Evaluating the Effect of a Mechanical Adjunct to Improve the Installation of Child Restraint Systems to Vehicles

Objectives: We explored if an alternative CRS design that utilized a mechanical adjunct to amplify the force applied to the adult seat belt (intervention CRS) results in more accurate and secure attachment between the CRS and the vehicle compared to similar CRS models that use LATCH or the existing adult seat belt. We conducted three separate studies to address this question and additionally explored: (1) the contribution of prior CRS installation experience (Study 1), (2) the value-added of CRS labeling (Study 2), and (3) paper-based vs. video instructions (Study 3).

Methods: In Studies 1 and 2 we assessed a forward facing combination CRS design (intervention CRS) compared to a commercially available LATCH equipped model (control CRS) and in Study 3 we conducted a similar study using a convertible model of both the intervention and control CRS. Participants installed both CRS in a contemporary minivan and could choose which type of attachment to use for the control CRS (LATCH or seat belt); order of installation was counter-balanced. Evaluators systematically examined installations for accuracy and security.

Results: Study 1: A greater proportion of participants in both the experienced and inexperienced groups was able to securely install the intervention CRS compared to the control CRS: (45% vs. 16%, p =.0001 for experienced) and (37% vs. 6%, p =.003 for inexperienced). No differences between the CRS were observed for accuracy of installation in either user group. Study 2: A greater proportion of participants were able to securely install the enhanced intervention CRS compared to the control CRS: (62% vs. 9%, p =.001). The intervention CRS demonstrated reduced installation accuracy: (30% vs. 61%, p =.001). Study 3: A greater proportion of participants was able to securely install the intervention CRS compared to the control CRS: 79% vs. 66% p =.03, but this effect was smaller than in the previous studies. Participants were less likely to achieve an accurate installation with the intervention CRS compared to the control CRS: 54% vs. 79%, p =.004. Common accuracy errors in each study included twisting or misrouting the seatbelt when installing the intervention CRS.

Conclusions: Our results suggest that novel CRS designs that utilize mechanical advantage to facilitate attachment of the CRS to the vehicle result in a tighter installation compared to LATCH equipped models, but an increase in accuracy errors occurred.     

Occupant responses in conventional and ABTS seats in high-speed rear sled tests

Objective: This study compared biomechanical responses of a normally seated Hybrid III dummy on conventional and all belts to seat (ABTS) seats in 40.2 km/h (25 mph) rear sled tests. It determined the difference in performance with modern (≥2000 MY) seats compared to older (<2000 MY) seats and ABTS seats.

Methods: The seats were fixed in a sled buck subjected to a 40.2 km/h (25 mph) rear sled test. The pulse was a 15 g double-peak acceleration with 150 ms duration. The 50th percentile Hybrid III was lap–shoulder belted in the FMVSS 208 design position. The testing included 11 <2000 MY, 8 ≥2000 MY, and 7 ABTS seats. The dummy was fully instrumented, including head accelerations, upper and lower neck 6-axis load cells, chest acceleration, thoracic and lumbar spine load cells, and pelvis accelerations. The peak responses were normalized by injury assessment reference values (IARVs) to assess injury risks. Statistical analysis was conducted using Student's t test. High-speed video documented occupant kinematics.

Results: Biomechanical responses were lower with modern (≥2000 MY) seats than older (<2000 MY) designs. The lower neck extension moment was 32.5 ± 9.7% of IARV in modern seats compared to 62.8 ± 31.6% in older seats (P =.01). Overall, there was a 34% reduction in the comparable biomechanical responses with modern seats. Biomechanical responses were lower with modern seats than ABTS seats. The lower neck extension moment was 41.4 ± 7.8% with all MY ABTS seats compared to 32.5 ± 9.7% in modern seats (P =.07). Overall, the ABTS seats had 13% higher biomechanical responses than the modern seats.

Conclusions: Modern (≥2000 MY) design seats have lower biomechanical responses in 40.2 km/h rear sled tests than older (<2000 MY) designs and ABTS designs. The improved performance is consistent with an increase in seat strength combined with improved occupant kinematics through pocketing of the occupant into the seatback, higher and more forward head restraint, and other design changes. The methods and data presented here provide a basis for standardized testing of seats. However, a complete understanding of seat safety requires consideration of out-of-position (OOP) occupants in high-speed impacts and consideration of the much more common, low-speed rear impacts.     

Thoracic and lumbar spine responses in high-speed rear sled tests

Objective: This study analyzed thoracic and lumbar spine responses with in-position and out-of-position (OOP) seated dummies in 40.2 km/h (25 mph) rear sled tests with conventional and all-belts-to-seat (ABTS) seats. Occupant kinematics and spinal responses were determined with modern (≥2000 MY), older (<2000 MY), and ABTS seats.

Methods: The seats were fixed in a sled buck subjected to a 40.2 km/h (25 mph) rear sled test. The pulse was a 15 g double-peak acceleration with 150 ms duration. The 50th percentile Hybrid III was lap–shoulder belted in the FMVSS 208 design position or OOP, including leaning forward and leaning inboard and forward. There were 26 in-position tests with 11 <2000 MY, 8 ≥2000 MY, and 7 ABTS and 14 OOP tests with 6 conventional and 8 ABTS seats. The dummy was fully instrumented. This study addressed the thoracic and lumbar spine responses. Injury assessment reference values are not approved for the thoracic and lumbar spine. Conservative thresholds exist. The peak responses were normalized by a threshold to compare responses. High-speed video documented occupant kinematics.

Results: The extension moments were higher in the thoracic than lumbar spine in the in-position tests. For <2000 MY seats, the thoracic extension moment was 76.8 ± 14.6% of threshold and the lumbar extension moment was 50.5 ± 17.9%. For the ≥2000 MY seats, the thoracic extension moment was 54.2 ± 26.6% of threshold and the lumbar extension moment was 49.8 ± 27.7%. ABTS seats provided similar thoracic and lumbar responses. Modern seat designs lowered thoracic and lumbar responses. For example, the 1996 Taurus had ?1,696 N anterior lumbar shear force and ?205.2 Nm extension moment. There was ?1,184 N lumbar compression force and 1,512 N tension. In contrast, the 2015 F-150 had ?500 N shear force and ?49.7 Nm extension moment. There was ?839 N lumbar compression force and 535 N tension. On average, the 2015 F-150 had 40% lower lumbar spine responses than the 1996 Taurus. The OOP tests had similar peak lumbar responses; however, they occurred later due to the forward lean of the dummy.

Conclusions: The design and performance of seats have significantly changed over the past 20 years. Modern seats use a perimeter frame allowing the occupant to pocket into the seatback. Higher and more forward head restraints allow a stronger frame because the head, neck, and torso are more uniformly supported with the seat more upright in severe rear impacts. The overall effect has been a reduction in thoracic and lumbar loads and risks for injury.     

The Influence of Enhanced Side Impact Protection on Kinematics and Injury Measures of Far- or Center-Seated Children in Forward-Facing Child Restraints

Objective: To evaluate the influence of forward-facing child restraint systems’ (FFCRSs) side impact structure, such as side wings, on the head kinematics and response of a restrained, far- or center-seated 3-year-old anthropomorphic test device (ATD) in oblique sled tests.

Methods: Sled tests were conducted utilizing an FFCRS with large side wings and with the side wings removed. The CRS were attached via LATCH on 2 different vehicle seat fixtures—a small SUV rear bench seat and minivan rear bucket seat—secured to the sled carriage at 20° from lateral. Four tests were conducted on each vehicle seat fixture, 2 for each FFCRS configuration. A Q3s dummy was positioned in FFCRS according to the CRS owner's manual and FMVSS 213 procedures. The tests were conducted using the proposed FMVSS 213 side impact pulse. Three-dimensional motion cameras collected head excursion data. Relevant data collected during testing included the ATD head excursions, head accelerations, LATCH belt loads, and neck loads.

Results: Results indicate that side wings have little influence on head excursions and ATD response. The median lateral head excursion was 435 mm with side wings and 443 mm without side wings. The primary differences in head response were observed between the 2 vehicle seat fixtures due to the vehicle seat head restraint design. The bench seat integrated head restraint forced a tether routing path over the head restraint. Due to the lateral crash forces, the tether moved laterally off the head restraint reducing tension and increasing head excursion (477 mm median). In contrast, when the tether was routed through the bucket seat's adjustable head restraint, it maintained a tight attachment and helped control head excursion (393 mm median).

Conclusion: This testing illustrated relevant side impact crash circumstances where side wings do not provide the desired head containment for a 3-year-old ATD seated far-side or center in FFCRS. The head appears to roll out of the FFCRS even in the presence of side wings, which may expose the occupant to potential head impact injuries. We postulate that in a center or far-side seating configuration, the absence of door structure immediately adjacent to the CRS facilitates the rotation and tipping of the FFCRS toward the impact side and the roll-out of the head around the side wing structure. Results suggest that other prevention measures, in the form of alternative side impact structure design, FFCRS vehicle attachment, or shared protection between the FFCRS and the vehicle, may be necessary to protect children in oblique side impact crashes.     

Vehicle characteristics associated with LATCH use and correct use in real-world child restraint installations

IntroductionThe objective of this study was to determine if vehicle features associated with LATCH ease-of-use in laboratory studies with volunteers predict LATCH use and misuse in real-world child restraint installations.MethodVehicle characteristics were extracted from prior surveys of more than 100 top-selling 2010–13 vehicles. Use and correct use of LATCH was determined from records of more than 14,000 child restraint installations in these vehicles that were inspected by child passenger safety technicians at Safe Kids car seat checkup events during 2010–12. Logistic regression was used to examine the association between vehicle features and use and correct use of lower anchors and top tethers, controlling for other relevant installation features.ResultsLower anchors were more likely to be used and correctly used when the clearance angle around them was greater than 54°, the force required to attach them to the lower anchors was less than 178 N, and their depth within the seat bight was less than 4 cm. Restraints were more likely to be attached correctly when installed with the lower anchors than with the seat belt. After controlling for lower anchor use and other installation features, the likelihood of tether use and correct use in installations of forward-facing restraints was significantly higher when there was no hardware present that could potentially be confused with the tether anchor or when the tether anchor was located on the rear deck, which is typical in sedans.ConclusionsThere is converging evidence from laboratory studies with volunteers and real-world child restraint installations that vehicle features are associated with correct LATCH use.Practical applicationsVehicle designs that improve the ease of installing child restraints with LATCH could improve LATCH use rates and reduce child restraint misuse.     

Association Between NCAP Ratings and Real-World Rear Seat Occupant Risk of Injury

Objective: Several studies have evaluated the correlation between U.S. or Euro New Car Assessment Program (NCAP) ratings and injury risk to front seat occupants, in particular driver injuries. Conversely, little is known about whether NCAP 5-star ratings predict real-world risk of injury to restrained rear seat occupants. The NHTSA has identified rear seat occupant protection as a specific area under consideration for improvements to its NCAP. In order to inform NHTSA's efforts, we examined how NCAP's current 5-star rating system predicts risk of moderate or greater injury among restrained rear seat occupants in real-world crashes.

Methods: We identified crash-involved vehicles, model year 2004–2013, in NASS-CDS (2003–2012) with known make and model and nonmissing occupant information. We manually matched these vehicles to their NCAP star ratings using data on make, model, model year, body type, and other identifying information. The resultant linked NASS-CDS and NCAP database was analyzed to examine associations between vehicle ratings and rear seat occupant injury risk; risk to front seat occupants was also estimated for comparison. Data were limited to restrained occupants and occupant injuries were defined as any injury with a maximum Abbreviated Injury Scale (AIS) score of 2 or greater.

Results: We linked 95% of vehicles in NASS-CDS to a specific vehicle in NCAP. The 18,218 vehicles represented an estimated 6 million vehicles with over 9 million occupants. Rear seat passengers accounted for 12.4% of restrained occupants. The risk of injury in all crashes for restrained rear seat occupants was lower in vehicles with a 5-star driver rating in frontal impact tests (1.4%) than with 4 or fewer stars (2.6%, P =.015); results were similar for the frontal impact passenger rating (1.3% vs. 2.4%, P =.024). Conversely, side impact driver and passenger crash tests were not associated with rear seat occupant injury risk (driver test: 1.7% for 5-star vs. 1.8% for 1–4 stars; passenger test: 1.6% for 5 stars vs 1.8% for 1–4 stars).

Conclusions: Current frontal impact test procedures provide some degree of discrimination in real-world rear seat injury risk among vehicles with 5 compared to fewer than 5 stars. However, there is no evidence that vehicles with a 5-star side impact passenger rating, which is the only crash test procedure to include an anthropomorphic test dummy (ATD) in the rear, demonstrate lower risks of injury in the rear than vehicles with fewer than 5 stars. These results support prioritizing modifications to the NCAP program that specifically evaluate rear seat injury risk to restrained occupants of all ages.     

Observed LATCH use and misuse characteristics of child restraint systems in seven states

INTRODUCTION: Although the LATCH System (Lower Anchors and Tethers for Children) holds the promise of simplifying the installation of a child restraint system (CRS) to the vehicle's seat, many drivers transporting young children have difficulties using this technology. This paper reports on an observation study of LATCH use and misuse. METHOD: Observations of approximately 1,000 children less than 5 years of age in CRSs, in the back seats of vehicles that were equipped with tether and lower anchors, in seven states. RESULTS: Tethers were used for 51% of the children when the forward-facing CRS had tether straps and the vehicle had tether anchors. Lower anchors were used for 58% of the children when the CRS had lower attachments and the vehicle had lower anchors. The most common tether and lower attachment misuses were loose tether straps (18% of cases) and loose lower attachment installation (30% of the cases), respectively. Vehicle safety belts were used in combination with lower attachments in 20% of all lower anchor installations. CONCLUSION: As more caregivers of young children drive vehicles equipped with LATCH, it will be important to promote the proper installation of CRSs using this technology. LATCH education messages must also emphasize that the lower anchors may not always be the safest choice for CRS attachment -- the safest attachment is the one that results in a tight fit and will be used correctly consistently.     

Predicting vehicle belt fit for children ages 6–12

Objective: To predict shoulder belt fit and lap belt fit as a function of child age, vehicle seat characteristics, and belt geometry.

Methods: In a previous study, the lap belt and shoulder belt fit of 44 children aged 5–12 were measured in a simulated vehicle seat while varying cushion length, cushion angle, seatback angle, and belt anchorage geometry. A regression model was developed to predict lap belt fit and shoulder belt fit as a function of vehicle parameters and child stature. These regression models were applied to the stature distribution of 6- to 12-year-olds using a range of vehicle geometry data to predict the proportion of children expected to achieve good belt fit in the second-row, outboard seating positions of 46 vehicles when not using belt-positioning boosters.

Results: Across the ranges observed in vehicles, lap belt angle had the strongest effect on lap belt fit, although vehicle cushion length also contributed. Shoulder belt fit was most strongly affected by D-ring location. Vehicles with the geometric conditions most suitable for children are estimated to provide good lap belt fit for 25% of children aged 6 to 12. In 20% of vehicles, the shoulder belt is too far inboard for the target child population; 20% of vehicles are estimated to have shoulder belt fit too far outboard for children ages 6 to 12.

Conclusions: Based on this geometric analysis, the rear seats of most vehicles are unlikely to provide good lap belt fit for up to 75% of children ages 6–12. Shoulder belt fit is outside the target range for 40% of children. Consequently, children under 12 years of age are likely to experience markedly poorer belt fit when transitioning out of a booster seat.     

Evaluation of give kids a boost: A school-based program to increase booster seat use among urban children in economically disadvantaged areas

Objective: This study evaluated the effectiveness of a series of 1-year multifaceted school-based programs aimed at increasing booster seat use among urban children 4–7 years of age in economically disadvantaged areas.

Methods: During 4 consecutive school years, 2011–2015, the Give Kids a Boost (GKB) program was implemented in a total of 8 schools with similar demographics in Dallas County. Observational surveys were conducted at project schools before project implementation (P₀), 1–4 weeks after the completion of project implementation (P₁), and 4–5 months later (P₂). Changes in booster seat use for the 3 time periods were compared for the 8 project and 14 comparison schools that received no intervention using a nonrandomized trial process.

The intervention included (1) train-the-trainer sessions with teachers and parents; (2) presentations about booster seat safety; (3) tailored communication to parents; (4) distribution of fact sheets/resources; (5) walk-around education; and (6) booster seat inspections.

The association between the GKB intervention and proper booster seat use was determined initially using univariate analysis. The association was also estimated using a generalized linear mixed model predicting a binomial outcome (booster seat use) for those aged 4 to 7 years, adjusted for child-level variables (age, sex, race/ethnicity) and car-level variables (vehicle type). The model incorporated the effects of clustering by site and by collection date to account for the possibility of repeated sampling.

Results: In the 8 project schools, booster seat use for children 4–7 years of age increased an average of 20.9 percentage points between P₀ and P₁ (P₀ = 4.8%, P₁ = 25.7%; odds ratio [OR] = 6.9; 95% confidence interval [CI], 5.5, 8.7; P < .001) and remained at that level in the P₂ time period (P₂ = 25.7%; P < .001, for P₀ vs. P₂) in the univariate analysis. The 14 comparison schools had minimal change in booster seat use. The multivariable model showed that children at the project schools were significantly more likely to be properly restrained in a booster seat after the intervention (OR = 2.7; 95% CI, 2.2, 3.3) compared to the P₀ time period and compared to the comparison schools.

Conclusion: Despite study limitations, the GKB program was positively associated with an increase in proper booster seat use for children 4–7 years of age in school settings among diverse populations in economically disadvantaged areas. These increases persisted into the following school year in a majority of the project schools. The GKB model may be a replicable strategy to increase booster seat use among school-age children in similar urban settings.     

Teaching infant car seat installation via interactive visual presence: An experimental trial

Objective: A large portion of child restraint systems (car seats) are installed incorrectly, especially when first-time parents install infant car seats. Expert instruction greatly improves the accuracy of car seat installation but is labor intensive and difficult to obtain for many parents. This study was designed to evaluate the efficacy of 3 ways of communicating instructions for proper car seat installation: phone conversation; HelpLightning, a mobile application (app) that offers virtual interactive presence permitting both verbal and interactive (telestration) visual communication; and the manufacturer's user manual.

Methods: A sample of 39 young adults of child-bearing age who had no previous experience installing car seats were recruited and randomly assigned to install an infant car seat using guidance from one of those 3 communication sources.

Results: Both the phone and interactive app were more effective means to facilitate accurate car seat installation compared to the user manual. There was a trend for the app to offer superior communication compared to the phone, but that difference was not significant in most assessments. The phone and app groups also installed the car seat more efficiently and perceived the communication to be more effective and their installation to be more accurate than those in the user manual group.

Conclusions: Interactive communication may help parents install car seats more accurately than using the manufacturer's manual alone. This was an initial study with a modestly sized sample; if results are replicated in future research, there may be reason to consider centralized “call centers” that provide verbal and/or interactive visual instruction from remote locations to parents installing car seats, paralleling the model of centralized Poison Control centers in the United States.     

An energy-absorbing sliding seat for reducing neck injury risks in rear impact—analysis for prototype built

Objective: This study investigated overall performance of an energy-absorbing sliding seat concept for whiplash neck injury prevention. The sliding seat allows its seat pan to slide backward for some distance under certain restraint force to absorb crash energy in rear impacts.

Methods: A numerical model that consisted of vehicle interior, seat, seat belt, and BioRID II dummy was built in MADYMO to evaluate whiplash neck injury in rear impact. A parametric study of the effects of sliding seat parameters, including position and cushion stiffness of head restraint, seatback cushion stiffness, recliner characteristics, and especially sliding energy-absorbing (EA) restraint force, on neck injury criteria was conducted in order to compare the effectiveness of the sliding seat concept with that of other existing anti-whiplash mechanisms. Optimal sliding seat design configurations in rear crashes of different severities were obtained. A sliding seat prototype with bending of a steel strip as an EA mechanism was fabricated and tested in a sled test environment to validate the concept. The performance of the sliding seat under frontal and rollover impacts was checked to make sure the sliding mechanism did not result in any negative effects.

Results: The protective effect of the sliding seat with EA restraint force is comparable to that of head restraint–based and recliner stiffness–based anti-whiplash mechanisms. EA restraint force levels of 3 kN in rear impacts of low and medium severities and 6 kN in impacts of high severity were obtained from optimization. In frontal collision and rollover, compared to the nonsliding seat, the sliding seat does not result in any negative effects on occupant protection. The sled test results of the sliding seat prototype have shown the effectiveness of the concept for reducing neck injury risks.

Conclusion: As a countermeasure, the sliding seat with appropriate restraint forces can significantly reduce whiplash neck injury risk in rear impacts of low, medium, and high severities with no negative effects on other crash load cases.     

Children's and Adults’ Comfort Experience of Extra Seat Belts When Riding in the Rear Seat of a Passenger Car

Objective: The objective of this study was to explore passengers’ comfort experience of extra seat belts during on-road driving in the rear seat of a passenger car and to investigate how the use of extra belts affects children's and adults’ attitudes to the product.

Methods: Two different seat belt systems were tested, criss-cross (CC) and backpack (BP), consisting of the standard 3-point belt together with an additional 2-point belt. In total, 32 participants (15 children aged 6–10, 6 youths aged 11–15, and 11 adults aged 20–79, who differed considerably in size, shape, and proportions) traveled for one hour with each system, including city traffic and highway driving. Four video cameras monitored the test subject during the drive. Subjective data regarding emotions and perceived discomfort were collected in questionnaires every 20 min. A semistructured interview was held afterwards.

Results: All participant groups accepted the new products and especially the increased feeling of safety (P <.01); 56% preferred CC and 44% preferred BP but the difference was not significant. In total, 81% wanted to have extra seat belts in their family car. CC was appreciated for its symmetry, comfort, and the perceived feeling of safety. Some participants found CC unpleasant because the belts tended to slip close to the neck, described as a strangling feeling. BP was simpler to use and did not cause annoyance to the neck in the way CC did. Instead, it felt asymmetric and to some extent less safe than CC. Body size and shape affected seat belt fit to a great extent, which in turn affected the experience of comfort, both initially and over time. Perceived safety benefit and experienced comfort were the most determinant factors for the attitude toward the extra seat belts. The extra seat belts were perceived as being better than the participants had expected before the test, and they became more used to them over time.

Conclusion: This exploratory study provided valuable knowledge from a user perspective for further development of new seat belt systems in cars. In addition to an increased feeling of safety, seat belt fit and comfort are supplementary influencing factors when it comes to gaining acceptance of new seat belt systems.     

Evaluating an intervention to improve belt fit for adult occupants

IntroductionPrevious laboratory studies have demonstrated that some drivers position their seat belts suboptimally. Specifically, the lap portion of the belt may be higher and farther forward relative to the pelvis than best practice, and the shoulder portion of the belt may be outboard or inboard of mid-shoulder. This study evaluated the performance of a video-based intervention for improving the belt fit obtained by drivers.MethodTwenty-nine adult drivers participated in this study. Belt fit was measured before and after the intervention in participants’ vehicles and in a laboratory mockup.ResultsData from both the in-vehicle and laboratory belt measures found that 95% of participants sampled improved some aspect of lap belt fit. For the in-vehicle test conditions, participants who lowered the lap belt location (Z) after the intervention showed an improvement of 26 mm on average. Among those participants who shifted the horizontal lap belt location rearward (closer to the pelvis), an average improvement of 36 mm was observed. No significant differences were observed between baseline and post-intervention shoulder belt fit.ConclusionsThe results provide preliminary evidence that an intervention improves driver belt fit. More research is needed to establish what aspects of this intervention affected behavior and how effective such an intervention is in the context of public health.Practical applicationsThese findings can help better inform intervention initiatives to improve occupant belt fit.     

Small female rib cage fracture in frontal sled tests

Objectives: The 2 objectives of this study are to (1) examine the rib and sternal fractures sustained by small stature elderly females in simulated frontal crashes and (2) determine how the findings are characterized by prior knowledge and field data.

Methods: A test series was conducted to evaluate the response of 5 elderly (average age 76 years) female postmortem human subjects (PMHS), similar in mass and size to a 5th percentile female, in 30 km/h frontal sled tests. The subjects were restrained on a rigid planar seat by bilateral rigid knee bolsters, pelvic blocks, and a custom force-limited 3-point shoulder and lap belt. Posttest subject injury assessment included identifying rib cage fractures by means of a radiologist read of a posttest computed tomography (CT) and an autopsy. The data from a motion capture camera system were processed to provide chest deflection, defined as the movement of the sternum relative to the spine at the level of T8.

?A complementary field data investigation involved querying the NASS-CDS database over the years 1997–2012. The targeted cases involved belted front seat small female passenger vehicle occupants over 40 years old who were injured in 25 to 35 km/h delta-V frontal crashes (11 to 1 o'clock).

Results: Peak upper shoulder belt tension averaged 1,970 N (SD = 140 N) in the sled tests. For all subjects, the peak x-axis deflection was recorded at the sternum with an average of ?44.5 mm or 25% of chest depth. The thoracic injury severity based on the number and distribution of rib fractures yielded 4 subjects coded as Abbreviated Injury Scale (AIS) 3 (serious) and one as AIS 5 (critical). The NASS-CDS field data investigation of small females identified 205 occupants who met the search criteria. Rib fractures were reported for 2.7% of the female occupants.

Conclusions: The small elderly test subjects sustained a higher number of rib cage fractures than expected in what was intended to be a minimally injurious frontal crash test condition. Neither field studies nor prior laboratory frontal sled tests conducted with 50th percentile male PMHS predicted the injury severity observed. Although this was a limited study, the results justify further exploration of the risk of rib cage injury for small elderly female occupants.     

Influence of Seat Properties on Occupant Dynamics in Severe Rear Crashes

Seat performance in retaining an occupant, transferring energy, and controlling neck responses is often questioned after severe rear crashes when fatal or disabling injury occur. It is argued that a stiffer seat would have improved occupant kinematics. However, there are many factors in occupant interactions with the seat. This study evaluates four different seat types in 26 and 32 mph (42 and 51 km/h), rear crash delta Vs. Two seats were yielding with k = 20 kN/m occupant load per displacement. One represented a 1970s yielding seat with j = 3.4°/kN frame rotation per occupant load, and 3 kN maximum load (660 Nm moment), and the other a high retention seat phased into production since 1997 with j = 1.4°/kN, and 10 kN maximum load (2200 Nm). Two seats were stiff with k = 40 kN/m. One represented a 1990s foreign benchmark with j = 1.8°/kN and a 7.7 kN maximum load (1700 Nm), and the other an all belts to seat (ABTS) with j = 1.0°/kN and 20 kN maximum load (4400 Nm). The crash was a constant acceleration of 11.8 g, or 14.5 g for 100 ms. Occupant interactions with the seat were modeled using a torso mass, flexible neck and head mass. By analysis of the equations of motion, the initial change in seatback angle (Δθ) is proportional to jk(y ? x), the product jk and the differential motion between the vehicle (seat cushion) and occupant. The transition from 1970s–80s yielding seats to stronger seats of the 1990s involved an increase in k stiffness; however, the jk property did not change as frame structures became stronger. The yielding seats of the 1970s had jk = 68°/m, while the stiff foreign benchmark seat had jk = 72°/m. The foreign benchmark rotated about the same as the 1970s seat up to 50 ms in the severe rear crashes. While it was substantially stronger, it produced higher loads on the occupant, and the higher loads increased seatback rotations and neck responses. The ABTS seat had the lowest rotations but also caused high neck responses because of the greater loads on the torso. Neck displacement (d) is initially proportional to (k/m_T) ∫∫ y, seat stiffness times the second integral of vehicle displacement divided by torso mass. As seat stiffness increases, head-torso acceleration, velocity, and neck displacement increase. This study shows that the jk seat property determines the initial seatback rotation in rear crashes. If a stronger seat has a higher stiffness, it rotates at higher loads on the occupant, reducing the overall benefit of the stronger frame, while increasing neck responses related to whiplash or neck extension prior to subsequent impacts. The aim of seat designs should be to reduce jk, provide pocketing of the pelvis, and give head-neck support for the best protection in severe rear crashes. For low-speed crashes, a low k is important to reduce early neck responses related to whiplash.     

Automated recognition of rear seat occupants' head position using Kinect™ 3D point cloud

IntroductionChild occupant safety in motor-vehicle crashes is evaluated using Anthropomorphic Test Devices (ATD) seated in optimal positions. However, child occupants often assume suboptimal positions during real-world driving trips. Head impact to the seat back has been identified as one important injury causation scenario for seat belt restrained, head-injured children (Bohman et al., 2011). There is therefore a need to understand the interaction of children with the Child Restraint System to optimize protection.MethodNaturalistic driving studies (NDS) will improve understanding of out-of-position (OOP) trends. To quantify OOP positions, an NDS was conducted. Families used a study vehicle for two weeks during their everyday driving trips. The positions of rear-seated child occupants, representing 22 families, were evaluated. The study vehicle – instrumented with data acquisition systems, including Microsoft Kinect™ V1 – recorded rear seat occupants in 1120 driving 26 trips. Three novel analytical methods were used to analyze data. To assess skeletal tracking accuracy, analysts recorded occurrences where Kinect™ exhibited invalid head recognition among a randomly-selected subset (81 trips). Errors included incorrect target detection (e.g., vehicle headrest) or environmental interference (e.g., sunlight). When head data was present, Kinect™ was correct 41% of the time; two other algorithms – filtering for extreme motion, and background subtraction/head-based depth detection are described in this paper and preliminary results are presented. Accuracy estimates were not possible because of their experimental nature and the difficulty to use a ground truth for this large database. This NDS tested methods to quantify the frequency and magnitude of head positions for rear-seated child occupants utilizing Kinect™ motion-tracking.ResultsThis study's results informed recent ATD sled tests that replicated observed positions (most common and most extreme), and assessed the validity of child occupant protection on these typical CRS uses.SummaryOptimal protection in vehicles requires an understanding of how child occupants use the rear seat space. This study explored the feasibility of using Kinect™ to log positions of rear seated child occupants. Initial analysis used the Kinect™ system’s skeleton recognition and two novel analytical algorithms to log head location.Practical applicationsThis research will lead to further analysis leveraging Kinect™ raw data – and other NDS data – to quantify the frequency/magnitude of OOP situations, ATD sled tests that replicate observed positions, and advances in the design and testing of child occupant protection technology.     

Restraint use in the Eastern Province of the Kingdom of Saudi Arabia

Objectives: This study set out to examine seat belt and child restraint use in the Dammam Municipality of the Kingdom of Saudi Arabia, based on the premise that an increase in seat belt use would significantly reduce personal injury in traffic crashes. It was expected that local data would help identify intervention strategies necessary to improve seat belt use in the region.

Methods: The research involved 2 methodologies. First, 1,389 face-to-face interviews were conducted with male and female adults in regional shopping plazas regarding their own and their children's restraint use in their vehicles and reasons for these attitudes and beliefs. Second, 2 on-road observation studies of adult and child restraint use were conducted by trained observers. Occupants of approximately 5,000 passenger vehicles were observed while stopped at representative signalized traffic intersections.

Results: The findings showed front seat belt use rates of between 43 and 47% for drivers and 26 to 30% for front seat passengers; rear seat belt use rates were lower. While there seemed to be some knowledge about the purpose and reasons for restraining both adults and children in suitable restraints, this failed to be confirmed in the on-road observations.

Conclusions: Reasons for these rates and findings are discussed fully, and recommendations for improving seat belt use in the Dammam Municipality are included.     

Chest injuries of elderly postmortem human surrogates (PMHSs) under seat belt and airbag loading in frontal sled impacts: Comparison to matching THOR tests

Abstract

Objective: The goal of the study was to develop experimental chest loading conditions that would cause up to Abbreviated Injury Scale (AIS) 2 chest injuries in elderly occupants in moderate-speed frontal crashes. The new set of experimental data was also intended to be used in the benchmark of existing thoracic injury criteria in lower-speed collision conditions.

Methods: Six male elderly (age >63) postmortem human subjects (PMHS) were exposed to a 35?km/h (nominal) frontal sled impact. The test fixture consisted of a rigid seat, rigid footrest, and cable seat back. Two restraint conditions (A and B) were compared. Occupants were restrained by a force-limited (2.5?kN [A] and 2?kN [B]) seat belt and a preinflated (16?kPa [A] and 11?kPa [B]; airbag). Condition B also incorporated increased seat friction. Matching sled tests were carried out with the THOR-M dummy. Infra-red telescoping rod for the assessment of chest compression (IRTRACC) readings were used to compute chest injury risk. PMHSs were exposed to a posttest injury assessment. Tests were carried out in 2 stages, using the outcome of the first one combined with a parametric study using the THUMS model to adjust the test conditions in the second. All procedures were approved by the relevant ethics board.

Results: Restraint condition A resulted in an unexpected high number of rib fractures (fx; 10, 14, 15 fx). Under condition B, the adjustment of the relative airbag/occupant position combined with a lower airbag pressure and lower seat belt load limit resulted in a reduced pelvic excursion (85 vs. 110?mm), increased torso pitch and a substantially lower number of rib fractures (1, 0, 4 fx) as intended.

Conclusions: The predicted risk of rib fractures provided by the THOR dummy using the C_max and PC Score injury criteria were lower than the actual injuries observed in the PMHS tests (especially in restraint condition A). However, the THOR dummy was capable of discriminating between the 2 restraint scenarios. Similar results were obtained in the parametric study with the THUMS model.     

Assessing tether anchor labeling and usability in pickup trucks

Objective: The objective of this study was to investigate vehicle factors associated with child restraint tether use and misuse in pickup trucks and evaluate 4 labeling interventions designed to educate consumers on proper tether use.

Methods: Volunteer testing was performed with 24 subjects and 4 different pickup trucks. Each subject performed 8 child restraint installations among the 4 pickups using 2 forward-facing restraints: a Britax Marathon G4.1 and an Evenflo Triumph. Vehicles were selected to represent 4 different implementations of tether anchors among pickups: plastic loop routers (Chevrolet Silverado), webbing routers (Ram), back wall anchors (Nissan Frontier), and webbing routers plus metal anchors (Toyota Tundra). Interventions included a diagram label, Quick Response (QR) Code linked to video instruction, coordinating text label, and contrasting text tag.

Results: Subjects used the child restraint tether in 93% of trials. However, tether use was completely correct in only 9% of trials. An installation was considered functional if the subject attached the tether to a tether anchor and had a tight installation (ignoring routing and head restraint position); 28% of subjects achieved a functional installation. The most common installation error was attaching the tether hook to the anchor/router directly behind the child restraint (near the top of the seatback) rather than placing the tether through the router and attaching it to the anchor in the adjacent seating position. The Nissan Frontier, with the anchor located on the back wall of the cab, had the highest rate of correct installations but also had the highest rate of attaching the tether to components other than the tether anchor (seat adjustor, child restraint storage hook, around head restraint). None of the labeling interventions had a significant effect on correct installation; not a single subject scanned the QR Code to access the video instruction. Subjects with the most successful installations spent extensive time reviewing the vehicle manuals.

Conclusion: Current implementations of tether anchors among pickup trucks are not intuitive for child restraint installations, and alternate designs should be explored. Several different labeling interventions were ineffective at achieving correct tether use in pickup trucks.     

Evaluation of interventions to make top tether hardware more visible during child restraint system (CRS) installations

Objectives: The objective of the study is to determine whether specific child restraint system (CRS) or vehicle conditions improve top tether attachment rates during volunteer installations.

Methods: A factorial randomized controlled trial was designed to evaluate 4 different experimental categories: (1) Color of tether adjuster casing (black or red), (2) labeling on tether adjuster casing (labeled with “Tether: Use for forward-facing” or unlabeled), (3) storage location of tether (bundled in a rubber band on the back of CRS or Velcroed over the forward-facing belt path), and (4) labeling in vehicle (labeled under head restraint and below anchor or unlabeled). Ninety-six volunteers were randomly assigned to one combination of conditions. One installation per volunteer was completed. The primary outcome measure was acceptable attachment of the top tether to the tether anchor. The secondary outcome measure was overall secureness of the installation. Pearson’s chi-square tests were used to identify significant predictors of acceptable outcomes and logistic regression was used to investigate interaction effects.

Results: A total of 66/96 subjects (68.8%) attached the top tether in an acceptable manner, with either zero errors (n?=?50) or minor errors (n?=?16). A total of 30/96 subjects (31.2%) had unacceptable tether outcomes, with either major errors (n?=?10) or nonuse the tether at all (n?=?20). None of the 4 experimental categories significantly affected tether outcomes. Subjects who opted to install the CRS with the lower anchors (LAs) had higher rates of acceptable tether attachment compared to subjects who installed using the seat belt or those who used both LA and seat belt together (χ² = 6.792, P = .034). Tether outcomes were not correlated with previous CRS experience, use of instruction manual(s), age, or sex. Only 15.6% of subjects produced overall correct and tight installations. Of those who used the seat belt in some manner, 70.2% neglected to switch the retractor into locking mode.

Conclusions: Conditions in this study including tether color, tether labeling, storage location, and vehicle labeling did not significantly affect tether attachment rates. High rates of tether misuse and nonuse warrant further exploration to find effective solutions to this usability problem.