An Observational Study of Child Safety Seat Use in an International Safe Community: Tehran, Iran

Background and Objective: Children are at high risk of serious injury or death from motor vehicle crashes. Children are the most affected passengers in cars crashes. The WHO has stated that 65% of children who die in an accident are passengers of cars and the use of adult safety belts only reduces injury risk by 32% for children aged 4 and younger. In contrast, Child Safety Seats(CSSs) reduce the risk of injury by 50–80% for children aged 4 and younger. Despite strong evidence of the effectiveness of CSSs in reducing injuries, the use of these devices in some communities is still rare. The purpose of this study was to determine the prevalence of child safety seats use and the factors influencing its use in the safe community of Tehran. Materials and Methods: This roadside observational study was conducted in Tehran in 2015. 2178 personal cars with a child under 12 years aboard were observed on Tehran’s streets in regard to use of child safety seats. The observation spots were selected by multistage cluster convenience sampling. Other variables such as the gender of the driver, drivers’ age group, type of street, region of municipality, time of day and day of the week were also collected. Descriptive statistics and univariable and multivariable binary logistic regression analyses were conducted. Crude and adjusted odds ratios with 95% confidence intervals were calculated. All analyses were carried out using SPSS21. Findings: The results showed that prevalence of CSSs use was 4.3%. Among all drivers, 83.2% were male and drivers who were in the 30–50 age group used CSSs more often (4.68%) than others. Also the prevalence of CSSs use on freeways (6.41%) was higher than that on side streets (3.65%) and main streets (2.84%). Multivariable logistic regression results showed that when the driver was female the prevalence of CSSs use was significantly higher (OR=2.25,1.38-3.65). Also the use was significantly higher on freeways than main streets (OR=2.47,1.73-4.28) and using CSSs were significantly higher in districts 1 (OR=5.17,1.72-15.58), 4 (OR=3.62,1.16-11.27) and 7 (OR=5.97,2.01-17.74). According to our results, the use of CSSs on holidays and work days was not significantly different; in addition, the difference between families with expensive cars and less expensive cars was not significant. There was no significant difference between using CSSs in the morning or afternoon. Conclusion: The prevalence of child safety seats use in Tehran as the most populous member of the international safe community was very low and most children commuted in insecure situations in the vehicle. Therefore, it is proposed that educational interventions and media programs should be made to increase the use of CSSs in international safe communities.

Keywords:

Child Safety Seat use , Safe Community , Safety seat , Observational study