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Still correlated with high mortality rates in traffic accidents traumatic aortic ruptures were frequently detected in unprotected car occupants in the early years. This biomechanical analysis investigates the different kinds of injury mechanisms leading to traumatic aortic injuries in todays traffic accidents and how the way of traffic participation affects the frequency of those injuries over the years. Based on GIDAS reported traffic accidents from 1973 to 2014 are analyzed. Results show that traumatic aortic injuries are mainly observed in high-speed accidents with high body deceleration and direct load force to the chest. Mostly chest compression is responsible for the load direction to the cardiac vessels. The main observed load vector is from caudal-ventral and from ventral solely, but also force impact from left and right side and in roll-over events with chest compression lead to traumatic aortic injuries. Classically, the injury appeares at the junction between the well-fixed aortic arch and the pars decendens following a kind of a scoop mechanism, a few cases with a hyperflexion mechanism are also described. In our analysis the deceleration effect alone never led to an aortic rupture. Comparing the past 40 years aortic injuries shift from unprotected car occupants to today's unprotected vulnerable road users like pedestrians, cyclists and motorcyclists. Still the accident characteristics are linked with chest compression force under high speed impact, no seatbelt and direct body impact.
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).
While cyclists and pedestrians are known to be at significant risk for severe injuries when exposed to road traffic accidents (RTAs) involving trucks, little is known about RTA injury risk for truck drivers. The objective of this study is to analyze the injury severity in truck drivers following RTAs. Between 1999 and 2008 the Hannover Medical School Accident Research Unit prospectively documented 43,000 RTAs involving 582 trucks. Injury severity including the abbreviated injury scale (AIS) and the maximum abbreviated injury scale (MAIS) were analyzed. Technical parameters (e.g. delta-v, direction of impact), the location of accident, and its dependency on the road type were also taken into consideration. The results show that the safety of truck drivers is assured by their vehicles, the consequence being that the risk of becoming injured is likely to be low. However, the legs especially are at high risk for severe injuries during RTAs. This probability increases in the instance of a collision with another truck. Nevertheless, in RTAs involving trucks and regular passenger vehicles, the other party is in higher risk of injury.
In this study, we compared the injury severity of occupants according to the seating position and the crashing direction in motor vehicle accidents. In the driver's point of view, it was separated the seating position as "Near-side" and "Far-side". The study subjects were targeted by people who visited 4 regional emergency centers following motor vehicle accidents. Real-world investigation was performed by direct and indirect methods after patient- consent. The information of the damaged vehicle was informed by Collision Deformation Classification (CDC) code and the information of the injury of patients was informed by using the Abbreviated Injury Score (AIS) and Injury Severity Score (ISS). When the column 3 in CDC code was P, damaged at the middle part of lateral side, the average point of AIS 3 was 1.91-±1.72 in near-side and 1.02-±1.31 in far-side (p<0.01). The average point of maximum AIS (MAIS) was 2.78-±1.39 in near-side and 2.02-±1.11 in far-side (p<0.01). The average point of ISS was 15.74-±14.71 in near-side and 8.11-±8.39 in far-side (p<0.01). Also, when the column 3 in CDC code was D, damaged at the whole part of lateral side, it was significant that the average point of AIS 3 and MAIS in near-side was bigger than in far-side (p=0.02).
The incidence of side impacts was investigated from GIDAS data. Both vehicle-fixed object and vehicle-vehicle collisions were analysed as these are enclosed within the consumer testing program. Vehicle-fixed object collisions were stratified according to ESC availability. Results indicated that vehicles equipped with ESC rarely have pure-lateral impacts. An increase in oblique collisions was seen for the vehicles with ESC whereby most vehicle were driving in left curves. The analysis of vehicle-vehicle collisions developed injury risk curves were developed at the AIS3+ injury severity for the vehicle-vehicle side impacts. Results suggested that greatest injury risk occurred when a Pre Euro NCAP vehicle was struck by a Post Euro-NCAP vehicle. The remaining curves did not show different behaviour, indicating that stiffness increased have been equally combated. This was attributable to the few Post Euro-NCAP vehicles that had a deployed curtain airbag available in the sample. The integration of Euro NCAP testing has shown to improve vehicle crashworthiness for pole collisions, as those vehicles with ESC rarely incur lateral impacts.
Recently, EuroNCAP updated the upper legform test protocols. The main objective of this study is to establish the upper legform test in KIDAS (Korean In-depth Accident Study) taking into account domestic pedestrian accident data as well as anthropometric data to protect elderly pedestrians whose average height and weight is much smaller and lighter than other age groups, especially compared to Europeans. Therefore 230 cases of pedestrian accidents from KIDAS were investigated to explore the injury severity of body regions as well as age related injury patterns. Injuries of all body regions were examined, with a special focus on injuries of abdomen and pelvic area. On the other hand, in order to explore Korea's pedestrian accident environment, national police data and KIDAS (Korean In-depth Accident Study) data were compared. The results should be taken into account in future analyses and possible improvements, such as regulations and KNCAP test protocols, of the pedestrian safety policy in Korea.
Trauma management (TM) covers two types of medical treatment: the initial one provided by Emergency Medical Services (EMS) and a further one provided by permanent medical facilities. There is a consensus in the professional literature that to reduce the severity and the number of road crash victims, the TM system should provide rapid and adequate initial care of injury, combined with sufficient further treatment at a hospital or trauma centre. Recognizing the important role of TM for reducing road crash injury outcome, it was decided, within the EU funded SafetyNet project, to develop road safety performance indicators (SPIs) which would characterize the level of TM systems" performance in European countries and enable country comparisons. The concept of TM SPIs was developed based on a literature study of performance indicators in TM, a survey of available practices in Europe and data availability examinations. A set of TM SPIs was introduced including 14 indicators which characterize five issues such as: availability of EMS stations; availability and composition of EMS medical staff; availability and composition of EMS transportation units; characteristics of the EMS response time, and availability of trauma beds in permanent medical facilities. Basic information on the TM systems was collected in close cooperation with the national expert group. A dataset with TM SPIs for 21 countries was created. It was demonstrated that the countries can be compared using selected TM SPIs. Moreover, a more general comparison of the TM systems' performance in the countries is possible, using multiple ranking and statistical weighting techniques. By both methods, final estimates were received enabling the recognition of groups of countries with similar levels of the TM system's performance. The results of various trials were consistent as to the recognition of countries with high or low level of the TM systems" performance, where in grouping countries with intermediate levels of the TM system's performance some differences were observed. The SafetyNet project's practice demonstrated that data collection for estimating TM SPIs is not an easy task but is realizable for the majority of countries. The TM SPIs" message is currently limited to the availability of trauma care services. Further development of the TM SPIs should focus on characteristics of actual treatment supplied, based on combined police and medical road crash related databases.
To improve vehicle safety in frontal collisions, the crash compatibility between the colliding vehicles is crucial. Compatibility aims to improve both the self and partner protection properties of vehicles. Although compatibility has received worldwide attention for many years, no final assessment approach has been defined. Within the Frontal Impact and Compatibility Assessment Research (FIMCAR) project, different frontal impact test procedures (offset deformable barrier [ODB] test as currently used for Economic Commission for Europe [ECE] R94, progressive deformable barrier test as proposed by France for a new ECE regulation, moveable deformable barrier test as discussed worldwide, full-width rigid barrier test as used in Federal Motor Vehicle Safety Standard [FMVSS] 208, and full-width deformable barrier test) were analyzed regarding their potential for future frontal impact legislation. The research activities focused on car-to-car frontal impact accidents based on accident investigations involving newer cars. Test procedures were developed with both a crash test program and numerical simulations. The proposal from FIMCAR is to use a full-width test procedure with a deformable element and compatibility metrics in combination with the current offset test as a frontal impact assessment approach that also addresses compatibility. By adding a full-width test to the current ODB test it is possible to better address the issues of structural misalignment and injuries resulting from high acceleration accidents as observed in the current fleet. The estimated benefit ranges from a 5 to 12 percent reduction of fatalities and serious injuries resulting from frontal impact accidents. By using a deformable element in the full-width test, the test conditions are more representative of real-world situations with respect to acceleration pulse, restraint system triggering time, and deformation pattern of the front structure. The test results are therefore expected to better represent real-world performance of the tested car. Furthermore, the assessment of the structural alignment is more robust than in the rigid wall test.
Road accidents are typically analyzed to address influences of human, vehicle, and environmental (primarily infrastructure) factors. A new methodology, based on a "Venn diagram" analysis, gives a broader perspective on the probable factors, and combinations of factors, contributing both to the occurrence of a crash and to sustaining injuries in that crash. The methodology was applied to 214 accidents on the Mumbai-Pune expressway. Factors contributing to accidents and injuries were addressed. The major human factors influencing accidents on this roadway were speeding (30%) and falling asleep (29%), while injuries were primarily due to lack of seat belt use (46%). The leading infrastructure factor for injuries was impact with a roadside manmade structure (28%), and the main vehicle factor for injuries was passenger compartment intrusion (73%). This methodology can help identify effective vehicle and infrastructure-related solutions for preventing accidents and mitigating injuries in India.
Injury severity of e.g. pedestrians or bikers after crashes with cars that are reversing is almost unknown. However, crash victims of these injuries can frequently be seen in emergency departments and account for a large amount of patients every year. The objective of this study is to analyze injury severity of patients that were crashed into by reversing cars. The Hannover Medical School local accident research unit prospectively documented 43,000 road traffic accidents including 234 crashes involving reversing cars. Injury severity including the abbreviated injury scale (AIS) and the maximum abbreviated injury scale (MAIS) was analyzed as well as the location of the accident. As a result 234 accidents were included into this study. Pedestrians were injured in 141 crashes followed by 70 accidents involving bikers. The mean age of all crash victims was 57 -± 23 years. Most injuries took place on straight stretches (n = 81) as well as parking areas (n = 59), entries (n = 36) or crossroads (n = 24). The AIS of the lower extremities was highest followed by the upper extremities. The AIS of the neck was lowest. The mean MAIS was 1.3 -± 0.6. The paper concludes that the lower extremities show the highest risk to become injured during accidents with reversing cars. However, the risk of severe injuries is likely low.
Ruptures and dissections of the thoracic and abdominal aortic vessel caused by traffic accidents are rare but potentially life-threatening injuries. They can occur by blunt trauma via seat belt or dashboard injury. The study aimed at evaluating the overall mortality, morbidity, neurological disorders, and differences in operative procedures of open repair and stenting. It shows that, with a change and improvement in diagnostic tools and surgical approach, mortality and morbidity of blunt aortic injuries were significantly reduced. Still an immediate life-threatening injury early diagnosis via multiple-slice and scans and surgical repair with minimally invasive stents showed excellent short-time results for selected patients.
In North America, frontal crash tests in both the regulatory environment and consumer-based safety rating schemes have historically been based on full-width and moderate-overlap (40%) vehicle to barrier impacts. The combination of improved seat-belt technologies, notably belt tensioning and load limiting systems, together with advanced airbags, has proven very effective in providing occupant protection in these crash modes. Recently, however, concern has been raised over the contribution of narrower frontal impacts, involving primarily the vehicle corners, to the incidence of fatality and serious injury as a result of the potential for increased occupant compartment intrusion and performance limitations of current restraint systems. Drawing on data documented in the National Automotive Sampling System (NASS)/ Crashworthiness Data System (CDS) for calendar years 1999 to 2012, the present study examines the characteristics of existing and proposed corner crash test configurations, and the nature of real-world collisions that approximate the test environments. In this analysis, particular emphasis is placed on crash pulse information extracted from vehicle-based event data recorders (EDR's).
Analysis of pedestrian leg contacts and distribution of contact points across the vehicle front
(2015)
Determining the risk to pedestrians that are impacted by areas of the front bumper not currently regulated in type-approval testing requires an understanding of the target population and the injury risk posed by the edges of the bumper. National statistics show that approximately 10% of all accident casualties are pedestrians, with 20% to 30% of these pedestrian casualties being killed or seriously injured. However, the contact position across the front of the bumper is not recorded in national statistics and so in-depth accident databases (OTS, UK and GIDAS, Germany) were used to examine injury risk in greater detail. The results showed that some injury types and severities of injuries appear to peak around the bumper edges. Although there are sometimes inconsistencies in the data, generally there is no evidence to suggest that the edges of the bumper are less likely to be contacted or cause injury.
The United Nations Economic Commission for Europe Informal Group on GTR No. 7 Phase 2 are working to define a build level for the BioRID II rear impact (whiplash) crash test dummy that ensures repeatable and reproducible performance in a test procedure that has been proposed for future legislation. This includes the specification of dummy hardware, as well as the development of comprehensive certification procedures for the dummy. This study evaluated whether the dummy build level and certification procedures deliver the desired level of repeatability and reproducibility. A custom-designed laboratory seat was made using the seat base, back, and head restraint from a production car seat to ensure a representative interface with the dummy. The seat back was reinforced for use in multiple tests and the recliner mechanism was replaced by an external spring-damper mechanism. A total of 65 tests were performed with 6 BioRID IIg dummies using the draft GTR No.7 sled pulse and seating procedure. All dummies were subject to the build, maintenance, and certification procedures defined by the Informal Group. The test condition was highly repeatable, with a very repeatable pulse, a well-controlled seat back response, and minimal observed degradation of seat foams. The results showed qualitatively reasonable repeatability and reproducibility for the upper torso and head accelerations, as well as for T1 Fx and upper neck Fx. However, reproducibility was not acceptable for T1 and upper neck Fz or for T1 and upper neck My. The Informal Group has not selected injury or seat assessment criteria for use with BioRID II, so it is not known whether these channels would be used in the regulation. However, the ramping-up behavior of the dummy showed poor reproducibility, which would be expected to affect the reproducibility of dummy measurements in general. Pelvis and spine characteristics were found to significantly influence the dummy measurements for which poor reproducibility was observed. It was also observed that the primary neck response in these tests was flexion, not extension. This correlates well with recent findings from Japan and the United States showing a correlation between neck flexion and injury in accident replication simulations and postmortem human subjects (PMHS) studies, respectively. The present certification tests may not adequately control front cervical spine bumper characteristics, which are important for neck flexion response. The certification sled test also does not include the pelvis and so cannot be used to control pelvis response and does not substantially load the lumbar bumpers and so does not control these parts of the dummy. The stiffness of all spine bumpers and of the pelvis flesh should be much more tightly controlled. It is recommended that a method for certifying the front cervical bumpers should be developed. Recommendations are also made for tighter tolerance on the input parameters for the existing certification tests.
In general the passive safety capability is much greater in newer versus older cars due to the stiff compartment preventing intrusion in severe collisions. However, the stiffer structure which increases the deceleration can lead to a change in injury patterns. In order to analyse possible injury mechanisms for thoracic and lumbar spine injuries, data from the German Inâ€Depth Accident Study (GIDAS) were used in this study. A twoâ€step approach of statistical and caseâ€byâ€case analysis was applied for this investigation. In total 4,289 collisions were selected involving 8,844 vehicles, 5,765 injured persons and 9,468 coded injuries. Thoracic and lumbar spine injuries such as burst, compression or dislocation fractures as well as soft tissue injuries were found to occur in frontal impacts even without intrusion to the passenger compartment. If a MAIS 2+ injury occurred, in 15% of the cases a thoracic and/or lumbar spine injury is included. Considering AIS 2+ thoracic and lumbar spine, most injuries were fractures and occurred in the lumbar spine area. From the case by case analyses it can be concluded that lumbar spine fractures occur in accidents without the engagement of longitudinals, lateral loading to the occupant and/or very severe accidents with MAIS being much higher than the spine AIS.
This study aimed at prediction of long bone fractures and assessment of lower extremity injury mechanisms in real world passenger car to pedestrian collision. For this purpose, two pedestrian accident cases with detail recorded lower limb injuries were reconstructed via combining MBS (Multi-body system) and FE (Finite element) methods. The code of PC Crash was used to determine the boundary conditions before collision, and then MBS models were used to reproduce the pedestrian kinematics and injuries during crash. Furthermore, a validated lower limb FE model was chosen to conduct reconstruction of injuries and prediction of long bone fracture via physical parameters of von Mises stress and bending moment. The injury outcomes from simulations were compared with hospital recorded injury data and the same long bone fracture patterns and positions can be observed. Moreover, the calculated long bone fracture tolerance corresponded to the outcome from cadaver tests. The result shows that FE model is capable to reproduce the dynamic injury process and is an effective tool to predict the risk of long bone fractures.
This study aimed at developing an injury estimation algorithm for AACN technologies for Germany and compared them to findings based on Japanese data. The data to build and to verify the algorithm was obtained from the German in-depth Accident Database (GIDAS) and split into a training and a validation dataset. Significant input variables and the generalized linear regression model to predict severe injuries (ISS>15) were selected to maximize area under the receiver operating characteristic curve (AUC). Probit regression with the input parameter multiple impact, delta v, seatbelt use and impact direction gave the largest AUC of 0.91. Sensitivity of the algorithm was validated at 90% and specificity at 76% for an injury risk threshold of 2%. It appears that no major differences between Japan and Germany exist for injury estimation based on delta v and impact direction. However, far side impact and multiple crash events appear to be associated with a larger risk increase in the German data.
Pedestrians represent about 20% of the overall fatalities in Europe- road traffic accidents. In this paper a methodology is proposed to understand why the numbers are so high, especially in the south of Europe and particularly in Portugal, . First a detailed statistical analysis using Ordinal Logistic Regression model (OLR) was applied to the gathered data from all Portuguese accidents with victims in the period 2010-2012. In a second stage accident reconstruction computational techniques using pedestrian biomechanical models are used to evaluate the accident conditions that lead to the injuries, such as the speed and the impact location. For biomechanical injury criterions, the AIS (Abbreviated Injury Scale), the HIC (Head Injury Criterion) and other injury criterions based on the resulting accelerations in the pedestrian's body are used. The statistical model reported that there were several predictors that significantly influenced the pedestrian injury severity in the event of a road accident, such as Pedestrian's age, Pedestrian's gender, Vehicle Design/Category or Driver's gender. The use of injury scales and biomechanical criterions in in-depth investigation of road accidents, such as AIS, can significantly improve the quality of the reconstruction process.
The paper gives an overview of the recent (mostly 2012) figures of killed bus/coach occupants (drivers and passengers) in 27 Member States of the European Union as reported by CARE. The Evolution of the figures of bus/coach occupants killed in road accidents urban, rural without motorway and on motorways from 1991 to 2010 in 15 Member States of the EU supplements this information. More detailed are the figures reported for Germany by the Federal Statistics. The paper displays long-term evaluations (1957 to 2012) for killed, seriously and slightly injured occupants in all kinds of buses/coaches. Midterm evaluations (1995 to 2012) of the figures of fatalities and casualties are displayed for different busses according to their identification of road using as coaches, urban buses, school buses, trolley buses and "other buses". To be able to compare the evolutions of the safety of vehicle occupants it is customary to use different risk indicators. Calculations and illustrations for three often used indicators with their development over time are given: fatalities, seriously injured and slightly injured per 100,000 vehicles registered, per 1 billion (109) vehicle-kilometres travelled and per 1 billion (109) person-kilometres. These indicators are shown for occupants of cars, goods vehicles and buses/coaches. For the period from 1957 until 2012 it is obvious, that for all three vehicle categories analysed there was a clear long-term trend towards more occupant safety in terms of casualties per vehicles registered and per vehicle mileage. This was most significant for car occupants but it can be seen for bus/coach occupants and goodsvehicle occupants as well. Figures of killed occupants and of casualties related to person-kilometres are calculated and displayed for the shorter period 1995 to 2012. Here it becomes obvious that the bus/coach is still the safest mode of transport for the occupants of road vehicles. Graphs for the casualty risk indices still show significantly higher risks for car occupants despite the corresponding curve moved sustainable downwards. It is remarkable, that the risks of being killed or injured for the occupants of urban buses is growing whereas the corresponding risk for the occupants of coaches in line traffic tends downwards. The article ends with a short comparison and discussion of the risk indicators which are actually published for the occupants (driver and passengers) of cars and the passengers of buses/coaches, railroads, trams and airplanes. The interpretation of such information depends on the perception and it seems that for a complete view not only one indicator should be used and the evolutions of the indicator values during longer periods (as displayed with examples in the paper) should also be taken into account.
An approach to the standardization of accident and injury registration systems (STAIRS) in Europe
(1998)
STAIRS is a European Commission funded study whose aim is to produce a set of guidelines for a harmonised, crash injury database. The need to evaluate the effectiveness of the forthcoming European Union front and side impact directives has emphasised the need for real world crash injury data-sets that can be representative of the crash population throughout Europe. STAIRS will provide a methodology to achieve this. The ultimate aim of STAIRS is to produce a set of data collection tools which will aid decision making on vehicle crashworthiness as well as providing a means to evaluate the effectiveness of safety regulations. This paper will disseminate the up-to-date findings of the group as they try to harmonise their methods. The stage has been reached where studies into the diverse methods of the UK, French and German systems of crash injury investigation have been undertaken. An assessment has already been made of the relationships between the three current systems in order to define the areas of agreement and divergence. The conclusions reached stated that there were many areas that are already closely related and that the differences were only at the detailed level. With the emphasis on secondary safety and injury causation, core data sets were decided upon, taking into account: vehicle description, collision configuration, structural response of vehicles, restraint and airbag performance, child restraint performance, Euro NCAP, pedestrian and vehicle occupant kinematics, injury description and causation. Each variable was studied objectively, the important elements isolated and developed into a form that all partners were agreeable on. A glossary of terms is being developed as the project progresses which includes ISO standards and other definitions from the associated CAREPLUS project, which addresses the comparability of national data sets. A major consideration of the group was the data collection method to be employed. The strengths and weaknesses of each study were investigated to obtain a clear idea of which aspects offered the best way forward. The quality of this information and transference into a common format, as well as the necessary error checking systems to be employed have just been completed and are described. In tandem with this area of study the problem of the statistical relationship of each sample to the national population is also being investigated. The study proposes a mechanism to use a sample of crash injury data to represent the national and international crash injury problem