Sonstige
Who doesn't wear seat belts?
(2009)
Using real world accident data, seat belts were estimated to be 61% effective at preventing fatalities, and 32% effective at preventing serious injuries. They were most effective for drivers with an airbag. Seat belts were estimated as having prevented 57,000 fatalities and 213,000 seriously injured casualties in the UK since 1983. Seat belt legislation was estimated to have prevented 31,000 fatalities and 118,000 seriously injured casualties. A future increase in effective seat belt wearing rate (which takes into account seating position) in the UK from 92.5% to 93% may prevent casualties valued at a societal cost of over -£18 million per year. To target a seat belt campaign, the question "who doesn"t wear seat belts?" must be answered. Seat belt wearing rates and the number of unbelted casualties were analysed. It was primarily young adult males who didn"t wear seat belts, and they made up the majority of unbelted fatalities and seriously injured casualties.
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.
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.
In road traffic accidents, a car-seat and its occupant can be subjected to various crash pulses in the case of a rear impact. This study investigates the influence of crash pulse shape on seat-occupant response and evaluates the corresponding risk of whiplash injury. For this purpose, a rigorously validated seat-occupant system model is used to study different carseat designs and crash pulses. Two different car-seat concepts are also presented which can effectively mitigate whiplash injury for a wide range of crash severity. It is shown that for crash pulses of similar severity, the level of whiplash-risk depends strongly on the combined effects of seat design and crash pulse shape.
This study is aimed to investigate the correlations of impact conditions and dynamic responses with the injuries and injury severity of child pedestrians by accident reconstruction. For this purpose, the pedestrian accident cases were selected from Sweden and Germany with detailed information about injuries, accident cars, and accident environment. The selected accident cases were reconstructed using mathematical models of pedestrian and passenger car. The pedestrian models were generated based on the height, weight, and age of the pedestrian involved in accidents. The car models were built up based on the corresponding accident car. The impact speeds in simulations were defined based on the reported data. The calculated physical quantities were analyzed to find the correlation with injury outcomes registered in the accident database. The reconstruction approaches are discussed in terms of data collection, estimating vehicle impact speeds, pedestrian moving speeds and initial posture, secondary ground impact, validity of the mathematical models, as well as impact biomechanics.
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.
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.
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).
The so-called "seat-belt injuries" or "seat-belt syndromes", described as 2-point seat-belt injuries, contain heavy inflection injuries of the lumbal spinal column, combined with heavy abdominal injuries as rupture of the upper intestinal bold or heavy injuries of the upper entrails. With "playing" children in the font of the car, with inappropriate plant of 3-point belts, identical injuries can occur.
In most of developed countries, the progress made in passive safety during the last three decades allowed to drastically reduce the number of killed and severely injured especially for occupants of passenger cars. This reduction is mainly observed for frontal impacts for which the AIS3+ injuries has been reduced about 52% for drivers and 38% for front passengers. The stiffening of the cars' structure coupled with the generalization of airbags and the improvement of the seatbelt restraint (load limiter, pretension, etc.) allowed to protect vital body regions such as head, neck and thorax. However, the abdomen did not take advantage with so much success of this progress. The objective of this study is to draw up an inventory on the abdominal injuries of the belted car occupants involved in frontal impact, to present adapted counter-measures and to assess their potential effectiveness. In the first part the stakes corresponding to the abdominal injuries will be defined according to types of impact, seat location, occupants' age and type of injured organs. Then, we shall focus on the abdominal injury risk curves for adults involved in frontal impact and on the comparisons of the average risks according to the seat location. In the second part we will list counter-measures and we shall calculate their effectiveness. The method of case control will be used in order to estimate odds ratio, comparing two samples, given by occupants having or not having the studied safety system. For this study, two type of data sources are used: national road injured accident census and retrospective in-depth accident data collection. Abdominal injuries are mainly observed in frontal impact (52%). Fatal or severe abdominal occupant- injuries are observed at least in 27% of cases, ranking this body region as the most injured just after the thorax (51%). In spite of a twice lower occupation rate in the back seats compared to the front seats, the number of persons sustaining abdominal injuries at the rear place is higher than in the front place. In recent cars, the risk of having a serious or fatal abdominal injury in a frontal impact is 1.6% for the driver, 3.6% for the front passenger and 6.3% for the rear occupants. The most frequently hurt organs are the small intestine (17%), the spleen (16%) and the liver (13%). The most common countermeasures have a good efficiency in the reduction of the abdominal injuries for the adults: the stiffness of the structure of the seats allows decreasing the abdominal injury risk from 54% (driver) to 60% (front occupant), the seatbelt pretensioners decrease also this risk from 90% (driver) to 83% (front passenger).