Data Analysis: Boosters Benefit Children Ages 4 Through 8

This article originated in the Nov/Dec 2009 issue of Safe Ride News.

An analysis of Partners for CPS (PCPS) data reaffirms that boosters are an important step in providing protection to child passengers. The research input was more complete than previously published studies, and the results still prove that belt-positioning booster (BPB) use is more protective than seat belts alone. Children ages 4 to 8 using BPBs were 45 percent less likely to sustain injuries than those using just the vehicle seat belt.

Interview data were obtained on 7,151 children in 6,591 State Farm-insured crashes from December 1, 1998, to November 30, 2007. The data sample was made up of children ages 4 to 8 with car crash injuries that were moderate to critical, who were seated in rear rows of model year 1990 or newer vehicles, and who were restrained by either a seat belt or a BPB.

The overall result of 45 percent injury reduction is lower than the 59 percent that was published in their previous study. According to the analysts, there are two major reasons for this. Unlike the current study, the previous study included children in both front and rear seating positions, and front seat placement involves a higher injury risk and lower BPB usage rate. In addition, as new data years were added, the relative use of seat belts and BPBs has changed. More young children are using BPBs, so a larger proportion of seat belt wearers are the older children in the range. Poor seat belt fit on older children may not be as pronounced as it is on younger children.

The head was the most common body region injured on children in either BPBs or seat belts alone. For children in seat belts, the next most common areas of injury were the abdomen and face, while for children in BPBs, they were the face and the lower extremities (legs and feet).

Children in side impact crashes and riding in BPBs had the most protective benefit. BPB riders had an additional injury reduction of 68 percent beyond the benefit of seat belt use alone in near-side (same side as child) impacts and 82 percent for far-side (opposite side from child) impacts.

One point of the study that is being questioned within the CPS community is the finding that the effectiveness of booster seats does not vary by highback or backless model type. Some crash experts have previously reported a significant benefit of highback models with deep side wings, especially in the case of near-side impacts. Earlier PCPS analysis also seemed to confirm this assertion, but this most recent analysis of the data does not.

The study concludes that parents, pediatricians, and health educators should continue to recommend the use of BPBs once a child outgrows a FF harness CR.


Arbogast, Kristy, et al. “Effectiveness of Belt Positioning Booster Seats: An Updated Assessment.” PEDIATRICS. November 2009. Vol. 124, No. 5: 1281-1286.