Relative mortality of unbelted infant passengers and belted non-infant passengers in air accidents with survivors.

Aircraft accidents with survivors were examined to determine the relative risk of mortality for unrestrained infant passengers vs seat-belted adult passengers. The crude relative risk was estimated to be 7.1, based on US data, and 7.4, based on worldwide data. More refined estimates allow for possible effect of seat location and for differences in lethality between crashes. Using such estimates, unbelted infant passengers have relative risk of 5.9 based on US data and 9.6 based on worldwide data. The injury experience of restrained vs unrestrained automobile passengers suggests that observed excess risk to infant air passengers may be related to the absence of a mechanical restraint system. Recommendations for a mechanical restraint system are made and the cost and benefits of implementing these recommendations in the US are discussed.