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      Use of child restraint system and patterns of child transportation in Riyadh, Saudi Arabia

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      PLoS ONE
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          Abstract

          Objective

          Child restraint system (CRS) is designed to protect children from injury during motor vehicle crash (MVC). However, there is no regulation or enforcement of CRS use in Saudi Arabia. This study estimated the prevalence of CRS use and identified patterns of child transportation in Riyadh, Saudi Arabia.

          Methods

          In this cross-sectional study, a self-administered questionnaire was distributed across Riyadh targeting families who drove with children aged less than 5 years. The questionnaire inquired about CRS availability, patterns of child transportation if a CRS was unavailable, seat belt use by the driver and adult passengers, and the perception of CRS.

          Results

          Of 385 respondents, only 36.6% reported the availability of a CRS (95% CI: 31.8–41.7%), with only half of those reported consistent use 74 (52.2%). Nearly 30% of all children aged less than 5 years were restrained during car journeys. Sitting on the lap of an adult passenger on the front seat was the most common pattern of child transportation (54.5%). Approximately 13.5% of respondents were involved in an MVC while driving with children; 63.5% of these children were unprotected by any safety system. Seat belt use by drivers was low, with only 15.3% reporting constant use.

          Conclusion

          The prevalence of CRS use in Riyadh is low, and safety practices are seldom used by drivers and passengers. In addition to legal enforcement of CRS use, implementation of a child transportation policy with age-appropriate height and weight specifications is imperative.

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          Most cited references24

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          Reviews of evidence regarding interventions to increase use of child safety seats.

          In 1998, nearly 600 child occupants of motor vehicles aged younger than 4 years died in motor vehicle crashes. Yet approximately 29% of children aged 4 years and younger do not ride in appropriate child safety seat restraints, which, when correctly installed and used, reduce the need for hospitalization in this age group by 69% and the risk of death by approximately 70% for infants and by 47% to 54% for toddlers (aged 1 to 4 years). The systematic review development team reviewed the scientific evidence of effectiveness for five interventions to increase child safety seat use. For each intervention, changes in the use of child safety seats or injury rates were the outcome measures evaluated to determine the success of the intervention. Database searching was concluded in March 1998. More than 3500 citations were screened; of these citations, 72 met the inclusion criteria for the reviews. The systematic review process identified strong evidence of effectiveness for child safety seat laws and distribution plus education programs. In addition, community-wide information plus enhanced enforcement campaigns and incentive plus education programs had sufficient evidence of effectiveness. Insufficient evidence was identified for education-only programs aimed at parents, young children, healthcare professionals, or law enforcement personnel. Evidence is available about the effectiveness of four of the five interventions we reviewed. This scientific evidence, along with the accompanying recommendations of the Task Force elsewhere in this supplement, can be a powerful tool for securing the resources and commitment required to implement these strategies.
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            Reviews of evidence regarding interventions to increase the use of safety belts.

            The use of safety belts is the single most effective means of reducing fatal and nonfatal injuries in motor vehicle crashes. If all motor vehicle occupants consistently wore safety belts, an estimated 9553 deaths would have been prevented in 1999 alone. The Guide to Community Preventive Services's methods for systematic reviews were used to evaluate the effectiveness of three interventions to increase safety belt use. Effectiveness was assessed on the basis of changes in safety belt use and number of crash-related injuries. Strong evidence was found for the effectiveness of safety belt laws in general and for the incremental effectiveness of primary safety belt laws relative to secondary laws. Strong evidence for the effectiveness of enhanced enforcement programs for safety belt laws was also found. Additional information is provided about the applicability, other effects, and barriers to implementation of these interventions. These reviews form the basis of the recommendations by the Task Force on Community Preventive Services presented elsewhere in this supplement. They can help decision makers identify and implement effective interventions that fit within an overall strategy to increase safety belt use.
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              Seat belt utilization in Saudi Arabia and its impact on road accident injuries.

              Most industrialized countries and many developing countries have passed laws that require the use of seat belts in motor vehicles. It is widely believed that seat belt use is an effective way to reduce road accident fatalities and injuries. Saudi Arabia joined these countries when it enacted a similar law on 5 December 2000 making seat belt use compulsory for all drivers and front-seat passengers. This study measures seat belt use rate and its impact on the number of road accident injuries during the first few months that followed the enactment of the law. It also investigates drivers' behaviour and personal characteristics and their relationship with using seat belts by using a questionnaire specially prepared for this purpose. Results show that seat belt use rate in two Riyadh suburbs were 33% and 87%, respectively, for drivers and 4% and 41%, respectively, for front-seat passengers (FSP's). Such belt use rates are considered low yet encouraging when compared with use rates before enacting the law. Results also show that there was a significant drop in certain types of injuries due to traffic accidents after the enactment of the seat belt law. Questionnaire results show that certain personal characteristics were correlated with seat belt use rate. Finally, implications of these findings in terms of future plans for improving traffic safety are discussed.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: InvestigationRole: MethodologyRole: Project administrationRole: Writing – original draftRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: MethodologyRole: SoftwareRole: ValidationRole: Writing – review & editing
                Role: Funding acquisitionRole: InvestigationRole: Project administrationRole: SupervisionRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                2 January 2018
                2018
                : 13
                : 1
                : e0190471
                Affiliations
                [1 ] College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
                [2 ] Department of Medical Education, College of Medicine King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
                [3 ] Pediatric Intensive Care Unit, King Abdullah Specialist Children’s Hospital, Riyadh, Saudi Arabia
                University of Illinois at Urbana-Champaign, UNITED STATES
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                http://orcid.org/0000-0002-6307-8863
                Article
                PONE-D-17-21690
                10.1371/journal.pone.0190471
                5749838
                29293659
                be401fc2-21f4-43cc-ac0a-5541bfa6e7b7
                © 2018 Alsanea et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 6 June 2017
                : 17 December 2017
                Page count
                Figures: 2, Tables: 3, Pages: 9
                Funding
                Funded by: King Abdullah International Medical Research Center (KAIMRC)
                Award Recipient :
                The study was funded by King Abdullah International Medical Research Center (KAIMRC) to TH. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Engineering and Technology
                Transportation
                People and Places
                Population Groupings
                Age Groups
                Children
                People and Places
                Population Groupings
                Families
                Children
                Social Sciences
                Law and Legal Sciences
                Criminal Justice System
                Law Enforcement
                People and places
                Geographical locations
                Asia
                Saudi Arabia
                Engineering and Technology
                Civil Engineering
                Transportation Infrastructure
                Roads
                Engineering and Technology
                Transportation
                Transportation Infrastructure
                Roads
                Biology and Life Sciences
                Population Biology
                Population Metrics
                Death Rates
                Social Sciences
                Sociology
                Education
                Educational Attainment
                Research and Analysis Methods
                Research Design
                Survey Research
                Questionnaires
                Custom metadata
                All relevant data are within the paper and its Supporting Information files.

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                Uncategorized

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