Division of Child Development and Rehabilitation Medicine, The Children's Hospital of Philadelphia, 3550 Market St., Philadelphia, PA, 19104, USA.
Matern Child Health J. 2011 Oct;15(7):949-54. doi: 10.1007/s10995-009-0539-1.
Physical disabilities may affect a child passenger's fit within a conventional motor vehicle restraint. The aim of this study is to describe and compare injury risk in motor vehicle crashes (MVC) among children with and without special physical health care needs (SPHCN). This analysis, conducted in 2007-2008, utilizes data collected between December 1998 and November 2002 in a cross-sectional study of children ≤15 years old involved in crashes of State-Farm insured vehicles in 15 states and the District of Columbia. Parent reports via telephone survey were used to define pre-crash SPHCN, restraint status, and occurrence of significant injuries using a validated survey. Complete data were collected for 18,852 children aged 0-15 years; 159 children were reported to have a SPHCN (0.8% and 0.7% of children aged 0-8 and 9-15 years, respectively). A greater proportion of children with SPHCN aged 0-8 years were appropriately restrained (P < 0.001), but there was no significant difference in restraint use among children with and without SPHCN aged 9-15 years. There was no significant association between the presence of a SPHCN and injury risk in either age group, after adjustment for child/driver characteristics (children aged 0-8 years: OR 1.27, 95% CI: 0.48-3.33; children aged 9-15 years: OR 1.51, 95% CI: 0.38-6.11). Children with and without SPHCN have similar injury risk in MVC, despite increased age-appropriate restraint usage among children aged 0-8 years. When counseling families about vehicle safety, practitioners should consider the fit of a child with SPHCN in a restraint system.
身体残疾可能会影响儿童乘客在常规汽车约束装置中的适配性。本研究旨在描述和比较有特殊身体保健需求（SPHCN）和无特殊身体保健需求（SPHCN）儿童在机动车碰撞（MVC）中的受伤风险。这项分析于 2007-2008 年进行，利用了在 15 个州和哥伦比亚特区参与 State-Farm 保险车辆碰撞的 15 岁以下儿童的横断面研究中，于 1998 年 12 月至 2002 年 11 月之间收集的数据。通过电话调查，父母报告用于定义 Crash 前 SPHCN、约束状态和使用验证调查确定的重大伤害的发生。共收集了 18852 名 0-15 岁儿童的完整数据；报告有 SPHCN 的儿童为 159 名（0-8 岁儿童占 0.8%，9-15 岁儿童占 0.7%）。更多有 SPHCN 的 0-8 岁儿童得到了适当的约束（P < 0.001），但 9-15 岁有和没有 SPHCN 的儿童在约束使用方面没有显著差异。在调整了儿童/驾驶员特征后，无论是在哪个年龄组，存在 SPHCN 与受伤风险之间都没有显著关联（0-8 岁儿童：OR 1.27，95%CI：0.48-3.33；9-15 岁儿童：OR 1.51，95%CI：0.38-6.11）。尽管 0-8 岁儿童的年龄适当约束使用率更高，但有和没有 SPHCN 的儿童在 MVC 中的受伤风险相似。在向家庭提供有关车辆安全的建议时，从业人员应考虑有 SPHCN 的儿童在约束系统中的适配性。
