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From Durbin and Colleagues

Durbin, Dennis R.; Chen, Irene; Winston, Flaura K.; Elliott, Michael

doi: 10.1097/01.ede.0000123356.99512.27
Commentary: Author Response

Department of Pediatrics and TraumaLink Children's Hospital of Philadelphia Philadelphia, PA (Durbin, Chen, Winston)

Center for Clinical Epidemiology and Biostatistics University of Pennsylvania School of Medicine Philadelphia, PA (Durbin, Elliott)

Dr. Robertson1 notes that the information on child seating position was obtained from the driver, raising a concern about the potential for information bias. As we2 reported in the manuscript, we have been able to compare these driver-reported data with evidence from on-site crash investigations for a subset of the sample, and we find excellent agreement. Our results are also consistent with recently-reported data on seating position of children obtained by direct observation.3 We therefore feel that bias in the reporting of seating position of children is minimal and not likely to affect the results of this study.

We concur with Dr. Robertson’s point that education coupled with legislation will change behavior more effectively than education alone. We noted in the paper that legislation (particularly through provisions in Graduated Driver Licensing laws to require rear seating of child occupants) would address one of the risk factors for front row seating. However, we also stated that educational efforts without supporting legislation can also change behavior. The results of our study, as well as others,4 demonstrate the effectiveness of public education efforts directed at reducing front row seating of children in vehicles equipped with passenger airbags.

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1.Robertson LS. Causes and prevention of motor vehicle injuries [commentary]. Epidemiology. 2004;15:350-351.
2.Durbin DR, Chen I, Elliott M, Winston FK. Factors associated with front row seating of children in motor vehicle crashes. Epidemiology. 2004;15:345-349.
3.Glassbrenner D. The use of child restraints in 2002. US Department of Transportation National Highway Traffic Safety Administration Research Note, DOT HS 809 555, February 2003.
4.Wittenberg E, Nelson TF, Graham JD. The effect of passenger airbags on child seating behavior in motor vehicles. Pediatrics. 1999;104:1247–1250.
© 2004 Lippincott Williams & Wilkins, Inc.