Sonstige
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.
In the context of this study, different data sources for accident research were examined regarding their possible data access and evaluated concerning the individual quality and extent of the data. Analyses of accidents require detailed and comprehensive information in particular concerning vehicle damages, injury patterns and descriptions of the accident sequence. The police documentation supplies the basic accident statistics and is amended in the context of the forensic treatment by further information, e.g. by medical and technical appraisals and witness questionings. As a new approach to the data acquisition for the analysis of fatal traffic accidents, the information was made usable which was collected by the police and by the investigations of the public prosecutor. The best strategy for obtaining reliable, extensive and complete data consists of combining the information from these two sources: the very complete, but elementary statistic data of the Niedersächsisches Landesamt für Statistik (Lower Saxony State Authority of Statistics), based on the police documentation as well as the very extensive accident information resulting from the investigation documentation of the public prosecutor after conclusion of the procedure, the so-called Court Records. Of all 715 fatal traffic accidents, which happened in the year 2003 in the German State of Lower Saxony, 238 cases were selected by means of a statistically coincidental selective procedure based on a statistically representative manner (every third accident). These cases cover the investigation documents of the 11 responsible public prosecutor- offices, which were requested and evaluated while preserving the data security. Of the 238 cases 202 cases were available, which were individually coded and stored in a data base using 160 variables. Thus a data base of a sample of representative data for fatal accidents in Lower Saxony was set up. The data base contains extensive information concerning general accident data (35 variables), concerning road and road surface data (30 variables), concerning vehicle-specific data (68 variables) as well as concerning personal and injury data (27 variables).
The fact that ADAC Air Rescue handles approximately 4,000 road accident missions every year gave rise to set up an accident research programme for which ADAC Air Rescue provides its data. This data is of initial informational quality and will be supplemented by data from the police, experts, fire brigades as well as hospitals and forensic institutes. Although the number of cases is still rather low, certain tendencies can be identified. The causes for most accidents occur when joining or intersecting traffic, followed by speeding in road bends and tailgating. Many accidents involve HGV rear end collisions, often causing serious injuries, considerable damage and technical problems for the rescue operations. With regard to the various impact types, it has become obvious that most of the extremely serious injuries are inflicted during a passenger car side impact. In addition, access to and removal of trapped passengers is becoming more and more complicated, partly due to the increasing use of high-strength materials, and rescue operations tend to be more time consuming.
Internationally, the need is expressed for harmonized traffic accident data collection (PSN, PENDANT, etc.). Together with this effort of harmonization, traffic accident investigation moves more and more in the direction of accident causation. As current methods only partly address these needs, a new method was set up. The main characteristics of this method are: • Accident/injury causation (associated) factors can objectively be identified and quantified, by comparison with exposure information from a normal population. • All relevant accident and exposure data can be included: human-, vehicle-, and environmental related data for the pre-crash, crash and postcrash situation (the so-called Haddon matrix). The level of detail can be chosen depending on interest and/or budget, which makes the method very flexible. In this paper the accident collection and control group method are presented, including some of the achieved results from a pilot study on 30 truck accidents and 30 control locations. The data were analyzed by using cross-tabulations and classification-tree analysis. The method proved useful for the identification of statistically significant causational aspects.
The "Seven Steps Method" is an analysis and classification system, which describes the human participation factors and their causes in the temporal sequence (from the perceptibility to concrete action errors) taking into consideration the logical sequence of individual basic functions. By means of the "seven steps" it is possible to describe the relevant human causes of accidents from persons involved in the accident in an economic way with a sufficient degree of exactitude, because the causes can be further differentiated in their value (e.g. diversion as external diversion with regard to impact due to surroundings) and their sub values (e.g. external diversion with regard to impact due to surroundings in the shape of a "capture" of the perception by a prominent object of the traffic environment). Theoretically it is possible that one or more causing moments can be assigned to a person involved in an accident in each of the "seven steps"; however it is also possible to sufficiently clarify the cause in only one level (examples for this are described). In the practice of accident investigation at the site of the accident, the sequence chart is also relevant. With its assistance the questioning of the people involved in an accident can be accomplished in a structured way by assigning a set of questions to each step.
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.
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.
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.
Traffic accidents were ranked the third among the major causes of death in Thailand. About 13,438 deaths and the death rate from traffic accident was 21.5 per 100,000 of population in 2002. The deaths and death rate varied upon the economic situation. After the economic crisis, traffic accidents were increased as well as the period of the bubble economy. In the Central region of Thailand numbers of road traffic crashes were lower than Bangkok Metropolis, but the highest in the number of deaths, death rate and serious injuries in 2002. Men aged 15"29 years old had higher numbers of deaths than men in other age groups and higher than women. Deaths and injuries from road traffic crashes were the highest in April and January, because there was a long weekend in those months. About 80 percent of road traffic crashes were caused by private car and motorcycle. In 2000 about 51 percent of traffic accidents took place on the straight way, followed by the junction and curves. In 2002, about 97 percent of road traffic crashes were caused by human factors including improper passing, speeding and disregarding to traffic signal, however, the identification of causes of traffic accident needed to improve. Drunk driving, disregarding on safety equipment usage, inefficiency of law enforcement and discontinuing of road safety programs were the deepest causes of traffic accidents. Research based information, a broad coalition of stakeholder and urban planning policy were needed to incorporate for a comprehensive road safety policy formulation and actions.
Nigeria ranks one of the highest countries in the world with the largest accident, especially when measured by whiplash associated disorders, whereas, traffic safety education rate, data and information been widely known as preventive indicators have been grossly neglected. In Nigeria, traffic safety enlightenment, awareness, political understanding and appreciation of the problem's magnitude are lacking. This study, therefore, seeks to understand and document the fact that accident causation factors in Nigeria relate more to the problem of development, poverty, knowledge and education as evidenced in most other developing countries. Among the primary accident causation factors on Nigerian roads are: - lack of a transportation system or multi-model integration - sub-standard and obsolete vehicles and road furniture - poor road maintenance, investment and engineering management - paucity of road users' and drivers' knowledge, skill, enlightenment and education of the road Use This paper submits that Nigeria being a developing nation requires purely primitive strategies being cost effective (health wise) than curative measures. It is in this light that an enduring, comprehensive and sustainable traffic safety educational programmes information base and data inventory, analysis and implementations form the focus of this study. This effort will provide basic guidelines framework and implementation procedure for a successful prevention of whiplash associated disorder resulting from road traffic crashes in Nigeria and other parts of the world.