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This paper reviews briefly the evolution of the investigation of transport accidents from the early beginnings when individual events were studied but systematic data was not collected. In the transport modes other than on the roads, accident investigation early on, even of single events, was important in introducing safety improvements. Road accidents, however, evolved enormously with the growth of car ownership without any comparable political response to the consequent deaths and injuries, equivalent to what happened with the other modes. From the 1950s data bases started to contribute to our knowledge of the epidemiology of road traffic injuries, and in-depth sample studies have contributed much to the body of knowledge in the last 30 years. However, even the basic input and output variables of a crash, its severity and the seriousness of the outcomes in terms of injuries and their consequences are not complete or agreed upon. Issues of experimental design and sampling are discussed. It is proposed that the most important area for current research to address is the effect of population variations on injury outcomes. The need for the establishment of good data bases for active safety issues is emphasised with the consequent need for better links between the research community and the police.
Pelvic fracture, cracking or breaking of a portion of the pelvis are extremely common injuries in the side impact collisions of motor vehicles. Due to both its shape and structural architecture, mechanics of the pelvic bone is complicated. There is a lack of knowledge regarding the dynamic behavior of the pelvis and its biomechanical tolerance under impact environment. Hence this study is aimed at the understanding of the mechanical response of the human pelvis with three-dimensional finite element (FE) models, under side impact load, applied through a structure, equivalent to a car door. The door structure was modeled, considering few layers, consisting of foam (Styrodur®, 3035 CS), plastic (UHMWPE), steel, glass and steel, putting them in series. A soft tissue layer (equivalent to fat) was also considered on the greater trochanter location. These FE models (with and without the car door structure) were analyzed with ANSYS-LS-DYNA-® dynamic finite element software to compare the effect of the car door padding system for shock absorption. It was observed that with proper combination of shock absorbing material (foam, etc.) and its thickness, the transmission of impact load to the body part (pelvis, etc.) from the outer surface of the car door could be reduced.
A total survey of road traffic accidents involving most severely injured, defined as sustaining a polytrauma or severe monotrauma (ISS > 15) or being killed, was conducted over 14 months in a large study region in Germany. Data on injuries, pre-clinical and clinical care, crash circumstances and vehicle damage were obtained both prospectively and retrospectively from trauma centers, dispatch centers, police and fire departments. 149 patients with a polytrauma and eight with a severe monotrauma were recorded altogether. 22 patients died in hospital. Another 76 victims had deceased at the accident scene. In 2008, 49 % of patients treated with life-threatening injuries were car or van occupants, 21 % motorcyclists, 18 % cyclists and 10 % pedestrians. Among fatalities at the scene, vehicle occupants constituted an even larger portion. The number of road users with life-threatening trauma in the region was extrapolated to the German situation. It suggests that 10 % among the "seriously injured" as defined in national accident statistics are surviving accident victims with a polytrauma or severe monotrauma.
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.
Motorcycle riders are one of the most vulnerable road users. Annually, on estimate 6000 people are killed in motorcycle accidents in the former 15 EU countries. The objective of this research was to investigate and analyze the main aspects and causes of this vulnerability and the accidents in general. For this aim around 70 accidents in The Netherlands were investigated in the framework of an international research program (MAIDS). Also a control group of motorcycles with riders was investigated so that exposure could be taken into account. An important result is that human failure is in 82% of the cases the main cause of the accident, in 52% this is due the other vehicle driver. Perception and decision failures are the most common failures. The most injuries are caused by the environment but they are typically only less severe (AIS1). Injuries caused by the car (front and side) are typically severe injuries (AIS4+). Previous convictions of the MC rider seem to be related to the chance to get involved in an accident. It was shown that the Dutch and the total MAIDS accident sample are comparable.
The following paper presents the nature and mechanism of injuries sustained in frontal impacts, focusing on car to car impacts. It was found that the body regions most frequently sustaining severe to fatal injuries were the legs and the thorax. The nature and mechanism of the injury sustained was investigated only for the thorax injuries, due to their potentially life threatening nature. The analysis revealed that the most frequent cause of the injury recorded was the seatbelt for low severity injuries and the front structure of the vehicle for higher severity injuries. An analysis of the effect of load limiter technology in the restraint system showed that the proportion of occupants who sustained "no thorax injury" did not increase when a load limiter was fitted to the restraint system. However, a decrease in the "organ" and "organ and skeletal" injuries was observed in the load limiter sample. Sample size and variation mean that these findings are not conclusive.
Powered Two Wheelers (PTWs) accidents constitute one of the road safety problems in Europe. PTWs fatalities represent 22% at EU level in 2006, having increased during last years, representing an opposite trend compared to other road users" figures. In order to reduce these figures it is necessary to investigate the accident causation mechanisms from different points of view (e.g.: human factor, vehicle characteristics, influence of the environment, type of accident). SAFERIDER project ("Advanced telematics for enhancing the SAFEty and comfort of motorcycle RIDERs", under the European Commission "7th Framework Program") has investigated PTW accident mechanisms through literature review and statistical analyses of National and In-depth accident databases; detecting and describing all the possible PTW's accident configurations where the implementation of ADAS (Advanced Driver Assistance Systems) and IVIS (In-Vehicle Information Systems) could contribute to avoid an accident or mitigate its severity. DIANA, the Spanish in-depth database developed by CIDAUT, has been analyzed for that purpose. DIANA comprises of accident investigation teams, in close cooperation with police forces, medical services, forensic surgeons, garages and scrap yards. An important innovation is the fact that before injured people arrive to hospitals, photographs and explanations about the possible accident injury mechanisms are sent to the respective hospitals (via 3G GPRS technology). By this, additional information to medical staff can be provided in order to predict in advance possible internal injuries and select the best medical treatment. This methodology is presented in this paper. On the other hand, the main results (corresponding to road, rider and PTW characteristics; pre and post-accident manoeuvres; road layout; rider behaviour; impact points; accident causations;...) from the analyses of the PTW accidents used for SAFERIDER are shown. Only accident types relevant to ADAS and IVIS devices have been considered.
The purpose of this work is to investigate the association between the injuries in motorcycle accident and the main accident configurations. The data were provided by a multicentric case-control study MAIDS regarding the risk of crash and injuries of motorcyclists. Chi-square test was used to evaluate the relationship between the variables and a logistic regression was performed to evaluate the association of injury severity with some variables supposed to be predictive factors. Lesive patterns characterized by internal haemorrhages are mainly associated with fronto-lateral crashes, above all in urban areas. Lacerations or abrasions, mainly reported in torso and lower extremities, are mostly associated with single crashes or accidents in queue also for crashes occurred to low speed (< 50 km/h). The severity of injuries is highly associated with impact speed, regardless of the crash configuration. Fractures and haemorrhages play an important role in determining the severity of injuries. The upper extremities are the most frequently traumatised anatomic areas.
Although ATV accidents account for numerous deaths in the US and Australia, the role in traffic accidents and hospital admissions in Germany is unknown. At a level I trauma centre, hospital and crash charts were analysed for medical and technical parameters of ATV accidents. ATV drivers were 0.1% of emergency trauma patients. The mean total hospital stayrnwas 15 days; there were 1.5 stays per patients with 2.0 surgical procedures needed. One patient died, only two recovered fully. 14 cases of ATV accidents out of 18990 (0.1%) were documented within 10 years. The mean impact velocity was 35 km/h. Car collisions were predominant. The upper extremity was the predominant injured region (AIS 0.7), Mean maximum AIS was 1.4. ATV accidents in Germany are rare but pose high risk for severe injuries. Possible reasons are low active and passive security, limited experience and risky driving behaviour. Preventive measures are discussed.rn
To elucidate the risk of pedestrians, bicycle and motorbike users, data of two accident research units from 1999 to 2014 were analysed in regard to demographic data, collision details, preclinical and clinical data using SPSS. 14.295 injured vulnerable road users were included. 92 out of 3610 pedestrians ("P", 2.5%), 90 out of 8307 bicyclists ("B", 1.1%) and 115 out of 4094 motorcycle users ("M", 2.8%) were diagnosed with spinal fractures. Thoracic fractures were most frequent ahead of lumbar and cervical fractures. Car collisions were most frequent mechanism (68, 62 and 36%). MAIS was 3.8, 2.8 and 3.2 for P, B and A with ISS 32, 16 and 23. AIS-head was 2.2, 1.3 and 1.5). Vulnerable road users are at significant risk for spine fractures. These are often associated with severe additional injuries, e.g. the head and a very high overall trauma severity (polytrauma).