Sonstige
Since the compulsory use of child restraints for children up to 5 years of age was introduced in 2000, restraint use among younger children has increased significantly. However, the observed rate of child restraint use plateaus at around 50%, and apparently little spillover effect has been found for older children who are not covered by the law. This report examines the restraint use patterns for children who were injured in cars in relation to driver and child passenger characteristics. Univariate and multivariate analyses were conducted to describe the association between the outcome measure (the proper use of restraints for children) and relevant variables. Better ways for parents and caregivers to improve the use of restraints for children are also discussed.
In Germany, in-depth accident investigations are carried out in the Hannover area since 1973. In 1999 a second region was added with surveys in Dresden and the surrounding area. Internationally, the acronym GIDAS (German In-Depth Accident Study) is commonly used for these surveys. Compared to many other countries, the sample sizes of the GIDAS surveys are much larger. The goal is to collect 1.000 accidents involving personal injuries per year and region. Data collection takes place by using a sampling procedure, which can be interpreted as a two-stage process with time intervals as primary units and accidents as secondary units. An important question is, to what extend these samples are representative for the target population from which they are drawn. Analyses show, for example, that accidents with persons killed or seriously injured are overrepresented in the samples compared to accidents with slightly injured persons. This means, that these data are subject to biases due to uncontrolled variation of sample inclusion probability. Therefore, appropriate weighting and expansion methods have to be applied in order to adjust or correct for these biases. The contribution describes the statistical and methodological principles underlying the GIDAS surveys with respect to sampling procedure, data collection and expansion. In addition, some suggestions regarding potential improvements of study design are made from a methodological point of view.
The incidence and treatment of sternal fractures among traffic accidents are of increasing importance to ensure best possible outcomes. Analysis of technical indicators of the collision, preclinical and clinical data of patients with sterna fractures from 1985-2004 among 42,055 injured patients were assessed by an Accident Research Unit. Two time groups were categorized: 1985-1994 (A) vs. 1995-2004 (B). 267/42,055 patients (0.64%) suffered a sterna fracture. Regarding the vehicle type, the majority occurred after car accidents in 0.81% (251/31,183 pts), followed by 0.19% (5/2,633pts) driving motorbike, and 0.11% (4/3,258pts) driving a truck. 91% wore a safety belt. Only 13% of all passengers suffering a sternal fracture had an airbag on board (33/255 car/trucks), with an airbag malfunction in 18%. The steering column was deformed in 39%, the steering wheel in 36%. Cars in the recent years were significantly older (7.67-±5 years (B) vs. 5.88-±5 years (A), p=0.003). Cervical spine injuries are frequent (23% vs. 22%), followed by multiple rib fractures (14% vs. 12%) and lung injuries (12% vs. 11%). We found 9/146 (6%) and 3/121 patients (3%) with heart contusion among the 267 sternal fractures. MAIS was 2.56-±1.3 vs. 2.62-±1.3 (A vs. B, p=0.349). 18% of patients were polytraumatized, with 11.2% dying at the scene, 2.3% in the hospital. Sternal fractures occur most often in old cars to seat-belted drivers often without any airbag. Severe multiple rib fractures and lung contusion are concomitant injuries in more than 10% each indicating the severity of the crash. Over a twentyyear period, the injury severity encountered was not different with 18% polytrauma patients suffering sternal fractures.
Zur Überwachung der Verkehrsentwicklung und zur Ermittlung der Verkehrsstärken auf den Bundesfernstraßen - Bundesautobahnen und Bundesstraßen - fand im Jahr 2005 wieder eine bundesweite Straßenverkehrszählung (SVZ 2005) im Rahmen des üblichen Fünfjahres-Turnus statt. Die Länder hatten die Möglichkeit, auch das nachgeordnete Netz (Landes- und Kreisstraßen) zu zählen und im Rahmen der SVZ 2005 auswerten zu lassen. Kreisstraßen wurden im Gegensatz zur SVZ 2000 nur in einigen Bundesländern und zudem nur in deutlich geringerem Maße erfasst, so dass zu dieser Straßenkategorie keine allgemeinen Aussagen getroffen werden können. Der vorliegende Bericht beinhaltet mittlere DTV-Werte und Jahresfahrleistungen, differenziert nach Fahrzeugarten und Straßenklassen sowohl für das Bundesgebiet insgesamt als auch für jedes einzelne Bundesland. Außerdem sind Beschreibungen zur Berechnung der DTV- und Fahrleistungsstatistiken enthalten sowie einige Ausführungen zu Entwicklungen der mittleren DTV-Werte und Jahresfahrleistungen in Bezug auf 2000.
Bicyclists are minimally or unprotected road users. Their vulnerability results in a high injury risk despite their relatively low own speed. However, the actual injury situation of bicyclists has not been investigated very well so far. The purpose of this study was to analyze the actual injury situation of bicyclists in Germany to create a basis for effective preventive measures. Technical and medical data were prospectively collected shortly after the accident at the accident scenes and medical institutions providing care for the injured. Data of injured bicyclists from 1985 to 2003 were analyzed for the following parameters: collision opponent, collision type, collision speed (km/h), Abbreviated Injury Scale (AIS), Maximum AIS (MAIS), incidence of polytrauma (Injury Severity Score >16), incidence of death (death before end of first hospital stay). 4,264 injured bicyclists were included. 55% were male and 45% female. The age was grouped to preschool age in 0.9%, 6 to 12 years in 10.8%, 13 to 17 years in 10.4%, 18 to 64 years in 64.7%, and over 64 years in 13.2%. The MAIS was 1 in 78.8%, 2 in 17.0%, 3 in 3.0%, 4 in 0.6%, 5 in 0.4%, and 6 in 0.2%. The incidence of polytrauma was 0.9%, and the incidence of death was 0.5%. The incidence of injuries to different body regions was as follows: head, 47.8%; neck, 5.2%, thorax, 21%; upper extremities, 46.3%; abdomen, 5.8%; pelvis, 11.5%, lower extremities, 62.1%. The accident location was urban in 95.2%, and rural in 4.8%. The accidents happened during daylight in 82.4%, during night in 12.2%, and during dawn/dusk in 5.3%. The road situation was as follows: straight, 27.3%; bend, 3.0%; junction, 32.0%; crossing, 26.4%; gate, 5.9%; others, 5.4%. The collision opponents were cars in 65.8%, trucks in 7.2%, bicycles in 7.4%, standing objects in 8.8%, multiple objects in 4.3%, and others in 6.5%. The collision speed was grouped <31 in 77.9%, 31-50 in 4.9%, 51-70 in 3.7%, and >70 in 1.5%. The helmet use rate was 1.5%. 68% of the registered head injuries were located in the effective helmet protection area. In bicyclists, head and extremities are at high risk for injuries. The helmet use rate is unsatisfactorily low. Remarkably, two thirds of the head injuries could have been prevented by helmets. Accidents are concentrated to crossings, junctions and gates. A significant lower mean injury severity was observed in victims using separate bicycle lanes. These results do strongly support the extension or addition of bicycle lanes and their consequent use. However, the lanes are frequently interrupted at crossings and junctions. This emphasizes also the important endangering of bicyclists coming from crossings, junctions and gates, i.e. all situations in which contact of bicyclists to motorized vehicles is possible. Redesigning junctions and bicycle traffic lanes to minimize the possibility of this dangerous contact would be preventive measures. A more consequent helmet use and use and an extension of bicycle paths for a better separation of bicyclists and motorized vehicle would be simple but very effective preventive measures.
During the last 5 years, the number of cars fitted with side airbags has dramatically increased. They are now standard equipment, even on many smaller cars or less luxurious vehicles. While some side airbags offer thoracic protection alone, there are those that combine thoracic and head protection (of which most deploy from the seat). Other systems employ separate airbags for head and thorax protection, which are designed to be effective noticeably in a crash against a pole. This paper proposes an evaluation of the effectiveness of side airbags in preventing thoracic injuries to passenger car occupants involved in side crashes. First, the target population (who can take benefit of side airbag deployment and in what circumstances) is defined. Side airbags can be especially effective in cases of impacts on the door with intrusion at a certain impact speed. Then, an example case of a side impact with side airbag deployment is given were side airbag deployment is thought to have had a positive effect on injury outcome. A further case is presented where the impact configuration is likely to have reduced the effect of side airbag deployment on injury outcome. Finally, the estimation of side airbag effectiveness (in terms of additional occupant protection brought exclusively by the airbag) is proposed by comparing injury risk sustained by occupants in (more or less) similar cars (fitted or non fitted with airbags) because, during these years, car structure, and side airbag conception have considerably evolved. In-depth accident data from France, the UK and Germany has been collected. Out of 2,035 side impact accident cases available in the databases, we selected 435 occupants of passenger cars (built from 1998 onwards) involved in an injury accident between year 1998 and year 2004 for EES (Energy Equivalent Speed) values between 20km/h and 50km/h. The occupants, belted or not, were sat on the struck side, whatever the obstacle and type of accidents (intersection, loss of control, etc.). For multiple impact crashes, the side impact is assumed to be the more severe one. Passenger cars were fitted with (96) or without (339) side airbags. Most of the potential risk explanatory variables were correctly and reliably reported in the databases (velocity " impact zone " impact angle " occupant characteristics, etc.). The analysis compared injury risks for different levels of EES and different types of side airbags. A logistic regression model was also computed with injury variables (such as thoracic AIS 2+ or AIS 3+) as the dependant variable and other variables (including airbag type and EES) as explanatory injury risk factors. Results revealed statistically non-significant reductions in thoracic AIS 2+ and AIS 3+ injury risk in side airbag equipped cars in the impact violence range selected (odds ratio between 0.84 and 0.98 depending on types of airbags). The results are discussed. The non-significance is assumed to be due to a low number of cases. Statistical analysis for head injuries was not possible due to the low number of accident cases with passenger cars fitted with head airbags in the databases. Moreover, the discrepancies between the data coming from different countries (especially calculation of EES) might have introduced instability in the analysis.
Due to recent years accident avoidance and crashworthiness on Austrian roads were mostly developed on national statistics and on-scene investigation respectively. Identification and elimination of black spots were main targets. In fact many fatal accidents do not occur on such black spots and black-spot investigation has reached a limit. New methods are required and therefore the Austrian Road Safety Programme was introduced by the Austrian Ministry of Transport, Innovation and Technology. The primary objective is the reduction of fatalities and severe injuries. Graz University of Technology initiated the project ZEDATU (Zentrale Datenbank tödlicher Unfälle) with the goal to identify similarities in different accident configurations. A matrix was established which categorizes risk and key factors of participating parties. Based on this information countermeasures were worked out.