Restraint use and seating position among children in motor vehicles in Bloemfontein

Background. Most child deaths from motor vehicle accidents (MVAs) occur in low- and middle-income countries. Effective measures to protect children involved in MVAs include wearing age-appropriate child restraints and being seated in the rear of the vehicle. Methods. A descriptive study was used to assess use of child restraints, seating positions of children, driver restraint and vehicle overloading in Bloemfontein in 2007. Two pairs of observers stood at selected sites recording these findings. The study was done over a period of 1 month. Results. A total of 512 children in 374 vehicles were assessed. Just over a third of the children were seated on the front seat of the vehicle, and 14.1% were seated on other people’s laps (73.6% of these were on the front seat). Restraints were used by 8.8% of children and 17.4% of drivers; 10 times more children used restraints if the driver was restrained versus not restrained. Between 9.3% and 20.4% of vehicles were assessed as being overloaded with passengers. Conclusion. The safety of child passengers in Bloemfontein in the event of an MVA is threatened by poor adherence to basic safety measures. Enforcement of correct seating position and use of child restraints will prevent unnecessary deaths, disabilities and suffering of child passengers injured in the event of an MVA. Driver motivation and responsibility is important in achieving safer seating of children in motor vehicles.