Pediatric Restraint Use and Injury in New York City Taxis Compared with Other Passenger Vehicles

Abstract

In New York City (NYC), as in several other U.S. cities, pediatric occupant restraint laws exempt rear-seated passengers in vehicles-for-hire from those that apply to private vehicles. This study compares rear-seated infant, child, adolescent, and teen passenger restraint use and injury in taxis compared with other passenger vehicles. New York State Department of Health Crash Outcome Data Evaluation System (CODES) was analyzed for rear-seated pediatric passengers aged 0–19 years traveling in taxis (n = 1,631) or other passenger vehicles (n = 21,984) involved in a crash in NYC 2011–2013. CODES is a probabilistically linked data set comprising emergency department, hospitalization, and Department of Motor Vehicle crash data. Bivariate and multivariable logistic regression odds ratios (OR) are reported with 95% CI. Taxi passenger restraint use was lower than in other passenger vehicles (51.2% vs. 86.7%, p < 0.0001). Use of a child restraint for ages < 8 years was low (5.9%) and one-tenth that of other passenger vehicles. Multivariable adjusted odds of restraint use was 9.80 (8.2–11.7) for other passenger vehicles compared with taxis. Compared with passengers in other vehicles, passengers in taxi crashes were twice as likely to be moderately or severely injured (p < 0.0001) and twice as likely to have traumatic brain injury (p = 0.0070). This study documents lower restraint use and higher injury, including traumatic brain injury, for pediatric taxi passengers compared with other passenger vehicles. Improved data systems, surveillance, and enforcement are needed to improve restraint use and reduce injury in children and teens, particularly those in vehicles-for-hire.