Sonstige
In most of developed countries, the progress made in passive safety during the last three decades allowed to drastically reduce the number of killed and severely injured especially for occupants of passenger cars. This reduction is mainly observed for frontal impacts for which the AIS3+ injuries has been reduced about 52% for drivers and 38% for front passengers. The stiffening of the cars' structure coupled with the generalization of airbags and the improvement of the seatbelt restraint (load limiter, pretension, etc.) allowed to protect vital body regions such as head, neck and thorax. However, the abdomen did not take advantage with so much success of this progress. The objective of this study is to draw up an inventory on the abdominal injuries of the belted car occupants involved in frontal impact, to present adapted counter-measures and to assess their potential effectiveness. In the first part the stakes corresponding to the abdominal injuries will be defined according to types of impact, seat location, occupants' age and type of injured organs. Then, we shall focus on the abdominal injury risk curves for adults involved in frontal impact and on the comparisons of the average risks according to the seat location. In the second part we will list counter-measures and we shall calculate their effectiveness. The method of case control will be used in order to estimate odds ratio, comparing two samples, given by occupants having or not having the studied safety system. For this study, two type of data sources are used: national road injured accident census and retrospective in-depth accident data collection. Abdominal injuries are mainly observed in frontal impact (52%). Fatal or severe abdominal occupant- injuries are observed at least in 27% of cases, ranking this body region as the most injured just after the thorax (51%). In spite of a twice lower occupation rate in the back seats compared to the front seats, the number of persons sustaining abdominal injuries at the rear place is higher than in the front place. In recent cars, the risk of having a serious or fatal abdominal injury in a frontal impact is 1.6% for the driver, 3.6% for the front passenger and 6.3% for the rear occupants. The most frequently hurt organs are the small intestine (17%), the spleen (16%) and the liver (13%). The most common countermeasures have a good efficiency in the reduction of the abdominal injuries for the adults: the stiffness of the structure of the seats allows decreasing the abdominal injury risk from 54% (driver) to 60% (front occupant), the seatbelt pretensioners decrease also this risk from 90% (driver) to 83% (front passenger).
The so-called "seat-belt injuries" or "seat-belt syndromes", described as 2-point seat-belt injuries, contain heavy inflection injuries of the lumbal spinal column, combined with heavy abdominal injuries as rupture of the upper intestinal bold or heavy injuries of the upper entrails. With "playing" children in the font of the car, with inappropriate plant of 3-point belts, identical injuries can occur.
In a first step, we have examined approximately 23 000 single vehicle accidents within the Austrian National Statistics database. In a second step, we considered 15% of all fatal "running off the road" accidents that occurred in Austria in 2003. As a result, two accident categories were specified; "leaving the road without preceding manoeuvre" and "leaving the road with preceding manoeuvre". These two categories can be basically characterised by the vehicle- heading angle and its velocity angle. In this report, we further suggest theoretical approaches for the dimensioning of a safety zone, an area adjacent to the road free of fixed objects or dangerous slopes. We also show the link between the two accident categories mentioned above and the real world accidents analysed in detail. These observations also form the basis for the required length for safety devices. Finally, we summarise accident avoidance strategies.
This study aims to analyze spine injuries in motor vehicle accidents. Between 1985 and 2004 the Hannover accident research unit documented 18353 accidents. We identified 161 front passengers (0.53%) with cervical spine injuries, 84 (0.28%) with thoracic and 95 (0.31%) with lumbar injuries. Technical and medical data was reviewed. Patients" records were retrieved. X-rays were evaluated and fractures were classified according to the Magerl classification. 68% and 57% of thoracic and lumbar fractures occurred in accidents with multiple impacts. Delta-v was 50, 40 and 40 kph in passengers with cervical, thoracic and lumbar spine, resp. Passengers with spinal fractures frequently showed numerous concomitant injuries, e.g. additional vertebral fractures. The influence of seat belts and airbags is discussed. Patient work-up has to include a thorough investigation for additional injuries.
The incidence and treatment of sternal fractures among traffic accidents are of increasing importance to ensure best possible outcomes. Analysis of technical indicators of the collision, preclinical and clinical data of patients with sterna fractures from 1985-2004 among 42,055 injured patients were assessed by an Accident Research Unit. Two time groups were categorized: 1985-1994 (A) vs. 1995-2004 (B). 267/42,055 patients (0.64%) suffered a sterna fracture. Regarding the vehicle type, the majority occurred after car accidents in 0.81% (251/31,183 pts), followed by 0.19% (5/2,633pts) driving motorbike, and 0.11% (4/3,258pts) driving a truck. 91% wore a safety belt. Only 13% of all passengers suffering a sternal fracture had an airbag on board (33/255 car/trucks), with an airbag malfunction in 18%. The steering column was deformed in 39%, the steering wheel in 36%. Cars in the recent years were significantly older (7.67-±5 years (B) vs. 5.88-±5 years (A), p=0.003). Cervical spine injuries are frequent (23% vs. 22%), followed by multiple rib fractures (14% vs. 12%) and lung injuries (12% vs. 11%). We found 9/146 (6%) and 3/121 patients (3%) with heart contusion among the 267 sternal fractures. MAIS was 2.56-±1.3 vs. 2.62-±1.3 (A vs. B, p=0.349). 18% of patients were polytraumatized, with 11.2% dying at the scene, 2.3% in the hospital. Sternal fractures occur most often in old cars to seat-belted drivers often without any airbag. Severe multiple rib fractures and lung contusion are concomitant injuries in more than 10% each indicating the severity of the crash. Over a twentyyear period, the injury severity encountered was not different with 18% polytrauma patients suffering sternal fractures.
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.