were traveling in the front seat. For children under 4 years traveling in the front seat, the relative risk of death was twice as great as when traveling in the rear, and that of serious injury was 60% greater. The relative risk of death whilst traveling in the front seat was almost four times greater for children aged under 1 year. We suggest that serious consideration should be given to mandating rear seating for children, particularly those aged 4 and under.