Petridou E, Skalkidou A, Lescohier I, Trichopoulos D
Department of Hygiene and Epidemiology, Athens University Medical School, Greece.
Arch Dis Child. 1998 Apr;78(4):335-9. doi: 10.1136/adc.78.4.335.
The protective effect of child restraint and the relative safety of front and rear seating in a population where children often travel unrestrained was assessed in a population based case-control study. The cases were all 129 children aged 0-11 years injured as car passengers in a motor vehicle accident who contacted, during 1996, one of the two major children's hospitals in Athens; emergency cases are accepted by the two hospitals on alternate days throughout the year, thus generating a random sample of children injured as car passengers. The prevalence of the studied exposures in the study base was estimated from an inspection survey comprising a random sample of 191 children of the same age who travelled in passenger cars. The survey was conducted by medical staff from our centre in collaboration with the road traffic police. Odds ratios (ORs) were calculated after adjustment for confounding factors through the Mantel-Haenszel procedure. The OR for injury was 3.3 among unrestrained children compared with restrained children (comparison essentially limited to children aged 0-4 years) and 5.0 for children seated in the front compared with those seated in the rear (comparison essentially limited among unrestrained children). Protective effect estimates derived from this analytical study suggest that in Greece about two thirds of all childhood injuries from car crashes could have been avoided through the regular use of a proper child restraint. The data also indicate that, in the absence of a child restraint system, a rear seating position conveys substantial protection and could explain the low mortality of children as car passengers in Greece, a country which is characterised by a high overall road traffic mortality as well as a high childhood accident mortality.
在一项基于人群的病例对照研究中，评估了儿童约束装置的保护作用以及在一个儿童乘车时经常无约束的人群中，前排和后排座位的相对安全性。病例为1996年期间在机动车事故中作为汽车乘客受伤的129名0至11岁儿童，他们前往雅典的两家主要儿童医院之一就诊；这两家医院全年轮流接收急诊病例，从而形成了作为汽车乘客受伤儿童的随机样本。通过一项检查调查估计了研究基数中所研究暴露因素的患病率，该调查包括对191名同年龄乘坐乘用车儿童的随机抽样。该调查由我们中心的医务人员与道路交通警察合作进行。通过Mantel-Haenszel程序对混杂因素进行调整后计算比值比（OR）。与使用约束装置的儿童相比，未使用约束装置的儿童受伤的OR为3.3（比较基本限于0至4岁儿童），与坐在后排的儿童相比，坐在前排的儿童受伤的OR为5.0（比较基本限于未使用约束装置的儿童）。这项分析研究得出的保护作用估计表明，在希腊，通过定期使用适当的儿童约束装置，约三分之二的儿童车祸伤害本可避免。数据还表明，在没有儿童约束系统的情况下，后排座位可提供实质性保护，这可以解释在希腊作为汽车乘客的儿童死亡率较低的原因，希腊总体道路交通死亡率高以及儿童事故死亡率高。
