Objectives:

To assess the protective effect of child restraints and the relative safety of front and rear seating in a population where children often travel unrestrained.

Methodology:

A population control study of children aged 0–11 years injured as car passengers in a motor vehicle accident in 1996 and treated at one of the two major children’s hospitals in Athens, and an observational study of a random sample of 191 children of the same age travelling in cars.

Key Findings:

• The Odds Ratio for injury was 3.3 among unrestrained children compared with restrained children (comparison essentially limited to children aged 0–4 years).

• The Odds Ratio for injury was 5.0 for children seated in the front compared with those seated in the rear (comparison essentially limited among unrestrained children).

• In Greece about two thirds of all childhood injuries from car crashes could have been avoided through the regular use of a proper child restraint.

• In the absence of a child restraint system, a rear seating position conveys substantial protection and could explain the low mortality of children as car passengers in Greece, a country which is characterised by a high overall road traffic mortality as well.

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