The role of alcohol in fatal motor vehicle crashes involving children has  been well established. However, the nonfatal injury burden of alcohol on child  passengers has not been comprehensively assessed.
This study sought to determine injury burden and restraint use in child  passengers aged 1–15 years in alcohol-related motor vehicle crashes.
A retrospective cohort study including all people involved in all crashes  with an injury or at least $1000 property damage occurring in Wisconsin in 2007  and involving at least one child passenger aged 1–15 years.
A total of 22,464 child passengers were involved in motor vehicle crashes in  Wisconsin in 2007; 2.5% (n=570) were in alcohol-related crashes. Child  passengers in alcohol-related crashes experienced twice the risk of injury  compared to non-alcohol-related crashes (risk ratio [RR]=2.42, 95% CI=2.08,  2.80). Two-vehicle crashes that were alcohol-related were more than two times  more likely to result in child injury than those that were not (RR=2.78, 95%  CI=2.30, 3.35). 
In alcohol-related crashes, the risk of injury in children was  higher if they were passengers in the alcohol-related vehicle compared to the  non-alcohol-related vehicle (RR=1.35, 95% CI=1.01, 1.79). Inappropriate  restraint of child passengers was higher in alcohol-related vehicles (34.5% vs  17.1%, p<0.00005), particularly in the group aged 4–7 years (70.8% vs  44.9% inappropriately restrained).
Motor vehicle crashes resulting from alcohol-related driving significantly  increased child passenger injury and were associated with inappropriate child  passenger restraint. Several evidence-based policies are recommended to address  this public health problem.
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