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Whiplash injuries are characterized by the high variability of its symptoms and by the subjectivity of its diagnosis, which sometimes leads to frauds perpetrated by victims of rear-end impacts. It is estimated that whiplash injuries cost annually about 10.000 million Euros in Europe. Therefore, the aim of this study was to investigate the influence of the dynamics of the accident in which the victim was involved in the probability of development of whiplash associated injuries. In the presented methodology, first an accident reconstruction is performed where the dynamics of the accident is determined. This is carried out using the software PC-Crash, police and insurance companies' data. Then biomechanical injuries criteria related with whiplash injuries are evaluated. For the evaluation of the probability of having whiplash injuries, the Neck Injury Criterion (NIC) of the victim and the mean acceleration of the vehicle were evaluated. Then, with medical reports, the results of the accident reconstruction are correlated with the reported injuries. Some examples are presented. The results obtained indicate that the study of the dynamics of the road accidents in which the victims were involved could be used as an auxiliary of the prognosis of whiplash injuries and is important for a precise diagnosis of this type of injuries.
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).
Still correlated with high mortality rates in traffic accidents traumatic aortic ruptures were frequently detected in unprotected car occupants in the early years. This biomechanical analysis investigates the different kinds of injury mechanisms leading to traumatic aortic injuries in todays traffic accidents and how the way of traffic participation affects the frequency of those injuries over the years. Based on GIDAS reported traffic accidents from 1973 to 2014 are analyzed. Results show that traumatic aortic injuries are mainly observed in high-speed accidents with high body deceleration and direct load force to the chest. Mostly chest compression is responsible for the load direction to the cardiac vessels. The main observed load vector is from caudal-ventral and from ventral solely, but also force impact from left and right side and in roll-over events with chest compression lead to traumatic aortic injuries. Classically, the injury appeares at the junction between the well-fixed aortic arch and the pars decendens following a kind of a scoop mechanism, a few cases with a hyperflexion mechanism are also described. In our analysis the deceleration effect alone never led to an aortic rupture. Comparing the past 40 years aortic injuries shift from unprotected car occupants to today's unprotected vulnerable road users like pedestrians, cyclists and motorcyclists. Still the accident characteristics are linked with chest compression force under high speed impact, no seatbelt and direct body impact.
To elucidate the risk of pedestrians, bicycle and motorbike users, data of two accident research units from 1999 to 2014 were analysed in regard to demographic data, collision details, preclinical and clinical data using SPSS. 14.295 injured vulnerable road users were included. 92 out of 3610 pedestrians ("P", 2.5%), 90 out of 8307 bicyclists ("B", 1.1%) and 115 out of 4094 motorcycle users ("M", 2.8%) were diagnosed with spinal fractures. Thoracic fractures were most frequent ahead of lumbar and cervical fractures. Car collisions were most frequent mechanism (68, 62 and 36%). MAIS was 3.8, 2.8 and 3.2 for P, B and A with ISS 32, 16 and 23. AIS-head was 2.2, 1.3 and 1.5). Vulnerable road users are at significant risk for spine fractures. These are often associated with severe additional injuries, e.g. the head and a very high overall trauma severity (polytrauma).
While cyclists and pedestrians are known to be at significant risk for severe injuries when exposed to road traffic accidents (RTAs) involving trucks, little is known about RTA injury risk for truck drivers. The objective of this study is to analyze the injury severity in truck drivers following RTAs. Between 1999 and 2008 the Hannover Medical School Accident Research Unit prospectively documented 43,000 RTAs involving 582 trucks. Injury severity including the abbreviated injury scale (AIS) and the maximum abbreviated injury scale (MAIS) were analyzed. Technical parameters (e.g. delta-v, direction of impact), the location of accident, and its dependency on the road type were also taken into consideration. The results show that the safety of truck drivers is assured by their vehicles, the consequence being that the risk of becoming injured is likely to be low. However, the legs especially are at high risk for severe injuries during RTAs. This probability increases in the instance of a collision with another truck. Nevertheless, in RTAs involving trucks and regular passenger vehicles, the other party is in higher risk of injury.
A study on knowledge and practices of first aid and CPR among police officers in Colombo and Gampaha
(2017)
Around 85% of deaths in developing countries have been found to be due to road traffic accidents (RTAs), which cost the countries around 1-2% of their gross national product (GNP). In Sri Lanka there were 2,436 deaths reported from 36,045 RTAs in 2014. This study aimed at assessing first aid and cardiopulmonary resuscitation (CPR) knowledge among police officers and identifying its relationship to their first aid and CPR practices. A study was done on 493 police officers from Colombo and Gampaha who were selected using convenience sampling through a self-administered questionnaire. The results showed that the police officers had unsatisfactory knowledge and practices of CPR and interventions for bleeding and fractures. These should therefore be focused in their further training.
In this study, we compared the injury severity of occupants according to the seating position and the crashing direction in motor vehicle accidents. In the driver's point of view, it was separated the seating position as "Near-side" and "Far-side". The study subjects were targeted by people who visited 4 regional emergency centers following motor vehicle accidents. Real-world investigation was performed by direct and indirect methods after patient- consent. The information of the damaged vehicle was informed by Collision Deformation Classification (CDC) code and the information of the injury of patients was informed by using the Abbreviated Injury Score (AIS) and Injury Severity Score (ISS). When the column 3 in CDC code was P, damaged at the middle part of lateral side, the average point of AIS 3 was 1.91-±1.72 in near-side and 1.02-±1.31 in far-side (p<0.01). The average point of maximum AIS (MAIS) was 2.78-±1.39 in near-side and 2.02-±1.11 in far-side (p<0.01). The average point of ISS was 15.74-±14.71 in near-side and 8.11-±8.39 in far-side (p<0.01). Also, when the column 3 in CDC code was D, damaged at the whole part of lateral side, it was significant that the average point of AIS 3 and MAIS in near-side was bigger than in far-side (p=0.02).
In-depth accident investigation offers many advantages for the analysis and comprehension of crash mechanisms. IFSTTAR makes such investigations since 1992 without interruption. The corresponding database contains more than 1200 accident case studies. Currently, in-depth accident investigation is one of the best ways to determine the speed or cars involved in accidents. This paper first presents the methods used for accident investigation and for accident kinematic reconstruction. Then, in order to illustrate the interest and possible applications of such accident data, it shows some results from a recent study based on the IFSTTAR in-depth accident study programme (IDAS) and dealing with the link between travelling speed and accident risk.
For the avoidance of traffic accidents by means of advanced driver assistance systems the knowledge of failures and deficiencies a few seconds before the crash is of increasing importance. This information e.g. is collected in the German accident survey GIDAS by an interview derived from the ACAS methodology. However to display the whole range of accident causation factors additional information is needed on enduring factors of the system components "human", "infrastructure" and "machine". On the strategic level these accident moderating factors include long term influences such as medical preconditions or a general higher risk taking behavior as well as influences on the immediate conflict level such as an aggressive response to a perceived previous traffic conflict. This study was conducted to examine the feasibility of collecting such causation information in the scope of an in-depth accident investigation like GIDAS. Due to the comprehensive amount of information necessary to estimate the moderating factors the collection of the information is distributed to different methods. 5 cases of real world crashes have been investigated where information was collected on-scene and retrospective by interviews. The identified moderating factors of the accidents and the method for collecting the information are displayed.
Motorcycle crashes in Austria: Analysis of causes and contributing factors based on in-depth data
(2017)
From CEDATU, the in-depth accident database run by the Vehicle Safety Institute at Graz University of Technology, a representative sample of 101 crashes involving at least one motorcycle was selected. The analysis focused on causes for crashes as well as on contributing factors, but also included parameters of road, riders and vehicles. Own riding speed and "unexpectable action by another road user" were the most frequent causes for accidents. Inappropriate safety distance or delayed reaction were frequent, both as causation factors and as contributing factors. Infrastructure issues never cause an accident, but they are very frequent as contributing factors; road geometry and road guidance are by far most frequent among these. This paper also discusses accidents by type and other parameters (e.g. injury severity by body region, collision speed, age and others), and compares accident causes to previous studies as well as the police reported accident statistics.