RESUMO
BACKGROUND: The use of booster seats continues to be low, despite their effectiveness in reducing injury in motor vehicle collisions. Many jurisdictions have introduced legislation requiring the use of booster seats. To date, there have been no Canadian studies evaluating the effectiveness of legislation on booster seat use. OBJECTIVES: To describe restraint use among Canadian children aged 4-8 years, and compare booster seat use between provinces/territories with and without legislation. METHODS: The data were obtained from a National Survey of Child Restraint Use/Misuse conducted between June and August 2006. A roadside observation survey was conducted at 182 sites across Canada. Weighted statistical analyses of differences in proportions were conducted, accounting for sampling stratification and clustering by car effects. RESULTS: The roadside survey estimated that 24.6% of children aged 4-8 were restrained in booster seats in provinces with legislation, compared with 16.6% in provinces without (p<0.001). CONCLUSION: This is the first Canadian national study using direct observation to determine the effect of legislation on booster seat use. Provinces with legislation had higher booster seat use, but overall rates were still disappointingly low. Ongoing surveillance of child safety seat use and evaluation of effective adjuncts to legislation is required in order to see collision-related child deaths and injuries drop in the future.