Child occupant injuries in the United Arab Emirates: a case for a safe system approach.

Road traffic crashes (RTCs) are the leading cause of injuries and fatalities for children in the United Arab Emirates (UAE), with vehicle occupants representing the majority of child traffic casualties. However, despite the high incidence and severity of child occupant injuries in the UAE, no dedicated study has yet focused on the factors associated with injury risk for child occupants. All previous studies have focused on child occupants in Al Ain city and were conducted between 10 and 30 years ago. Accordingly, the current study sought to assess the current state of child occupant safety in the UAE using a recent national dataset for children aged 0-17 years. A retrospective, population-based analysis of UAE national crash data from 2012 to 2023 was conducted to identify key risk factors for child occupant injury severity. The principles of the safe system approach (SSA) were used to anchor the analysis of the identified risk factors. A hierarchical approach was employed where the initial model comprised the safe road users variables only. Variables corresponding to the other pillars of the SSA were added sequentially to evaluate the contribution of each SSA pillar to child passenger injury severity. Safe road user factors (gender, seating position, child age), safe speeds (posted speed), safe roads (road condition, lighting condition), and system management (emirate) were significantly associated with the severity of child occupant injuries. Strict enforcement of existing legislation regarding underage driving and front-row seating for young children, posted speed limit reductions, road safety behavioral change interventions targeting boys, child occupant safety awareness campaigns, and increased emergency response should be pursued to enhance child occupant safety in the UAE.