Impact of helmet use on traumatic brain injury from road traffic accidents in Cambodia

Objective: Rapid urbanization and motorization without corresponding increases in helmet usage have made traumatic brain injury due to road traffic accidents a major public health crisis in Cambodia. This analysis was conducted to quantify the impact of helmets on severity of injury, neurosurgical indication, and functional outcomes at discharge for motorcycle operators who required hospitalization for a traumatic brain injury following a road traffic accident in Cambodia.

Methods: The medical records of 491 motorcycle operators who presented to a major tertiary care center in Cambodia with traumatic brain injury were retrospectively analyzed using multivariate logistic regression.

Results: The most common injuries at presentation were contusions (47.0%), epidural hematomas (30.1%), subdural hematomas (27.9%), subarachnoid hemorrhages (12.4%), skull fractures (21.4%), and facial fractures (18.5%). Moderate-to-severe loss of consciousness was present in 36.3% of patients. Not wearing a helmet was associated with an odds ratio of 2.20 (95% confidence interval [CI], 1.15–4.22) for presenting with moderate to severe loss of consciousness compared to helmeted patients. Craniotomy or craniectomy was indicated for evacuation of hematoma in 20.0% of cases, and nonhelmeted patients had 3.21-fold higher odds of requiring neurosurgical intervention (95% CI, 1.25–8.27). Furthermore, lack of helmet usage was associated with 2.72-fold higher odds of discharge with functional deficits (95% CI, 1.14–6.49). In total, 30.1% of patients were discharged with severe functional deficits.

Conclusions: Helmets demonstrate a protective effect and may be an effective public health intervention to significantly reduce the burden of traumatic brain injury in Cambodia and other developing countries with increasing rates of motorization across the world.     

The crash severity impacts of fixed roadside objects

INTRODUCTION: This study analyzes the in-service performance of roadside hardware on the entire urban State Route system in Washington State by developing multivariate statistical models of injury severity in fixed-object crashes using discrete outcome theory. The objective is to provide deeper insight into significant factors that affect crash severities involving fixed roadside objects, through improved statistical efficiency along with disaggregate and multivariate analysis. METHOD: The developed models are multivariate nested logit models of injury severity and they are estimated with statistical efficiency using the method of full information maximum likelihood. RESULTS: The results show that leading ends of guardrails and bridge rails, along with large wooden poles (e.g. trees and utility poles) increase the probability of fatal injury. The face of guardrails is associated with a reduction in the probability of evident injury, and concrete barriers are shown to be associated with a higher probability of lower severities. Other variables included driver characteristics, which showed expected results, validating the model. For example, driving over the speed limit and driving under the influence of alcohol increase the probability of fatal accidents. Drivers that do not use seatbelts are associated with an increase in the probability of more severe injuries, even when an airbag is activated. IMPACT ON INDUSTRY: The presented models show the contribution of guardrail leading ends toward fatal injuries. It is therefore important to use well-designed leading ends and to upgrade badly performing leading ends on guardrails and bridges. The models also indicate the importance of protecting vehicles from crashes with rigid poles and tree stumps, as these are linked with greater severities and fatalities.     

The contribution of traumatic brain injury to the medical and economic outcomes of motor vehicle-related injuries in Ohio

Objective

To describe traumatic brain injury (TBI) among injured roadway users. Aim 1 assessed the association of age, gender, alcohol/drug use, safety equipment use, type of roadway user, metropolitan area, and primary payer with motor vehicle-related TBI outcome. Aim 2 assessed the relationship of motor vehicle-related TBI and risk/protective factors with medical and economic outcomes.

Methods

Population-level hospital and trauma databases from the Ohio Hospital Association and Ohio Department of Public Safety, respectively, were probabilistically linked for 2003 through 2006. Injured roadway users (motor vehicle occupants, motorcyclists, bicyclists, pedestrians, and others) were assessed for TBI, ventilator use, intensive care unit (ICU) admission, injury severity score (ISS), need for rehabilitation, death, and total hospital charges.

Results

The odds of a motor vehicle-related TBI were greater among those not using safety equipment (OR = 1.56). The interactions of alcohol/drug use by gender and of alcohol/drug use by location were significant. Sustaining a TBI increased the odds of requiring ventilation (OR = 3.66), being admitted to the ICU (OR = 2.51), having a high ISS (OR = 4.24), requiring rehabilitation (OR = 2.22), or death (OR = 2.52). When compared with a non-TBI, total hospital charges increased by a factor of 1.35 for a TBI. Hospital charges were $46,441 on average for individuals who sustained a TBI, whereas mean hospital charges were $32,614 for patients with a non-TBI.

Conclusions

Among injured roadway users, individuals who sustain a TBI are more likely to require extensive medical care and have injuries resulting in death.

Impact on industry

Prevention strategies aimed at reducing alcohol use and increasing safety device use should be encouraged to reduce the burden of TBI.     

Epidemiology of occupational acute traumatic hand injuries: a literature review

The purpose of this review was to summarize the literature on occupational, acute, traumatic hand injury and suggest directions for future research. In 1996, the leading occupational injury treated in United States' hospital emergency departments was an acute hand injury (e.g. laceration, crush or fracture). These injuries affected 30% of an estimated 3.3 million injured workers (990,000). Cuts and lacerations of the fingers ranked third after back and leg strains in the number of lost workday cases in the USA in 1994. The incidence rate of hand injuries studied in seven manufacturing environments around the world ranged from 4 to 11 per 100 workers per year. Workers aged 24 years or less had the highest risk of hand injury. Men had higher rates of severe hand injury than women.Despite the high frequency and significant amount of lost work time associated with these injuries, they are poorly understood from an etiological perspective. There is only one case-control study of occupational hand injury in the literature. That study suggested an important role for both fixed (age) and transient risk factors (doing an unusual task) at the time of the injury. More analytic epidemiological research is needed to identify potentially modifiable risk or protective factors (e.g. glove use) for acute hand injuries. In this regard, the case-crossover design, a relatively new epidemiological approach using cases as their own controls, could prove an efficient method for determining transient, modifiable risk factors for acute, occupational hand injury.     

The Costs and Characteristics of Occupational Injuries Admitted to a Trauma Unit

Abstract

Occupational injuries requiring admission to a trauma unit were examined to outline the events surrounding the injury and to examine the costs. Sixty-nine patients were admitted over a 12-month period, representing 4.30% of all work-related injuries attending the emergency department and 4.25% of all admissions to the trauma unit. Most were male (91%), working in skilled trade occupations (65%), with a mean age of 38.8 years. Personal protective equipment was used only by 46% of injured workers who should have been using it. Sixty-one percent of patients believed that their injury was preventable. Half of the injuries were to the upper limb, fall was the most frequent mechanism (25%) and the median duration of admission was 2 days. The direct hospital costs were estimated at over 300 000 GBP. Failure to use protective equipment and to follow health and safety guidelines suggests that opportunities exist for injury prevention.     

Validation of a booted finite element model of the WIAMan ATD lower limb in component and whole-body vertical loading impacts with an assessment of the boot influence model on response

Objective: A novel anthropomorphic test device (ATD) representative of the 50th percentile male soldier is being developed to predict injuries to a vehicle occupant during an underbody blast (UBB). The main objective of this study was to develop and validate a finite element (FE) model of the ATD lower limb outfitted with a military combat boot and to insert the validated lower limb into a model of the full ATD and simulate vertical loading experiments.

Methods: A Belleville desert combat boot model was assigned contacts and material properties based on previous experiments. The boot model was fit to a previously developed model of the barefoot ATD. Validation was performed through 6 matched pair component tests conducted on the Vertically Accelerated Loads Transfer System (VALTS). The load transfer capabilities of the FE model were assessed along with the force-mitigating properties of the boot. The booted lower limb subassembly was then incorporated into a whole-body model of the ATD. Two whole-body VALTS experiments were simulated to evaluate lower limb performance in the whole body.

Results: The lower limb model accurately predicted axial loads measured at heel, tibia, and knee load cells during matched pair component tests. Forces in booted simulations were compared to unbooted simulations and an amount of mitigation similar to that of experiments was observed. In a whole-body loading environment, the model kinematics match those recorded in experiments. The shape and magnitude of experimental force–time curves were accurately predicted by the model. Correlation between the experiments and simulations was backed up by high objective rating scores for all experiments.

Conclusion: The booted lower limb model is accurate in its ability to articulate and transfer loads similar to the physical dummy in simulated underbody loading experiments. The performance of the model leads to the recommendation to use it appropriately as an alternative to costly ATD experiments.     

The role of sales of new motorcycles in a recent increase in motorcycle mortality rates

INTRODUCTION: The National Highway Traffic Safety Administration (NHTSA) has reported that mortality rates from crashes among motorcycle riders in the United States increased from 21.0 per 100 million motorcycle miles traveled in 1997 to 38.4 per 100 million motorcycle miles traveled in 2003. At the same time, annual domestic sales of new, on-road motorcycles increased from 247,000 in 1997 to 648,000 in 2003. METHOD: This study used data from the NHTSA Fatality Analysis Reporting System and annual sales figures for on-road motorcycles to determine if newer motorcycles were more likely to be involved in fatal crashes and if fatal crashes involving newer motorcycles could account for the mortality increase after 1997. RESULTS: Mortality rates were 7.9, 8.1, 5.4, and 2.9 per 10,000 motorcycles sold for motorcycles <1, 1-3, 4-6, and 7-11 years old, respectively, from 1994 to 2003. Assuming complete registration, the number of motorcycles sold during the 2000-2003 time period accounted for 42.4% of the total number of motorcycles registered in 2003. Motorcycles sold during 2000-2003 were associated with 52.5% of all motorcycle deaths in 2003. The increase in the number of deaths associated with motorcycles less than four years old between 1997 and 2003 accounted for 78.1% of the total increase in motorcyclist deaths over this time period. CONCLUSIONS: Two possible explanations for the association between high sales volumes and mortality rates are: (a) increased exposure from more extensive use of motorcycles when they are new; and (b) inexperience with motorcycle riding or with specific motorcycles. IMPACT ON INDUSTRY: This study suggests that the deaths of growing numbers of motorcyclists are a consequence of the financial success of the motorcycle industry.     

9mm子弹对由芳纶、聚乙烯或铝板保护的尸体头骨产生的动态影响实验研究

本文对防护头盔所使用的复合板设计了两个实验来确定其所产生的伤害程度。实验结论:可优化复合材料制成的防弹头盔来避免大范围瞬时变形,从而减少对头部造成的冲击和钝挫伤。     

Children's behavioral traits and risk of injury: Analyses from a case-control study of agricultural households

Problem

Children on family agricultural operations have high risk of injury. The association between children's behavioral traits and their risk of injury is not well understood.

Method

Data from the Regional Rural Injury Study-II were used to assess behavioral risk factors for injury to children ages six to < 20 years. A total of 379 injury events (cases) and 1,562 randomly selected controls were identified. Adjusted odds ratios (OR) and 95% confidence intervals (CI), calculated using logistic regression, were used to estimate injury risk in reference to behavioral traits.

Results

Injury risks were greater for children with high levels of depressive symptoms (OR = 1.9, CI = 1.0-3.7) and aggression (OR = 1.6, CI = 0.9-2.7), and low levels of careful/cautious behavior (OR = 1.8, CI = 1.1-2.9). Children with low levels of self-regulation had reduced risks (OR = 0.4, CI = 0.2-0.8).

Discussion

Results suggest that children's behaviors affect their risk of agricultural injury. Additional research could elucidate mechanisms and inform interventions.

Impact on industry

The development of multifaceted, sustainable approaches for prevention is necessary for this unique population. These findings suggest a need for interventions that incorporate specific behavior-related risk factors in the context of family farms and ranches.     

Disparities in the prevalence of smoke alarms in U.S. households: Conclusions drawn from published case studies

Introduction

Deaths from fires and burns are a leading cause of fatal home injury in the United States. Smoke alarms are one of the most effective interventions to prevent residential fire deaths. Nationwide, more than 95% of homes are estimated to have at least one smoke alarm. There is evidence that homes at highest risk of fire deaths lag behind national averages in smoke alarm use and maintenance.

Method

We compiled a comprehensive list of published studies that focus on smoke alarm prevalence in high-risk homes. Our findings show that there are substantial gaps in both smoke alarm presence and functional status between high-risk homes and national average estimates.

Conclusions

To save more lives, improved efforts are needed to reduce the disparity in smoke alarm prevalence and functional use in the United States.     

Animal-related injuries: a population-based study of a five-state region in the upper Midwest: Regional Rural Injury Study II

PROBLEM: While agricultural injury has been identified among the major causes of occupational injury mortality and morbidity, data have been limited pertinent to the magnitude, consequences, and potential risk factors for animal-related injuries -- a major source of morbidity among agricultural operations. METHODS: Demographics, exposure, and injury data were collected for 1999 and 2001 among agricultural households in a five-state region. Causal models facilitated survey design, data analyses, and interpretation of results; directed acyclic graphs guided multivariate modeling. RESULTS: From 7,420 households (84% response of eligible), a total of 5,045 injury events were reported; 1,016 (20.1%) were animal-related. Multivariate analyses revealed increased risks for those <20 years; residents of all states compared to Minnesota; all age groups compared to 0-4 years; >0 hours worked; and prior agricultural injury history. For those 20+ years, increased risks were identified for: South Dakota residents; males; >0 hours worked; and prior agricultural injury history. For those cases <20 and 20+ years of age, 58% and 46%, respectively, resulted in lost work time on their agricultural operations (31% and 50%, one week or more). CONCLUSIONS: Animal-related injury has a major impact on the agricultural industry. Results serve as a basis for interventions and further research. IMPACT ON INDUSTRY: The impact of animal-related injuries on the agricultural industry appears significant; among age groups <20 and 20+, 85% and 82%, respectively, had some resulting restriction. For all events combined, 29% and 30%, respectively, involved restriction from one week to 3+ months; 12% and 15% involved restriction for one month or more. Among those <20 and 20+ years of age, 58% and 46%, respectively, lost work time on their own agricultural operation as a result of injuries associated with their own operation; 22% and 15% lost one week or more. Moreover, of the non-agriculture-related injuries, 31% and 50% resulted in lost work time on their own operation; 15% and 28%, respectively, lost one week or more. Restrictions such as these can affect the productivity of the operation, resulting in financial impacts, especially on small operations that have few people to manage the required tasks.     

An evaluation of the effectiveness of a baby walker safety standard to prevent stair-fall injuries

PROBLEM: During the early 1990s the number of baby walker injuries treated in U.S. hospital emergency departments averaged almost 25,000 annually; about 80% resulted from falls down stairs. After initiating a regulatory proceeding in 1994, the U.S. Consumer Product Safety Commission staff worked with industry to develop requirements to address the stair-fall hazard. This study evaluates the effectiveness of the stair-fall requirements, which became effective in 1997 as part of a revised voluntary standard. METHOD: Annual baby walker emergency department injury rates were constructed for the 1981-2002 study period. A multivariate negative binomial regression model was used to estimate the effectiveness of the stair-fall requirements in reducing the injury rate. RESULTS: The stair-fall requirements reduced the emergency department injury rate by an estimated 63% (95% CI, 52% to 71%). IMPACT ON INDUSTRY: Given the substantial reduction in walker injuries, and the high level of industry conformance with the stair-fall requirements, the Commission terminated its regulatory proceeding in May, 2002. The success of the baby walker project highlights the ability of government and industry to work together cooperatively to develop effective safety improvements for consumer products.     

The theory of planned behavior (TPB) and texting while driving behavior in college students

Objective: To examine the role of intent and other theory of planned behavior (TPB) constructs in predicting college students' willingness to text while driving (TWD).

Methods: This was a cross-sectional study. 243 male and female college students enrolled in the 2013–2014 academic year in the College of Health, Human Services & Nursing completed a survey on TWD. Inclusion criteria: All races and ethnicities, ≥18 years of age, cell phone owner, and licensed driver.

Results: Over 70% of the sample (n = 243) reported talking on a cell phone and sending and receiving text messages “at least a few times” while driving within the past week. However, only 27% reported being stopped by police. Of these, 22% reported being fined. Within the past 30 days, 26% reported reading or sending TWD and having to slam on the brakes to avoid hitting another car or pedestrian(s) as a result. In all, 47% of the variance in intention to send TWD was accounted for by the full TPB model. Intention, in turn, predicted willingness to TWD. Intention also mediated the relationship between perceived behavioral control and willingness to TWD.

Conclusion: Attitude was found to be the strongest predictor of intention. In addition, intention was found to mediate the relationship of willingness to TWD on perceived behavioral control. These findings highlight potential factors that could be targeted in behavioral change interventions seeking to prevent TWD.     

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

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

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

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

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

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

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

Evaluating repeated patient handling injuries following the implementation of a multi-factor ergonomic intervention program among health care workers

Objective

The objective of this study was to evaluate repeated patient handling injuries following a multi-factor ergonomic intervention program among health care workers.

Methods

This was a quasi-experimental study which had an intervention group and a non-randomized control group. Data were collected from six hospitals in Saskatchewan, Canada from September 1, 2001 to December 1, 2006.

Results

A total of 1,480 individuals who had a previous injury were eligible for the study. Medium and small size hospitals in the intervention group had significantly fewer repeated injuries than in the control group. Multivariate analysis showed that the intervention group had 38.1% lower odds of having repeated injury compared to the control group, after adjusting for hospital size.

Conclusions

The work-related repeated injury after a multi-factor intervention program was reduced. The synergistic relationships between components of multi-factor intervention and applicability of injury prevention programs to different settings need to be further explored.

Impact on Industry

Implementing a multi-factor program with the right equipment and training can lower the risk of injury among health care workers.     

剧毒化学品甲苯-2，4-二异氰酸酯运输危险性评估

为探讨低挥发性剧毒化学品甲苯-2,4-二异氰酸酯在运输过程中大量泄漏引起群体中毒事故的可能性以及对环境的影响,对本品的急性毒性、扩散模型、环境转归、生态毒性,以及运输泄漏事故资料进行综合分析和评估。评估结果本品吸人中毒的潜在危险性指数为低度危险物质;扩散模型运输泄漏模拟危险区域下风向距离小于某些非剧毒品;环境转归研究显示本品在环境介质中没有持久性,没有明显的生物蓄积性,生态毒性较低;历年来运输泄漏事故分析未见发生大规模严重群体中毒和环境污染事故。认为本品在运输过程中大量泄漏,不会大范围扩散引起严重群体中毒事故,也不会对环境造成严重和长期的危害,建议在运输环节中运输条件适当放宽,按照一般有毒品进行管理。     

A study on chest injury mechanism and the effectiveness of a headform impact test for pedestrian chest protection from vehicle collisions

This study was aimed at investigating the injury mechanism of pedestrian chests in collisions with passenger vehicles of various frontal shapes and examining the influence of the local structural stiffness on the chest injury risk by using the headform impact test at the chest contact area of the vehicle. Three simulations of vehicle to pedestrian collisions were conducted using three validated pedestrian finite element (FE) models of three pedestrian heights of 177 (AM50th), 165 and 150 cm and three FE vehicles models representing a one-box vehicle, a minicar and a medium car. The validity of the vehicle models was evaluated by comparing the headform acceleration against the measured responses from headform impact tests. The chest impact kinematics and the injury mechanisms were analyzed in terms of the distribution of the von Mises stress of the ribcage and in terms of the chest deflections. The chest contact locations on the front panel and the bonnet top were identified in connection to the causation of rib fractures. The risk of rib fractures was predicted by using the von Mises stress distribution. The headform impact tests were carried out at the chest contact area on the front panel and bonnet to examine the safety performance with respect to pedestrian chest protection. In simulations of the one-box vehicle to pedestrian collisions, the chest was struck directly by the frontal structure at a high velocity and deformed substantially, since a shear force was generated by the stiff windshield frame. The acceleration of the headform was related to the rib deflections. The injury threshold of the ribcage deflection (42 mm) corresponded to the headform average acceleration of 68 G. In the minicar collision, the chest was struck with the bonnet top and cowl area at a low velocity, and the deformation was small due to the distributed contact force between the chest and the bonnet top. Besides, the ribcage deformation was too small for bridging a relation between the headform accelerations and rib deflections. In the medium car collision, the deformation mode of the chest was similar to that in the minicar collision. The chest collided with the bonnet top at a low velocity and deformed uniformly. The deflection of the ribs had an observable correlation with the headform accelerations measured in the headform impact tests. The frontal shape of a vehicle has a large influence on a pedestrian’s chest loadings, and the chest deformation depends on the size of the pedestrian and the stiffness of the vehicle. The one-box passenger vehicle causes a high chest injury risk. The headform impactor test can be utilized for the evaluation of the local stiffness of a vehicle’s frontal structure. The reduction of the headform acceleration is an effective measure for pedestrian chest protection for specific shapes of vehicles by efficacy in modifying the local structural stiffness.     

The effect of precrash velocity reduction on occupant response using a human body finite element model

Objective: The objective of this study is to use a validated finite element model of the human body and a certified model of an anthropomorphic test dummy (ATD) to evaluate the effect of simulated precrash braking on driver kinematics, restraint loads, body loads, and computed injury criteria in 4 commonly injured body regions.

Methods: The Global Human Body Models Consortium (GHBMC) 50th percentile male occupant (M50-O) and the Humanetics Hybrid III 50th percentile models were gravity settled in the driver position of a generic interior equipped with an advanced 3-point belt and driver airbag. Fifteen simulations per model (30 total) were conducted, including 4 scenarios at 3 severity levels: median, severe, and the U.S. New Car Assessment Program (U.S.-NCAP) and 3 extra per model with high-intensity braking. The 4 scenarios were no precollision system (no PCS), forward collision warning (FCW), FCW with prebraking assist (FCW+PBA), and FCW and PBA with autonomous precrash braking (FCW + PBA + PB). The baseline ΔV was 17, 34, and 56.4 kph for median, severe, and U.S.-NCAP scenarios, respectively, and were based on crash reconstructions from NASS/CDS. Pulses were then developed based on the assumed precrash systems equipped. Restraint properties and the generic pulse used were based on literature.

Results: In median crash severity cases, little to no risk (<10% risk for Abbreviated injury Scale [AIS] 3+) was found for all injury measures for both models. In the severe set of cases, little to no risk for AIS 3+ injury was also found for all injury measures. In NCAP cases, highest risk was typically found with No PCS and lowest with FCW + PBA + PB. In the higher intensity braking cases (1.0–1.4 g), head injury criterion (HIC), brain injury criterion (BrIC), and chest deflection injury measures increased with increased braking intensity. All other measures for these cases tended to decrease. The ATD also predicted and trended similar to the human body models predictions for both the median, severe, and NCAP cases. Forward excursion for both models decreased across median, severe, and NCAP cases and diverged from each other in cases above 1.0 g of braking intensity.

Conclusions: The addition of precrash systems simulated through reduced precrash speeds caused reductions in some injury criteria, whereas others (chest deflection, HIC, and BrIC) increased due to a modified occupant position. The human model and ATD models trended similarly in nearly all cases with greater risk indicated in the human model. These results suggest the need for integrated safety systems that have restraints that optimize the occupant's position during precrash braking and prior to impact.     

The INDICATE safety program: evaluation of a method to proactively improve airline safety performance

A number of recent and highly publicised fatal aircraft accidents, within the Australian regional airline industry, has highlighted the need for operators of regular public transport aircraft to be more proactive in identifying and addressing aviation safety hazards. Despite this need, there are currently few proactive safety management programs that are practical, simple, cost effective and which reliably demonstrate improvements in airline safety performance. This paper outlines a new proactive airline safety program called INDICATE (Identifying Needed Defences In the Civil Aviation Transport Environment) that has been applied within the Australian regional airline industry. To evaluate the INDICATE program, a major Australian regional airline agreed to implement the program in one of its operational bases while another base was used as a control group. Five evaluation criteria were applied to determine whether the program would have a positive influence on the airline's safety performance. These criteria included airline safety culture, staff risk perception of aviation safety hazards, willingness of staff to report safety hazards, action taken on identified safety hazards and staff comments about safety management within the airline. Results from the trial suggest that the program can have a positive influence on airline safety performance, specifically: improving staff confidence in how safety is managed, increasing staff willingness to report safety hazards and incidents, improving organisational safety culture and reducing staff perceptions of the severity and likelihood of safety hazards occurring within the airline. The success of the trial has resulted in a number of Australian and International airlines adopting the program.