When children are passengers in cars, trucks, and vans, low numbers of them are using car safety restraints appropriate for their age group, a new study shows.

Researchers also found that many youngsters may be at an increased risk of injury during a motor vehicle accident because they are sitting in the front seat of cars at ages when they shouldn't be and when seat belts might not fit them -- if they are worn at all.

"The most important finding from this study is that, while age and racial disparities exist, overall few children are using the restraints recommended for their age group, and many children over 5 are sitting in the front seat," says Michelle Macy, MD, in a news release. She is a pediatrician specializing in emergency medicine at the C.S. Mott Children's Hospital at the University of Michigan in Ann Arbor.

"We found that few children remain rear-facing after age 1, fewer than 2% use a booster seat after age 7, and many over age 6 sit in the front seat," says Macy.

This study revealed that more than 1 in 3 kids aged 11 to 12 were riding in the front seat, 1 in 4 children aged 8 to 10 were front seat passengers, as were 1 in 7 of those aged 6 to 7.

The findings appear online in the American Journal of Preventive Medicine.
Babies and Children on Board

For the study, researchers analyzed data from nearly 21,500 American children under the age of 13. The data were collected nationwide between 2007 and 2009 from observations made of drivers with children less than 13 as passengers when arriving at locations such as gas stations, fast-food chains, recreation centers, and child-care centers.

For drivers, researchers recorded factors such as their seat belt use, vehicle type, gender, age, and number of passengers. For the children, they considered age, ethnicity, location in the car, and use and positioning of car safety restraints.

Some key study results include:

    In every age group, minority children had lower rates of age-appropriate car safety restraint use than white children.
    As kids got older, child safety seat use decreased and the number of children not wearing seat belts increased.
    In vehicles where the driver was not wearing a seat belt, the odds were 23 times higher that child passengers would also not be wearing seat restraints.

New guidelines from the American Academy of Pediatrics on child passenger safety were released in 2011 and recommend:

    Rear-facing car seats at least until a child reaches age 2
    Forward-facing car seats with a five-point harness for as long as possible until a child is the maximum height and weight suggested by the manufacturer
    Booster seats until an adult seat belt fits properly -- typically when a child reaches roughly 57 inches in height (4 foot, 9 inches)
    Riding in the back seat until a child reaches age 13

Although this research data was collected during a three-year period when these exact guidelines were not in place, only 3% of children aged 1 to 3 who were involved in this study were sitting in rear-facing car seats. And just 10% of children aged 8 to 10 were sitting in and strapped into a car- or booster seat.