The objective of this research was to describe the use and incorrect use of child restraint systems in Manitoba, Canada. In 2004, a team of inspectors made up of Royal Canadian Mounted Police officers and trained car seat technicians from the Manitoba child seat coalition conducted a descriptive survey of types and frequency of child restraint systems' incorrect use. The setting was 10 roadside inspection sites located around the city of Winnipeg, Manitoba. The subjects were parents and primary caregivers of children using child restraint systems. The main outcome measured was the reported appropriate use rate as determined by the compliance to safety standards for correct installation and use of child restraints. A total of 340 child restraint systems were assessed. The overall rate of incorrect use was 70%. The errors present in stage III systems (booster seats) are much lower than the errors present in stage I systems (rear-facing child safety seats) and stage II systems (forward-facing child safety seats). The data presented illustrate that incorrect use of child restraint systems in the province of Manitoba is a large problem and must be dealt with immediately in order to ensure child safety now and in the future. Community-wide information and enhanced enforcement campaigns, consisting of activities such as mass media, information and publicity, child restraint systems displays and special enforcement strategies (check points, dedicated law enforcement officials, alternative penalties) should be used to increase the correct use of child restraint systems. Failure to use child restraint systems properly can contribute to serious injury or death of a child.
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