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This study aimed to identify the occurrence, type and mechanisms of the traumatic injuries of the vulnerable road users in vehicle collisions, and to determine the effects of human, engineering, and environment factors on traffic accidents and injuries. The pedestrian accident cases were collected in the years 2000 to 2005 from Changsha Wujing hospital China and Accident Research Unit at Medical University Hannover in Germany. A statistic analysis was carried out using the collected accident data. The results from analysis of Changsha data were compared with results from analysis of GIDAS data Hannover. The injury severities were determined using AIS code and ISS values. The results were presented in terms of cause of injuries, injury distributions, injury patterns, injury severity. The factors influenced the injury outcomes were proposed and discussed for the vehicle transport environment and road users. The results were discussed with regard to accident data collection, accident sampling and injury distributions etc. In the urban area of Changsha, motorcycles and passenger cars are most frequently involved in vehicle pedestrian accidents. Head and lower extremities injuries are the predominant types of pedestrian injuries. The pedestrian accidents were identified as vital issue in urban traffic safety and therefore a high priority should be given to this road user group in research of safe urban transportation. In Hannover area, cars are most frequently involved in traffic accidents, injured pedestrians are involved in road traffic of Germany in 13% of all causalities only in 2005 and have nearly the same number as motorcyclists, but the half of bicyclists.
Description of road traffic related knee injuries in published investigations is very heterogeneous. The purpose of this study was to estimate the risk of knee injuries in real world car impacts in Germany focusing vulnerable road users (pedestrians, bicyclists and motorcyclists) and restrained car drivers. The accident research unit analyses technical and medical data collected shortly after the accident at scene. Two different periods (years 1985-1993 and 1995-2003) were compared focusing on knee injuries (Abbreviated Injury Scale (AISKnee) 2/3). In order to determine the influences type of collision, direction and speed as well as the injury pattern and different injury scores (AIS, MAIS, ISS) were examined. 1.794 pedestrians, 742 motorcyclists, 2.728 bicyclists and 1.116 car drivers were extracted. 2% had serious ligamentous or bony injuries in relation to all injured. The risk of injury is higher for twowheelers than for pedestrians, but knee injury severity is higher for the latter group. Overall the current knee injury risk is low and significant reduced comparing both time periods (27%, p<0,0001). Severe injuries (AISKnee 2/3) were below 1%). Improved aerodynamic design of car fronts reduced the risk for severe knee injuries significantly (p=0,0015). Highest risk of injury is for motorcycle followed by pedestrians, respectively. Knee protectors could prevent injuries by reducing local forces. The classically described dashboard injury was rarely identified. The overall injury risk for knee injuries in road traffic is lower than estimated and reduced comparing both periods. The aerodynamic shape of current cars compared to older types reduced the incidence and severity of knee injuries. Further modification and optimization of the interior and exterior design could be a proper measurement. Classic described injury mechanisms were rarely identified. It seems that the AIS is still underestimating extremity injuries and their long term results.
The primary goal of this investigation was to determine the relative risk of traffic accidents in students. In a two year period, a survey amongst 2,325 students was carried out, and 3,645 injuries sustained by students treated at our hospital were analyzed. Moped-riding in adolescents were associated with a 23.75-fold increased risk for injury as compared to biking. Children who ride bicycles have a 2.2-fold increased risk for an injury sustained by traffic accidents compared to pedestrians. None of 50 injured bicycle riders with helmet had an AIS for head injuries of more than 2. 24 of 233 injured bicycle drivers without helmet had an AIS for head injuries of more than 2. The use of a protective helmet significantly reduced the severity of head injuries. The level of awareness towards danger and a history of previous accidents correlate with the likelihood of future accidents. Due to the severity of traffic accidents, more adequate prevention measures (wearing of bicycle helmets and better education for moped riders) are urgently needed.
The number of injuries sustained by car occupants involving the head, thorax, spine, pelvis and the upper limbs have been reduced significantly during recent years. This is probably due to better safety features in the cars, especially the availability and usage of safety belts, airbags etc. Therefore one can notice clinically a relative increase in survivors of severe frontal crashes, but many of them have injuries to the lower extremities. To verify this, we analyzed the foot and ankle injuries of front seat passengers.
Validation of human pedestrian models using laboratory data as well as accident reconstruction
(2007)
Human pedestrian models have been developed and improved continually. This paper shows the latest stage in development and validation of the multibody pedestrian model released with MADYMO. The biofidelity of the multibody pedestrian model has been verified using a range of full pedestrian-vehicle impact tests with a large range in body sizes (16 male, 2 female, standing height 160-192cm, weight 53.5-90kg). The simulation results were objectively correlated to experimental data. Overall, the model predicted the measured response well. In particular the head impact locations were accurately predicted, indicated by global correlation scores over 90%. The correlation score for the bumper forces and accelerations of various body parts was lower (47-64%), which was largely attributed to the limited information available on the vehicle contact characteristics (stiffness, damping, deformation). Also, the effects of the large range in published leg fracture tolerances on the predicted risk to leg fracture by the pedestrian model were evaluated and compared with experimental results. The validated mid-size male model was scaled to a range of body sizes, including children and a female. Typical applications for the pedestrian models are trend studies to evaluate vehicle front ends and accident reconstructions. Results obtained in several studies show that the pedestrian models match pedestrian throw distances and impact locations observed in real accidents. Larger sets of well documented cases can be used to further validate the models especially for specific populations as for instance children. In addition, these cases will be needed to evaluate the injury predictive capability of human models. Ongoing developments include a so-called facet pedestrian model with a more accurate geometry description and a more humanlike spine and neck and a full FE model allowing more detailed injury analysis.
NASS: the glass is half full
(2007)
The National Accident Sampling System (NASS) was born in the late 1970s. It was based on a substantial amount of experience and analysis of what was needed in the United States to understand the safety challenges of our highways. This work also showed how to collect high quality and useful crash data efficiently. Unfortunately, when Ronald Reagan - a President who believed in limited government - was elected, any hope of full funding for NASS was lost. The concept of 75 teams investigating about 18,000 serious crashes in detail annually was never realized. The system got up to 50 teams, then was cut to 36, and finally to 24 teams investigating fewer than a quarter of the originally anticipated number of crashes per year. Despite this, the NASS investigations provide a rich source of data, collected according to a sophisticated statistical sampling system to facilitate detailed national estimates of road casualties on our nation- highways and their causes. In addition, changes have been made in recent years to increase the number of more serious crashes of recent model vehicles to make the results more relevant to improving vehicle safety. A recent, detailed examination of hundreds of rollovers has provided considerable insight into rollover casualties and into what can be done to reduce them. Some of these results will be presented that show the value of the NASS system. Our experience with NASS and the Fatal Accident Reporting System (FARS) suggests a number of improvements that could be made in the United States" crash data systems. It also provides justification for a doubling or tripling of our national expenditures on crash data collection.
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.
This study examines the severity and types of injuries sustained by child pedestrians aged 18 years and below in order to identify the body regions at greatest risk for injury in a pedestrian accident. Detailed medical diagnoses were reviewed retrospectively for 572 child pedestrians admitted to an urban pediatric trauma center with injuries during the time period from January 2001 to December 2005. Eighty percent of these children sustained AIS 2 or greater injuries, most commonly to the lower extremity (41%) and head (34%). Fortyfour percent of admitted children had more significant AIS 3 or greater injuries primarily to the head (58%), thorax (17%) and lower extremities (14%). Testing procedures to assess the child- interaction with the motor vehicle should include injury assessment for the pediatric head, thorax and lower extremities. This understanding of how child pedestrians interact with motor vehicles may provide insight into effective countermeasures with potential for implementation in vehicle designs world-wide.
Powered Two Wheelers (PTWs) accidents constitute one of the road safety problems in Europe. PTWs fatalities represent 22% at EU level in 2006, having increased during last years, representing an opposite trend compared to other road users" figures. In order to reduce these figures it is necessary to investigate the accident causation mechanisms from different points of view (e.g.: human factor, vehicle characteristics, influence of the environment, type of accident). SAFERIDER project ("Advanced telematics for enhancing the SAFEty and comfort of motorcycle RIDERs", under the European Commission "7th Framework Program") has investigated PTW accident mechanisms through literature review and statistical analyses of National and In-depth accident databases; detecting and describing all the possible PTW's accident configurations where the implementation of ADAS (Advanced Driver Assistance Systems) and IVIS (In-Vehicle Information Systems) could contribute to avoid an accident or mitigate its severity. DIANA, the Spanish in-depth database developed by CIDAUT, has been analyzed for that purpose. DIANA comprises of accident investigation teams, in close cooperation with police forces, medical services, forensic surgeons, garages and scrap yards. An important innovation is the fact that before injured people arrive to hospitals, photographs and explanations about the possible accident injury mechanisms are sent to the respective hospitals (via 3G GPRS technology). By this, additional information to medical staff can be provided in order to predict in advance possible internal injuries and select the best medical treatment. This methodology is presented in this paper. On the other hand, the main results (corresponding to road, rider and PTW characteristics; pre and post-accident manoeuvres; road layout; rider behaviour; impact points; accident causations;...) from the analyses of the PTW accidents used for SAFERIDER are shown. Only accident types relevant to ADAS and IVIS devices have been considered.
The bicyclist accidents were analyzed to get better understanding of the occurrences and frequency of the accidents, injury distributions, as well as correlation of injury severity/outcomes with engineering and human factors in two different countries of China and Germany. The accident cases that occurred from 2001 to 2006 were collected from IVAC database in Changsha and GIDAS database in Hannover. Based on specified sampling criteria, 1,570 bicyclist cases were selected from IVAC database in Changsha, and 1806 cases were collected from Hannover, documented in GIDAS database. Statistical analyses were carried out by using these selected data. The results from the statistical analysis are presented and discussed in this study.
The aim of this study is to investigate the differences in car occupant injury severity recorded in AIS 2005 compared to AIS 1990 and to outline the likely effects on future data analysis findings. Occupant injury data in the UK Cooperative Crash Injury Study Database (CCIS) were coded for the period February 2006 to November 2007 using both AIS 1990 and AIS 2005. Data for 1,994 occupants with over 6000 coded injuries were reviewed at the AIS and MAIS level of severities and body regions to determine changes between the two coding methodologies. Overall there was an apparent general trend for fewer injuries to be coded at the AIS 4+ severity and more injuries to be coded at the AIS 2 severity. When these injury trends were reviewed in more detail it was found that the body regions which contributed the most to these changes in severity were the head, thorax and extremities. This is one of the first studies to examine the implications for large databases when changing to an updated method for coding injuries.
The national accident statistics demonstrate that the situation of passenger car side impacts is dominated by car to car accidents. Car side to pole impacts are relatively infrequent events. However the importance of car side to pole impacts is significantly increasing with fatal and seriously injured occupants. For the present study the German in-depth database GIDAS (German In-Depth-Accident Study) and the UK based database CCIS (Co-operative Crash Injury Study) were used. Two approaches were undertaken to better understand the scenario of car to pole impacts. The first part is a statistical analysis of passenger car side to pole impacts to describe the characteristics and their importance relevant to other types of impact and to get further knowledge about the main factors influencing the accident outcome. The second part contains a case by case review on passenger cars first registered 1998 onwards to further investigate this type of impact including regression analysis to assess the relationship between injury severity and pole impact relevant factors.
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.
One goal of the assessment of the crashworthiness of passenger cars is to characterize the potential of injury outcome to occupants of cars involved in an accident. This can be achieved by the help of an index that puts the number of injured occupants of passenger cars in relation to the number of cars involved in an accident. As a consequence, this index decreases with a lower potential of injury and rises with a higher number of injuries while assuming a fixed number of accidents. Another index is introduced that uses an economical weighting of each injury level. The consequential injury costs are calculated using the average economical costs for lightly, severely and fatally injured persons. The calculation of the safety indices is based on an anonymized sample of accident data provided by the Federal Statistical Office. An index of Mercedes passenger car drivers depending on the year of registration between 1991 and 2006 is compared to the index of drivers of cars of other makes within the same range of registration years.
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.
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.
Novice drivers are at high risk for crash involvement. We performed an analysis of causations, injury patterns and distributions of novice drivers in cars and on motorcycles in road traffic as a basis for proper measurements. Method Data of accident and hospital records of novice drivers (licence < 2 years) were analysed focusing the following parameters: injury type, localisation and mechanism, Abbreviated Injury Scale (AIS), maximum AIS (MAIS), delta-v, collision speed and other technical parameters and have been compared to those of experienced drivers. In 18352 accidents in the area of Hannover (years1985"2004), 2602 novice drivers and 18214 experienced drivers were recorded having an accident. Novice car drivers were more often and severe injured than experienced and on motorcycles the experienced riders were at higher risk. Novice drivers of both groups sustained more often extremity injuries. 4.5 % novice car drivers were not restraint compared to 3.7 % of the experienced drivers and 6.1 % novice motorcycle drivers did not wear a proper helmet (versus 6.5 %). Severe injuries sustained at a rate of 20 % at collision speeds below 30 km/h and in 80% at collision speeds above 50 km/h. Novice car drivers drove significant older cars. The risk profile of novice drivers is similar to those of drivers older than 65 years. Structural protection and special lectures like skidding courses could be proper remedial action next to harder punishment of violations.
In Germany averagely two million traffic accidents happen each year and emergency medical services are called to more than 400 000 patients. Even though this number is decreasing continuously (due to improvements in the fields of vehicle safety, road construction, and accident prevention) every case is yet a challenge for the rescuers and requires improvements in emergency medicine as well. Especially during diagnostics right at the accident scene, there are only limited instruments available to gain the necessary knowledge of the injuries suffered, to come to essential decisions about treatment or transport. To provide an additional diagnostic aid by scouting and estimating the situation, a software-tool calculating the likeliness of the most frequent severe injuries (AIS 3-6) of front occupants in passenger cars has been developed to deliver this necessary information about particular accident scenarios. To achieve this, logistic likelihood functions have been calculated in a multivariate regression analysis analysing all AIS 3+ injuries in the GIDAS database of the years 1999-2006 that happened more than four times
Side impacts, both nearside and farside, have been indicated by research to be responsible for a large proportion of serious injuries from road crashes. This study aimed to compare and contrast the characteristics of nearside and farside crashes in Australia, Germany and the U.S., using the ANCIS, GIDAS and NASS/CDS in-depth-databases, in order to establish the impact and injury severity associated with these crashes, and the types of injuries sustained. The analyses revealed some interesting similarities, as well as differences, between both nearside and farside crashes, and the emergent trends between the three investigated countries. More specifically, it was indicated that whilst the severity of injury sustained in nearside crashes was slightly greater overall than that found for farside crashes, careful consideration of struck and nonstruck side occupants must be made when considering aspects such as vehicle design and occupant protection.
The head impact of pedestrians in the windscreen area shows a high relevance in real-world accidents. Nevertheless, there are neither biomechanical limits nor elaborated testing procedures available. Furthermore, the development of deployable protection systems like pop-up bonnets or external airbags has made faster progress than the corresponding testing methods. New requirements which are currently not considered are taken into account within a research project of BASt and the EC funded APROSYS (Advanced PROtection SYStems) integrated project relating to passive pedestrian protection. Testing procedures for head impact in the windscreen area should address these new boundary conditions. The presented modular procedure combines the advantages of virtual testing, including full-scale multi-body and finite element simulations, as well as hardware testing containing impactor tests based on the existing procedures of EEVC WG 17. To meet the efforts of harmonization in legislation, it refers to the Global Technical Regulation of UNECE (GTR No. 9). The basis for this combined hardware and virtual testing procedure is a robust categorization covering all passenger cars and light commercial vehicles and defining the testing zone including the related kinematics. The virtual testing part supports also the choice of the impact points for the hardware test and determines head impact timing for testing deployable systems. The assessment of the neck rotation angle and sharp edge contact in the rear gap of pop-up bonnets is included. For the demonstration of this procedure, a hardware sedan shaped vehicle was modified by integrating an airbag system. In addition, tests with the Honda Polar-II Dummy were performed for an evaluation of the new testing procedure. Comparing these results, it was concluded that a combination of simulation and updated subsystem tests forms an important step towards enhanced future pedestrian safety systems considering the windscreen area and the deployable systems.
Estimation of the benefits for the UK for potential options to modify UNECE Regulation No. 95
(2010)
The side impact problem in Europe remains substantial. UK data shows that between 22% and 26% of car occupant casualties are involved in a side impact, but this rises to between 29% and 38% for those who are fatally injured. This indicates the more injurious nature of side impacts compared with frontal impacts. The European Enhanced Vehicle safety Committee (EEVC) has performed work to address the side impact issue since 1979. As part of its continuing work, it has recently investigated potential options for regulatory changes to improve side impact protection in cars further. To support this work the UK undertook an analysis to estimate the benefit for potential options to modify UNECE Regulation 95. The analysis used the UK national STATS19 and detailed Co-operative Crash Injury Study (CCIS) accident databases. Of the potential options reviewed, it was found that the addition of a pole test offered the greatest benefit.
An increased use of bicycles comes along with an increased number of bicycle accidents. Bicycle accidents are more frequent than recorded by the police. To evaluate the real number of bicycle accidents during 12 months in Münster, Germany, injuries were collected by the Police and in each emergency unit anonymously. 2,153 patients had to be treated in a hospital, nearly triple the number of accidents that were registered by the police. Beside fractures of the upper extremities with major surgery, traumatic brain injuries were the leading cause for hospital admission. Bicycle helmet use can reduce traumatic brain injuries and the related number of deaths and hospital admissions. Laws on bicycle helmet might decrease the use of bicycles and therefore the reduction of positive health benefits. Other methods of accident prevention may lead to positive effects as helmet legislation as well, while having no reduction in bicycle use.
Females sustain Cervical Spine Distortion injury (CSD) more often than males. Most work dealing with the biomechanics background (e.g. injury mechanism/criteria) as well as the application in seat design/testing, focuses on the occupant model of an average male. Therefore the EU-Project ADSEAT (Adaptive Seat to Reduce Neck Injuries for Female and Male Occupants) is aimed at adding a female model for gender balanced research of CSD and improving seat design. An extensive literature review, searching for risk factors and injury criteria for males and females, was accompanied by the evaluation of different databases containing CSD cases. The database evaluations suggests that an anthropometry quite close to the 50%ile female anthropometry as known from crash test dummy design is appropriate. The results presented here form the basis for the future development of a computational female model and the improvement of seat design for better protection of both males and females in the frame of the ADSEAT-Project.
Pedestrian and cyclist are the most vulnerable road users in traffic crashes. One important aspect of this study was the comparable analysis of the exact impact configuration and the resulting injury patterns of pedestrians and cyclists in view of epidemiology. The secondary aim was assessment of head injury risks and kinematics of adult pedestrian and cyclists in primary and secondary impacts and to correlate the injuries related to physical parameters like HIC value, 3ms linear acceleration, and discuss the technical parameter with injuries observed in real-world accidents based documented real accidents of GIDAS and explains the head injuries by simulated load and impact conditions based on PC-Crash and MADYMO. A subsample of n=402 pedestrians and n=940 bicyclists from GIDAS database, Germany was used for preselection, from which 22 pedestrian and 18 cyclist accidents were selected for reconstruction by initially using PC-Crash to calculate impact conditions, such as vehicle impact velocity, vehicle kinematic sequence and throw out distance. The impact conditions then were employed to identify the initial conditions in simulation of MADYMO reconstruction. The results show that cyclists always suffer lower injury outcomes for the same accident severity. Differences in HIC, head relative impact velocity, 3ms linear contiguous acceleration, maximum angular velocity and acceleration, contact force, throwing distance and head contact timing are shown. The differences of landing conditions in secondary impacts of pedestrians and cyclists are also identified. Injury risk curves were generated by logistic regression model for each predicting physical parameters.
The paper presents a methodology for the benefit estimation of several secondary safety systems for pedestrians, using the exceptional data depth of GIDAS. A total of 667 frontal pedestrian accidents up to 40kph and more than 500 AIS2+ injuries have been considered. In addition to the severity, affected body region, exact impact point on the vehicle, and the causing part of every injury, the related Euro NCAP test zone was determined. One results of the study is a detailed impact distribution for AIS2+ injuries across the vehicle front. It can be stated, how often a test zone or vehicle part is hit by pedestrians in frontal accidents and which role the ground impact plays. Basing on that, different secondary safety measures can be evaluated by an injury shift method concerning their real world effectiveness. As an example, measures concerning the Euro NCAP pedestrian rating tests have been evaluated. It was analysed which Euro NCAP test zones are the most effective ones. In addition, real test results have been evaluated. Using the presented methodology, other secondary safety like the active bonnet (pop-up bonnet) or a pedestrian airbag measures can be evaluated.
The accident research of Hanover and (from 1999 on) Dresden registered 736 leg injuries (AIS ≥ 2) from 1983 to March 2007. 174 of these injuries (23.6 %) were fractures or dislocations of foot and ankle. 149 feet of 141 front seat car occupants in 140 cars were affected. Of these 117 were drivers, 24 were front seat passengers. The mean age of occupants was 38.5 -± 16.8 years. Ankle fractures were the most frequent injury (n = 82; 80 malleolar fractures, 2 pilon fractures). 34 fractures and dislocations affected the hindfoot (5 talus and 26 calcaneal fractures, 2 subtalar dislocations and 1 subtotal amputation) , 16 to midfoot (4 navicular fractures, 5 cuboid fractures, 3 fractures of cuneiformia, 2 dislocations of chopart joint, 1 subtotal amputation, and one severe decollement) and 39 the forefoot (metatarsal fractures). Open fractures were seldom seen (2 malleolar fractures, 1 metatarsal fracture). Both feet were injured in 10 cases. 33 occupants (23.4 %) were polytaumatic had a polytrauma, 17 of them died. 81 percent of the occupants were belted. The cars were divided in pre EuroNCAP (year of manufacture 1997 and older) and post EuroNCAP cars (year of manufacture 1998 and newer). Most of the foot injuries were seen in pre EuroNCAP cars. Most of the occupants sat in compact cars (40 drivers and 9 front seat passengers) and large family cars (27 drivers and 7 co-drivers). 49 of 140 accidents occurred on country roads, 26 on main roads and 13 on motorways. The crash direction was mostly frontal. Generally were found no differences of delta v- and EES-level between the injured foot regions, but divided into pre- and post-EuroNCAP cars there was a tendency to higher delta v- and EES-levels in newer cars. The frequency of foot injuries increased linearly with increasing delta v-level; but above delta v-level of 55 km/h the linear increase only was seen in pre-EuroNCAP cars, post-EuroNCAP cars showed no further increase of injuries. The footwell intrusion showed no difference between the injured foot regions but pre-EuroNCAP cars had a tendency to higher footwell intrusion. There were no differences in footwell intrusion between the car types. Only 29 of 174 fractures or dislocations of foot were seen in post-EuroNCAP cars, the predominate number of these injuries (n = 145) were noticed in pre-EuroNCAP cars. A lower probability of long-term impairment was found in post-EuroNCAP cars for equal delta v levels, using the AIS2008 associated Functional Capacity Index (FCI) for the foot region.
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
Aim of the study was to evaluate the protective effect of bicycle helmets particularly considering injuries to the head and to the face. Accidents with the participation of bicyclists which occurred from 2000 to 2007 were chosen from GIDAS. We observed that injuries to the head and face were more severe in the group of non-helmeted riders. There seems to be no significant difference in injuries with AIS 3-6. Altogether 26 cyclists were killed. 2 of them wore a helmet (1% of helmeted cyclists), 24 did not (1% of non-helmeted cyclists). Only one killed rider (without helmet) did not suffer from polytrauma (only head injuries recorded). The findings seem to support the thesis of a preventive effect of the bicycle helmet, however the two groups are different in their characteristics related to riding speed. Necessarily we need a multivariate model to evaluate the effect of helmets.
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 work aims at bringing evidence for mass incompatibility in frontal impact for cars built according to the UNECE R94 regulation. French national injury accidents database census for years 2005 to 2008 were used for the analysis. The heterogeneity of frontal self-protection among cars of different masses is investigated, as well as the partner protection parameter offered by these cars. The last part of the analysis deals with the estimation of the benefit, in terms of fatal and severe injuries avoided, if crashworthiness was harmonized for the whole fleet of vehicle. This calculation is done for France and is extended to all Europe.
The share of high-tensile steel in car bodies has increased over the last years. While occupant safety has generally benefited from this measure, there is a potential risk that, as a result, rescue time may increase considerably. In more than 60% of all car occupant fatalities a technical rescue has been necessary. These are in particular those cases where occupants die immediately at the accident scene. Therefore, in these cases "rescue time" is a very sensitive parameter. In addition to the general analysis of the need of technical rescue and the actual rescue time depending on model years, the injury pattern of occupants requiring technical rescue will be analysed to provide advice for rescue teams. Furthermore, a detailed analysis of rescue measures for the most popular car models depending on the safety cell design is given.
Small overlap frontal crashes are defined by a damage pattern with most of the vehicle deformation concentrated outboard of the main longitudinal structures. These crashes are prominent among frontal crashes resulting in serious and fatal injuries, even among vehicles that perform well in regulatory and consumer information crash tests. One of the critical aspects of understanding these crashes is knowing the crash speeds that cause the types of damage associated with serious injuries. Laboratory crash tests were conducted using 12 vehicles in three small overlap test conditions: pole, vehicle-to-vehicle collinear, and vehicle-to-vehicle oblique (15-degree striking angle). Field reconstruction techniques were used to estimate the delta V for each vehicle, and these results were compared with actual delta V values based on vehicle accelerometer data. Estimated delta Vs were 50% lower than actual values. Velocity change estimates for small overlap frontal crashes in databases such as NASS-CDS significantly underestimate actual values.
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.
Although the statistics show a decreasing rate of child injuries and fatalities in German road accidents more efforts can be made to protect children in cars e.g. by developing appropriate child restraint systems. An important part in of this work can be achieved with the help of crash tests using child dummies. However these crash tests cannot completely reflect the situation of real world crashes as factors like children moving out of the optimal position or children incorrectly fastened by their parents are difficult to predict. Therefore this study gives an overview over the current accident and injury situation of child occupants in cars in German road accidents.
The NHTSA-sponsored Crash Injury Research and Engineering Network (CIREN) has collected and analyzed crash, vehicle damage, and detailed injury data from over 4000 case occupants who were patients admitted to Level-I trauma centers following involvement in motor vehicle crashes. Since 2005, CIREN has used a methodology known as "BioTab" to analyze and document the causes of injuries resulting from passenger vehicle crashes. BioTab was developed to provide a complete evidenced-based method to describe and document injury causation from in-depth crash investigations with confidence levels assigned to the causes of injury based on the available evidence. This paper describes how the BioTab method is being used in CIREN to leverage the data collected from in-depth crash investigations, and particularly the detailed injury data available in CIREN, to develop evidence-based assessments of injury causation. CIREN case examples are provided to demonstrate the ability of the BioTab method to improve real-world crash/injury data assessment.
In 2012 the fifth ESAR conference (Expert Symposium on Accident Research) was held in Hannover. ESAR is an international convention of experts, who analyze traffic accidents all over the world and discuss their results in this context, conducted at the Medizinische Hochschule Hannover every 2 years. It connected representatives of public authorities, engineers in automotive development and scientists and offers a forum with particular emphasis on In-Depth-Analyses of accident statistics and accident analyses. Special focus is placed on research on the basis of so-called "In-Depth-Accident-Investigations" [data collections at the sites of the accidents], which are characterized by extensive documentations of the sites of the accidents, of the vehicles as well as of the injuries, encompassing several scientific fields. ESAR aims at a multi-disciplinary compilation of scientific results and at discussing them on an international, scientific level. It is thus a scientific colloquium and a platform for exchanging information for all accident researchers. Experiences in accident prevention as well as in the complex field of accident reconstruction are stated and new research fields are added. Existing results of long-term research work in Europe, the US, Australia and Japan include different infrastructural correlations and give findings on population, vehicle population and driver characteristics, which offer a basis for recommendations to be derived and measures for increasing road safety.
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.
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.
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.
Real world accident reconstruction with the Total Human Model for Safety (THUMS) in Pam-Crash
(2013)
Further improvement of vehicle safety needs detailed analysis of real world accidents. According to GIDAS (German In-Depth Accident Study) most car to car front accidents occur at mid-crash severity. In this range thoracic injuries already occur. In this study a real world frontal crash with mid-crash severity out of the AARU database was reconstructed. The selected car to car accident was reconstructed by AARU by means of pc-crash software in order to get the initial dynamic accident conditions. These initial conditions were used to reconstruct the complete accident in more detail using FE models for the car structure and the occupants. Occupant simulations were performed with FE HIII-dummy models and the THUMS using Pam-Crash code. An initial THUMS validation was performed in order to verify the model-´s biofidelity by means of table-top test simulations. THUMS bone stiffness values were modified to match the real word occupant age. A comparison between driver and passenger restraint system loading was done, as well as an injury prediction comparison between the HIII-dummy model and THUMS response for both cases. Detailed comparison between the HIII-dummy models and THUMS regarding thoracic loading are discussed.
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.
The main objective of EC CASPER research project is to reduce fatalities and injuries of children travelling in cars. Accidents involving children were investigated, modelling of human being and tools for dummies were advanced, a survey for the diagnosis of child safety was carried out and demands and applications were analysed. From the many research tasks of the CASPER project, the intention of this paper is to address the following: • In-depth investigation of accidents and accident reconstruction. These will provide important points for the injury risk curve, in order to improve it. Different accident investigation teams collected data from real road accidents, involving child car passengers, in five different European countries. Then, a selection of the most appropriate cases for the injury risk curve and the purposes of the project was made for an in-depth analysis. The final stage of this analysis was to conduct an accident reconstruction to validate the results obtained. The in-depth analysis included on-scene accident investigation, creating virtual simulations of the accident/possible reconstruction, and conducting the reconstruction. In the cases of successful reconstructions, new points were introduced to the injury risk curves. Accident reconstructions of selected cases were carried out in test laboratories as the next step following in-depth road accident investigation. These cases were reconstructed using similar child restraint systems (CRS) and the same type make and model as in the real accidents. Reconstructing real cases has several limitations, such as crash angle, cars" approximation paths and crash speed. However, a few changes and applications on the testing conditions were applied to reduce the limitations and improved the representations of the real accidents. After conducting the reconstructions, a comparison between the deformations of the cars on the real accident and the vehicles from the reconstructions was made. Additionally, a correlation between the data captured from the dummies and the injury data from the real accident was sought. This finalises an in-depth analysis of the accident, which will provide new relevant points to the injury risk curve. The CASPER project conducted a large research programme on child safety. On technical points, a promising research area is the developing injury risk curves as a result of in-depth accident investigations and reconstructions. This abstract was written whilst the project was not yet finished and final results are not yet known, but they will be available by the time of the conference. All the works and findings will not necessarily be integrated in the industrial versions of evaluation tools as the CASPER project is a research program.
Injuries in motorbike accidents in correlation with protective clothes and mechanism of the accident
(2013)
This study deals with a possible connection between safety clothing / accident mechanism and injury severity in a state-wide traffic accident investigation with focus on light and small motorbike-involvement for accidents in the area of the Saarland in which the persons riding the bike have been injured or killed. An interdisciplinary team of medical scientists and engineers collected the medical and technical data as well as all the relevant traces of the accident on scene and in time. During twenty months of data collection a total of 401 cases could be gathered. Grave injuries were more common for the group of heavier motorcycles (>125 ccm). Motorcyclists had been polytraumatized only in the group where the accident was connected with a collision. Significant correlation between protective clothes and injury severity could only be found for protective gloves and protective trousers. The knowledge about mechanism of the accident, protective clothes and severity of injuries can be helpful for the improvement of road and motorcyclists' safety.
This study analyses no.39 cases in which n.41 motorcyclists were fatally injured, or 36% of total motorcycle fatalities in Northern Ireland between 2004 and 2010 (n.114). There were n.17 cases (43.6%) where the actions of another vehicle driver caused the collision, in thirteen of these cases the motorcycles had their lights switched on. The remaining n.22 collisions (56.4%) were due to the actions of the motorcyclist. In the approach to the collision scene, there were n.13 cases (31.7%) in which the approach was a right hand bend and in n.8 (19.5%) cases, the approach was a left hand bend. In the remaining n.18 (43.9%) cases, the approach was a straight road. Of the n.17 (41.4%) motorcycles that slid after falling, n.10 (24.4%) fell onto their right side and the remaining n.7 (17.1%) fell onto their left side. The information from this study identifies primary and contributory causes of motorcycle collisions.
The objective of the study is to measure the risk of pedestrian and bicyclist in urban traffic through an analysis of real-world accident data. The kinematics and injury mechanisms for both pedestrian and bicyclists are investigated to find the correlation of injury risks with injury related parameters. For this purpose, firstly 338 cases are selected as a sample from an IVAC accident database based on the In-depth Investigation of Vehicle Accident in Changsha of China. A statistic measurement of the fatality and serious injury risks with respect to impact speed was carried out by logistic regression analysis. Secondly, 12 pedestrian and 12 bicyclist accidents were further selected for reconstruction with MADYMO program. A comparative analysis was conducted based on the results from accident analysis and computer reconstructions for the injury risk, head impact conditions and dynamic response of pedestrians and bicyclists. The results indicate that bicyclists suffered lower risks of severe injuries and fatalities compared with pedestrians. The risks of AIS 3+ injury and fatality are 50% for pedestrians at impact speeds of 53.2 km/h and 63.3 km/h, respectively, while that for bicyclists at 62.5 km/h and 71.1 km/h, respectively. The findings could have a contribution to get a better understanding of pedestrians" and bicyclists" exposures in urban traffic in China, and provide background knowledge to generate strategies for pedestrian protection.
Cycle helmets have continued to increase in popularity since their introduction half a century ago. Many studies indicate that overall, head injury can be significantly reduced by wearing them. This study was conducted using two distinct sets of real-world cycling collision data from Ireland, namely cases involving police collision reports and cases involving admission to a hospital emergency department. The analyses sought to simulate and analyse the protective performance of cycle helmets in such collision scenarios, by comparing the Head Injury Criterion score and peak head accelerations, both linear and angular. Cycle collisions were simulated using the specialised commercial software MADYMO. From the simulation results, these key metrics were compared between the same-scenario helmeted and unhelmeted cyclist models. Results showed that the inclusion of bicycle helmets reduced linear accelerations very significantly, but also increased angular accelerations significantly compared to unhelmeted situations. Given the modest protective performance of cycle helmets against angular accelerations, it is recommended that cycle helmet manufacturers and international test standards need to pay more attention to head angular accelerations.
The number of road accidents in Portugal has decreased significantly in the last decades, however, this tendency is not similar in all types of transportation. In the most recent years and by European standards, Portugal is still one of the leading countries concerning the number of fatalities in Powered Two Wheelers (PTW) accidents. To this effect, the in-depth investigation of PTW accidents is crucial and so, a thorough statistical analysis concerning the main factors influencing PTW riders injury severity accidents was undertaken regarding the 2007-2010 period in the National Road Safety Authority (ANSR) injured riders database using the software SPSS. In addition, to determine the importance of absent factors in the database analysis, such as velocity, a set of 53 real accidents involving PTW were also investigated and computationally reconstructed using the software PC-Crash. Lateral collisions between a motorcycle, its rider and the side of three different passenger cars were also simulated, varying the motorcycle impact angle and velocity in order to estimate the PTW deformation energy and the rider- injuries, as this accident configuration stands out in terms of frequency and even severity. The results of this detailed study are presented.
It is very important for Automotive OEMs to get feedback on their product performance on real roads for continuous improvement. Every OEM has a way of collecting this feedback for various performance parameters. Systematic accident research is a way to generate the information related to safety performance of the vehicle. In India, while there is a large amount of data related to the accidents, it is found this data is aimed at understanding the gross statistics and not directly useful for technology development. This paper explains learnings from a pilot study carried out in collaboration with an Emergency Medical Services provider on one of the expressways (motorways). This pilot study has resulted in development of working model that could now be scaled up at for wider application. The paper also presents some of the important observations based on the data collected.
The number of injured car occupants decreases constantly. Nevertheless, they account for nearly 50% of all fatalities and about 44% of all seriously injured persons in German traffic accidents. Further reductions of casualties require multiple efforts in all parts of traffic safety. In this paper a detailed analysis of the important pre-hospital rescue phase was done. The basis for future improvements is the knowledge about injury causation of car occupants in combination with other corresponding influence factors. For that reason more than 1.200 severe (AIS3+) injuries of frontal car occupants were analyzed. For the most relevant injuries of car occupants multivariate analysis models were created to predict the probability of these injuries in a real crash scenario. In addition to the collision severity different influence factors like impact direction, seat belt usage, age of the occupant, and gender were analyzed. Furthermore, the models were checked regarding the goodness of fit and all results all results were checked concerning their robustness. The prediction models were created on the basis of 5.000 car accidents. Afterwards, the models were validated using 4.000 different car accidents. The prediction of the probability of severe injuries could be used for different applications in the field of traffic safety. One possibility is the implementation of the models in a tool for the on-the-spot diagnosis. The background for the development of such applications is the fact, that there are only limited diagnostic possibilities available at the accident scene. Nevertheless, the rescue forces have to make essential decisions like the alerting of the necessary medical experts, appropriate treatment, the type of transportation and the choice of an adequate hospital. These decisions quite often decide between life and death or influence the long-term effects of injured persons. At this point, indications of expectable injuries could help enormously. To enable even persons with limited technical knowledge to use the tool, a procedure was developed that facilitates the assumption of the given crash severity. Another important possibility for the application of the prediction models is the use for the qualification of information sent by e-call systems.