Potentially preventable prehospital deaths from motor vehicle collisions

Background: In 2011, about 30,000 people died in motor vehicle collisions (MVCs) in the United States. We sought to evaluate the causes of prehospital deaths related to MVCs and to assess whether these deaths were potentially preventable.

Methods: Miami–Dade Medical Examiner records for 2011 were reviewed for all prehospital deaths of occupants of 4-wheeled motor vehicle collisions. Injuries were categorized by affected organ and anatomic location of the body. Cases were reviewed by a panel of 2 trauma surgeons to determine cause of death and whether the death was potentially preventable. Time to death and hospital arrival times were determined using the Fatality Analysis Reporting System (FARS) data from 2002 to 2012, which allowed comparison of our local data to national prevalence estimates.

Results: Local data revealed that 39% of the 98 deaths reviewed were potentially preventable (PPD). Significantly more patients with PPD had neurotrauma as a cause of death compared to those with a nonpreventable death (NPD) (44.7% vs. 25.0%, P =.049). NPDs were significantly more likely to have combined neurotrauma and hemorrhage as cause of death compared to PPDs (45.0% vs. 10.5%, P <.001). NPDs were significantly more likely to have injuries to the chest, pelvis, or spine. NPDs also had significantly more injuries to the following organ systems: lung, cardiac, and vascular chest (all P <.05). In the nationally representative FARS data from 2002 to 2012, 30% of deaths occurred on scene and another 32% occurred within 1 h of injury. When comparing the 2011 FARS data for Miami–Dade to the remainder of the United States in that year, percentage of deaths when reported on scene (25 vs. 23%, respectively) and within 1 h of injury (35 vs. 32%, respectively) were similar.

Conclusions: Nationally, FARS data demonstrated that two thirds of all MVC deaths occurred within 1 h of injury. Over a third of prehospital MVC deaths were potentially preventable in our local sample. By examining injury patterns in PPDs, targeted intervention may be initiated.     

Variability in vehicle and dummy responses in rear-end collisions

OBJECTIVE: The objective of this study was to quantify the occupant response variability due to differences in vehicle and seat design in low-speed rear-end collisions. METHODS: Occupant response variability was quantified using a BioRID dummy exposed to rear-end collisions in 20 different vehicles. Vehicles were rolled rearward into a rigid barrier at 8 km/h and the dynamic responses of the vehicle and dummy were measured with the head restraint adjusted to the up most position. In vehicles not damaged by this collision, additional tests were conducted with the head restraint down and at different impact speeds. RESULTS: Despite a coefficient of variation (COV) of less than 2% for the impact speed of the initial 8 km/h tests, the vehicle response parameters (speed change, acceleration, restitution, bumper force) had COVs of 7 to 23% and the dummy response parameters (head and T1 kinematics, neck loads, NIC, N(ij) and N(km)) had COVs of 14 to 52%. In five vehicles tested multiple times, a head restraint in the down position significantly increased the peak magnitude of many dummy kinematic and kinetic response parameters. Peak head kinematics and neck kinetics generally varied linearly with head restraint back set and height, although the neck reaction moment reversed and increased considerably if the dummy's head wrapped onto the top of the head restraint. CONCLUSIONS: The results of this study support the proposition that the vehicle, seat, and head restraint are a safety system and that the design of vehicle bumpers and seats/head restraint should be considered together to maximize the potential reduction in whiplash injuries.     

Alcohol is a predictor of mortality in motor vehicle collisions

IntroductionIt is well recognized that driving while intoxicated increases the probability of a motor-vehicle collision (MVC). The effect of alcohol on the chance of surviving the MVC is less clear. Method: Using data from the Fatality Analysis Reporting System (FARS) we conducted analyses for the outcome of mortality using alcohol and other variables as predictors. We also selected alcohol positive (AP) and alcohol negative (AN) persons from the same MVC and vehicle to control for confounding characteristics. Results: The odds ratio (OR) for mortality for alcohol positive drivers was 2.57, (p < 0.001 for all the following OR). Other harmful predictive factors were age OR 1.01 per year, vehicle age OR 1.05 per year, male sex OR 1.23, avoidance maneuver OR 1.09, speed related OR 2.89, rollover mechanism OR 2.75, and collision with a fixed object OR 6.70. Protective factors were proper restraint use – OR 0.19 and collision with another moving vehicle, OR 0.21. In the multivariate analysis the OR of mortality for AP vs AN was 1.46. Proper restraint use (OR 0.27) remained protective along with collision with another moving vehicle. When AP and AN persons from the same MVC and the same vehicle were compared, the adjusted OR’s for mortality were 1.46 and 2.08, respectively. Conclusions: Alcohol is an independent predictor of mortality in an MVC. Proper restraint use is the strongest protective factor. This finding allows a more complete understanding of the risks of driving while intoxicated, not only a higher probability of an MVC, but decreased survival once the MVC occurs. Practical Applications: Identification of alcohol as an independent predictor of mortality in an accident may improve risk assessment and influence drivers to avoid driving while intoxicated.     

基于Multi-class SVM的车辆换道行为识别模型研究

自动安全换道是车辆实现无人驾驶的关键,为精确识别行驶车辆换道状态,保证行车安全,设计了一种基于多分类支持向量机(Multi-class Support Vector Machine,Multiclass SVM)的车辆换道识别模型。从NGSIM数据集中选取美国101公路车辆轨迹数据进行分类处理,并将车辆换道过程划分为车辆跟驰阶段、车辆换道准备阶段和车辆换道执行阶段。采用网格搜索结合粒子群优化算法(Grid Search-PSO)对SVM模型中惩罚参数C和核参数g进行寻优标定,利用多分类支持向量机换道识别模型对样本数据进行训练和测试,模型测试精度达97.68%。研究表明,模型能够很好地识别车辆在换道过程中的行为状态,为车辆换道阶段的研究提供支持。     

Acciphilia on the road: An analysis of severe collisions

Introduction

Although prior studies of road traffic accidents have found between-group differences in risk, little attention has been given to the encounter between drivers involved in severe collisions.

Method

The present study empirically evaluates two different possible causes of "social accidents," which are defined as collisions between two or more drivers where some faulty social interaction might be assumed, and which are the most prevalent cause of road injuries. The analyses use merged Israeli collision records from 1983 to 2004 with data from two national censuses, thus providing an unprecedented empirical basis to study the social foundations of car accidents. The data are used to adjudicate between two alternative hypotheses: the heterogeneity hypothesis (socially different drivers tend to collide) versus the homogeneity hypothesis (socially similar drivers tend to collide).

Results

Multivariate analyses provide preliminary support for the latter hypothesis. Given an accident, there are more collisions among drivers from the same broad educational group, and the factors that influence this correlation are independent of geography. The paper thus leads to the idea that severe collisions reflect a sociological or ecological process that is akin to acciphilia.

Impact on Industry

The preliminary findings suggest that variation between drivers may be preferable to similarity, since apparently there is a greater tendency toward collisions between similar drivers.     

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.     

Development of injury risk models to guide CT evaluation in the emergency department after motor vehicle collisions

Abstract

Objective: The clinical evaluation of motor vehicle collision (MVC) victims is challenging and commonly relies on computed tomography (CT) to detect internal injuries. CT scans are financially expensive and each scan exposes the patient to additional ionizing radiation with an associated, albeit low, risk of cancer. Injury risk prediction based on regression modeling has been to be shown to be successful in estimating Injury Severity Scores (ISSs). The objective of this study was to (1) create risk models for internal injuries of occupants involved in MVCs based on CT body regions (head, neck, chest, abdomen/pelvis, cervical spine, thoracic spine, and lumbar spine) and (2) evaluate the performance of these risk prediction models to predict internal injury.

Methods: All Abbreviated Injury Scale (AIS) 2008 injury codes were classified based on which CT body region would be necessary to scan in order to make the diagnosis. Cases were identified from the NASS-CDS. The NASS-CDS data set was queried for cases of adult occupants who sought medical care and for which key crash characteristics were all present. Forward stepwise logistic regression was performed on data from 2010–2014 to create models predicting risk of internal injury for each CT body region. Injury risk for each region was grouped into 5 levels: very low (<2%), low (2–5%), medium (5–10%), high (10–20%), and very high (20%). The models were then tested using weighted data from 2015 in order to determine whether injury rates fell within the predicted risk level.

Results: The inclusion and exclusion criteria identified 5,477 cases in the NASS-CDS database. Cases from 2010–2014 were used for risk modeling (n?=?4,826). Seven internal injury risk models were created based on the CT body regions using data from 2010–2014. These models were tested against data from 2015 (n?=?651). In all CT body regions, the majority of occupants fell in the very low or low predicted injury rate groups, except for the head. On average, 57% of patients were classified as very low risk and 15% as low risk for each body region. In most cases the actual rate of injury was within the predicted injury risk range. The 95% confidence interval overlapped with predicting injury risk range in all cases.

Conclusion: This study successfully demonstrated the ability for internal injury risk models to accurately identify occupants at low risk for internal injury in individual body regions. This represents a step towards incorporating telemetry data into a clinical tool to guide physicians in the use of CT for the evaluation of MVC victims.     

考虑驾驶员反应时间的车辆碰撞预警模型

为了保证车辆在行驶过程中的安全性,提出了一种考虑驾驶员反应时间的车辆碰撞预警模型,改进了传统模型中驾驶员反应时间定值化的缺点。首先,依据车辆的制动过程分析了驾驶员反应时间对制动距离的影响。其次,设计驾驶员反应时间的模糊推理算法,选取驾龄、疲劳强度和应变能力3个主要因素作为评价指标来计算反应时间。最后,采用分等级的预警策略建立考虑驾驶员反应时间的碰撞预警模型,并通过Carsim-Matlab/Simulink联合仿真与传统模型进行对比分析。结果表明,设计的预警模型可以对不同类型的驾驶员进行差异化碰撞预警,在30 km/h和80 km/h两种车速下实际停车距离与理论值的最大误差为8%。     

Methodology for computer aided fuzzy fault tree analysis

Probabilistic risk assessment (PRA) is a comprehensive, structured and logical analysis method aimed at identifying and assessing risks of complex process systems. PRA uses fault tree analysis (FTA) as a tool to identify basic causes leading to an undesired event, to represent logical dependency of these basic causes in leading to the event, and finally to calculate the probability of occurrence of this event.To conduct a quantitative fault tree analysis, one needs a fault tree along with failure data of the basic events (components). Sometimes it is difficult to have an exact estimation of the failure rate of individual components or the probability of occurrence of undesired events due to a lack of sufficient data. Further, due to imprecision in basic failure data, the overall result may be questionable. To avoid such conditions, a fuzzy approach may be used with the FTA technique. This reduces the ambiguity and imprecision arising out of subjectivity of the data.This paper presents a methodology for a fuzzy based computer-aided fault tree analysis tool. The methodology is developed using a systematic approach of fault tree development, minimal cut sets determination and probability analysis. Further, it uses static and dynamic structuring and modeling, fuzzy based probability analysis and sensitivity analysis.This paper also illustrates with a case study the use of a fuzzy weighted index and cutsets importance measure in sensitivity analysis (for system probabilistic risk analysis) and design modification.     

基于系统动力学的地铁火灾调度安全模型研究

全自动驾驶已经成为城市轨道交通建设发展的必然趋势,车辆火灾场景是影响列车全自动运行安全最大的场景之一,因此制定合理的火灾调度安全控制方案具有极其重要的意义。以地铁全自动驾驶中车辆火灾场景为研究对象,将系统动力学理论方法用于构建调度安全影响因子模型。与传统的地铁安全模型不同,该模型以全自动驾驶场景为标准形成影响因子库。通过德菲尔法相关思想的专家评分法确定各子系统权重比,利用Vensim-PLE软件对模型进行仿真试验,对各影响因子进行动态预测,对比不同的安全投入方案及调度人员配置比方案,优选出最有效的火灾调度安全控制方案。     

Cross-correlation between the controlled collision environment and real-world motor vehicle collisions: Evaluating the protection of the thoracic side airbag

Objective: Thoracic side airbags (tSABs) were integrated into the vehicle fleet to attenuate and distribute forces on the occupant's chest and abdomen, dissipate the impact energy, and move the occupant away from the intruding structure, all of which reduce the risk of injury. This research piece investigates and evaluates the safety performance of the airbag unit by cross-correlating data from a controlled collision environment with field data.

Method: We focus exclusively on vehicle–vehicle lateral impacts from the NHTSA's Vehicle Crash Test Database and NASS-CDS database, which are replicated in the controlled environment by the (crabbed) barrier impact. Similar collisions with and without seat-embedded tSABs are matched to each other and the injury risks are compared.

Results: Results indicated that dummy-based thoracic injury metrics were significantly lower with tSAB exposure (P <.001). Yet, when the controlled collision environment data were cross-correlated with NASS-CDS collisions, deployment of the tSAB indicated no association with thoracic injury (tho. MAIS 2+ unadjusted relative risk [RR] = 1.14; 90% confidence interval [CI], 0.80–1.62; tho. MAIS 3+ unadjusted RR = 1.12; 90% CI, 0.76–1.65).

Conclusion: The data from the controlled collision environment indicated an unequivocal benefit provided by the thoracic side airbag for the crash dummy; however, the real-world collisions demonstrate that no benefit is provided to the occupant. This has resulted from a noncorrelation between the crash test/dummy-based design taking the abstracting process too far to represent the real-world collision scenario.     

The influence of lower extremity postures on kinematics and injuries of cyclists in vehicle side collisions

Objective: A cyclist assumes various cyclic postures of the lower extremities while pushing the pedals in a rotary motion while pedaling. In order to protect cyclists in collisions, it is necessary to understand what influence these postures have on the global kinematics and injuries of the cyclist.

Method: Finite element (FE) analyses using models of a cyclist, bicycle, and car were conducted. In the simulations, the Total Human Model of Safety (THUMS) occupant model was employed as a cyclist, and the simulation was set up such that the cyclist was hit from its side by a car. Three representative postures of the lower extremities of the cyclist were examined, and the kinematics and injury risk of the cyclist were compared to those obtained by a pedestrian FE model. The risk of a lower extremity injury was assessed based on the knee shear displacement and the tibia bending moment.

Results: When the knee position of the cyclist was higher than the hood leading edge, the hood leading edge contacted the leg of the cyclist, and the pelvis slid over the hood top and the wrap-around distance (WAD) of the cyclist's head was large. The knee was shear loaded by the hood leading edge, and the anterior cruciate ligament (ACL) ruptured. The tibia bending moment was less than the injury threshold. When the cyclist's knee position was lower than the hood leading edge, the hood leading edge contacted the thigh of the cyclist, and the cyclist rotated with the femur as the pivot point about the hood leading edge. In this case, the head impact location of the cyclist against the car was comparable to that of the pedestrian collision. The knee shear displacement and the tibia bending moment were less than the injury thresholds.

Conclusion: The knee height of the cyclist relative to the hood leading edge affected the global kinematics and the head impact location against the car. The loading mode of the lower extremities was also dependent on the initial positions of the lower extremities relative to the car structures. In the foot up and front posture, the knee was loaded in a lateral shear direction by the hood leading edge and as a result the ACL ruptured. The bicycle frame and the struck-side lower extremity interacted and could influence the loadings on lower extremities.     

Characterization of fatal occupational versus nonoccupational motor vehicle collisions in Kentucky (1998-2000)

Motor vehicle collisions (MVCs) are the leading cause of occupational fatalities in Kentucky as well as in the nation. The characteristics of and contributing factors for occupational versus nonoccupational MVC fatalities in the Commonwealth of Kentucky were examined from 1998 to 2000. Semi trucks were most frequently involved in fatal occupational MVCs, and passenger cars were most frequently involved in nonoccupational MVCs. More than half of the decedent drivers resided outside of Kentucky. The percentage of occupational fatalities occurring on a four-lane highway was double the percentage observed for nonoccupational MVC fatalities. In addition, an increased proportion of occupational MVC deaths occurred on limited access highways compared to nonoccupational fatalities. When human factors contributing to these fatal incidents were examined, the two primary human factors involved in occupational motor vehicle fatalities were driver distraction/inattention and falling asleep, whereas unsafe speed and alcohol were the primary human factors contributing to a nonoccupational fatality. These results suggest that semi drivers traveling on four-lane highways are more at risk for a fatal occupational injury in Kentucky. Therefore, additional epidemiological studies are needed to further examine human factors, the nature of the Kentucky highway system, and trucking controls (e.g., weigh station hours of operation) within the Kentucky transportation industry.     

高速公路汽车防碰撞模型仿真研究

随着高速公路的快速建设,交通事故迅猛增长.保证适当的车辆行驶距离是预防高速公路事故的有效手段.论文根据车辆制动规律和运行状态,得出行车安全距离模型,同时对模型中的参数进行了说明和分析.采用MATLAB软件对高速公路车辆的安全距离模型进行仿真分析,得出安全距离随车速和附着系数的变化规律,寻求既保证车辆安全行驶又不影响道路通行能力的合理的安全距离值,为降低高速事故率提供一定的依据.     

重型车辆荷载下埋地天然气管道的安全分析

道路下的埋地天然气管道在重型车辆荷载通过时,管道受力一旦达到破坏强度就可能产生安全事故,造成天然气泄漏而引发燃烧与爆炸的危害,需要进行安全分析来判定重载车辆能否安全的通过道路运输。该文用理论计算和实验检测的方法综合起来分析埋地管道的相关力学参数,然后与管道自身的强度参数进行比较,从而判断埋地管道是否破坏。通过实例验证的方法说明了该方法在类似的项目分析中具有适用性和操作性,并提出了分析方法应用的初始条件。该方法可以作为判断埋地天然气管道在重载车辆作用下的一种安全评价方法,在条件允许的情况下可以利用数值模拟的方法进行比较印证,从而得到更为可靠的判断结论。同时,该方法也为埋地天然气管线在重载作用下的保护提供了基础资料,可以在此指导下更有效的保护天然气管线免受破坏。     

起重机主梁结构可靠性混合模型的建立和分析

为了预防大型工程中起重机安全事故,通过建立混合模型研究了桥式起重机主梁结构的可靠性.首先分析影响主梁结构可靠性的不确定性参数.其次建立了基于凸模型-随机模糊模型的可靠性分析模型,其中考虑了一些因素的相关性.最后在凸模型-随机模糊混合模型的基础上,对某型号桥式起重机进行了可靠性分析,考虑材料强度与结构所受应力之间的相关性(情况一)、横向应力与纵向应力之间的相关性(情况二),验证了模型的有效性.研究表明,该模型意义明确,对模糊信息处理也比较合理,可作为可靠性计算方法的一种补充.