WHAT'S KNOWN ON THIS SUBJECT: Appropriate child-restraint and seating practices reduce child-passenger injury risk, and child-passenger safety education typically targets parent drivers. Grandparents also drive with their grandchildren, yet little is known about their child-passenger safety practices or injuries after crashes. WHAT THIS STUDY ADDS: In this study, grandparents represented nearly 10% of drivers in crashes involving child occupants. The adjusted risk of child injury for grandparent drivers was 50% lower than that for parent drivers, despite less optimal use of child restraint in grandparent-driver crashes. abstract OBJECTIVES: To compare restraint-use practices and injuries among children in crashes with grandparent versus parent drivers. METHODS: This was a cross-sectional study of motor vehicle crashes that occurred from January 15, 2003, to November 30, 2007, involving children aged 15 years or younger, with cases identified via insur-ance claims and data collected via follow-up telephone surveys. We calculated the relative risk of significant child-passenger injury for grandparent-driven versus parent-driven vehicles. Logistic regression modeling estimated odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for several child occupant, driver, vehicle, and crash characteristics. RESULTS: Children driven by grandparents comprised 9.5% of the sample but resulted in only 6.6% of the total injuries. Injuries were reported for 1302 children, for an overall injury rate of 1.02 (95% CI: 0.90 –1.17) per 100 child occupants. These represented 161 weighted injuries (0.70% injury rate) with grandparent drivers and 2293 injuries (1.05% injury rate) with parent drivers. Although nearly all children were reported to have been restrained, children in crashes with grand-parent drivers used optimal restraint slightly less often. Despite this, children in grandparent-driven crashes were at one-half the risk of injuries as those in parent-driven crashes (OR: 0.50 [95% CI: 0.33– 0.75]) after adjustment.
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