There are few studies on the travel safety of child passenger in China. The study aims to describe the seating position and restraint practice of child passenger in China’s first-tier cities. The travel information on the children enrolled in 10 early education institutions, 15 kindergartens and 10 primary schools was randomly selected in Beijing, Shanghai, Guangzhou, Chongqing and Jinan in recent years. A total of 4900 parents were surveyed to collect children’s travel information and 3556 valid questionnaires were taken back. The adjusted rate ratios for optimal seating position (rear-seated alone) versus suboptimal seating position and restraint use versus non-use of restraints among child passengers were analyzed and evaluated using multivariate binomial regression. Through the survey, it is found that the suboptimal seat ing position (31.2%) and non-use of restraints (45.4%) were common among child passengers. Younger age (≤8 years old) is an unfavorable factor resulting in seating in rear seats by child passengers; and the higher the driver’s degree of education, the higher the family income and the more understanding about car seat is, the bigger likelihood of being rear-seated alone by child passengers is. Younger age (≤8 years old) is also an unfavorable factor resulting in restraint use by child passengers; and the more understanding about car seat, the more concern on the relevant legislative information and the more knowledge about defective car seat recall have by parents, the bigger likelihood of using restraints for their children during travel. This study suggests that restraint non-use and suboptimal seating position are still common among child passengers in China’s first-tier cities and also identifies the factors influencing restraint use and seating position choice for child passengers. There is an urgent need to improve child passenger safety in China. At the same time, it is also necessary to strengthen the publicity about child passenger’s safety before the relevant laws and regulations are promulgated.
Travel safety of children is a current social hot spot in China. In 2010, traffic accident caused 2690 children (1 - 15 years) died and 14,733 children injured in China, with the number of child death accounted for 39.3% of the total number of deaths in the current population statistics [
The vast majority of child passenger injuries are preventable. The study shows that rear seating and restraint use for child passengers can effectively reduce injury risks in crashes [
Prioritizing appropriate countermeasures to reduce child passenger casualties in road accidents (such as increasing child restraint use and rear seating) requires an understanding about the social context, especially parents whose cognition will determine how children travel in car. Compared with other developed countries, China’s concern on child passenger safety practice is still quite missing. This paper aimed to fully describe child passenger safety practices in China’s first-tier cities and obtain the information about parental attributes influence on child passengers’ seating position and restraint use through questionnaire study on child passenger safety practice in five cities including Beijing, Shanghai, Guangzhou, Chongqing and Jinan.
During the period from May 2014 to May 2015, a total of 4900 parents were subject to the questionnaire survey conducted in 10 early education institutions, 15 kindergartens and 10 primary schools randomly selected in Beijing, Shanghai, Guangzhou, Chongqing and Jinan. A unified questionnaire was used in the survey. All questionnaires were delivered to all children who took home the questionnaires and transferred to their parents. The completed questionnaires were returned in the second day. Research experts participated in the entire survey process, where they were responsible for questionnaire design, discussion and data analysis.
The questionnaire consists of two parts: basic information and restraint type. Basic information includes child’ age (year), gender, relationship with driver, driver’s education, family income(RMB/year), understanding about car seat, concern on legislation of car seat and understanding about recall of defective car seat; Restraint type includes restraint used, type of restraint used and seating position.
For data analysis, two outcomes were selected as the dependent variables in this paper: seating position and restraint use by child passengers. The classification was done in a binary way, that is, seating position as optimal (rear seated other than on an adult lap) and suboptimal (including always front seated, sitting on an adult’s lap and others); restraint use as any restraint use (including car seat, booster and seat belt) and no restraint use; each child’s age as either ≤8 years (preschool age) and >9 years (school age); gender as male and female; relationship between driver and children as parent and non-parent; driver education level as college or above and college or lower; family income as high (>RMB 100,000 a year) and low (
This paper describes the use and form of restraints (such as car seat, adult seat belt) as well as seating position of the children in different age groups and different cities through descriptive statistics. The binary logistic regression analysis was used to evaluate the factors that affect restraint use and the rear seating position. All data analyses were completed using SPASS 17.0. The degree of influence on the dependent variables caused by independent variables was analyzed mainly by using the adjusted rate ratios (RR).
A total of 4900 questionnaires were handed out and 3556 valid questionnaires were returned in this survey, with an effective questionnaire rate of 72.6%. As shown in
Age group | Total | |||
---|---|---|---|---|
Ages 0 - 3 | Ages 4 - 8 | Ages 9 - 15 | N/(%) | |
Primarily infants and toddlers | Preschool children | School children | ||
Total (N) | 568 | 1823 | 1165 | 3556 |
Restraint used | ||||
Yes | 319 (56.2) | 966 (53.0) | 660 (56.7) | 1945 (54.7) |
No | 249 (43.8) | 857 (47.0) | 505 (43.3) | 1611 (45.3) |
Type of restraint used | ||||
Car seat | 253 (44.5) | 386 (21.2) | 104 (8.9) | 743 (20.9) |
Seatbelt | 97 (17.1) | 658 (36.1) | 594 (51.0) | 1349 (37.9) |
Both | 31 | 78 | 38 | |
Seating positiona | ||||
Front seated | 40 (7.0) | 77 (4.2) | 83 (7.1) | 200 (5.6) |
Rear seated | 216 (38.0) | 1299 (71.3) | 933 (80.1) | 2448 (68.8) |
Adult’s lap | 205 (36.1) | 144 (7.9) | 9 (0.8) | 358 (10.1) |
Others | 15 (2.6) | 267 (14.6) | 125 (10.7) | 407 (11.4) |
aLess than the total because of missing value.
Five cities in China were involved in this survey: Beijing, Shanghai, Guangzhou, Chongqing and Jinan. As shown in
3427 respondents (96.4%) were parents, while the rest were relatives or hired professional drivers. 6.7% of the respondents (n = 238) reported that they had never heard of car seat; 72.8% of the respondents (n = 2,589) stated that they had heard of it but knew little; 20.5% of the respondents (n = 20.5%) reported that they used car seat and had a full understanding about it. About 80% of the respondents thought that it was necessary to have child in a car seat during the travel.
When it came to the reason for not using car seat, 8.4% of the parents were lacking of awareness; 39.7% of the parents did not care about the legislation on car seat and 59.7% of the parents considered the price of car seat on the market were too high. As shown in
This study demonstrates that the child’s age, driver’s education level, family income and degree of understanding about car seat were associated with how children in China are seated, while the child’s age, degree of understanding about car seat, concern on legislative information about car seat and the degree of understanding about recall of defective car seat were associated with whether children use restraints in cars. The results highlight the urgent need for improving
City | |||||
---|---|---|---|---|---|
Beijing | Shanghai | Guangzhou | Chongqing | Jinan | |
Total (N) | 632 | 743 | 721 | 729 | 731 |
Restraint used | |||||
Yes | 333 (52.7) | 414 (55.7) | 381 (52.8) | 413 (56.7) | 404 (55.3) |
No | 299 (47.3) | 329 (44.3) | 340 (47.2) | 316 (43.3) | 327 (44.7) |
Type of restraint used | |||||
Car seat | 105 (16.6) | 183 (24.6) | 137 (19.0) | 162 (22.2) | 156 (21.3) |
Seatbelt | 248 (39.2) | 253 (34.1) | 273 (37.9) | 294 (40.3) | 281 (38.4) |
Both | 20 | 22 | 29 | 43 | 33 |
Seating positiona | |||||
Front seated | 35 (5.5) | 55 (7.4) | 27 (3.7) | 30 (4.1) | 53 (7.3) |
Rear seated | 459 (72.6) | 495 (66.6) | 475 (65.9) | 472 (64.7) | 547 (74.8) |
Adult’s lap | 40 (6.3) | 91 (12.2) | 72 (10.0) | 85 (11.7) | 70 (9.6) |
Others | 92 (14.6) | 67 (9.0) | 112 (15.5) | 87 (11.9) | 49 (6.7) |
aLess than the total because of missing value.
N (3556) | RR (95% CI) | ||
---|---|---|---|
Properly rear seated | Use car seat or seatbelt | ||
Age (years) | |||
≤8 | 2391 | 0.349 (0.294, 0.415)** | 0.715 (0.616, 0.831)** |
>9 | 1165 | Ref | Ref |
Gender | |||
Boy | 1712 | 1.088 (0.940, 1.259) | 0.945 (0.823, 1.086) |
Girl | 1844 | Ref | Ref |
Relationship with driver | |||
Parent | 3427 | 0.841 (0.569, 1.243) | 1.303 (0.895, 1.896) |
Not parent | 129 | Ref | Ref |
Driver’s education | |||
≥College | 2245 | 1.318 (1.126, 1.544)** | 1.024 (0.882, 1.189) |
1311 | Ref | Ref | |
Family income (RMB/year) | |||
≥10 w | 2144 | 1.272 (1.091, 1.483)** | 1.014 (0.876, 1.173) |
<10 w | 1412 | Ref | Ref |
Understanding about car seat |
Known | 729 | 1.993 (1.633, 2.434)** | 4.484 (3.659, 5.495)** |
---|---|---|---|
Unknown | 2827 | Ref | Ref |
Concern on legislation of car seat | |||
Concern | 2373 | 0.915 (0.780, 1.074) | 1.400 (1.206, 1.625)** |
Not concern | 1183 | Ref | Ref |
Understanding about recall of defective car seat | |||
Known | 705 | 0.995 (0.824, 1.202) | 1.279 (1.065, 1.536)** |
Unknown | 2851 | Ref | Ref |
*0.01 < p < 0.05; **p < 0.01.
child restraint use and seating practice for child passengers in China by taking appropriate measures and provide some insight into the relevant factors influencing these practices.
The prevalence (68.8%) of rear seating among child passengers is lower in this study than that (83.1%) reported among 970 parents surveyed in Shanghai in the period of 2008-2009 [
The prevalence of child restraint use (20.9%) among children in this study is much lower than that seen in developed countries, for example, 86% in the USA and 90% in Australia [
This study found that younger children (aged ≤ 8 years) were less likely to be always rear seated, which is opposite to the trend in Australia and in European countries [
This study found that younger children were less likely to use child restraints, which is consistent with the results of the study on child safety conducted in Shantou [
In the absence of legislation mandating child restraint use among children and because of less public lectures about child restraint use and optimal sitting position, educational lectures on child travel safety may be organized to face the current situation in Chinese first-tier cities and improve child safety during travel. Moreover, the government needs to take a mandatory intervention in case of not using child restraints during travel [
In addition to targeting deficiencies in knowledge about child restraints among most of parents, efforts to improve child passenger safety shall be considered, such as regular release of information about child travel safety on the national authority’s websites and improvement of prevalence of child restraint use. In addition, installation requirements for child restraints should be taken into consideration during vehicle design. During this period of rapid motorization in China, appropriate measures are taken to improve child travel safety and it is necessary to define the institutions or departments for specific implementation of relevant measures at the same time. For example, regular release of information about child restraints, relevant legislation information and the recall information of defective child restraint product can enhance the parents’ knowledge about child travel safety in cars. Meanwhile, other measures such as price cut on child restraints also have a great impact on improving child restraint use [
This survey summarizes the current condition of child travel safety in five cities to explore the factors influencing child passenger safety practices. However, the selected samples are only representative of the first-tier cities in China, rather than most of the second-tier and third-tier cities. At the same time, the representativeness of the surveyed locations randomly selected remains also to be discussed. In addition, the questionnaire does not cover some conditions such as whether driver was wearing seat belt and how many passengers were sitting in the car, which may affect the child travel safety. The studies showed that the survey data is always superior to the data obtained in on-site observation, especially when the surveyed parents agreed with the necessity of using child restraints; therefore, the questionnaire survey results often lead to overestimation of child restraint use [
By describing the low utilization of child restraint system (20.9%) and common suboptimal of child seating position (31.2%) in China, this study sets out the case for urgent attention to child passenger safety as well as supports the development and implementation of child passenger safety regulations and education programs in China.
Liu, K. (2018) The Exploration of Factors That Affect Travel Safety of Child Passengers. Open Access Library Journal, 5: e4574. https://doi.org/10.4236/oalib.1104574