BACKGROUND: Although the value of child and teen restraint when riding in a motor vehicle is well established, there continues to be gaps in backseat restraint laws covering this population in many areas of the U.S. In New York City (NYC), more than 2 million resident children and teens, and countless similarly-aged visitors, are covered by backseat restraint laws that have gaps: 1) children and teens are exempt from wearing a seat belt when riding in taxis and other vehicles for hire; 2) persons aged 16 and older are also exempt from restraint use in private vehicles except when riding with a junior driver. This study examines seat belt use and injury in taxis compared to private vehicles for persons aged 0-19 years.
METHODS: The New York State Department of Health and the Center for Injury Epidemiology and Prevention at Columbia University collaborated on a study using the Crash Outcome Data Evaluation System (CODES) from years 2011-2013 to compare seat belt use and injury in NYC passengers aged 0-19 years commuting in taxis (n=1,631) vs. private vehicles (n=21,984). The data sets containing hospitalizations, emergency department visits, and Department of Motor Vehicle crash data were merged using probabilistic linkage. Statistical analysis used SAS 9.4 for calculation of Chi square and risk ratios with independent predictors being assessed using logistic regression models with unadjusted and adjusted odds ratios with 95% confidence intervals for restraint use and injury.
RESULTS: Compared to taxis, child passengers involved in crashes in private vehicles were 10 times more likely to be restrained and were 81.8% less likely to be injured. Child passengers in taxis were 2.5 times more likely to experience facial injury and 2.0 times more likely to have a traumatic brain injury than children in private vehicles. Independent predictors of being restrained included riding in a private vehicle, driver belted, seating position (left or right), driver age, female driver, younger passenger age, fewer than 4 passengers, daytime, and outside of Manhattan. Among the independent predictors of increased passenger injury were travel in a taxi, being unbelted, older child passenger age, being female, manner of collision and county of crash.
CONCLUSIONS: Gaps in backseat restraint laws for children riding in taxis in NYC are associated with lower seat belt wearing and increased likelihood of injury compared to those commuting in private vehicles.