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NASS: the glass is half full
(2007)
The National Accident Sampling System (NASS) was born in the late 1970s. It was based on a substantial amount of experience and analysis of what was needed in the United States to understand the safety challenges of our highways. This work also showed how to collect high quality and useful crash data efficiently. Unfortunately, when Ronald Reagan - a President who believed in limited government - was elected, any hope of full funding for NASS was lost. The concept of 75 teams investigating about 18,000 serious crashes in detail annually was never realized. The system got up to 50 teams, then was cut to 36, and finally to 24 teams investigating fewer than a quarter of the originally anticipated number of crashes per year. Despite this, the NASS investigations provide a rich source of data, collected according to a sophisticated statistical sampling system to facilitate detailed national estimates of road casualties on our nation- highways and their causes. In addition, changes have been made in recent years to increase the number of more serious crashes of recent model vehicles to make the results more relevant to improving vehicle safety. A recent, detailed examination of hundreds of rollovers has provided considerable insight into rollover casualties and into what can be done to reduce them. Some of these results will be presented that show the value of the NASS system. Our experience with NASS and the Fatal Accident Reporting System (FARS) suggests a number of improvements that could be made in the United States" crash data systems. It also provides justification for a doubling or tripling of our national expenditures on crash data collection.
The increase in light duty trucks (LDT) on the road in the US is a safety concern because of their aggressivity, or risk they present to occupants of cars, especially in side impacts. We use FARS data to look at fatality trends in frontal and side impacts between cars and LDT. FARS data is also used to determine risk, or fatalities per registered vehicle, imposed on car drivers from other vehicle types. We use NASS CDS data to investigate sources of serious injuries in vehicles with side impact. These sources of injury are categorized into three major groups: 1) contact without intrusion, 2) contact with intrusion, and 3) restraints. We find a greater fraction of intrusion related injuries in cars struck on their side by SUV or pick-up trucks than when they are struck by other cars.
This study examines the severity and types of injuries sustained by child pedestrians aged 18 years and below in order to identify the body regions at greatest risk for injury in a pedestrian accident. Detailed medical diagnoses were reviewed retrospectively for 572 child pedestrians admitted to an urban pediatric trauma center with injuries during the time period from January 2001 to December 2005. Eighty percent of these children sustained AIS 2 or greater injuries, most commonly to the lower extremity (41%) and head (34%). Fortyfour percent of admitted children had more significant AIS 3 or greater injuries primarily to the head (58%), thorax (17%) and lower extremities (14%). Testing procedures to assess the child- interaction with the motor vehicle should include injury assessment for the pediatric head, thorax and lower extremities. This understanding of how child pedestrians interact with motor vehicles may provide insight into effective countermeasures with potential for implementation in vehicle designs world-wide.
The number of injuries sustained by car occupants involving the head, thorax, spine, pelvis and the upper limbs have been reduced significantly during recent years. This is probably due to better safety features in the cars, especially the availability and usage of safety belts, airbags etc. Therefore one can notice clinically a relative increase in survivors of severe frontal crashes, but many of them have injuries to the lower extremities. To verify this, we analyzed the foot and ankle injuries of front seat passengers.
This study aimed to identify the occurrence, type and mechanisms of the traumatic injuries of the vulnerable road users in vehicle collisions, and to determine the effects of human, engineering, and environment factors on traffic accidents and injuries. The pedestrian accident cases were collected in the years 2000 to 2005 from Changsha Wujing hospital China and Accident Research Unit at Medical University Hannover in Germany. A statistic analysis was carried out using the collected accident data. The results from analysis of Changsha data were compared with results from analysis of GIDAS data Hannover. The injury severities were determined using AIS code and ISS values. The results were presented in terms of cause of injuries, injury distributions, injury patterns, injury severity. The factors influenced the injury outcomes were proposed and discussed for the vehicle transport environment and road users. The results were discussed with regard to accident data collection, accident sampling and injury distributions etc. In the urban area of Changsha, motorcycles and passenger cars are most frequently involved in vehicle pedestrian accidents. Head and lower extremities injuries are the predominant types of pedestrian injuries. The pedestrian accidents were identified as vital issue in urban traffic safety and therefore a high priority should be given to this road user group in research of safe urban transportation. In Hannover area, cars are most frequently involved in traffic accidents, injured pedestrians are involved in road traffic of Germany in 13% of all causalities only in 2005 and have nearly the same number as motorcyclists, but the half of bicyclists.
The primary goal of this investigation was to determine the relative risk of traffic accidents in students. In a two year period, a survey amongst 2,325 students was carried out, and 3,645 injuries sustained by students treated at our hospital were analyzed. Moped-riding in adolescents were associated with a 23.75-fold increased risk for injury as compared to biking. Children who ride bicycles have a 2.2-fold increased risk for an injury sustained by traffic accidents compared to pedestrians. None of 50 injured bicycle riders with helmet had an AIS for head injuries of more than 2. 24 of 233 injured bicycle drivers without helmet had an AIS for head injuries of more than 2. The use of a protective helmet significantly reduced the severity of head injuries. The level of awareness towards danger and a history of previous accidents correlate with the likelihood of future accidents. Due to the severity of traffic accidents, more adequate prevention measures (wearing of bicycle helmets and better education for moped riders) are urgently needed.
Description of road traffic related knee injuries in published investigations is very heterogeneous. The purpose of this study was to estimate the risk of knee injuries in real world car impacts in Germany focusing vulnerable road users (pedestrians, bicyclists and motorcyclists) and restrained car drivers. The accident research unit analyses technical and medical data collected shortly after the accident at scene. Two different periods (years 1985-1993 and 1995-2003) were compared focusing on knee injuries (Abbreviated Injury Scale (AISKnee) 2/3). In order to determine the influences type of collision, direction and speed as well as the injury pattern and different injury scores (AIS, MAIS, ISS) were examined. 1.794 pedestrians, 742 motorcyclists, 2.728 bicyclists and 1.116 car drivers were extracted. 2% had serious ligamentous or bony injuries in relation to all injured. The risk of injury is higher for twowheelers than for pedestrians, but knee injury severity is higher for the latter group. Overall the current knee injury risk is low and significant reduced comparing both time periods (27%, p<0,0001). Severe injuries (AISKnee 2/3) were below 1%). Improved aerodynamic design of car fronts reduced the risk for severe knee injuries significantly (p=0,0015). Highest risk of injury is for motorcycle followed by pedestrians, respectively. Knee protectors could prevent injuries by reducing local forces. The classically described dashboard injury was rarely identified. The overall injury risk for knee injuries in road traffic is lower than estimated and reduced comparing both periods. The aerodynamic shape of current cars compared to older types reduced the incidence and severity of knee injuries. Further modification and optimization of the interior and exterior design could be a proper measurement. Classic described injury mechanisms were rarely identified. It seems that the AIS is still underestimating extremity injuries and their long term results.
In September 2004 the first international symposium called ESAR (Expert Symposium on Accident Research) was carried out at the University of Hannover (Germany). The idea for such international conference was to bring together experts from the fields of accident investigation teams worldwide to present their results for a common audience of people from government, industry and other universities. The first conference was a really sufficient one and followed by the second symposium also at the Hannover Medical School two years later in 2006. This two year rhythm was now continued with the third conference in Hannover again in 2008. It is planned to carry out ESAR every two years also in the future. ESAR is a scientific colloquium and can be seen as a platform for exchange of information on accident research issues based on methodologies of investigation, injury mechanisms and injury assessment, accident causation and other issues of statistical accident data analysis. Representatives from authorities as well as from medical and technical institutions come together to discuss new research issues and exchange experiences on accident prevention and the complex field of accident reconstruction. Special focus was given to the target the European Union set for itself in 2000 which stipulates that within 10 years the number of person killed in road traffic accidents must be cut in half. To reach this goal, optimized measures, comprehensive research and analysis are necessary. A key hurdle comes from the European Union extension to 27 member states, each featuring different levels of traffic safety standards and different accident scenarios. Existing results from long term research projects in Europe, the USA, Australia and Japan including analyses of infrastructure, population, vehicle fleet and driver behaviour offer an excellent basis for understanding and improving countermeasures and research support needs in underdeveloped countries. ESAR's goal is to bring together researchers from all parts of the world, who will report on their methods and recommendations to improve traffic safety based on "In-Depth-Investigations" of real world accidents. These In-depth-investigations of accidents require thorough documentation and an accident data analysis on multidisciplinary levels which must be carried out immediately after it occurs. ESAR presents scientists the opportunity to present their studies on a common basis of research level.
The second ESAR Conference took place at the Medical University Hannover. This year conference presents the current state of affairs of relevant research activities in the field of in-depth investigations. The first conference on ESAR (Expert Symposium on Accident Research) was established in 2004. It is planned to hold ESAR every two years. Hannover seems to be the right place for this conference concerning the fact that the first in-depth research team was found here in the year 1973 and comprehensive studies on accident analysis were spread out from here around the world continuously. This year conference topped all expectations in terms of the numbers of participants, in the variety of papers and the interdisciplinary of presenters from medical, psychological and engineering background. More than 100 delegates from all over the world, that means 13 different countries and from 4 different continents, came to Hannover, presented their results of accident investigation and discussed countermeasures for accident prevention and injury reduction. ESAR should be a platform for exchange of knowledge to find an optimized way for increase of traffic and vehicle safety by in-depth investigation and methodology. ESAR as international conference should be a platform for consideration of all nations round the world. This seems to be very important for the current situation, having high safety in the high industrial countries of Europe, US and Australia, but low safety and high injury risk in Asia and Africa.
In recent years considerable progress in active and passive safety of road vehicles has been made. The road traffic of today is much safer than in the past. A current vehicle has a lot more safety elements resulting in an improved inner and outer technique. In most European countries the number of fatalities is decreasing despite growing traffic and road usage. Nevertheless, the number of casualties in road traffic accidents is high enough, thus more progress is needed if the number of fatalities is to be reduced by 50%, as postulated by the European Commission for the year 2010. In order to develop countermeasures and further possibilities for injury prevention, it is increasingly important to have accident data available, supplying results quickly and giving the best overview across Europe. In-Depth-Data Sampling Procedures have a huge historical development, starting in the 60ies by the car manufactures, continued during the 70ies mostly by some universities mainly in England, Sweden, France and Germany, today a net of in-depth-investigation teams are working across Europe and around the world.One of the oldest teams is located at the Hannover Medical School, founded in 1973 by the German Government on behalf of the Federal Highway Research Institute Bast. It was the only team worldwide that was equipped with blue light emergency cars, working on scene in time so directly after the event and working continuously during the years, collecting 20 thousand accidents within 30 years period. Since 1999 the order is carried out in cooperation with the German car industry, which is interested and has benefit on the data too. On the basis of the new data collection, so called GIDAS (German In-Depth Accident Study), that has been run at the Technical University Dresden and the Medical University Hannover), a special tool for In-Depth-Accident Analysis was founded. It is the task of this conference to build a platform for such research based on In-Depth-Investigation. The conference is specially aimed at the area of accident data analysis in order to contribute to the harmonization of different investigation methods and accumulation of different results that does exist for different countries worldwide. Up to now no special conference did exist to deal with accident data only following in the discussion for an improvement in traffic and vehicle safety. ESAR - expert symposium on accident research - should be a step forward. This first international conference is being organized by the Accident Research Unit at the Medical University Hannover jointly with the German Federal Highway Research Institute Bast and the Research Association of German Car Manufacturers FAT. The conference should be a platform for an interdisciplinary exchange of information based on the different presentations from participants around the world.