Motor vehicle restraint system use and risk of spine injury

OBJECTIVE: Motor vehicle collision (MVC)-related spinal injury is a severe and often permanently disabling injury. In addition, strain injuries have been reported as a common outcome of MVCs. Although advances in automobile crashworthiness have reduced both fatalities and severe injuries, the impact of varying occupant restraint systems (seatbelts and airbags) on thoracolumbar spine injuries is unknown. This study examined the relationship between the occurrence of mild to severe cervical and thoracolumbar spine injury and occupant restraint systems among front seat occupants involved in frontal MVCs. METHODS: A retrospective cohort study was conducted among subjects obtained from the 1995-2004 National Automotive Sampling System. Cases were identified based on having sustained a spine injury of >/=1 on the Abbreviated Injury Scale (AIS), 1990 Revision. Risk risks (RRs) and 95% confidence intervals (CIs) were computed comparing occupant restraint systems with unrestrained occupants. RESULTS: We found an overall incidence of AIS1 cervical (11.8%) and thoracolumbar (3.7%) spinal injury. Seatbelt only restraints were associated with increased cervical AIS1 injury (RR = 1.40, 95% CI 1.04-1.88). However, seatbelt only restraints showed the greatest risk reduction for AIS2 spinal injuries. Airbag only restraints reduced thoracolumbar AIS1 injuries (RR = 0.29, 95% CI 0.08-1.04). Seatbelt combined with airbag use was protective for cervical AIS3+ injury overall (RR = 0.29, 95% CI 0.14-0.58), cervical neurological injury (RR = 0.19, 95% CI 0.05-0.81), and thoracolumbar AIS3+ injury overall (RR = 0.20, 95% CI 0.05-0.70). CONCLUSIONS: The results of this study suggest that seatbelts alone or in combination with an airbag increased the incidence of AIS1 spinal injuries, but provide protection against more severe injury to all regions of the spine. Airbag deployment without seatbelt use did not show increased protection relative to unrestrained occupants.     

Sensitivity of Head and Cervical Spine Injury Measures to Impact Factors Relevant to Rollover Crashes

Objective: Serious head and cervical spine injuries have been shown to occur mostly independent of one another in pure rollover crashes. In an attempt to define a dynamic rollover crash test protocol that can replicate serious injuries to the head and cervical spine, it is important to understand the conditions that are likely to produce serious injuries to these 2 body regions. The objective of this research is to analyze the effect that impact factors relevant to a rollover crash have on the injury metrics of the head and cervical spine, with a specific interest in the differentiation between independent injuries and those that are predicted to occur concomitantly.

Methods: A series of head impacts was simulated using a detailed finite element model of the human body, the Total HUman Model for Safety (THUMS), in which the impactor velocity, displacement, and direction were varied. The performance of the model was assessed against available experimental tests performed under comparable conditions. Indirect, kinematic-based, and direct, tissue-level, injury metrics were used to assess the likelihood of serious injuries to the head and cervical spine.

Results: The performance of the THUMS head and spine in reconstructed experimental impacts compared well to reported values. All impact factors were significantly associated with injury measures for both the head and cervical spine. Increases in impact velocity and displacement resulted in increases in nearly all injury measures, whereas impactor orientation had opposite effects on brain and cervical spine injury metrics. The greatest cervical spine injury measures were recorded in an impact with a 15° anterior orientation. The greatest brain injury measures occurred when the impactor was at its maximum (45°) angle.

Conclusions: The overall kinetic and kinematic response of the THUMS head and cervical spine in reconstructed experiment conditions compare well with reported values, although the occurrence of fractures was overpredicted. The trends in predicted head and cervical spine injury measures were analyzed for 90 simulated impact conditions. Impactor orientation was the only factor that could potentially explain the isolated nature of serious head and spine injuries under rollover crash conditions. The opposing trends of injury measures for the brain and cervical spine indicate that it is unlikely to reproduce the injuries simultaneously in a dynamic rollover test.     

Differences in Long-term Medical Consequences Depending on Impact Direction Involving Passenger Cars

Objective: There is limited knowledge of the long-term medical consequences for occupants injured in car crashes in various impact directions. Thus, the objective was to evaluate whether injuries leading to permanent medical impairment differ depending on impact direction.

Methods: In total, 36,743 injured occupants in car crashes that occurred between 1995 and 2011 were included. All initial injuries (n = 61,440) were classified according to the Abbreviated Injury Scale (AIS) 2005. Injured car occupants were followed for at least 3 years to assess permanent medical impairment. The data were divided into different groups according to impact direction and levels of permanent impairment. The risk of permanent medical impairment was established for different body regions and injury severity levels, according to AIS.

Results: It was found that almost 12% of all car occupants sustained a permanent medical impairment. Given an injury, car occupants involved in rollover crashes had the highest overall risk to sustain a permanent medical impairment. Half of the head injuries leading to long-term consequences occurred in frontal impacts. Far-side occupants had almost the same risk as near-side occupants. Occupants who sustained a permanent medical impairment from cervical spine injuries had similar risk in all impact directions (13%) except from rollover (17%). However, these injuries occurred more often in rear crashes. Most of the injuries leading to long-term consequences were classified as minor injuries by AIS for all impact directions.

Conclusions: Studying crash data from a perspective of medical impairment is important to identify injuries that might not be prioritized only considering the AIS but might lead to lower quality of life for the occupant and also costs for society. These results can be used for road transport system strategies and for making priority decisions in vehicle design.     

Cervical and thoracic spine injury in pediatric motor vehicle crash passengers

Objective: Motor vehicle occupants aged 8 to 12 years are in transition, in terms of both restraint use (booster seat or vehicle belt) and anatomical development. Rear-seated occupants in this age group are more likely to be inappropriately restrained than other age groups, increasing their vulnerability to spinal injury. The skeletal anatomy of an 8- to 12-year-old child is also in developmental transition, resulting in spinal injury patterns that are unique to this age group. The objective of this study is to identify the upper spine injuries commonly experienced in the 8- to 12-year-old age group so that anthropomorphic test devices (ATDs) representing this size of occupant can be optimized to predict the risk of these injuries.

Methods: Motor vehicle crash cases from the National Trauma Data Bank (NTDB) were analyzed to characterize the location and nature of cervical and thoracic spine injuries in 8- to 12-year-old crash occupants compared to younger (age 0–7) and older age groups (age 13–19, 20–39).

Results: Spinal injuries in this trauma center data set tended to occur at more inferior vertebral levels with older age, with patients in the 8- to 12-year-old group diagnosed with thoracic injury more frequently than cervical injury, in contrast to younger occupants, for whom the proportion of cases with cervical injury outnumbered the proportion of cases with thoracic injury. With the cervical spine, a higher proportion of 8- to 12-year-olds had upper spine injury than adults, but a substantially lower proportion of 8- to 12-year-olds had upper spine injury than younger children. In terms of injury type, the 8- to 12-year-old group’s injury patterns were more similar to those of teens and adults, with a higher relative proportion of fracture than younger children, who were particularly vulnerable to dislocation and soft tissue injuries. However, unlike for adults and teens, catastrophic atlanto-occipital dislocations were still more common than any other type of dislocation for 8- to 12-year-olds and vertebral body fractures were particularly frequent in this age group.

Conclusions: Spinal injury location in the cervical and thoracic spine moved downward with age in this trauma center data set. This shift in injury pattern supports the need for measurement of thoracic and lower cervical spine loading in ATDs representing the 8- to 12-year-old age group.     

Review: The Dynamics of Near Vertex Head Impact and its Role in Injury Prevention and the Complex Clinical Presentation of Basicranial and Cervical Spine Injury

The clinical presentation of cervical and basilar skull fractures following bead impact is often complex, particularly when multiple noncontiguous fractures are present. Based on the results of 22 human cadaver head-neck impact experiments, a biomechanical framework of spinal injury is developed in which these complex cases may be better understood. This includes the significance of head rebound, head and neck decoupling, cervical spine buckling, cervical injury mechanisms, basilar skull fractures, and cervical spine tolerance. These data also demonstrate that compliant pads significantly increase the risk for spinal injury though they also significantly reduce peak head force and the head injury criteria (p < 0.04). On the basis of these observations, we hypothesize that impact injury should be modeled as the dynamic response of two large masses, coupled by a segmented curved beam-column composed of seven small masses with interposed nonlinear viscoelastic flexibility elements.     

Estimated Injury Risk for Specific Injuries and Body Regions in Frontal Motor Vehicle Crashes

Objective: Injury risk curves estimate motor vehicle crash (MVC) occupant injury risk from vehicle, crash, and/or occupant factors. Many vehicles are equipped with event data recorders (EDRs) that collect data including the crash speed and restraint status during a MVC. This study's goal was to use regulation-required data elements for EDRs to compute occupant injury risk for (1) specific injuries and (2) specific body regions in frontal MVCs from weighted NASS-CDS data.

Methods: Logistic regression analysis of NASS-CDS single-impact frontal MVCs involving front seat occupants with frontal airbag deployment was used to produce 23 risk curves for specific injuries and 17 risk curves for Abbreviated Injury Scale (AIS) 2+ to 5+ body region injuries. Risk curves were produced for the following body regions: head and thorax (AIS 2+, 3+, 4+, 5+), face (AIS 2+), abdomen, spine, upper extremity, and lower extremity (AIS 2+, 3+). Injury risk with 95% confidence intervals was estimated for 15–105 km/h longitudinal delta-Vs and belt status was adjusted for as a covariate.

Results: Overall, belted occupants had lower estimated risks compared to unbelted occupants and the risk of injury increased as longitudinal delta-V increased. Belt status was a significant predictor for 13 specific injuries and all body region injuries with the exception of AIS 2+ and 3+ spine injuries. Specific injuries and body region injuries that occurred more frequently in NASS-CDS also tended to carry higher risks when evaluated at a 56 km/h longitudinal delta-V. In the belted population, injury risks that ranked in the top 33% included 4 upper extremity fractures (ulna, radius, clavicle, carpus/metacarpus), 2 lower extremity fractures (fibula, metatarsal/tarsal), and a knee sprain (2.4–4.6% risk). Unbelted injury risks ranked in the top 33% included 4 lower extremity fractures (femur, fibula, metatarsal/tarsal, patella), 2 head injuries with less than one hour or unspecified prior unconsciousness, and a lung contusion (4.6–9.9% risk). The 6 body region curves with the highest risks were for AIS 2+ lower extremity, upper extremity, thorax, and head injury and AIS 3+ lower extremity and thorax injury (15.9–43.8% risk).

Conclusions: These injury risk curves can be implemented into advanced automatic crash notification (AACN) algorithms that utilize vehicle EDR measurements to predict occupant injury immediately following a MVC. Through integration with AACN, these injury risk curves can provide emergency medical services (EMS) and other patient care providers with information on suspected occupant injuries to improve injury detection and patient triage.     

Evaluation of pedestrian subsystem test method using legform and upper legform impactors for assessment of high-bumper vehicle aggressiveness

In accidents involving sports utility vehicles (SUVs), injuries to pedestrian leg, knee ligaments, and femur are likely to occur. Therefore, the European Enhanced Vehicle Safety Committee proposed two subsystem test methods for evaluation of SUV bumper aggressiveness. Such evaluation can be conducted by means of either a legform impactor (evaluation of risk of knee and tibia injury), or an upper legform impactor (evaluation of risk of thigh and pelvis injury) test. Each of these two test methods has its own injury criteria and injury acceptance levels. Therefore, the first objective of this research is to clarify any differences between the test results obtained when evaluating SUV bumper aggressiveness by means of these two impactors. The second objective is to determine whether or not a legform impactor can be applied to estimate the risk of femur fracture, and if an upper legform impactor can be used to estimate the risk of knee ligament injury. The present results indicate the test method using an upper legform impactor yields higher ratios of injury criteria to the relevant EEVC/WG17 injury acceptance levels than by using a legform impactor. Thus, the upper legform impactor test rates an SUV bumper as more aggressive than the legform impactor test. The present study suggests the lower leg acceleration obtained by the legform impactor can be used to adequately assess the risk of femur fracture, when evaluating the aggressiveness of an SUV bumper using proposed injury acceptance levels reported in the literature. Similarly, the impact force obtained by the upper legform impactor can be used to assess the risk of cruciate ligament injury.     

Comparison of epidemiology and injury profile between vulnerable road users and motor vehicle occupants in road traffic fatalities

Objective: Road traffic injuries (RTIs) are a major global health issue causing a global burden of mortality and morbidity. Half of all fatalities on the world’s roads are vulnerable road users (VRUs). The targeted intervention strategies based on fatality analysis focusing on VRUs can effectively contribute to reducing RTIs. This study aimed to compare VRUs and motor vehicle occupants (MVOs) in terms of epidemiology and injury profile.

Methods: We utilized a nationwide, prospective database of RTI-related mortality cases for patients who visited 23 emergency departments between January 2011 and December 2015. All fatalities due to RTIs in the prehospital phase or in-hospital were eligible, excluding patients with unknown mode of transport and those admitted to general wards. The primary and secondary outcomes were fracture injuries and visceral injuries diagnosed using the International Classification of Diseases, Tenth Revision (ICD-10). We compared fracture injuries between VRUs and MVOs using Abbreviated Injury Scale (AIS) 2? and 2+ classification.

Results: Among a total 3,694 road traffic fatalities (RTFs), 43.3% were pedestrians, followed by MVOs (27.0%), motorcyclists (18.9), bicyclists (6.6%), and agricultural vehicle users (4.2%). The elderly (>60 years old) accounted for 54.9% of VRU fatalities. RTFs occurred most frequently in the autumn and the VRU group and the MVO group showed significant differences in weekly and diurnal variation in RTFs. The injury severities (AIS 2+) of the head, neck, and thorax were significantly different between the 2 groups (P?Conclusions: Elderly pedestrians should be targeted for decreases in RTFs, and road traffic safety interventions for VRUs should be made based on the analysis of temporal epidemiology and injury profiles of RTFs.     

The effect of muscle activation on neck response

Prevention of neck injuries due to complex loading, such as occurs in traffic accidents, requires knowledge of neck injury mechanisms and tolerances. The influence of muscle activation on outcome of the injuries is not clearly understood. Numerical simulations of neck injury accidents can contribute to increase the understanding of injury tolerances. The finite element (FE) method is suitable because it gives data on stress and strain of individual tissues that can be used to predict injuries based on tissue level criteria.The aim of this study was to improve and validate an anatomically detailed FE model of the human cervical spine by implement neck musculature with passive and active material properties. Further, the effect of activation time and force on the stresses and strains in the cervical tissues were studied for dynamic loading due to frontal and lateral impacts.The FE model used includes the seven cervical vertebrae, the spinal ligaments, the facet joints with cartilage, the intervertebral disc, the skull base connected to a rigid head, and a spring element representation of the neck musculature. The passive muscle properties were defined with bilinear force-deformation curves and the active properties were defined using a material model based on the Hill equation. The FE model's responses were compared to volunteer experiments for frontal and lateral impacts of 15 and 7 g. Then, the active muscle properties where varied to study their effect on the motion of the skull, the stress level of the cortical and trabecular bone, and the strain of the ligaments.The FE model had a good correlation to the experimental motion corridors when the muscles activation was implemented. For the frontal impact a suitable peak muscle force was 40 N/cm2 whereas 20 N/cm2 was appropriate for the side impact. The stress levels in the cortical and trabecular bone were influenced by the point forces introduced by the muscle spring elements; therefore a more detailed model of muscle insertion would be preferable. The deformation of each spinal ligament was normalized with an appropriate failure deformation to predict soft tissue injury. For the frontal impact, the muscle activation turned out to mainly protect the upper cervical spine ligaments, while the musculature shielded all the ligaments disregarding spinal level for lateral impacts. It is concluded that the neck musculature does not have the same protective properties during different impacts loadings.     

Motorcycle helmets and spinal cord injury: helmet usage and type

The objective of this study was to assess the role of helmets and helmet type in relation to injury to the cervical spinal cord. It was based on a consecutive series of 110 motorcyclists with neurological damage to the spinal cord admitted alive (referred to as acute survivors) to a specialist spinal cord injuries unit at an Australian hospital. Cases were those with injury to the cervical spinal cord and controls were those with injury to the cord of other segments of the spine. The study showed that there was no significant difference in the odds of cervical spinal cord injury among unhelmeted and helmeted motorcyclist acute survivors. In addition, it confirmed the findings of a recently published Australian fatality study demonstrating no difference in the odds of cervical spinal cord injury among full-face and open-face helmet wearers. These results contrasted with the findings of earlier studies. In consideration of the limitations of existing research on the role of helmets in spinal cord injury, further study is required based on a larger series or a series having a higher proportion of non-wearers and open-face helmet wearers, including both survivors and those killed, and including assessment of cord and non-cord spinal injuries separately, helmet type, head impact, and helmet retention.     

The role of door orientation on occupant injury in a nearside impact: a CIREN, MADYMO modeling and experimental study

OBJECTIVE: This study addressed the effects of vehicle height mismatch in side impact crashes. A light truck or SUV tends to strike the door of a passenger car higher causing the upper border to lead into the occupant space. Conversely, an impact centered lower on the door, from a passenger car, causes the lower border to lead. We proposed the hypothesis that the type of injury sustained by the occupant could be related to door orientation during its intrusion into the passenger compartment. METHOD: Data on door orientation and nearside occupant injuries were collected from 125 side impact crashes reported in the CIREN database. Experimental testing was performed using a pendulum carrying a frame and a vehicle door, impacting against a USDOT SID. The frame allowed the door orientation to be changed. A model was developed in MADYMO (v 6.2) using the more biofidelic dummies, BIOSID, and SIDIIs as well as USDOT SID. RESULTS: In side impact crashes with the lower border of the door leading, 81% of occupants sustained pelvic injury, 42% suffered rib fractures, and the rate of organ injury was 0.84. With the upper border leading, 46% of occupants sustained pelvic injury, 71% sustained rib fracture, and the rate of organ injuries per case increased to 1.13. The differences in the groups with respect to pelvic injury were significant at p = 0.01, rib fracture, p = 0.10, and organ injury, p = 0.001. Experimental testing showed that when the door angle changed from lower to upper border leading, peak T4 acceleration increased by 273% and pelvic acceleration decreased by 44%. The model demonstrated that when the door angle changed from lower to upper border leading, the USDOT SID showed a 29% increase in T4 acceleration and a 57% decrease in pelvic acceleration. The BIOSID dummy demonstrated a 36% increase in T1 acceleration, a 44% increase in abdominal rib 1 deflection, a 91% increase in thoracic rib 1 deflection, and a 33% decrease in pelvic acceleration. CONCLUSIONS: These data add more insight to the problem of mismatch during side impacts, where the bumper of the striking vehicle overrides the door beam, causing the upper part of the door to lead the intrusion into the passenger compartment. Even with the same delta V and intrusion, with the upper border of the door leading, more severe chest and organ injuries resulted. This data suggests that door orientation should be considered when testing subsystems for side impact protection.     

A 6-year survey of road traffic accidents in Southwest China: Emphasis on traumatic brain injury

Background: The objective of this study is to provide an up-to-date overview of the patterns of injuries, especially traumatic brain injury (TBI) caused by RTAs and to discuss some of the public health consequences. Methods: A scientific team was established to collect road traffic accidents occurring between 2013 and 2018 in Chongqing, Southwest China. For each accident, the environment-, vehicle-, and person- variables were analyzed and determined. The overall injury distribution and TBI patterns of four types of road users (driver, passenger, motorcyclist and pedestrian) were compared. The environmental and time distribution of accidents with TBI were shown by bar and pie chart. The risks of severe brain injury whether motorcyclist wearing helmets or not were compared and the risk factors of severe TBI in pedestrian were determined by odds ratio analysis. Results: This study enrolled 2131 accidents with 2741 persons of all kind of traffic participants, 1149 of them suffered AIS1+ head injury and 1598(58%) died in 7 days. The most common cause of deaths is due to head injury with 714(85%) and 1266(79%) persons died within 2 hours. Among 423 persons suffered both skull fracture and intracranial injury, 102 (24.1%) have an intracranial injury but no skull fractures, while none of the skull fractures without intracranial injury was found. Besides, motorcyclists without a helmet were at higher risks for all the brain injury categories. The risk of pedestrian suffering severe TBI at an impact speed of more than 70 km/h is 100 times higher than that with an impact speed of less than 40 km/h. Conclusion: It is urgently needed to develop a more reliable brain injury evaluation criterion for better protection of the road users. We believe that strengthening the emergency care to head injury at the scene is the most effective way to reduce traffic fatality.     

Finite Element Analysis of Knee Injury Risks in Car-to-Pedestrian Impacts

In vehicle–pedestrian collisions, lower extremities of pedestrians are frequently injured by vehicle front structures. In this study, a finite element (FE) model of THUMS (total human model for safety) was modified in order to assess injuries to a pedestrian lower extremity. Dynamic impact responses of the knee joint of the FE model were validated on the basis of data from the literature. Since in real-world accidents, the vehicle bumper can impact the lower extremities in various situations, the relations between lower extremity injury risk and impact conditions, such as between impact location, angle, and impactor stiffness, were analyzed. The FE simulation demonstrated that the motion of the lower extremity may be classified into a contact effect of the impactor and an inertia effect from a thigh or leg. In the contact phase, the stress of the bone is high in the area contacted by the impactor, which can cause fracture. Thus, in this phase the impactor stiffness affects the fracture risk of bone. In the inertia phase, the behavior of the lower extremity depends on the impact locations and angles, and the knee ligament forces become high according to the lower extremity behavior. The force of the collateral ligament is high compared with other knee ligaments, due to knee valgus motions in vehicle-pedestrian collisions.     

Finite element analysis of knee injury risks in car-to-pedestrian impacts

In vehicle-pedestrian collisions, lower extremities of pedestrians are frequently injured by vehicle front structures. In this study, a finite element (FE) model of THUMS (total human model for safety) was modified in order to assess injuries to a pedestrian lower extremity. Dynamic impact responses of the knee joint of the FE model were validated on the basis of data from the literature. Since in real-world accidents, the vehicle bumper can impact the lower extremities in various situations, the relations between lower extremity injury risk and impact conditions, such as between impact location, angle, and impactor stiffness, were analyzed. The FE simulation demonstrated that the motion of the lower extremity may be classified into a contact effect of the impactor and an inertia effect from a thigh or leg. In the contact phase, the stress of the bone is high in the area contacted by the impactor, which can cause fracture. Thus, in this phase the impactor stiffness affects the fracture risk of bone. In the inertia phase, the behavior of the lower extremity depends on the impact locations and angles, and the knee ligament forces become high according to the lower extremity behavior. The force of the collateral ligament is high compared with other knee ligaments, due to knee valgus motions in vehicle-pedestrian collisions.     

Analysis of rider and child pillion passenger kinematics along with injury mechanisms during motorcycle crash

Abstract

Objective: Traffic fatalities among motorcycle users are intolerably high in Thailand. They account for 73% of the total number of road fatalities. Children are also among these victims. To improve countermeasures and design of protection equipment, understanding the biomechanics of motorcycle users under impact conditions is necessary. The objective of this work is to analyze the overall kinematics and injuries sustained by riders and child pillion passengers in various accident configurations.

Methods: Motorcycle accident data were analyzed. Common accident scenarios and impact parameters were identified. Two numerical approaches were employed. The multibody model was validated with a motorcycle crash test and used to generate possible accident cases for various impact conditions specified to cover all common accident scenarios. Specific impact conditions were selected for detailed finite element analysis. The finite element simulations of motorcycle-to-car collisions were conducted to provide insight into kinematics and injury mechanisms.

Results: Global kinematics found when the motorcycle’s front wheel impacts a car (config-MC) highlighted the translation motion of both the rider and passenger toward the impact position. The rider’s trunk impacted the handlebar and the head either impacted the car or missed. The hood constituted the highest head impact occurrence for this configuration. The child mostly impacted the rider’s back. Different kinematics were found when car impacted the lateral side of the motorcycle (config-CM). Upper bodies of both rider and child were laterally projected toward the car front. The windshield constituted the highest proportion of head impacts. The hood and A-pillar recorded a moderate proportion. The rider in finite element simulations with config-MC experienced high rib stress, lung strain, and pressure beyond the injury limit. A high head injury criterion was observed when the head hit the car. However, the simulation with config-CM exhibited high lower extremities stress and lung pressure in both occupants. Hyperextension of the rider’s neck was observed. The cumulative strain damage measure of the child’s brain was higher than the threshold for diffuse axonal injury (DAI).

Conclusions: This study revealed 2 kinematics patterns and injury mechanisms. Simulations with config-MC manifested a high risk of head and thorax injury to the rider but a low risk of severe injury to the child. Thorax injury to the rider due to handlebar impact was only found in simulations with config-MC. However, a high risk of skull, lower extremity, brain, and neck injuries were more pronounced for cases with config-CM. A high risk of DAI was also noticed for the child. In simulations with config-CM the child exhibited a higher risk of severe injury.     

Effects of vehicle impact velocity, vehicle front-end shapes on pedestrian injury risk

Objective: This study aimed at investigating the effects of vehicle impact velocity, vehicle front-end shape, and pedestrian size on injury risk to pedestrians in collisions with passenger vehicles with various frontal shapes. Method: A series of parametric studies was carried out using 2 total human model for safety (THUMS) pedestrian models (177 and 165?cm) and 4 vehicle finite element (FE) models with different front-end shapes (medium-size sedan, minicar, one-box vehicle, and sport utility vehicle [SUV]). The effects of the impact velocity on pedestrian injury risk were analyzed at velocities of 20, 30, 40, and 50?km/h. The dynamic response of the pedestrian was investigated, and the injury risk to the head, chest, pelvis, and lower extremities was compared in terms of the injury parameters head injury criteria (HIC), chest deflection, and von Mises stress distribution of the rib cage, pelvis force, and bending moment diagram of the lower extremities. Result: Vehicle impact velocity has the most significant influence on injury severity for adult pedestrians. All injury parameters can be reduced in severity by decreasing vehicle impact velocities. The head and lower extremities are at greater risk of injury in medium-size sedan and SUV collisions. The chest injury risk was particularly high in one-box vehicle impacts. The fracture risk of the pelvis was also high in one-box vehicle and SUV collisions. In minicar collisions, the injury risk was the smallest if the head did not make contact with the A-pillar. Conclusion: The vehicle impact velocity and vehicle front-end shape are 2 dominant factors that influence the pedestrian kinematics and injury severity. A significant reduction of all injuries can be achieved for all vehicle types when the vehicle impact velocity is less than 30?km/h. Vehicle designs consisting of a short front-end and a wide windshield area can protect pedestrians from fatalities. The results also could be valuable in the design of a pedestrian-friendly vehicle front-end shape. [Supplementary materials are available for this article. Go to the publisher's online edition of Traffic Injury Prevention for the following free supplemental resource: Head impact conditions and injury parameters in four-type vehicle collisions and validation result of the finite element model of one-box vehicle and minicar. ].     

Adjusting for car occupant injury liability in relation to age, speed limit, and gender-specific driver crash involvement risk

It is well established that older drivers' fragility is an important factor associated with higher levels of fatal crash involvement for older drivers. There has been less research on age-related fragility with respect to the sort of minor injuries that are more common in injury crashes. This study estimates a quantity that is related to injury fragility: the probability that a driver or a passenger of that driver will be injured in crashes involving two cars. The effects of other factors apart from drivers' fragility are included in this measure, including the fragility of the passengers, the crashworthiness of cars driven, seatbelt use by the occupants, and characteristics of crashes (including configuration and impact speed). The car occupant injury liability estimates appropriately includes these factors to adjust risk curves by age, gender, and speed limit accounting for overrepresentation in crashes associated with fragility and these other factors.     

Using latent class clustering and binary logistic regression to model Australian cyclist injury severity in motor vehicle–bicycle crashes

Introduction: In recent years, Australia is seeing an increase in the total number of cyclists. However, the rise of serious injuries and fatalities to cyclists has been a major concern. Understanding the factors affecting the fatalities and injuries of bicyclists in crashes with motor vehicles is important to develop effective policy measures aimed at improving the safety of bicyclists. This study aims to identify the factors affecting motor vehicle-bicycle (MVB) crashes in Victoria, Australia and introducing effective countermeasures for the identified risk factors. Method: A data set of 14,759 MVB crash records from Victoria, Australia between 2006 and 2019 was analyzed using the binary logit model and latent class clustering. Results: It was observed that the factors that increase the risk of fatalities and serious injuries of bicyclists (FSI) in all clusters are: elderly bicyclist, not using a helmet, and darkness condition. Likewise, in areas with no traffic control, clear weather, and dry surface condition (cluster 1), high speed limits increase the risk of FSI, but the occurrence of MVB crashes in cross intersection and T-intersection has been significantly associated with a reduction in the risk of FSI. In areas with traffic control and unfavorable weather conditions (cluster 2), wet road surface increases the risk of FSI, but the areas with give way sign and pedestrian crossing signs reduce the risk of FSI. Practical Applications: Recommendations to reduce the risk of fatalities or serious injury to bicyclists are: improvement of road lighting and more exposure of bicyclists using reflective clothing and reflectors, separation of the bicycle and vehicle path in mid blocks especially in high-speed areas, using a more stable bicycle for the older people, monitoring helmet use, improving autonomous emergency braking, and using bicyclist detection technology for vehicles.     

Injury risk in behind armor blunt thoracic trauma.

First responders and military personnel are particularly susceptible to behind armor blunt thoracic trauma in occupational scenarios. The objective of this study was to develop an armored thorax injury risk criterion for short duration ballistic impacts. 9 cadavers and 2 anthropomorphic test dummies (AUSMAN and NIJ 0101.04 surrogate) were tested over a range of velocities encompassing low severity impacts, medium severity impacts, and high severity impacts based upon risk of sternal fracture. Thoracic injuries ranged from minor skin abrasions (abbreviated injury scale [AIS] 1) to severe sternal fractures (AIS 3+) and were well correlated with impact velocity and bone mineral density. 8 male cadavers were used in the injury risk criterion development. A 50% risk of AIS 3+ injury corresponded to a peak impact force of 24,900 +/- 1,400 N. The AUSMAN impact force correlated strongly with impact velocity. Recommendations to improve the biofidelity of the AUSMAN include implementing more realistic viscera and decreasing the skin thickness.