This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (6)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Medical Practice  • Health Policy  • Pediatrics, Other  • Injury Prevention & Control  • Infectious Diseases  • Alert me on articles by topic  Social Bookmarking   What's this?

Thomas B. Newman, MD, MPH; Brian D. Johnston, MD, MPH; David C. Grossman, MD, MPH

Arch Pediatr Adolesc Med. 2003;157:969-974.

Context  The US Federal Aviation Administration is planning a new regulation requiring children younger than 2 years to ride in approved child-restraint seats on airplanes.

Objectives  To estimate the annual number of child air crash deaths that might be prevented by the proposed regulation, the threshold proportion of families switching from air to car travel above which the risks of the policy would exceed its benefits, and the cost per death prevented.

Design  Risk and economic analyses.

Results  Child-restraint seat use could prevent about 0.4 child air crash deaths per year in the United States. Increased deaths as a result of car travel could exceed deaths prevented by restraint seat use if the proportion of families switching from air to car travel exceeded about 5% to 10%. The estimate for this proportion varied with assumptions about trip distance, driver characteristics, and the effectiveness of child-restraint seats but is unlikely to exceed 15%. Assuming no increase in car travel, for each dollar increase in the cost of implementing the regulation per round trip per family, the cost per death prevented would increase by about $6.4 million.

Conclusions  Unless space for young children in restraint seats can be provided at low cost to families, with little or no diversion to automobile travel, a policy requiring restraint seat use could cause a net increase in deaths. Even excluding this possibility, the cost of the proposed policy per death prevented is high.

From the Departments of Epidemiology and Biostatistics and Pediatrics, University of California, San Francisco, School of Medicine (Dr Newman); and the Harborview Injury Prevention and Research Center, Department of Pediatrics, University of Washington, Seattle (Drs Johnston and Grossman).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Universal Bilirubin Screening, Guidelines, and Evidence
Newman
Pediatrics 2009;124:1199-1202.
FULL TEXT  

Do we neglect infant safety during air travel?
Barrett and Molloy
Arch. Dis. Child. 2009;94:562-562.
FULL TEXT  

Increasing Infant Safety in Air Travel: Deficiencies Are Not Limited to Child Restraint Systems
Molloy
Arch Pediatr Adolesc Med 2004;158:1093-1093.
FULL TEXT  

The power of stories over statistics
Newman
BMJ 2003;327:1424-1427.
FULL TEXT  

Hearts and Minds and Child Restraints in Airplanes
Bishai
Arch Pediatr Adolesc Med 2003;157:953-954.
FULL TEXT