Prevention of neck injury in frontal impacts

'Whiplash' or Soft Tissue Neck Injwy (STNI) has traditionally been recognized as a car-to-car rear impact phenomenon; studies worldwide verify that the risk of sustaining neck injury in a car crash is approximately three-fold the risk of sustaining the same injury in other crash-types. In general, as such injuries are not characterized by a high risk of threat-to-life (as measured by internationally adopted injury severity scales such as the Abbreviated Injury Scale), prevention of them has perhaps not been seen as a high priority. However, in recent times, it has been recognized that such injury can be very debilitating to those afflicted and costs to sociery as a result of the injury can be correspondingly high. Techniques have therefore evolved over the past 5-l0 years that are aimed at the prevention of neck injury, mostly in rear impacts, and these are predominantly based on current understandings of the actual injurycoupled with the injury mechanism. Such studies usually indicate that the design of vehicle seat and head restraint is critical in the prevention of neck injury. However, neck injury does not only occur in rear-end crashes. Some studies have shown that the risk of sustaining neck injury in front and side impacts is between 15-20%. As these crash-types occur more frequently than rear impacts, the actual exposure to neck injury could be higher than in rear impacts. However, so far there have been no design techniques specifically aimed at neck injury prevention in such impacts. Recently, two studies of real-world crashes have examined the effects of arl-bags in frontal impacts. These are reported in this paper. Both studies have shown that the deploying air-bag in conjunction with a seat belt in a frontal crash can significantly reduce the incidence of neck injury in a frontal impact. The first is an on-going study of vehicle crash performance and occupant injury which is being conducted by Folksam Insurance in Sweden using data obtained from on-board crash recorders. The second study uses preliminary data from an on-going study of vehicle crash peiformance and occupant injury, which is being conducted by the Monash Universiy's Accident Research Centre

The combined benefits of motorcycle antilock braking systems (ABS) in preventing crashes and reducing crash severity

<p><b>Objective</b>: Several studies have reported the benefits of motorcycle antilock braking systems (ABS) in reducing injury crashes, due to improved stability and braking performance. Both aspects may prevent crashes but may also reduce the crash severity when a collision occurs. However, it is still unknown to what extent the reductions in injury crashes with ABS may be due to a combination of these mechanisms.</p> <p><b>Methods</b>: Swedish hospital and police reports (2003–2012) were used. The risk for permanent medical impairment (RPMI) was calculated, showing the risk of at least 1 or 10% permanent medical impairment. In total, 165 crashes involving ABS-equipped motorcycles were compared with 500 crashes with similar motorcycles without ABS.</p> <p>The analysis was performed in 3 steps. First, the reduction in emergency care visits with ABS was calculated using an induced exposure approach. Secondly, the injury mitigating effects of ABS were investigated. The mean RPMI 1+ and RPMI 10+ were analyzed for different crash types. The distributions of impairing injuries (PMI 1+) and severely impairing injuries (PMI 10+) were also analyzed. In the third step, the total reduction of PMI 1+ and PMI 10+ injured motorcyclists was calculated by combining the reductions found in the previous steps. An additional analysis of combined braking systems (CBS) together with ABS was also performed.</p> <p><b>Results</b>: The results showed that emergency care visits were reduced by 47% with ABS. In the second step, it was found that the mean RPMI 1+ and RPMI 10+ with ABS were 15 and 37% lower, respectively. Finally, the third step showed that the total reductions in terms of crash avoidance and mitigation of PMI 1+ and PMI 10+ injured motorcyclists with ABS were 67 and 55%, respectively. However, PMI 1+ and PMI 10+ leg injuries were not reduced by ABS to the same extent. Indications were found suggesting that the benefits of ABS together with CBS may be greater than ABS alone.</p> <p><b>Conclusions</b>: This article indicated that motorcycle ABS reduced impairing injuries, mostly due to fewer emergency care visits but also due to a reduction in crash severity. This may seem reasonable as the improved stability and braking performance provided by ABS could prevent some crashes but would also decrease crash severity if a collision still occurs. As suggested by previous studies, however, the lower extremities would be more exposed in a crash with ABS. It is recommended that future research should follow up these results with additional data.</p

Fatal Bicyclist Accidents on Rural Roads

This article is part of the Proceedings of the 6th Annual International Cycling Safety Conference held in Davis, California, USA on September 20th through 23rd in the year 2017.<br><br>Paper ID: 3

Risk of Permanent Medical Impairment (RPMI) in Car Crashes Correlated to Age and Gender

<div><p><b>Objective:</b> As fatalities from car crashes decrease, focus on medical impairment following car crashes becomes more essential. This study assessed the risk of permanent medical impairment based on car occupant injuries. The aim was to study whether the risk of permanent medical impairment differs depending on age and gender.</p><p><b>Methods:</b> In total, 36,744 injured occupants in car crashes that occurred between 1995 and 2010 were included. All initial injuries (<i>n</i> = 61,440) were classified according to the Abbreviated Injury Scale (AIS) 2005. If a car occupant still had residual symptoms 3 years after a crash, the case was classed as a permanent medical impairment. In total, 5,144 injuries led to permanent medical impairment. The data were divided into different groups according to age and gender as well as levels of permanent impairment. The risk of permanent medical impairment was established for different body regions and injury severity levels, according to the AIS.</p><p><b>Results:</b> The cervical spine was the body region that had the highest number of diagnoses, and occupants who sustained injuries to the upper and lower extremities had the highest risk of medical impairment for both genders. Females aged 60 and above had a higher risk of permanent medical impairment from fractures in the extremities compared to males in the same age group and younger females. Females aged 44 or younger had a higher risk of permanent medical impairment from whiplash-associated disorders (WAD) than males in the same age group. Minor and moderate injuries (AIS 1–2) had a higher risk of permanent medical impairment among older car occupants compared to younger ones.</p><p><b>Conclusions:</b> Differences in long-term outcome were dependent on both gender and age. Differences between age groups were generally greater than between genders. The vast majority of permanent medical impairments resulted from diagnoses with a low risk of fatality. The results emphasize the impact of age and gender in long-term consequences from car crashes. They could be used when designing safety technology in cars as well as to improve health care by contributing to better allocation of rehabilitation resources following trauma.</p></div