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In Germany averagely two million traffic accidents happen each year and emergency medical services are called to more than 400 000 patients. Even though this number is decreasing continuously (due to improvements in the fields of vehicle safety, road construction, and accident prevention) every case is yet a challenge for the rescuers and requires improvements in emergency medicine as well. Especially during diagnostics right at the accident scene, there are only limited instruments available to gain the necessary knowledge of the injuries suffered, to come to essential decisions about treatment or transport. To provide an additional diagnostic aid by scouting and estimating the situation, a software-tool calculating the likeliness of the most frequent severe injuries (AIS 3-6) of front occupants in passenger cars has been developed to deliver this necessary information about particular accident scenarios. To achieve this, logistic likelihood functions have been calculated in a multivariate regression analysis analysing all AIS 3+ injuries in the GIDAS database of the years 1999-2006 that happened more than four times
Crash involvement studies using routine accident and exposure data : a case for case-control designs
(2009)
Fortunately, accident involvement is a rare event: the chance of an individual road user trip to end up in a crash is close to zero. Thus, according to general epidemiological principles one can expect the case-control study design to be especially suitable for quantifying the relative risk (odds ratio) of accident involvement of road users with a certain risk factor as compared to road users that do not have this characteristic. Ideally, of course, the database for such a case-control study should be established by drawing two independent random samples of cases (accidental units) and controls (nonaccidental units), respectively. If, however, special data collection is not an option, it is nevertheless possible to analyze routine accident and exposure data under a case-control design in order to fully exploit the information contained in already existing databases. As a prerequisite, accident and exposure data from different sources are to be combined in a single file of micro or grouped data in a way consistent with the case-control study design. Among other things, the proposed methodological approach offers the possibility to use in-depth data of the GIDAS type also in investigations of active vehicle safety by combining this data with appropriate vehicle trip data collected in mobility surveys.
Novice drivers are at high risk for crash involvement. We performed an analysis of causations, injury patterns and distributions of novice drivers in cars and on motorcycles in road traffic as a basis for proper measurements. Method Data of accident and hospital records of novice drivers (licence < 2 years) were analysed focusing the following parameters: injury type, localisation and mechanism, Abbreviated Injury Scale (AIS), maximum AIS (MAIS), delta-v, collision speed and other technical parameters and have been compared to those of experienced drivers. In 18352 accidents in the area of Hannover (years1985"2004), 2602 novice drivers and 18214 experienced drivers were recorded having an accident. Novice car drivers were more often and severe injured than experienced and on motorcycles the experienced riders were at higher risk. Novice drivers of both groups sustained more often extremity injuries. 4.5 % novice car drivers were not restraint compared to 3.7 % of the experienced drivers and 6.1 % novice motorcycle drivers did not wear a proper helmet (versus 6.5 %). Severe injuries sustained at a rate of 20 % at collision speeds below 30 km/h and in 80% at collision speeds above 50 km/h. Novice car drivers drove significant older cars. The risk profile of novice drivers is similar to those of drivers older than 65 years. Structural protection and special lectures like skidding courses could be proper remedial action next to harder punishment of violations.
Side impacts, both nearside and farside, have been indicated by research to be responsible for a large proportion of serious injuries from road crashes. This study aimed to compare and contrast the characteristics of nearside and farside crashes in Australia, Germany and the U.S., using the ANCIS, GIDAS and NASS/CDS in-depth-databases, in order to establish the impact and injury severity associated with these crashes, and the types of injuries sustained. The analyses revealed some interesting similarities, as well as differences, between both nearside and farside crashes, and the emergent trends between the three investigated countries. More specifically, it was indicated that whilst the severity of injury sustained in nearside crashes was slightly greater overall than that found for farside crashes, careful consideration of struck and nonstruck side occupants must be made when considering aspects such as vehicle design and occupant protection.
The national accident statistics demonstrate that the situation of passenger car side impacts is dominated by car to car accidents. Car side to pole impacts are relatively infrequent events. However the importance of car side to pole impacts is significantly increasing with fatal and seriously injured occupants. For the present study the German in-depth database GIDAS (German In-Depth-Accident Study) and the UK based database CCIS (Co-operative Crash Injury Study) were used. Two approaches were undertaken to better understand the scenario of car to pole impacts. The first part is a statistical analysis of passenger car side to pole impacts to describe the characteristics and their importance relevant to other types of impact and to get further knowledge about the main factors influencing the accident outcome. The second part contains a case by case review on passenger cars first registered 1998 onwards to further investigate this type of impact including regression analysis to assess the relationship between injury severity and pole impact relevant factors.
While many medical studies have dealt with the incidence, nature and treatment of polytrauma the injury-causing accident mechanisms are rarely discussed in detail, mostly due to the lack of documentation of the technical aspects. The present prospective study was started in late 2007 and collects data from traffic accidents with most severely injured in six south- German counties and two larger cities for the duration of one year. It is aimed at identifying and documenting all polytrauma cases (ISS ≥ 16) caused by traffic accidents and their crash circumstances. The data collection is based on an interdisciplinary concept to include both the police, emergency dispatch centers, hospitals and fire departments in the region and is completely anonymous. Potentially relevant cases where an emergency physician was called to the scene of a traffic accident are provided by the dispatch center. All three hospitals in the region suited for the treatment of polytraumatised patients record injuries, major diagnostic and surgery data. Data and images from the accident scene are provided by the police and by fire departments. The latter provide information which is usually not available from the police, like deployed airbags, vehicle extrication measures and detailed views of car interiors. The main objective of the study is to determine the structure of road users who sustain a polytrauma, their crash opponents and the injury patterns found in relation to the collision configuration and the protection by seat belts, air bags and other devices. With detailed documentation of vehicle damage and extrication measures the study is also intended to support the development of injury predictors for pre-hospital treatment and provide field data regarding further improvement of technical rescue.
The aim of this study is to investigate the differences in car occupant injury severity recorded in AIS 2005 compared to AIS 1990 and to outline the likely effects on future data analysis findings. Occupant injury data in the UK Cooperative Crash Injury Study Database (CCIS) were coded for the period February 2006 to November 2007 using both AIS 1990 and AIS 2005. Data for 1,994 occupants with over 6000 coded injuries were reviewed at the AIS and MAIS level of severities and body regions to determine changes between the two coding methodologies. Overall there was an apparent general trend for fewer injuries to be coded at the AIS 4+ severity and more injuries to be coded at the AIS 2 severity. When these injury trends were reviewed in more detail it was found that the body regions which contributed the most to these changes in severity were the head, thorax and extremities. This is one of the first studies to examine the implications for large databases when changing to an updated method for coding injuries.
Today, Euro NCAP is a well established rating system for passive car safety. The significance of the ratings must however be evaluated by comparison with national accident data. For this purpose accidents with involvement of two passenger cars have been taken from the German National Road Accident Register (record years 1998 to 2004) to evaluate the results of the NCAP frontal impact test configuration. Injury data from both drivers involved in frontal car to car collisions have been sampled and have been compared, using a "Bradley Terry Model" which is well established in the area of paired comparisons. Confounders " like mass ratio of the cars involved, gender of the driver, etc. " have been accounted for in the statistical model. Applying the Bradley Terry Model to the national accident data the safety ranking from Euro NCAP has been validated (safety level: 1star <2 star <3 star <4 star). Significant safety differences are found between cars of the 1 and 2 star category as compared to cars of the 3 and 4 star category. The impact of the mass ratio was highly significant and most influential. Changing the mass ratio by an amount of 10% will raise the chance for the driver of the heavier car to get better off by about 18%. The impact of driver gender was again highly significant, showing a nearly 2 times lower injury risk for male drivers. With regard to the NCAP rating drivers of a high rated car are more than 2 times more probable (70% chance) to get off less injured in a frontal collision as compared to the driver of a low rated car.
In recent years special attention has been paid to reducing the number of fatalities resulting from road traffic accidents. The ambitious target to cut in half the number of road users who are killed each year by 2010 compared with the 2001 figures, as set out in the European White Paper "European Transport Policy for 2010: Time to Decide" implies a general approach covering all kinds of road users. Much has been achieved, e.g. in relation to the safety of car passengers and pedestrians but PTW accidents still represent a significant proportion of fatal road accidents. More than 6,000 motorcyclists die annually on European roads which amounts to 16% of the EU-15 road fatalities. The European Commission therefore launched in 2004 a Sub- Project dealing with motorcycle accidents within an Integrated Project called APROSYS (Advanced PROtection SYStems) forming part of the 6th Framework Programme. In a first step, the combined national statistical data collections of Germany, Italy, the Netherlands and Spain were analysed. Amongst other things parameters like accident location, road conditions, road alignment and injury severity have been explored. The main focus of the analysis was on serious and fatal motorcycle accidents and the results showed similar trends in all four countries. From these results 7 accident scenarios were selected for further investigation via such in-depth databases as the DEKRA database, the GIDAS 2002 database, the COST 327 database and the Dutch element of the MAIDS database. Three tasks, namely the study of PTW collisions with passenger cars, PTW accidents involving road infrastructure features, and motorcyclist protective devices have been assessed and these will concentrate inter alia on accident causes, rider kinematics and injury patterns. A detailed literature review together with the findings of the in-depths database analysis is presented in the paper. Conclusions are drawn and the further stages of the project are highlighted.
Empirical vehicle crashworthiness studies are usually based on national or in-depth traffic accident surveys: Data on accident-involved cars/drivers are analysed in order to quantify the chance of driver injury and to assess certain risk factors like car make and model. As the cars/drivers involved in the same accident form a "cluster", where the size of the cluster equals the number of accident-involved parties, traffic accident survey data are typical multi-level data with accidents as first-level or primary and cars/drivers as secondlevel or secondary units (car occupants in general are to be considered as third level units). Consequently, appropriate statistical multi-level models are to be used for driver injury risk estimation purposes as these models properly account for the cluster structure of traffic accident survey data. In recent years various types of regression models for clustered data have been developed in the statistical sciences. This paper presents multi-level statistical models, which are generally applicable for vehicle crashworthiness assessment in the sense that data on single and multiple car crashes can be analysed simultaneously. As a special case of multi-level modelling driver injury risk estimation based on paired-by-collision car/driver data is considered. It is demonstrated that assessment results may be seriously biased, if the cluster structure inherent in traffic accident survey data is erroneously ignored in the data analysis stage.