Australia lags behind many other countries in legislating to keep children as safe as possible in cars, leaving parents confused about the safest restraints and seating positions, a major review of restraint legislation, accident statistics and parent surveys has found.
Current Australian guidelines recommend that children graduate to an adult seatbelt - without the use of a booster seat - when they are approximately 145cm tall, or about 11 years old, and that children under 12 years of age should travel in the rear seat.
However, legislation currently requires only that infants up to the age of one year travel in a properly-fitted, Australian Standards-approved child restraint.
The review, co-authored by Assistant Director of the Australian Paediatric Surveillance Unit, Dr Yvonne Zurynski, appears in the latest issue of the Medical Journal of Australia.
It found that in a car crash children aged 2-5 years wearing an adult seatbelt are 3.5 times more likely to suffer a significant injury and 4.2 times more likely to sustain a head injury than those using a dedicated child restraint.
"Many children move to an adult seatbelt too early," Dr Zurynski said. "In New South Wales and Victoria, the mean age of transition to a seatbelt is 5.6 years (and as early as 3 years).
"Australian parents (and) carers were confident about their knowledge of child restraints, but most were not aware of the recommendations for choosing the optimum restraint according to the child's age and size and when to progress to adult seatbelts."
Australian legislation needs to be reviewed to increase the rate of optimal restraint use, Dr Zurynski said. "Australian child restraint laws lag behind those of other countries," she said.
"In 2006, the United Kingdom and 12 other countries in the European Union introduced child restraint laws for children up to 12 years of age (or 135 cm tall). Canada and the US are gradually making booster seats mandatory for children less than 145cm tall. Since the introduction of child restraint laws in New Zealand the number of injuries and deaths has decreased significantly."
Recently proposed changes to the Australian Road Rules would require children to use a restraint with an in-built harness up the age of 4, and then a booster seat to the age of 7.
"If adopted, these changes will need to be enacted by each state for legislative effect," Dr Zurynski said.