Sonstige
A reduction of around 48% of all road fatalities was achieved in Europe in the past years including a reduced number of fatalities with an older age. However, among all road fatalities, the proportion of elderly is steadily increasing. In an ageing society, the European (Horizon2020) project SENIORS aims to improve the safe mobility of older road users, who have different transportation habits compared to other age groups. To increase their level of safe mobility by determining appropriate requirements for vehicle safety systems, the characteristics of current road traffic collisions involving the elderly and the injuries that they sustain need to be understood in detail. Hereby, the paper focuses on their traffic participation as pedestrian, cyclist or passenger car occupant. Following a literature review, several national and international crash databases and hospital statistics have been analysed to determine the body regions most frequently and severely injured, specific injuries sustained and types of crashes involved, always comparing older road users (65 years and more) with mid-aged road users (25-64 years). The most important crash scenarios were highlighted. The data sources included European statistics from CARE, data on national level from Germany, Sweden, Italy, United Kingdom and Spain as well as in-depth crash information from GIDAS (Germany), RAIDS (UK), CIREN and NASS-CDS (US). In addition, familiar hospital data from Germany (TraumaRegister DGU-®), Italy (Italian Register of Acute Traumas) and UK hospital statistics (TARN) were included in the study to gain further insight into specific injury patterns. Comprehensive data analyses were performed showing injury patterns of older road users in crashes. When comparing with mid-aged road users, all databases showed that the thorax body region is of particularly high importance for the older car occupant with injury severities of AIS 2 or AIS 3+, whereas the body regions lower extremities, head and thorax need to be considered for the older pedestrians and cyclists. Besides these comparisons, the most frequent and severe top 5 injuries were highlighted per road user group. Further, the most important crash configurations were identified and injury risk functions are provided per age group and road user group. Although several databases have been analysed, the picture on the road safety situation of older road users in Europe was not complete, as only Western European data was available. The linkage between crash data and hospital data could only be made on a general level as their inclusion criteria were quite different.
Europe has benefited from a decreasing number of road traffic fatalities. However, the proportion of older road users increases steadily. In an ageing society, the SENIORS project aims to improve the safe mobility of older road users by determining appropriate requirements towards passive vehicle safety systems. Therefore, the characteristics of road traffic crashes involving the elderly people need to be understood. This paper focuses on car occupants and pedestrians or cyclists in crashes with modern passenger cars. Ten crash databases and four hospital statistics from Europe have been analysed to answer the questions on which body regions are most frequently and severely injured in the elderly, and specific injuries sustained by always comparing older (65 years and above) with midâ€aged road users (25â€64 years). It was found that the body region thorax is of particularly high importance for the older car occupant with injury severities of AIS2 or AIS3+, where as the lower extremities, head and the thorax need to be considered for older pedestrians and cyclists. Further, injury risk functions were provided. The hospital data analysis showed less difference between the age groups. The linkage between crash and hospital data could only be made on a general level as their inclusion criteria were quite different.
The presence and performance of Advanced Driver Assistance Systems (ADAS) has increased over last years. Systems available on the market address also conflicts with vulnerable road users (VRUs) such as pedestrians and cyclists. Within the European project PROSPECT (Horizon2020, funded by the EC) improved VRU ADAS systems are developed and tested. However, before determining systems" properties and starting testing, an up-to-date analysis of VRU crashes was needed in order to derive the most important Use Cases (detailed crash descriptions) the systems should address. Besides the identified Accident Scenarios (basic crash descriptions), this paper describes in short the method of deriving the Use Cases for car-to-cyclist crashes. Method Crashes involving one passenger car and one cyclist were investigated in several European crash databases looking for all injury severity levels (slight, severe and fatal). These data sources included European statistics from CARE, data on national level from Germany, Sweden and Hungary as well as detailed accident information from these three countries using GIDAS, the Volvo Cars Cyclist Accident database and Hungarian in-depth accident data, respectively. The most frequent accident scenarios were studied and Use Cases were derived considering the key aspects of these crash situations (e.g., view orientation of the cyclist and the car driver- manoeuvre intention) and thus, form an appropriate basis for the development of Test Scenarios. Results Latest information on car-to-cyclist crashes in Europe was compiled including details on the related crash configurations, driving directions, outcome in terms of injury severity, accident location, other environmental aspects and driver responsibilities. The majority of car-to-cyclist crashes occurred during daylight and in clear weather conditions. Car-to-cyclist crashes in which the vehicle was traveling straight and the cyclist is moving in line with the traffic were found to result in the greatest number of fatalities. Considering also slightly and seriously injured cyclists led to a different order of crash patterns according to the three considered European countries. Finally the paper introduced the Use Cases derived from the crash data analysis. A total of 29 Use Cases were derived considering the group of seriously or fatally injured cyclists and 35 Use Cases were derived considering the group of slightly, seriously or fatally injured cyclists. The highest ranked Use Case describes the collision between a car turning to the nearside and a cyclist riding on a bicycle lane against the usual driving direction. A unified European dataset on car-to-cyclist crash scenarios is not available as the data available in CARE is limited, hence national datasets had to be used for the study and further work will be required to extrapolate the results to a European level. Due to the large number of Use Cases, the paper shows only highest ranked ones.
The use of proper child restraint systems (CRS) is mandatory for children travelling in cars in most countries of the world. The analysis of the quantity of restrained children shows that more than 90% of the children in Germany are restrained. Looking at the quality of the protection, a large discrepancy between restrained and well protected children can be seen. Two out of three children in Germany are not properly restrained. In addition, considerable difference exists with respect to the technical performance of CRS. For that reason investigations and optimisations on two different topics are necessary: The technical improvement of CRS and the ease of use of CRS. Consideration of the knowledge gained by the comparison of different CRS in crash tests would lead to some improvements of the CRS. But improvement of child safety is not only a technical issue. People should use CRS in the correct way. Misuse and incorrect handling could lead to less safety than correct usage of a poor CRS. For that reason new technical issues are necessary to improve the child safety AND the ease of use. Only the combination of both parts can significantly increase child safety. For the assessment of the safety level of common CRS, frontal and lateral sled tests simulating different severity levels were conducted comparing pairs of CRS which were felt to be good and CRS which were felt to be poor. The safety of some CRS is currently at a high level. All well known products were not damaged in the performed tests. The performance of non-branded CRS was mostly worse than that of the well known products. Although the branded child restraint systems already show a high safety level it is still possible to further improve their technical performance as demonstrated with a baby shell and a harness type CRS.
In recent years the boundaries between active and passive safety blurred more and more. Passive safety in the traditional term includes all safety aspects to prevent occupants to be injured or at least injury severity should be reduced. Passive Safety starts with the collision (first vehicle contact) and ends with rescue (open vehicle doors). Within this phase the occupant has to be protected by the passenger compartment whereby no intrusion should occur. Active safety on the other side was developed to interact prior to the collision whereby the goal is to prevent accidents. The extensive interaction between active and passive safety led to the terminologies "Primary" and "Secondary" safety whereas the expression Integrated Safety Concept was generated. Within this study the most well documented single vehicle accidents with cars not equipped with ESP were identified from the PENDANT database and reconstructed. Additional cases were found in the database ZEDATU of TU Graz. In comparison each case was simulated with the assumption that the cars were equipped with ESP. The differences regarding accident avoidance or crash severity as well as reduction of injury risk were analysed.
This paper uses the national accident statistics of Great Britain to evaluate the effectiveness of Electronic Stability Control Systems (ESC) to reduce crash involvement rates. The crash experience of 8,951 cars is analysed and compared to a closely matching set of non-ESC cars using case-control methods. This is one of the largest ESC samples analysed to date. Overall the cars with ESC are involved in 3% fewer crashes although the effectiveness is substantially higher under conditions of adverse road friction. ESC equipped cars are involved in 15% fewer fatal crashes although this reduction represents the combined effect of ESC and passive safety improvements.
Sedan type vehicles in which adult rear seat passengers were present and which were involved in frontal collisions were investigated, and the influence of unbelted rear seat passengers on the injuries of front seat occupants was studied. Unbelted rear seat passengers move forward during impact. It was observed that there were not only cases in which front seat occupants sustained injuries caused by direct contact with rear seat passengers, but also cases where front seat occupants received severe injuries due to additional force from rear seat passengers, either impacting directly or indirectly as a result of deformation of the front seat. Severe injuries of front seat occupants were observed in the latter cases. This research validates the importance of seat-belt use for rear seat passengers, not only to protect themselves but also to mitigate injuries of front seat occupants.
Since its beginning in 1999, the German In-Depth Accident Study (GIDAS) evolved into the presumably leading representative road traffic accident investigation in Europe, based on the work started in Hanover in 1973. The detailed and comprehensive description of traffic accidents forms an essential basis for vehicle safety research. Due to the ongoing extension of demands of researchers, there is a continuous progress in the techniques and systematic of accident investigation within GIDAS. This paper presents some of the most important developments over the last years. Primary vehicle safety systems are expected to have a significant and increasing influence on reducing accidents. GIDAS therefore began to include and collect active safety parameters as new variables from the year 2005 onwards. This will facilitate to assess the impact of present and future active safety measures. A new system to analyse causation factors of traffic accidents, called ACASS, was implemented in GIDAS in the year 2008. The whole process of data handling was optimised. Since 2005 the on-scene data acquisition is completely conducted with mobile tablet PCs. Comprehensive plausibility checks assure a high data quality. Multi-language codebooks are automatically generated from the database structure itself and interfaces ensure the connection to various database management systems. Members of the consortium can download database and codebook, and synchronize half a terabyte of photographic documentation through a secured online access. With the introduction of the AIS 2005 in the year 2006, some medical categorizations have been revised. To ensure the correct assignment of AIS codes to specific injuries an application based on a diagnostic dictionary was developed. Furthermore a coding tool for the AO classification was introduced. All these enhancements enable GIDAS to be up to date for future research questions.
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.
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.
This paper describes the methodology of In-Depth Investigation in Germany on the example of GIDAS (German In-Depth Accident Study). Since 1999 in Germany a joint project between FAT (Forschungsvereinigung Automobiltechnik or Automotive Industry Research Association) and BASt (Bundesanstalt für Straßenwesen or the Federal Road Research Institute) is being carried out in Hannover and Dresden. The methodology of this project is based on a statistically orientated procedure of data sampling (sampling plan, weighting factors). The paper describes the possibilities of such in-depth investigation on the results of the offered title. The accident cases were collected randomly within GIDAS at Hannover. There are more cases existing from previous investigation started in 1985 under the same methodology. The portion of rollovers can be established at 3.7% of all accidents with casualties in the year 2000. For the study 434 cases of car accidents with rollovers are used for a detail comprehensive analysis. The accidents happened in the years 1994 to 2000 in the Hannover area. The injury distribution will report about 741 occupants with rollover accident event. The presented paper will give an overview of the accident situations following in rollover movements of cars. The distributions of injury frequencies, injury severity AIS for the whole body and for the body regions of occupants will be presented and compared to technical details like the impact speed and the deformation pattern. The speed of the car was determined at the point of rollover and on the point of accident initiency. The characteristics of the kinematics followed in a rollover movement are analyzed and the major defined types of rollover will be shown in the paper. The paper will describe the possibilities of In-Depth Investigation methods for the approach of finding countermeasures on the example of car accidents with rollover and explaining the biomechanics of injuries in rollover movements.
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.
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).
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
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.
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.
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.
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.
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.
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.