Display options
Share it on
Full text links
HighWire Free PMC Article

Inj Prev. 1997 Mar;3(1):17-22. doi: 10.1136/ip.3.1.17.

High levels of incorrect use of car seat belts and child restraints in Fife--an important and under-recognised road safety issue.

Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention

H Campbell, S Macdonald, P Richardson


  1. Department of Public Health Sciences, University of Edinburgh.

PMID: 9113842 PMCID: PMC1067758 DOI: 10.1136/ip.3.1.17
Free PMC Article


OBJECTIVE: To pilot data collection instruments and to make a preliminary estimate of the level of incorrect use of car seat belts and child restraints in Fife, Scotland.

DESIGN: Cross sectional survey of cars containing adults and children at a number of public sites across Fife in 1995 to assess use of car occupant restraints. Trained road safety officers assessed whether seat restraints were appropriate for the age of the passengers and whether restraints were used correctly. These assessments were based on standards published by the Child Accident Prevention Trust.

PARTICIPANTS: The survey gathered data from 596 occupants in 180 cars: 327 adults and 269 children. Ten per cent of drivers who were approached refused to participate. Car occupant restraint was assessed in 180 drivers, 151 front seat passengers, and 265 rear seat passengers.

MAIN RESULTS: Three hundred and sixty one occupants wore seat belts, 68 were restrained by a seat belt and booster cushion, 63 in toddler seats, 25 in two way seats, and 18 in rear facing infant carriers. Ninety seven per cent of drivers, 95% of front seat passengers, and 77% of rear seat passengers were restrained. However, in 98 (52%) vehicles at least one passenger was restrained by a device that was used incorrectly. Seven per cent of adults and 28% of children were secured incorrectly. The commonest errors were loose seat belts and restraint devices not adequately secured to the seat. Rates of incorrect use were highest in child seat restraints, reaching 60% with two way seats and 44% with rear facing infant seats.

CONCLUSIONS: The incorrect use of car occupant restraints is an under-recognised problem, both by health professionals, and the general public. Incorrect use has been shown to reduce the effectiveness of restraints, can itself result in injury, and is likely to be an important factor in child passenger injuries. The correct use of car seat restraints merits greater attention in strategies aiming to reduce road traffic casualties. Areas of intervention that could be considered include raising public awareness of this problem, improving information and instruction given to those who purchase child restraints, and encouraging increased collaboration between manufacturers of cars and child restraints, in considering safety issues.

Cited by

Morris SD, Arbogast KB, Durbin DR, Winston FK.
Inj Prev. 2000 Dec;6(4):281-4. doi: 10.1136/ip.6.4.281.
PMID: 11144628


  1. J Trauma. 1964 May;4:397-9 - PubMed
  2. Practitioner. 1962 Apr;188:467-73 - PubMed
  3. Med J Aust. 1973 Oct 27;2(17):797-801 - PubMed
  4. J Trauma. 1975 Jan;15(1):20-3 - PubMed
  5. J Bone Joint Surg Br. 1976 Aug;58(3):328-31 - PubMed
  6. Br Med J. 1976 Nov 27;2(6047):1310-11 - PubMed
  7. Br J Surg. 1985 Mar;72(3):239 - PubMed
  8. Br Med J (Clin Res Ed). 1985 Aug 24;291(6494):515 - PubMed
  9. Injury. 1985 Jul;16(7):478-80 - PubMed
  10. Am J Public Health. 1986 Jan;76(1):31-4 - PubMed
  11. Injury. 1986 Jan;17(1):37-9 - PubMed
  12. J Trauma. 1987 Apr;27(4):393-7 - PubMed
  13. J Pediatr Health Care. 1987 Jul-Aug;1(4):190-5 - PubMed
  14. J Trauma. 1987 Jul;27(7):740-5 - PubMed
  15. J Trauma. 1987 Jul;27(7):750-3 - PubMed
  16. Pediatrics. 1988 Jan;81(1):98-101 - PubMed
  17. Pediatrics. 1988 May;81(5):717-20 - PubMed
  18. Accid Anal Prev. 1988 Apr;20(2):129-36 - PubMed
  19. Am J Public Health. 1989 Mar;79(3):304-6 - PubMed
  20. Pediatrics. 1989 Aug;84(2):348-54 - PubMed
  21. J Trauma. 1989 Sep;29(9):1279-82 - PubMed
  22. Accid Anal Prev. 1990 Apr;22(2):167-75 - PubMed
  23. J Trauma. 1991 Jan;31(1):60-7 - PubMed
  24. Accid Anal Prev. 1991 Apr-Jun;23(2-3):165-74 - PubMed
  25. Fam Med. 1992 Jul;24(5):382-5 - PubMed
  26. N Z Med J. 1992 Nov 11;105(945):449-50 - PubMed
  27. Pediatr Emerg Care. 1992 Dec;8(6):351-3 - PubMed
  28. J Public Health Med. 1993 Mar;15(1):88-92 - PubMed
  29. Pediatrics. 1993 May;91(5):897-901 - PubMed
  30. Accid Anal Prev. 1993 Aug;25(4):421-9 - PubMed
  31. Public Health. 1993 Nov;107(6):429-35 - PubMed
  32. Pediatrics. 1994 Jun;93(6 Pt 1):960-5 - PubMed
  33. Accid Anal Prev. 1994 Dec;26(6):813-20 - PubMed
  34. Arch Dis Child. 1994 Dec;71(6):548-54 - PubMed
  35. J Am Med Assoc. 1957 Jan 26;163(4):249-55 - PubMed
  36. J Trauma. 1971 Mar;11(3):207-18 - PubMed

MeSH terms

Publication Types

LinkOut - more resources