Peer-reviewed article
Association between the United Arab Emirates child safety seat and mandatory seatbelt legislation and child passenger injuries and fatalities.
Abdulazeez MU, Abdullahi AS, Koppel S, Alao D, Abdullah K ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined whether UAE child passenger legislation enacted in 2017, which requires child safety seats for children under 4 and seatbelts for ages 5 and above, reduced crash-related injuries and deaths. Using crash and hospital data from 2014-2020, the law was associated with major reductions in fatal injuries for young children but an unexpected increase in minor injuries for older children. The findings suggest the legislation successfully protects younger children but raises questions about protection for older age groups.
Key points
- The child passenger legislation was associated with 62-85% reduction in fatal injury rates for children aged 0-4 years
- Fatal injury rates for children aged 5-9 years reduced by 66% after the legislation
- An unexpected 75% increase in adjusted minor injury rates was found for children aged 10-14 years post-legislation
- The UAE previously had one of the highest crash-related injury and fatality rates for child occupants globally
- The study used national crash data and hospital trauma records over multiple years for analysis
Limitations
The study cannot explain why minor injuries increased for older children or determine whether this reflects changes in crash patterns, reporting practices, or other confounding factors. The analysis is observational and cannot definitively prove causation between the legislation and the outcomes.
Abstract
Child occupants in the United Arab Emirates (UAE) have one of the highest crash-related injury and fatality rates globally. The UAE child passenger legislation (CPL) enacted in 2017 mandates the use of child safety seats for child occupants until age of 4 years and seatbelt use from age of 5. The current study aimed to evaluate this legislation's association with reductions in crash-related injuries and trauma (Injury Severity Score [ISS]) among child occupants aged 0-14 years. Additionally, the study examined whether the relationship between crash injury characteristics and injury severity changed after the implementation of the CPL. The child occupant injury data was obtained from the UAE Ministry of Interior for 5 years (2015-2019), while the trauma data was obtained from Al Ain Hospital for 6 years (2014-2020). Poisson regression analyses were used to compare the pre-CPL and post-CPL periods. The CPL was significantly associated with 62 and 85% reductions in the crude (IRR: 0.38, CI: 0.16-0.81) and adjusted (IRR: 0.15, CI: 0.01-0.83) rates of fatal injuries per 1000 crashes among children aged 0-4 years. Equally, the CPL was significantly associated with a 66% reduction in the crude rate of fatal injuries (IRR: 0.34, CI: 0.10-0.95) per 1000 crashes for children aged 5-9 years. Conversely, the CPL was significantly associated with a 75% increase in the adjusted rate of minor injuries (IRR: 1.75, CI: 1.06-2.95) per 1000 crashes for children aged 10-14 years. These findings will provide key insights for policymakers and road safety practitioners, thereby informing both legislative and non-legislative interventions aimed at strengthening child occupant protection and ensuring children travel while they are safely and securely restrained.