Use of child restraint system and patterns of child transportation in Riyadh, Saudi Arabia

Objective: Child restraint system (CRS) is designed to protect children from injury during motor vehicle crash (MVC). However, there is no regulation or enforcement of CRS use in Saudi Arabia. This study estimated the prevalence of CRS use and identified patterns of child transportation in Riyadh, Saudi Arabia. Methods: In this cross-sectional study, a self-administered questionnaire was distributed across Riyadh targeting families who drove with children aged less than 5 years. The questionnaire inquired about CRS availability, patterns of child transportation if a CRS was unavailable, seat belt use by the driver and adult passengers, and the perception of CRS. Results: Of 385 respondents, only 36.6% reported the availability of a CRS (95% CI: 31.8–41.7%), with only half of those reported consistent use 74 (52.2%). Nearly 30% of all children aged less than 5 years were restrained during car journeys. Sitting on the lap of an adult passenger on the front seat was the most common pattern of child transportation (54.5%). Approximately 13.5% of respondents were involved in an MVC while driving with children; 63.5% of these children were unprotected by any safety system. Seat belt use by drivers was low, with only 15.3% reporting constant use. Conclusion: The prevalence of CRS use in Riyadh is low, and safety practices are seldom used by drivers and passengers. In addition to legal enforcement of CRS use, implementation of a child transportation policy with age-appropriate height and weight specifications is imperative.