Boosting correct and appropriate booster seat use in Australia

The main aims of the current study were to (1) investigate misuse and/or inappropriate use across different booster seat types (including high back booster seats, booster seat cushions, and booster seats/cushions used in combination with an H-harness) through an Australian CRS/booster seat inspection program conducted between October 2004 and October 2011, and (2) determine whether misuse and/or inappropriate use across booster seat types changed following the introduction in 2009 of new Australian CRS/booster seat and motor vehicle restraint use legislation for children aged 7 years and under. Results reveal high levels of booster seat misuse among booster seats (including high back booster seats, booster seat cushions, and booster seats/cushions used in combination with an H-harness) installed in Australian motor vehicles that present at CRS inspection clinics. Of all the booster seats inspected, almost two thirds (62%) were reported as having at least one instance of misuse, with almost all aspects of the booster seat misused in some way. Misuse was highest for booster seats/cushions used in combination with an H-harness (84%), compared to booster cushions (63%) and high back booster seats (55%). Of the 792 booster seats inspected, 673 (85%) were inspected before, and 119 (15%) were inspected following, the introduction of the new CRS legislation. While it was not possible to ensure similarity between components of the sample observed in the pre- and post-legislation periods, significantly more misuse and inappropriate use was observed in the post-legislation component of the sample. For example, inappropriate booster seat use increased significantly across the pre- and post-legislation periods (5% vs. 9%, χ2(1) = 4.719, p < 0.05). In addition, there were significantly more: H-harness errors (17% vs. 55%), missing gated buckles/locking clips (12% vs. 29%), tether errors (3% vs. 13%) and anchor errors (3% vs. 8%). These findings highlight the need for more targeted CRS/booster seat education to complement legislative changes, including information on correct and appropriate booster seat use in order to maximise the level of specialised protection provided by the CRS/booster seat for child vehicle occupants in the event of a crash.

► Booster seats provide specialised protection older child vehicle occupants.
► High levels of booster seat misuse were observed in Australian motor vehicles (62%).
► Misuse was highest for booster seats/cushions used in combination with an H-harness (85%).
► Targeted education needed to maximise the level of protection provided by booster seats.