Car Seats Are for Cars: Injuries From Misuse of Infant Car Seats in the United States, 2003-2007

Monday, October 19, 2009: 2:15 PM
Congressional Ballroom A-B (Renaissance)
Shital N. Parikh, M.D. and Lindsay M. Wilson, Pediatric Orthopaedics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH


Infant car seats should be used to prevent injuries or deaths during motor vehicle accidents. When used improperly, the car seat can place an infant at risk of injury and even death. The objective of the current study is to describe the misuse of car seats in infants (< 12 months), and its associated injuries in the US from 2003 – 2007.


The National Electronic Injury Surveillance System (NEISS) of the United States Consumer Product Safety Commission (CPSC) database was accessed to obtain information regarding injuries in infants related to car seats from 2003-2007. Motor vehicle accidents were excluded. Demographics, type of injury, body location, disposition, injury circumstances, and other pertinent information was extracted from the database and recorded


An estimated 43,562 (range, 41,519 – 45,605, 95% CI) injuries in infants related to car seats were treated in the ED during the 5 year period. The national estimate was based on a weighted sample of 1,944 infants treated in the ED during that period. There were 1,054 males and 890 females. 1,210 (62%) injuries occurred in infants < 4 month old, and 573 (29%) in the 5–8 month group. 947 (49%) injuries occurred at home, and 162 (8%) infants had to be hospitalized. The commonest mechanism of injuries were the infant falling from the car seat, the car seat falling from an elevated surface, and the car seat overturning when placed on a soft surface. The most common injuries were head injuries in 1,254 (64%) of infants. There were 132 fractures (91 skull, 10 femur, 7 tibia, 6 forearm, 1 C2 fracture) and 24 radial head dislocations. 3 deaths were reported


Use of car seat as an infant carrier with improper use of restraint, placement of car seat on an elevated surface or its placement on a soft surface where it can overturn is a dangerous practice. Injury prevention efforts should be focused on eliminating the hazardous misuse of car seats outside the vehicle. The AAP and the manufacturers should not only guide parents about the importance of child seat and its use, but they also need to caution parents against the potential misuse of car seats.