Please see the enclosed Statement on child auto restraints and feel free to
comment directly to the author or posting to this group.

Thanks.

Best,

Stephen

Stephen Miles Sacks, Ph.D.
Editor and Publisher
SCIPOLICY-The Journal of Science and Health Policy
Box 504, Haverford, PA 19041
Telephone: 610-660-0220
Fax: 610-660-0120
Website: http://Scipolicy.net
E-mail: editor@...
and
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Sent: Tuesday, August 30, 2005 10:55 AM
Subject: Message from Flaura Winston, MD PhD - Please distribute: Credible
information on child passenger safety


I am writing this note to direct you to resources regarding child passenger
safety and to ask your help in dissemination and distribution of this
information. We have become aware of a faulty analysis that may have confused
parents and policymakers regarding the effectiveness of child restraints - and
could ultimately put children in danger.

As leaders in healthcare, and with the understanding that car crashes are the
number one killer of children older than one year, you understand the critical
importance of getting sound information into the hands of parents- especially
given an 80% misuse rate for most child restraints. PCPS has limited funding for
distribution and promotion of information to parents (largely available on our
website) and would welcome suggestions as to channels of distribution through
e-mail links, newsletters, or high-profile links to our website.

By way of background: Steven Levitt and Stephen Dubner, authors of
Freakonomics, called into question the effectiveness of child safety seats in
the July 10 issue of the New York Times Magazine, in an article entitled "The
Seat Belt Solution." The authors proposed glibly that parents' money would be
just as well spent on a DVD player to keep children seated in the back seat..
The study, unfortunately, received coverage in the national media (NPR, NBC's
Today Show, regional media as part of the book tour).

Decades' worth of peer-reviewed rigorous medical and biomechanical research has
shown that while seat belts are better than no restraint, properly fitting child
restraints are more effective than belts alone in protecting children in
crashes. Child restraints reduce the risk of injury by 71% in children under
age 14 as compared to seat belts alone; and for children ages 4 through 7, the
use of booster seats reduces injury risk by 59%. Disregarding previous findings,
Levitt and Dubner chose to promote their research in the media without
submitting it for peer review and overinterpreted their results with policy
implications (on their website). Peer review would have revealed a selection
bias in their data source and other errors in their analysis that led to
underestimation of the effectiveness of child restraints relative to seat belts.
They examined children in fatal crashes (about 1200 per year) while ignoring the
equally informative data on those in non-fatal crashes (about 450,000 per year).
As my colleague, Dennis Durbin, MD, MSCE and I state in our July 24th
letter-to-the-editor in response to the authors' article, premature publication
of Levitt's results without proper peer review was both irresponsible and
dangerous - as evidenced by posts on the web supporting and promoting their
interpretation following the flurry of media on this subject.

Crashes are not only the leading cause of death in children older than one year,
but also are the leading cause of acquired disability for children who sustain
injuries. In 2003, 1,794 children under 16 were killed in crashes and
approximately 241,000 were injured. Preventable injuries such as paralysis,
traumatic brain injury, facial scarring, injuries to abdominal organs, and
serious fractures can be devastating to both children and their families.
Parents who use age- and -size-appropriate restraints for their children on
every trip and place those younger than 13 years of age in the rear seat reduce
their children's risk of serious injury to less than 2 percent.

To learn more about the effectiveness of child restraint systems and how to
properly install a car seat or booster seat, view the interactive videos at the
Partners for Child Passenger Safety Web site (www.chop.edu/carseat). Please feel
free to contact Dana Mortensen (267-426-6092 / mortensen@...) with
comments, questions or suggestions.

I hope that you found this update helpful.

Best regards,

Flaura Winston, MD PhD

Senior Fellow, Leonard Davis Institute for Health Economics
Associate Professor, Pediatrics, University of Pennsylvania
Principal Investigator, PCPS (on-going child-focused crash surveillance system
with information on more 557,000 children in crashes)

[Non-text portions of this message have been removed]