A Bayesian assessment of the effect of highway bypasses in Iowa on crashes and crash rate

Introduction

A common contention is that the construction of highway bypasses negatively impacts the economy of local communities by reducing pass-by traffic for businesses. However, as access to specific business' account records is limited, this impact is difficult to quantify. Another common contention is that bypasses contribute to a reduction in overall crashes in the community and in the surrounding areas. Even though a large number of bypasses have been constructed in the State of Iowa over the past several years, their actual impact in terms of traffic safety has not been quantified.

Objectives

This study seeks answers to the following questions: (a) Are bypasses in Iowa associated with a reduction in crash frequencies and crash rates on the bypassed highway? (b) Do bypasses in Iowa introduce a reduction of overall crash frequencies and rates or do they merely shift crashes from the highways through the communities to the bypasses with no significant overall reduction?

Method

We obtained crash information from the Iowa DOT at 19 sites on which a bypass was constructed sometime during the past 23 years. We also obtained the same information at six sites used as comparison sites on which no bypasses were constructed at least until 2005. We them employed a Bayesian approach to estimating the association between the construction of the bypass and crash rates, while also accounting for other factors.

Results

The construction of bypasses in Iowa is associated with a significant increase in traffic safety both on the main road through town and on the combined main road and bypass roadway.     

Drowsy drivers: The effect of light and circadian rhythm on crash occurrence

Drowsiness has been recognized as a pervasive problem for drivers, with effects comparable to alcohol. Alcohol, however, has a clear legal limit for impairment; there are no comparable criteria to suggest sleepiness. Drowsiness has been associated with light and circadian rhythm. To investigate the joint effects of these factors on crash occurrence, along with other factors, single vehicle crashes reported in Ontario (1999–2004) were analyzed. Crashes occurring at four times of day, when light varies and circadian rhythm is low (2–5 a.m. and 2–4 p.m.) and with similar light conditions and higher circadian rhythm (9–11 p.m. and 10 a.m.–12 noon). Logistic regression was used to see how light and other factors are associated with single vehicle crashes occurring at times of low circadian rhythm, when drowsiness is more likely.Initial results indicated many circumstances associated with occurrence at these times: the age and sex of the driver and reported driver condition as well as weather. There is, however, an interaction between light and presumed alertness. In separate analyses for daytime and night time crashes most variables were significant for nighttime crashes but not for daytime events. The effects of alcohol and youth remained. A lack of light may exacerbate the effects of other factors at times of low alertness; this should be further investigated in controlled environments such as sleep laboratories and/or driving simulators.     

平原区交叉口安全分析与改善对策研究

针对目前平原区公路交叉口事故多发的现状,笔者对平原区公路交叉口与山区公路交叉口进行对比,指出平原区公路交叉口具有数量多、范围大、车速高的特点;同时分析平原区公路事故情况,指出平原区公路交叉口事故多发的主要致因是缺乏渠化、路权不清,车速过高和视距不足;提出了交叉口安全保障的一般措施,并具体介绍了明确路权、降低车辆行驶速度和增加交叉口行车视距的方法。除介绍了平原区公路交叉口的一般处置措施外,笔者还将平原区公路交叉口分为大型交叉口、村镇交叉口和小型交叉口,并针对不同类型的交叉口的特点,从标志、标线、减速丘、薄层铺装、宣传教育等方面提出了相应的安全保障措施。     

Development of a method to rate the primary safety of vehicles using linked New Zealand crash and vehicle licensing data

Objective: Vehicle safety rating systems aim firstly to inform consumers about safe vehicle choices and, secondly, to encourage vehicle manufacturers to aspire to safer levels of vehicle performance. Primary rating systems (that measure the ability of a vehicle to assist the driver in avoiding crashes) have not been developed for a variety of reasons, mainly associated with the difficult task of disassociating driver behavior and vehicle exposure characteristics from the estimation of crash involvement risk specific to a given vehicle. The aim of the current study was to explore different approaches to primary safety estimation, identifying which approaches (if any) may be most valid and most practical, given typical data that may be available for producing ratings.

Methods: Data analyzed consisted of crash data and motor vehicle registration data for the period 2003 to 2012: 21,643,864 observations (representing vehicle-years) and 135,578 crashed vehicles. Various logistic models were tested as a means to estimate primary safety: Conditional models (conditioning on the vehicle owner over all vehicles owned); full models not conditioned on the owner, with all available owner and vehicle data; reduced models with few variables; induced exposure models; and models that synthesised elements from the latter two models.

Results: It was found that excluding young drivers (aged 25 and under) from all primary safety estimates attenuated some high risks estimated for make/model combinations favored by young people. The conditional model had clear biases that made it unsuitable. Estimates from a reduced model based just on crash rates per year (but including an owner location variable) produced estimates that were generally similar to the full model, although there was more spread in the estimates. The best replication of the full model estimates was generated by a synthesis of the reduced model and an induced exposure model.

Conclusions: This study compared approaches to estimating primary safety that could mimic an analysis based on a very rich data set, using variables that are commonly available when registered fleet data are linked to crash data. This exploratory study has highlighted promising avenues for developing primary safety rating systems for vehicle makes and models.     

The impact of environmental, vehicle and driver characteristics on injury severity in older drivers hospitalized as a result of a traffic crash

INTRODUCTION: Compared to younger age groups, older people are more likely to be seriously injured or to die as a result of a traffic crash. METHOD: The aim of the study is to examine the impact of environmental, vehicle, crash, and driver characteristics on injury severity in older drivers involved in traffic crashes by using recently linked police crash records and hospitalization data from New South Wales, Australia. The severity of injury resulting from traffic crashes was measured using the International Classification of Diseases, 10th revision (ICD-10) Injury Severity Score (ICISS). RESULTS: Multivariate analysis identified rurality, presence of complex intersections, road speed limit, driver error, speeding, and seat belt use as independent predictors of injury severity in older people. The type of intersection configuration explained over half of the observed variations in injury severity. IMPACT ON INDUSTRY: Environmental modification such as intersection treatments might contribute to a decrease in the severity of injury in older people involved in road crashes.     

An estimate of the effectiveness of an in-vehicle automatic collision notification system in reducing road crash fatalities in South Australia

Objectives: The aim of this study was to estimate the potential effectiveness of an in-vehicle automatic collision notification (ACN) system in reducing all road crash fatalities in South Australia (SA).

Methods: For the years 2008 to 2009, traffic accident reporting system (TARS) data, emergency medical services (EMS) road crash dispatch data, and coroner's reports were matched and examined. This was done to initially determine the extent to which there were differences between the reported time of a fatal road crash in the mass crash data and the time EMS were notified and dispatched. In the subset of fatal crashes where there was a delay, injuries detailed by a forensic pathologist in individual coroner's reports were examined to determine the likelihood of survival had there not been a delay in emergency medical assistance.

Results: In 25% (N = 53) of fatalities in SA in the period 2008 to 2009, there was a delay in the notification of the crash event, and hence dispatch of EMS, that exceeded 10 min. In the 2-year crash period, 5 people were likely to have survived through more prompt crash notification enabling quicker emergency medical assistance. Additionally, 3 people potentially would have survived if surgical intervention (or emergency medical assistance to sustain life until surgery) occurred more promptly.

Conclusions: The minimum effectiveness rate of an ACN system in SA with full deployment is likely to be in the range of 2.4 to 3.8% of all road crash fatalities involving all vehicle types and all vulnerable road users (pedestrians, cyclists, and motorcyclists) from 2008 to 2009. Considering only passenger vehicle occupants, the benefit is likely to be 2.6 to 4.6%. These fatality reductions could only have been achieved through earlier notification of each crash and their location to enable a quicker medical response. This might be achievable through a fully deployed in-vehicle ACN system.     

正面碰撞事故中大客车乘员损伤影响因素分析

为研究乘客在大客车正面碰撞事故中的损伤机理,建立某全承载大客车有限元模型,并通过试验验证有限元模型的仿真精度。基于验证模型对不同碰撞速度条件下大客车车身结构力学响应、生存空间、座椅固定件强度、乘员运动响应和损伤等进行综合分析及评价。结果表明:高速碰撞条件下,驾驶员生存空间容易被侵入,座椅固定件强度存在失效的风险;乘员头部、颈部和胸部的损伤值受碰撞速度、安全带类型和乘员位置影响较大;三点式安全带保护效果明显优于两点式安全带。     

The combined benefits of motorcycle antilock braking systems (ABS) in preventing crashes and reducing crash severity

Objective: Several studies have reported the benefits of motorcycle antilock braking systems (ABS) in reducing injury crashes, due to improved stability and braking performance. Both aspects may prevent crashes but may also reduce the crash severity when a collision occurs. However, it is still unknown to what extent the reductions in injury crashes with ABS may be due to a combination of these mechanisms.

Methods: Swedish hospital and police reports (2003–2012) were used. The risk for permanent medical impairment (RPMI) was calculated, showing the risk of at least 1 or 10% permanent medical impairment. In total, 165 crashes involving ABS-equipped motorcycles were compared with 500 crashes with similar motorcycles without ABS.

The analysis was performed in 3 steps. First, the reduction in emergency care visits with ABS was calculated using an induced exposure approach. Secondly, the injury mitigating effects of ABS were investigated. The mean RPMI 1+ and RPMI 10+ were analyzed for different crash types. The distributions of impairing injuries (PMI 1+) and severely impairing injuries (PMI 10+) were also analyzed. In the third step, the total reduction of PMI 1+ and PMI 10+ injured motorcyclists was calculated by combining the reductions found in the previous steps. An additional analysis of combined braking systems (CBS) together with ABS was also performed.

Results: The results showed that emergency care visits were reduced by 47% with ABS. In the second step, it was found that the mean RPMI 1+ and RPMI 10+ with ABS were 15 and 37% lower, respectively. Finally, the third step showed that the total reductions in terms of crash avoidance and mitigation of PMI 1+ and PMI 10+ injured motorcyclists with ABS were 67 and 55%, respectively. However, PMI 1+ and PMI 10+ leg injuries were not reduced by ABS to the same extent. Indications were found suggesting that the benefits of ABS together with CBS may be greater than ABS alone.

Conclusions: This article indicated that motorcycle ABS reduced impairing injuries, mostly due to fewer emergency care visits but also due to a reduction in crash severity. This may seem reasonable as the improved stability and braking performance provided by ABS could prevent some crashes but would also decrease crash severity if a collision still occurs. As suggested by previous studies, however, the lower extremities would be more exposed in a crash with ABS. It is recommended that future research should follow up these results with additional data.     

农村摩托车驾驶员驾驶行为调查分析——以山东莒南为例

为探究农村摩托车驾驶员常见的不安全驾驶行为及农村摩托车事故多发的原因,采用问卷调查的方法,从人、车、交通管理等几个角度对我国山东农村地区的480名摩托车驾驶员进行了入户问卷调查.通过SPSS17.0软件对收集的数据进行处理,重点对驾驶员的驾驶行为进行分析,结果显示在403名驾驶员中仅有60(14.9%)人拥有驾照、74...     

施工承包企业安全成本及其核算的研究

依据施工承包企业安全管理的目标、特点和程序,提出安全成本的概念和构成以及保证性安全成本对损失性安全成本的直接影响.同时,借助施工安全成本与安全度的关系、提高安全技术工作的经济合理性、加速构建施工承包企业安全成本核算制度,优化施工承包企业的安全管理工作,并为提高企业经济效益及社会经济运行的安全度奠定基础.     

Assessment of Integrated Pedestrian Protection Systems with Autonomous Emergency Braking (AEB) and Passive Safety Components

Objective: Autonomous emergency braking (AEB) systems fitted to cars for pedestrians have been predicted to offer substantial benefit. On this basis, consumer rating programs—for example, the European New Car Assessment Programme (Euro NCAP)—are developing rating schemes to encourage fitment of these systems. One of the questions that needs to be answered to do this fully is how the assessment of the speed reduction offered by the AEB is integrated with the current assessment of the passive safety for mitigation of pedestrian injury. Ideally, this should be done on a benefit-related basis.

The objective of this research was to develop a benefit-based methodology for assessment of integrated pedestrian protection systems with AEB and passive safety components. The method should include weighting procedures to ensure that it represents injury patterns from accident data and replicates an independently estimated benefit of AEB.

Methods: A methodology has been developed to calculate the expected societal cost of pedestrian injuries, assuming that all pedestrians in the target population (i.e., pedestrians impacted by the front of a passenger car) are impacted by the car being assessed, taking into account the impact speed reduction offered by the car's AEB (if fitted) and the passive safety protection offered by the car's frontal structure. For rating purposes, the cost for the assessed car is normalized by comparing it to the cost calculated for a reference car.

The speed reductions measured in AEB tests are used to determine the speed at which each pedestrian in the target population will be impacted. Injury probabilities for each impact are then calculated using the results from Euro NCAP pedestrian impactor tests and injury risk curves. These injury probabilities are converted into cost using “harm”-type costs for the body regions tested. These costs are weighted and summed. Weighting factors were determined using accident data from Germany and Great Britain and an independently estimated AEB benefit. German and Great Britain versions of the methodology are available. The methodology was used to assess cars with good, average, and poor Euro NCAP pedestrian ratings, in combination with a current AEB system. The fitment of a hypothetical A-pillar airbag was also investigated.

Results: It was found that the decrease in casualty injury cost achieved by fitting an AEB system was approximately equivalent to that achieved by increasing the passive safety rating from poor to average. Because the assessment was influenced strongly by the level of head protection offered in the scuttle and windscreen area, a hypothetical A-pillar airbag showed high potential to reduce overall casualty cost.

Conclusions: A benefit-based methodology for assessment of integrated pedestrian protection systems with AEB has been developed and tested. It uses input from AEB tests and Euro NCAP passive safety tests to give an integrated assessment of the system performance, which includes consideration of effects such as the change in head impact location caused by the impact speed reduction given by the AEB.     

Computational modeling and analysis of thoracolumbar spine fractures in frontal crash reconstruction

Abstract

Objective: This study aimed to reconstruct 11 motor vehicle crashes (6 with thoracolumbar fractures and 5 without thoracolumbar fractures) and analyze the fracture mechanism, fracture predictors, and associated parameters affecting thoracolumbar spine response.

Methods: Eleven frontal crashes were reconstructed with a finite element simplified vehicle model (SVM). The SVM was tuned to each case vehicle and the Total HUman Model for Safety (THUMS) Ver. 4.01 was scaled and positioned in a baseline configuration to mimic the documented precrash driver posture. The event data recorder crash pulse was applied as a boundary condition. For the 6 thoracolumbar fracture cases, 120 simulations to quantify uncertainty and response variation were performed using a Latin hypercube design of experiments (DOE) to vary seat track position, seatback angle, steering column angle, steering column position, and D-ring height. Vertebral loads and bending moments were analyzed, and lumbar spine indices (unadjusted and age-adjusted) were developed to quantify the combined loading effect. Maximum principal strain and stress data were collected in the vertebral cortical and trabecular bone. DOE data were fit to regression models to examine occupant positioning and thoracolumbar response correlations.

Results: Of the 11 cases, both the vertebral compression force and bending moment progressively increased from superior to inferior vertebrae. Two thoracic spine fracture cases had higher average compression force and bending moment across all thoracic vertebral levels, compared to 9 cases without thoracic spine fractures (force: 1,200.6 vs. 640.8 N; moment: 13.7 vs. 9.2?Nm). Though there was no apparent difference in bending moment at the L1–L2 vertebrae, lumbar fracture cases exhibited higher vertebral bending moments in L3–L4 (fracture/nonfracture: 45.7 vs. 33.8?Nm). The unadjusted lumbar spine index correctly predicted thoracolumbar fracture occurrence for 9 of the 11 cases (sensitivity?=?1.0; specificity?=?0.6). The age-adjusted lumbar spine index correctly predicted thoracolumbar fracture occurrence for 10 of the 11 cases (sensitivity?=?1.0; specificity?=?0.8). The age-adjusted principal stress in the trabecular bone was an excellent indicator of fracture occurrence (sensitivity?=?1.0; specificity?=?1.0). A rearward seat track position and reclined seatback increased the thoracic spine bending moment by 111–329%. A more reclined seatback increased the lumbar force and bending moment by 16–165% and 67–172%, respectively.

Conclusions: This study provided a computational framework for assessing thoracolumbar fractures and also quantified the effect of precrash driver posture on thoracolumbar response. Results aid in the evaluation of motor vehicle crash–induced vertebral fractures and the understanding of factors contributing to fracture risk.     

Cross-sectional study of road accidents and related law enforcement efficiency for 10 countries: A gap coherence analysis

Objective: Road crashes are considered as the eighth leading causes of death. There is a wide disparity in crash severity and law enforcement efficiency among low-, medium-, and high-income countries. It would be helpful to review the crash severity trends in these countries, identify the vulnerable road users, and understand the law enforcement effectiveness in devising efficient road safety improvement strategies.

Method: The crash severity, fatality rate among various age groups, and law enforcement strategies of 10 countries representing low-income (i.e., India and Morocco), medium-income (i.e. Argentina, South Korea, and Greece), and high-income (i.e., Australia, Canada, France, the UK, and the United States) are studied and compared for a period of 5 years (i.e., 2008 to 2012). The critical parameters affecting road safety are identified and correlated with education, culture, and basic compliance with traffic safety laws. In the process, possible road safety improvement strategies are identified for low-income countries.

Results: The number of registered vehicles shows an increasing trend for low-income countries as do the crash rate and crash severity. Compliance related to seat belt and helmet laws is high in high-income countries. In addition, recent seat belt– and helmet-related safety programs in middle-income countries helped to curb fatalities. Noncompliance with safety laws in low-income countries is attributed to education, culture, and inefficient law enforcement.

Conclusion: Efficient law enforcement and effective safety education taking into account cultural diversity are the key aspects to reduce traffic-related injuries and fatalities in low-income countries like India.     

交通信号倒计时对车速与交通安全的影响

研究交通信号倒计时对自由流车速及交通安全的影响。选择城市道路交叉口,使用雷达测速设备采集进口道自由流车速等数据。运用描述统计、方差分析、列联表等统计方法,进行数据分析。数据显示,仅考虑单因素影响时,交通违法检测设备存在与否对车速均值有显著影响,而绿灯信号倒计时则无显著影响;考虑多因素相互影响时,在有绿灯信号倒计时但无交通违法检测设备的情况下,车辆速度均值会更高,且绿灯倒计时会对超速率产生影响。红灯倒计时对车速离散程度有明显的影响。结果表明,使用绿灯信号倒计时应同时安装交通违法检测设备,红灯倒计时路口应确保充分的绿灯间隔时间。     

Effects of red light camera enforcement on fatal crashes in large U.S. cities

Objective

To estimate the effects of red light camera enforcement on per capita fatal crash rates at intersections with signal lights.

Methods

From the 99 large U.S. cities with more than 200,000 residents in 2008, 14 cities were identified with red light camera enforcement programs for all of 2004-2008 but not at any time during 1992-1996, and 48 cities were identified without camera programs during either period. Analyses compared the citywide per capita rate of fatal red light running crashes and the citywide per capita rate of all fatal crashes at signalized intersections during the two study periods, and rate changes then were compared for cities with and without cameras programs. Poisson regression was used to model crash rates as a function of red light camera enforcement, land area, and population density.

Results

The average annual rate of fatal red light running crashes declined for both study groups, but the decline was larger for cities with red light camera enforcement programs than for cities without camera programs (35% vs. 14%). The average annual rate of all fatal crashes at signalized intersections decreased by 14% for cities with camera programs and increased slightly (2%) for cities without cameras. After controlling for population density and land area, the rate of fatal red light running crashes during 2004-2008 for cities with camera programs was an estimated 24% lower than what would have been expected without cameras. The rate of all fatal crashes at signalized intersections during 2004-2008 for cities with camera programs was an estimated 17% lower than what would have been expected without cameras.

Conclusions

Red light camera enforcement programs were associated with a statistically significant reduction in the citywide rate of fatal red light running crashes and a smaller but still significant reduction in the rate of all fatal crashes at signalized intersections.

Impact on Industry

The study adds to the large body of evidence that red light camera enforcement can prevent the most serious crashes. Communities seeking to reduce crashes at intersections should consider this evidence.     

Trauma demography and clinical epidemiology of motorcycle crash–related head injury in a neurosurgery practice in an African developing country

Objective: Though motor vehicle crashes (MVCs) were the main cause of head trauma from road traffic injuries (RTIs), motorcycle crashes (MCCs) are now a major cause of RTI-related head injury (HI) in many developing countries.

Methods: Using a prospective database of HIs from a neurosurgical practice in a sub-Saharan African developing country, a cross-sectional survey was conducted for the trauma demography and clinical epidemiology of this MCC-related HI.

Results: Motorcycle crashes accounted for 57% (473/833) of all RTI-related HIs in this registry. The victims, with a mean age of 33.1 years (SD = 18.3), consisted mainly of males (83.1%), those of low socioeconomic status (>90%), and those aged between 20 and 40 years old (56%). MCCs involved only riders in 114 cases (114/473, 32.1%), of which 69% were motorcycle–motorcycle crashes. The HI was moderate–severe in 50.8%; clinical symptomatology of significant HI included loss of consciousness (92%), anisocoria (35%), Abbreviated Injury Scale head (AIS–head) score > 3 (28%), and CT-Rotterdam score > 3 (30%). Extracranial systemic injury involved the limbs most frequently, with an Injury Severity Score (ISS) >25 in 49%. The fatality rate was 24%.

MCC-related HI among pedestrian victims involved more vulnerable age groups (the young and elderly) but have lower mean ISS compared to motorcycle passengers (mean ISS = 23.5 [11.6] vs. 27.4 [13.0]; 95% confidence interval [CI], 1.27–6.49; P = .004). In addition, compared to a contemporary cohort of MVC-related HIs in our registry, MCC victims were older (mean age 34.8 years [18.0] vs. 30.8 [18.4]; P = .002); had higher proportions of certain extracranial trauma like long bone fractures (71 vs. 29%; P = .02); and suffered fewer surgical brain lesions (25.5 vs. 17.2%; P = .004).

Conclusions: Motorcycle crashes are now a significant threat to the heads, limbs, and lives of vulnerable road users in developing countries.     

Effects of turning on and off red light cameras on fatal crashes in large U.S. cities

IntroductionThis study updates estimates of effects of activating red light cameras and offers a first look at effects of turning them off.MethodAmong 117 large U.S. cities with more than 200,000 residents in 2014, trends in citywide per capita rates of fatal red light running crashes and of all fatal crashes at signalized intersections were compared between 57 cities that initiated camera programs during 1992–2014 and 33 cities without cameras to examine effects of activating camera programs. Trends also were compared between 19 cities that removed cameras and 31 regionally matched cities with continuous camera programs to evaluate effects of terminating camera programs. Because several cities removed cameras during 2005–2008 and estimated effects might have been confounded by the subsequent economic downturn, primary analyses were limited to the 14 cities that removed cameras during 2010–2014 and 29 regionally matched cities with continuous camera programs. Poisson regression examined the relationship of activating and deactivating cameras with fatal crash rates.ResultsAfter controlling for temporal trends in annual fatal crash rates, population density, and unemployment rates, rates of fatal red light running crashes and of all fatal crashes at signalized intersections were 21% and 14% lower, respectively, in cities with cameras after cameras were turned on than would have been expected without cameras; 30% and 16% higher, respectively, in 14 cities that terminated cameras during 2010–2014 after cameras were terminated than expected had cameras remained; and 18% and 8% higher, respectively, in all 19 cities that removed cameras, but not significantly.ConclusionsThis study adds to the body of evidence that red light cameras can reduce the most serious crashes at signalized intersections, and is the first to demonstrate that removing cameras increases fatal crashes.Practical applicationsCommunities thinking about removing cameras should consider impacts to safety.     

我国核与辐射安全监督执法能力建设初探

核与辐射安全监管现代化是国家治理体系和治理能力现代化建设的重要组成部分,而实现我国核与辐射安全监管现代化就是要不断推进我国核与辐射安全监管体系和监管能力现代化进程。当前,作为我国核与辐射安全监管能力之一的监督执法能力,其重要性愈来愈突出,如何促进监督执法能力建设这一现实问题已经引起了社会的普遍关注。从我国核与辐射安全监督执法能力的理论基础出发,总结了近年来我国核与辐射安全监督执法能力建设的主要做法以及取得的成效,最后指出存在的不足。     

Functional outcomes of motor vehicle crash thoracic injuries in pediatric and adult occupants

Objective: Characterization of the severity of injury should account for both mortality and disability. The objective of this study was to develop a disability metric for thoracic injuries in motor vehicle crashes (MVCs) and compare the functional outcomes between the pediatric and adult populations.

Methods: Disability risk (DR) was quantified using Functional Independence Measure (FIM) scores within the National Trauma Data Bank for the most frequently occurring Abbreviated Injury Scale (AIS) 2–5 thoracic injuries. Occupants with thoracic injury were classified as disabled or not disabled based on the FIM scale, and comparisons were made between the following age groups: pediatric, adult, middle-aged, and older occupants (ages 7–18, 19–45, 46–65, and 66+, respectively). For each age group, DR was calculated by dividing the number of patients who were disabled and sustained a given injury by the number of patients who sustained a given injury. To account for the effect of higher severity co-injuries, a maximum AIS adjusted DR (DR_MAIS) was also calculated for each injury. DR and DR_MAIS could range from 0 to 100% disability risk.

Results: The mean DR_MAIS for MVC thoracic injuries was 20% for pediatric occupants, 22% for adults, 29% for middle-aged adults, and 43% for older adults. Older adults possessed higher DR_MAIS values for diaphragm laceration/rupture, heart laceration, hemo/pneumothorax, lung contusion/laceration, and rib and sternum fracture compared to the other age groups. The pediatric population possessed a higher DR_MAIS value for flail chest compared to the other age groups.

Conclusion: Older adults had significantly greater overall disability than each of the other age groups for thoracic injuries. The developed disability metrics are important in quantifying the significant burden of injuries and loss of quality life years. Such metrics can be used to better characterize severity of injury and further the understanding of age-related differences in injury outcomes, which can influence future age-specific modifications to AIS.