Efficacy of side airbags in reducing driver deaths in driver-side car and SUV collisions

OBJECTIVE: To estimate the efficacy of side airbags in preventing driver deaths in passenger vehicles struck on the driver side. METHODS: Risk ratios for driver deaths per driver-side collision were computed for side airbag-equipped cars and SUVs, relative to vehicles without side airbags. Driver fatality ratios also were calculated for the same vehicles in front and rear impacts, and these were used to adjust the side crash risk ratios for differences in fatality risk unrelated to side airbags. Risk ratios were calculated separately for side airbags providing torso-only protection and side airbags with head protection; almost all head protecting airbags also had airbags protecting the torso. RESULTS: Car driver death risk in driver-side crashes was reduced by 37 percent for head protecting airbags and 26 percent for torso-only side airbags. Car driver death risk was reduced for older and younger drivers, males and females, and drivers of small and midsize cars, and when the striking vehicle was an SUV/pickup or a car/minivan. Death risk for drivers of SUVs was reduced by 52 percent with head protecting side airbags and by 30 percent with torso-only airbags. The effectiveness of side airbags could not be assessed for pickups and minivans due to the small number of these vehicles with airbags involved in crashes. CONCLUSION: Side airbags substantially reduce the risk of car and SUV driver death in driver-side collisions. Making side airbags with head protection available to drivers and right front passengers in all passenger vehicles could reduce the number of fatalities in motor vehicle crashes in the United States by about 2,000 each year.     

Side impact crashes--factors affecting incidence and severity: review of the literature

Many traffic crashes are side impact collisions resulting in significant death and injury. A review was conducted of the evidence of driver, road, and vehicle characteristics affecting either the risk of occurrence or the severity of injury in such crashes for papers published from 1996 to early 2003. For drivers, evidence was found of increased crash risk or injury severity only for age and age-related medical conditions (e.g., dementia). Traffic roundabouts and other traffic control devices--stop signs, traffic lights, and so on--had mixed results; traffic controls were better than no controls, but their effectiveness varied with circumstance. Most vehicle characteristics have had little or no effect on crash occurrence. Antilock braking systems (ABS) in the striking vehicle had been anticipated to reduce the risk of crashes, but so far have demonstrated little effect. The primary emphasis in vehicle design has been on protective devices to reduce the severity of injury. Disparity in the size of the two vehicles, especially when the struck vehicle is smaller and lighter, is almost a consistent risk factor for occupant injury. The occupants of light trucks, however, when struck by passengers cars on the opposite side, were at higher risk of injury. Wearing seat belts had a consistently protective effect; airbags did not, but there were few studies, and no field studies, of lateral airbags found. Of all the characteristics examined, vehicle design, including occupant restraints, is the most easily modified in the short term, although road design, traffic control, and the monitoring of older drivers may also prove effective in reducing side impact crashes in the longer term.     

Characteristics of rear-end crashes involving passenger vehicles with automatic emergency braking

Abstract

Objectives: Automatic emergency braking (AEB) is a proven effective countermeasure for preventing front-to-rear crashes, but it has not yet fully lived up to its estimated potential. This study identified the types of rear-end crashes in which striking vehicles with AEB are overrepresented to determine whether the system is more effective in some situations than in others, so that additional opportunities for increasing AEB effectiveness might be explored.

Methods: Rear-end crash involvements were extracted from 23?U.S. states during 2009–2016 for striking passenger vehicles with and without AEB among models where the system was optional. Logistic regression was used to examine the odds that rear-end crashes with various characteristics involved a striking vehicle with AEB, controlling for driver and vehicle features.

Results: Striking vehicles were significantly more likely to have AEB in crashes where the striking vehicle was turning relative to when it was moving straight (odds ratio [OR]?=?2.35; 95% confidence interval [CI], 1.76, 3.13); when the struck vehicle was turning (OR = 1.66; 95% CI, 1.25, 2.21) or changing lanes (OR = 2.05; 95% CI, 1.13, 3.72) relative to when it was slowing or stopped; when the struck vehicle was not a passenger vehicle or was a special use vehicle relative to a car (OR = 1.61; 95% CI, 1.01, 2.55); on snowy or icy roads relative to dry roads (OR = 1.83; 95% CI, 1.16, 2.86); or on roads with speed limits of 70+ mph relative to those with 40 to 45?mph speed limits (OR = 1.49; 95% CI, 1.10, 2.03). Overall, 25.3% of crashes where the striking vehicle had AEB had at least one of these overrepresented characteristics, compared with 15.9% of strikes by vehicles without AEB.

Conclusions: The typical rear-end crash occurs when 2 passenger vehicles are proceeding in line, on a dry road, and at lower speeds. Because atypical crash circumstances are overrepresented among rear-end crashes by striking vehicles with AEB, it appears that the system is doing a better job of preventing the more typical crash scenario. Consumer information testing programs of AEB use a test configuration that models the typical rear-end crash type. Testing programs promoting good AEB performance in crash circumstances where vehicles with AEB are overrepresented could guide future development of AEB systems that perform well in these additional rear-end collision scenarios.     

The Crash Compatibility of Cars and Light Trucks

This paper investigates the compatibility of cars, light trucks, and vans (LTVs) involved in traffic crashes. An analysis of U.S. crash statistics shows that, although LTVs currently account for approximately one–third of registered U.S. passenger vehicles, collisions between cars and LTVs account for over one–half of all fatalities in light vehicle–to–vehicle crashes. In these crashes, 81 percent of the fatally injured are found to be occupants of the car. These statistics suggest that LTVs and passenger cars are incompatible in traffic crashes, and that LTVs are the more aggressive of the two vehicle classes. The fundamental incompatibility between cars and LTVs is observed even when the analysis is restricted to collisions between vehicles of model year 1990 or later - indicating that, despite the availability of newer safety countermeasures, e.g., airbags, the incompatibility between cars and LTVs will persist in future fleets. Through examination of crash test results, field crash statistics, and vehicle measurements, the paper explores the design imbalances between cars and LTVs, e.g., mass, stiffness, and geometry, which lead to these severe crash incompatibilities.     

Relationships of frontal offset crash test results to real-world driver fatality rates

In a study of the relationship between Insurance Institute for Highway Safety frontal offset crash test ratings and real-world fatality rates, there was a clear trend for better-rated vehicles to have lower driver fatality risk, although the correlation was not uniform across all vehicle groups or statistically significant in all cases. For all types of crashes combined, fatality rates per registered vehicle were generally lower for vehicles rated good than for vehicles rated poor, but rates for acceptable and marginal vehicles were not always within this range. A more precise examination of fatality risk was accomplished by comparing driver outcomes in fatal two-vehicle crashes. When a rated vehicle collided with a nonrated vehicle, the fatality risk for the rated vehicle driver was highest for poorly rated vehicles, then progressively smaller for vehicles with marginal, acceptable, or good ratings. For two-vehicle crashes of similar vehicles rated good and poor, the odds of driver fatality was 34 percent lower for the good vehicle than for the poor vehicle, but this estimate was not statistically significant. Finally, in head-on crashes of rated vehicles, the estimated odds of driver fatality was approximately 74 percent lower for the good vehicle than for the poor vehicle, with confidence limits ranging from 28 to 91 percent.     

Fatal pedestrian crashes on interstates and other freeways in the United States

Introduction: More than 800 pedestrians die annually in crashes on interstates and other freeways in the United States, but few studies have examined their characteristics. Method: Data from the Fatality Analysis Reporting System on pedestrians fatally injured during 2015–2017 were analyzed. Chi-square tests compared characteristics of pedestrians killed on interstates and other freeways with those that died on other roads, and across crash types among freeway deaths. Land use characteristics of locations where pedestrians were killed while crossing freeways in a large state (California) were identified using Google Earth. Results: A larger proportion of pedestrians killed on freeways died on dark and unlit roads (48% vs. 32%), were male (78% vs. 68%), or were ages 20–44 (55% vs. 32%) compared with pedestrians killed on other roads. Crossing (42%) was the most common crash type among pedestrian deaths on freeways, followed by disabled-vehicle-related crashes (18%). Pedestrians who died while crossing more often had blood alcohol concentrations ≥ 0.08 g/dL (40%) than those in disabled-vehicle-related (22%) or other crashes (34%). Deaths in crossing crashes were more likely than other freeway deaths to occur on urban roads (81%), at speed limits ≤50 mph (13%), or between 18:00 and 23:59 (49%), and 58% of crossing crashes analyzed for land use were located between residential and other (e.g., commercial, recreational) uses. Over a third (37%) of deaths in disabled-vehicle-related crashes occurred at speed limits ≥70 mph. Conclusions: A surprising proportion of pedestrian deaths occur on controlled-access roads not designed for walking. Countermeasures for these crashes need to be implemented to see meaningful reductions in pedestrian fatalities overall. Practical applications: Improving roadway and vehicle lighting, requiring reflective warning devices for marking disabled vehicles, constructing pedestrian overpasses and underpasses in areas frequently crossed, and promoting alternative means of traveling between residential and commercial areas could help.     

Safety belt effectiveness in preventing driver fatalities versus a number of vehicular, accident, roadway, and environmental factors

Safety belt effectiveness in preventing fatalities to drivers is examined versus a number factors (vehicle, accident, and environmental) by applying the double-pair comparison method to appropriate subsets of the Fatal Accident Reporting System (FARS) data. For each of 13 factors studied, safety belt effectiveness (the percent of fatally injured unbelted drivers who would not have been killed if they had been wearing safety belts) is estimated, as is an associated standard error of the estimate. The results, which are presented graphically, provide no evidence that safety belt effectiveness is systematically influenced by most of the factors investigated, including car mass and model year. The absence of any systematic relationship with car mass is in agreement with an earlier finding based on the pedestrian fatality exposure method; this agreement adds plausibility to the assumptions used for both the earlier and the present methods. Safety belt effectiveness is greater for single-car crashes (62 ± 5) % than for crashes involving two cars (30 ± 8) % , this difference being statistically significant at p<.02. The results suggest weakly that safety belt effectiveness is greater for two-door (48 ± 6) % than for four-door (38 ± 10) % cars, and is greater for striking (44 ± 6) % cars than for struck (27 ± 12)% cars. The above differences probably reflect higher effectiveness in frontal (or rollover) crashes than in side impacts.     

Heavy trucks, conspicuity treatment, and the decline of collision risk in darkness

IntroductionThe influence of amendments to Federal Motor Vehicle Safety Standard (FMVSS) 108, requiring conspicuity treatments on heavy tractors and trailers, was determined in analyses of the odds of fatal collisions in darkness.MethodComparisons were made between crashes in which conspicuity treatment was likely relevant, and those in which it was likely irrelevant.ResultsOver 23 years, the odds that a fatal collision involving a heavy truck occurred in darkness declined by 58% among relevant crashes, while little decline was observed for irrelevant crashes. Disaggregation into crash types revealed the largest declines occurred in fatal rear-end and angle collisions. A parallel analysis of light vehicles also found declines but no differences among crash type. Similar trends were also observed for nonfatal rear end collisions.ConclusionThe results suggest that detection failure may have contributed to the risk of striking a tractor-semitrailer in darkness, and that conspicuity treatments have reduced this risk.Impact on IndustryConspicuity treatments appear to reduce risk of collision into heavy trucks in darkness. It is likely that this benefit would also extend to other vehicles that are not included in the FMVSS 108 regulation (e.g., buses, single unit trucks, recreational vehicles), although many are so equipped, regardless of the regulation.     

Investigation of injury severities in single-vehicle crashes in North Carolina using mixed logit models

IntroductionRoadway departure (RwD) crashes, comprising run-off-road (ROR) and cross-median/centerline head-on collisions, are one of the most lethal crash types. According to the FHWA, between 2015 and 2017, an average of 52 percent of motor vehicle traffic fatalities occurred each year due to roadway departure crashes. An avoidance maneuver, inattention or fatigue, or traveling too fast with respect to weather or geometric road conditions are among the most common reasons a driver leaves the travel lane. Roadway and roadside geometric design features such as clear zones play a significant role in whether human error results in a crash. Method: In this paper, we used mixed-logit models to investigate the contributing factors on injury severity of single-vehicle ROR crashes. To that end, we obtained five years' (2010–2014) of crash data related to roadway departures (i.e., overturn and fixed-object crashes) from the Federal Highway Administration's Highway Safety Information System Database. Results: The results indicate that factors such as driver conditions (e.g., age), environmental conditions (e.g., weather conditions), roadway geometric design features (e.g., shoulder width), and vehicle conditions significantly contributed to the severity of ROR crashes. Conclusions: Our results provide valuable information for traffic design and management agencies to improve roadside design policies and implementing appropriately forgiving roadsides for errant vehicles. Practical applications: Our results show that increasing shoulder width and keeping fences at the road can reduce ROR crash severity significantly. Also, increasing road friction by innovative materials and raising awareness campaigns for careful driving at daylight can decrease the ROR crash severity.     

An examination of the increases in pedestrian motor-vehicle crash fatalities during 2009–2016

IntroductionPedestrian fatalities increased 46% in the United States during 2009–2016. This study identified circumstances under which the largest increases in deaths occurred during this period.MethodAnnual counts of U.S. pedestrian fatalities and crash involvements were extracted from the Fatality Analysis Reporting System and General Estimates System. Poisson regression examined if pedestrian fatalities by various roadway, environmental, personal, and vehicle factors changed significantly during 2009–2016. Linear regression examined changes over the study period in pedestrian deaths per 100 crash involvements and in horsepower per 1000 pounds of weight among passenger vehicles involved in fatal single-vehicle pedestrian crashesResultsPedestrian deaths per 100 crash involvements increased 29% from 2010, when they reached their lowest point, to 2015, the most recent year for which crash involvement data were available. The largest increases in pedestrian deaths during 2009–2016 occurred in urban areas (54% increase from 2009 to 2016), on arterials (67% increase), at nonintersections (50% increase), and in dark conditions (56% increase). The rise in the number of SUVs involved in fatal single-vehicle pedestrian crashes (82% increase) was larger than the increases in the number of cars, vans, pickups, or medium/heavy trucks involved in these crashes. The power of passenger vehicles involved in fatal single-vehicle pedestrian crashes increased over the study period, with larger increases in vehicle power among more powerful vehicles.ConclusionsEfforts to turn back the recent increase in pedestrian fatalities should focus on the conditions where the rise has been the greatest.Practical applicationsTransportation agencies can improve urban arterials by investing in proven countermeasures, such as road diets, median crossing islands, pedestrian hybrid beacons, and automated speed enforcement. Better road lighting and vehicle headlights could improve pedestrian visibility at night.     

Improvement of the performance of animal crossing warning signs

Introduction: Animal–vehicle collisions (AVCs) can result in serious injury and death to drivers, animals' death, and significant economic costs. However, the cost effectiveness of the majority of AVC mitigation measures is a significant issue. Method: A mobile-based data collection effort was deployed to measure signs under the Utah Department of Transportation's (UDOT) jurisdiction. The crash data were obtained from the UDOT risk management database. ArcGIS was employed to link these two data sets and extract animal-related crashes and signs. An algorithm was developed to process the data and identify AVCs that occurred within sign recognition distance. Kernel density estimation (KDE) technique was applied to identify potential crash hotspots. Results: Only 2% of AVCs occurred within the recognition distance of animal crossing signs. Almost 58% of animal-related crashes took place on the Interstate and U.S. highways, wherein only 30% of animal crossing signs were installed. State routes with a higher average number of signs experienced a lower number of AVCs per mile. The differences between AVCs that occurred within versus outside of sign recognition distance were not statistically significant regarding crash severity, time of crash, weather condition, driver age, vehicle speed, and type of animal. It is more likely that drivers become accustomed to deer crossing signs than cow signs. Conclusions: Based on the historical crash data and landscape structure, with attention given to the low cost safety improvement methods, a combination of different types of AVC mitigation measures can be developed to reduce the number of animal-related crashes. After an in-depth analysis of AVC data, warning traffic signs, coupled with other low cost mitigation countermeasures can be successfully placed in areas with higher priority or in critical areas. Practical applications: The findings of this study assist transportation agencies in developing more efficient mitigation measures against AVCs.     

Spillover effects of yield-to-pedestrian channelizing devices

A great number of pedestrians are killed or injured in traffic crashes every year in the US. Vehicle crashes involving pedestrians are often more severe than other crashes because pedestrians are unprotected and are hence more likely to suffer injuries or death if struck by a motor vehicle. To improve pedestrian safety, a variety of treatments such as overhead flashing beacons, in-street crossing signs, in-roadway warning lights, and traffic calming measures have been used. One treatment, in-street yield-to-pedestrian channelizing devices (YTPCD), has been used in many states, including Pennsylvania, where approximately 10% of traffic crash fatalities are pedestrians each year.In an effort to improve pedestrian safety, the Pennsylvania Department of Transportation (PennDOT) has widely deployed YTPCD. This study examines the spillover (indirect) effects of such devices on motorist and pedestrian behavior. With data collected from eight sites that did not have but were in the vicinity of YTPCD implementations, analysis results show that such devices have significantly positive spillover effects on pedestrian safety at intersections, but they tend to have negative spillover effects at mid-block locations. Overall, the YTPCD appear to have a positive impact on changing motorist and pedestrian behavior, and merit consideration for future usage of this type of device.     

Analyses of rear-end crashes based on classification tree models

OBJECTIVE: Signalized intersections are accident-prone areas especially for rear-end crashes due to the fact that the diversity of the braking behaviors of drivers increases during the signal change. The objective of this article is to improve knowledge of the relationship between rear-end crashes occurring at signalized intersections and a series of potential traffic risk factors classified by driver characteristics, environments, and vehicle types. METHODS: Based on the 2001 Florida crash database, the classification tree method and Quasi-induced exposure concept were used to perform the statistical analysis. Two binary classification tree models were developed in this study. One was used for the crash comparison between rear-end and non-rear-end to identify those specific trends of the rear-end crashes. The other was constructed for the comparison between striking vehicles/drivers (at-fault) and struck vehicles/drivers (not-at-fault) to find more complex crash pattern associated with the traffic attributes of driver, vehicle, and environment. RESULTS: The modeling results showed that the rear-end crashes are over-presented in the higher speed limits (45-55 mph); the rear-end crash propensity for daytime is apparently larger than nighttime; and the reduction of braking capacity due to wet and slippery road surface conditions would definitely contribute to rear-end crashes, especially at intersections with higher speed limits. The tree model segmented drivers into four homogeneous age groups: < 21 years, 21-31 years, 32-75 years, and > 75 years. The youngest driver group shows the largest crash propensity; in the 21-31 age group, the male drivers are over-involved in rear-end crashes under adverse weather conditions and the 32-75 years drivers driving large size vehicles have a larger crash propensity compared to those driving passenger vehicles. CONCLUSIONS: Combined with the quasi-induced exposure concept, the classification tree method is a proper statistical tool for traffic-safety analysis to investigate crash propensity. Compared to the logistic regression models, tree models have advantages for handling continuous independent variables and easily explaining the complex interaction effect with more than two independent variables. This research recommended that at signalized intersections with higher speed limits, reducing the speed limit to 40 mph efficiently contribute to a lower accident rate. Drivers involved in alcohol use may increase not only rear-end crash risk but also the driver injury severity. Education and enforcement countermeasures should focus on the driver group younger than 21 years. Further studies are suggested to compare crash risk distributions of the driver age for other main crash types to seek corresponding traffic countermeasures.     

Situational characteristics of fatal pedestrian accidents involving vehicles traveling at low speeds in Japan

Abstract

Objective: This study aimed to investigate the situational characteristics of fatal pedestrian accidents involving vehicles traveling at low speeds in Japan. We focused on vehicles with 4 or more wheels. Such characteristics included daytime or nighttime conditions, road type, vehicle behaviors preceding the accident, and vehicle impact locations.

Methods: Pedestrian fatality data on vehicle–pedestrian accidents were obtained from the Institute for Traffic Accident Research and Data Analysis of Japan (ITARDA) from 2005 to 2014. Nine vehicle classifications were considered: Trucks with gross vehicle weight (GVW) ≥7.5 tons and <7.5 tons, buses, box vans, minivans, sport utility vehicles (SUVs), sedans, light passenger cars (LPCs), and light cargo vans (LCVs). We compared the situational daytime or nighttime conditions, road type, vehicle behaviors preceding the accident, and vehicle impact locations for accident-involved vehicles traveling at low and higher speeds across all vehicle types.

Results: The results indicate that pedestrian fatalities involving vehicles traveling at low speeds occurred more often under daytime conditions across all vehicle types. At signalized intersections, the relative proportions of pedestrian fatalities were significantly higher when vehicles were traveling at low speed, except when the accidents involved box vans or SUVs. Similarly, when vehicles turned right, the relative proportions of pedestrian fatalities were significantly higher when vehicles traveling at low speed were involved across all vehicle types. In terms of the frontal right vehicle impact location, the relative proportions of pedestrian fatalities were significantly higher when trucks with GVW ≥7.5 tons or <7.5 tons, sedans, or LCVs traveling at low speed were involved.

Conclusions: The situational characteristics of fatal pedestrian accidents involving vehicles traveling at low speeds identified in this study can guide targeted development of new traffic safety regulations or technologies specific to vehicle–pedestrian interactions at low vehicle travel speeds (i.e., driver alert devices or automated emergency braking systems). Ultimately, these developments can improve pedestrian safety by reducing the frequency or severity of vehicle–pedestrian accidents for vehicles turning right at intersections and/or reducing the number of resultant pedestrian fatalities.     

Effects of lane departure warning on police-reported crash rates

ObjectiveTo evaluate the effects of lane departure warning (LDW) on single-vehicle, sideswipe, and head-on crashes.MethodPolice-reported data for the relevant crash types were obtained from 25 U.S. states for the years 2009–2015. Observed counts of crashes with fatalities, injuries, and of all severities for vehicles with LDW were compared with expected counts based on crash involvement rates for the same passenger vehicles without LDW, with exposure by vehicle series, model year, and lighting system standardized between groups. For relevant crashes of all severities and those with injuries, Poisson regression was used to estimate the benefits of LDW while also controlling for demographic variables; fatal crashes were too infrequent to be modeled.ResultsWithout accounting for driver demographics, vehicles with LDW had significantly lower involvement rates in crashes of all severities (18%), in those with injuries (24%), and in those with fatalities (86%). Adding controls for driver demographics in the Poisson regression reduced the estimated benefit of LDW only modestly in crashes of all severities (11%, p < 0.05) and in crashes with injuries (21%, p < 0.07).ConclusionsLane departure warning is preventing the crash types it is designed to address, even after controlling for driver demographics. Results suggest that thousands of lives each year could be saved if every passenger vehicle in the United States were equipped with a lane departure warning system that performed like the study systems.Practical applicationsPurchase of LDW should be encouraged, and, because drivers do not always keep the systems turned on, future efforts should focus on designing systems to encourage greater use and educating consumers about the benefits of using the systems.     

Factors contributing to serious and fatal injuries in belted rear seat occupants in frontal crashes

Abstract

Objectives: Earlier research has shown that the rear row is safer for occupants in crashes than the front row, but there is evidence that improvements in front seat occupant protection in more recent vehicle model years have reduced the safety advantage of the rear seat versus the front seat. The study objective was to identify factors that contribute to serious and fatal injuries in belted rear seat occupants in frontal crashes in newer model year vehicles.

Methods: A case series review of belted rear seat occupants who were seriously injured or killed in frontal crashes was conducted. Occupants in frontal crashes were eligible for inclusion if they were 6 years old or older and belted in the rear of a 2000 or newer model year passenger vehicle within 10 model years of the crash year. Crashes were identified using the 2004–2015 National Automotive Sampling System Crashworthiness Data System (NASS-CDS) and included all eligible occupants with at least one Abbreviated Injury Scale (AIS) 3 or greater injury. Using these same inclusion criteria but split into younger (6 to 12 years) and older (55+ years) cohorts, fatal crashes were identified in the 2014–2015 Fatality Analysis Reporting System (FARS) and then local police jurisdictions were contacted for complete crash records.

Results: Detailed case series review was completed for 117 rear seat occupants: 36 with Maximum Abbreviated Injury Scale (MAIS) 3+ injuries in NASS-CDS and 81 fatalities identified in FARS. More than half of the injured and killed rear occupants were more severely injured than front seat occupants in the same crash. Serious chest injury, primarily caused by seat belt loading, was present in 22 of the injured occupants and 17 of the 37 fatalities with documented injuries. Nine injured occupants and 18 fatalities sustained serious head injury, primarily from contact with the vehicle interior or severe intrusion. For fatal cases, 12 crashes were considered unsurvivable due to a complete loss of occupant space. For cases considered survivable, intrusion was not a large contributor to fatality.

Discussion: Rear seat occupants sustained serious and fatal injuries due to belt loading in crashes in which front seat occupants survived, suggesting a discrepancy in restraint performance between the front and rear rows. Restraint strategies that reduce loading to the chest should be considered, but there may be potential tradeoffs with increased head excursion, particularly in the absence of rear seat airbags. Any new restraint designs should consider the unique needs of the rear seat environment.     

Diseases and motor vehicle fatalities in Finland in 2001 and 2002

OBJECTIVES: The possible connection between diseases among drivers and traffic accidents was examined for traffic safety purposes. METHODS: We studied medical conditions of drivers and passengers in all motor vehicle crashes with fatalities in Finland in 2001 and 2002 by using reports of road accident investigation teams, including autopsy reports. We analyzed a total of 542 crashes with 640 fatalities. Findings were also compared with available epidemiological data in Finland. RESULTS: An insignificant difference in the number of reported diseases was present between the different parties involved in crashes. However, among killed key drivers, so-called A-parties, psychiatric diseases, especially alcoholism, depression, and unspecific mental disorders, were diagnosed more often than in the groups of other drivers or passengers. In addition, A-parties were reported to more frequently suffer from cerebral arteriosclerosis and arterial hypertension. CONCLUSIONS: Drivers' diseases can be a risk factor for traffic accidents. Fitness to drive should therefore be considered in medical practice, particularly in patients with alcoholism and other psychiatric disorders.