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.

Structural Design Strategies for Improved Small Overlap Crashworthiness Performance

In 2012, the Insurance Institute for Highway Safety (IIHS) began a 64 km/h small overlap frontal crash test consumer information test program. Thirteen automakers already have redesigned models to improve test performance. One or more distinct strategies are evident in these redesigns: reinforcement of the occupant compartment, use of energy-absorbing fender structures, and the addition of engagement structures to induce vehicle lateral translation. Each strategy influences vehicle kinematics, posing additional challenges for the restraint systems. The objective of this two-part study was to examine how vehicles were modified to improve small overlap test performance and then to examine how these modifications affect dummy response and restraint system performance. Among eight models tested before and after design changes, occupant compartment intrusion reductions ranged from 6 cm to 45 cm, with the highest reductions observed in models with the largest number of modifications. All redesigns included additional occupant compartment reinforcement, one-third added structures to engage the barrier, and two modified a shotgun load path. Designs with engagement structures produced greater glance-off from the barrier and exhibited lower delta Vs but experienced more lateral outboard motion of the dummy. Designs with heavy reinforcement of the occupant compartment had higher vehicle accelerations and delta V. In three cases, these apparent trade-offs were not well addressed by concurrent changes in restraint systems and resulted in increased injury risk compared with the original tests. Among the 36 models tested after design changes, the extent of design changes correlated to structural performance. Half of the vehicles with the lowest intrusion levels incorporated aspects of all three design strategies. Vehicle kinematics and dummy and restraint system characteristics were similar to those observed in the before/after pairs. Different combinations of structural improvement strategies for improving small overlap test performance were found to be effective in reducing occupant compartment intrusion and improving dummy kinematics in the IIHS small overlap test with modest weight increase.

Minimizing the injury potential of deploying airbag interactions with car occupants

Minimizing the injury potential of the interactions between deploying airbags and car occupants is the major issue with the design of airbag systems. This concern was identified in 1964 by Carl Clark when he presented the results of human volunteer and dummy testing of the "Airstop" system that was being developed for aircraft. The following is a chronological summary of the actions taken by the car manufacturers, airbag suppliers, SAE and ISO task groups, research institutes and universities, and consumer and government groups to address this issue.

Comparing the performance of residential fire sprinklers with other life-safety technologies

Residential fire sprinklers have long proven themselves as life-safety technologies to the fire service community. Yet, about 1% of all one- and two-family dwelling fires occur in homes protected by sprinklers. It has been argued that measured sprinkler performance has ignored factors confounding the relationship between sprinkler use and performance. In this analysis, sprinkler performance is measured by comparing 'like' structure fires, while conditioning on smoke detection technology and neighborhood housing and socioeconomic conditions, using propensity score matching. Results show that residential fire sprinklers protect occupant and firefighter health and safety, and are comparable to other life-safety technologies.

Child passenger safety

Despite significant reductions in the number of children killed in motor vehicle crashes over the past decade, crashes continue to be the leading cause of death for children 4 years and older. Therefore, the American Academy of Pediatrics continues to recommend inclusion of child passenger safety anticipatory guidance at every health-supervision visit. This technical report provides a summary of the evidence in support of 5 recommendations for best practices to optimize safety in passenger vehicles for children from birth through adolescence that all pediatricians should know and promote in their routine practice. These recommendations are presented in the revised policy statement on child passenger safety in the form of an algorithm that is intended to facilitate their implementation by pediatricians with their patients and families. The algorithm is designed to cover the majority of situations that pediatricians will encounter in practice. In addition, a summary of evidence on a number of additional issues that affect the safety of children in motor vehicles, including the proper use and installation of child restraints, exposure to air bags, travel in pickup trucks, children left in or around vehicles, and the importance of restraint laws, is provided. Finally, this technical report provides pediatricians with a number of resources for additional information to use when providing anticipatory guidance to families.

Are airbags a dangerous safety measure? A meta-analysis of the effects of frontal airbags on driver fatalities

A meta-analysis has been conducted of the effectiveness of frontal airbags in reducing driver fatalities, and some potential moderator variables for airbag effectiveness have been investigated. The results confirm the assumption that airbags reduce accident fatalities among belted drivers, but the results are too heterogeneous for drawing conclusions about the size of the overall effect. No support has been found for the hypothesis that airbags increase overall fatality risk, as has been found in the study by Meyer and Finney (Meyer, M., Finney, T., 2005. Who wants Airbags? Chance, 18 (19) 3-16). The results do not seem to be affected by publication bias, and no indications of confounding effects of vehicle characteristics or impact velocity have been found. In frontal collisions belted driver fatalities were found to be reduced by about 22% when all types of airbags are regarded together. The revision of the test criteria for airbags in the USA in 1997 has improved airbag effectiveness. For unbelted drivers airbags are neither effective nor counterproductive, but may increase fatality risk in single vehicle accidents. The results show that there is a lack of knowledge about the effects of airbags in accidents that are not frontal collisions.

Use of fatal real-life crashes to analyze a safe road transport system model, including the road user, the vehicle, and the road

OBJECTIVE

To evaluate if the Swedish Road Administration (SRA) model for a safe road transport system, which includes the interaction between the road user, the vehicle, and the road, could be used to classify fatal car crashes according to some safety indicators. Also, to present a development of the model to better identify system weakness.

METHODS

Real-life crashes with a fatal outcome were classified according to the vehicle's safety rating by Euro NCAP (European Road Assessment Programme) and fitment of ESC (Electronic Stability Control). For each crash, the road was also classified according to EuroRAP (European Road Assessment Programme) criteria, and human behavior in terms of speeding, seat belt use, and driving under the influence of alcohol. Each crash was compared with the model criteria, to identify components that might have contributed to fatal outcome. All fatal crashes where a car occupant was killed that occurred in Sweden during 2004 were included: in all, 215 crashes with 248 fatalities. The data were collected from the in-depth fatal crash data of the Swedish Road Administration (SRA).

RESULTS

It was possible to classify 93% of the fatal car crashes according to the SRA model. A number of shortcomings in the criteria were identified since the model did not address rear-end or animal collisions or collisions with stationary/parked vehicles or trailers (18 out of 248 cases). Using the further developed model, it was possible to identify that most of the crashes occurred when two or all three components interacted (in 85 of the total 230 cases). Noncompliance with safety criteria for the road user, the vehicle, and the road led to fatal outcome in 43, 27, and 75 cases, respectively.

CONCLUSIONS

The SRA model was found to be useful for classifying fatal crashes but needs to be further developed to identify how the components interact and thereby identify weaknesses in the road traffic system. This developed model might be a tool to systematically identify which of the components are linked to fatal outcome. In the presented study, fatal outcomes were mostly related to an interaction between the three components: the road, the vehicle, and the road user. Of the three components, the road was the one that was most often linked to a fatal outcome.

Engineering with uncertainty: monitoring air bag performance

Modern engineering is complicated by an enormous number of uncertainties. Engineers know a great deal about the material world and how it works. But due to the inherent limits of testing and the complexities of the world outside the lab, engineers will never be able to fully predict how their creations will behave. One way the uncertainties of engineering can be dealt with is by actively monitoring technologies once they have left the development and production stage. This article uses an episode in the history of automobile air bags as an example of engineers who had the foresight and initiative to carefully track the technology on the road to discover problems as early as possible. Not only can monitoring help engineers identify problems that surface in the field, it can also assist them in their efforts to mobilize resources to resolve problem.

Using head-on collisions to compare risk of driver death by frontal air bag generation: a matched-pair cohort study

US air bag regulations were changed in 1997 to allow tests of unbelted male dummies in vehicles mounted and accelerated on sleds, resulting in longer crash pulses than rigid-barrier crashes. This change facilitated depowering of frontal air bags and was intended to reduce air bag-induced deaths. Controversy ensued as to whether sled-certified air bags could increase adult fatality risk. A matched-pair cohort study of two-vehicle, head-on, fatal collisions between drivers involving first-generation versus sled-certified air bags during 1998-2005 was conducted by using Fatality Analysis Reporting System data. Sled certification was ascertained from public information and a survey of automakers. Conditional Poisson regression for matched-pair cohorts was used to estimate risk ratios adjusted for age, seat belt status, vehicle type, passenger car size, and model year for driver deaths in vehicles with sled-certified air bags versus first-generation air bags. For all passenger-vehicle pairs, the adjusted risk ratio was 0.87 (95% confidence interval: 0.77, 0.98). In head-on collisions involving only passenger cars, the adjusted risk ratio was 1.04 (95% confidence interval: 0.85, 1.29). Increased fatality risk for drivers with sled-certified air bags was not observed. A borderline significant interaction between vehicle type and air bag generation suggested that sled-certified air bags may have reduced the risk of dying in head-on collisions among drivers of pickup trucks.

Deaths among drivers and right-front passengers in frontal collisions: redesigned air bags relative to first-generation air bags

OBJECTIVE

After automakers were allowed the option of using sled tests for unbelted male dummies to certify the frontal crash performance of vehicles, most frontal air bags were depowered, starting in model year 1998, to reduce deaths and serious injuries arising from air bag deployments. Concern has been expressed that depowering air bags could compromise the protection of adult occupants. This study aimed to determine the effects of changes in air bag designs on risk of death among front-seat occupants.

METHODS

Deaths among drivers and right-front passengers per involvement in frontal police-reported crashes during calendar years 1998-2004 were compared among vehicles with sled-certified air bags (model years 1998-2004) and first-generation air bags (model years 1994-97). Frontal crash deaths were identified from the Fatality Analysis Reporting System. National estimates of police-reported crashes were derived from the National Automotive Sampling System/General Estimates System. Sled certification status for model years 1998-2004 was ascertained from published federal data and a survey of automobile manufacturers. Passenger cars, pickup trucks, sport utility vehicles, and minivans were studied. Stratified analyses were done to compute risk ratios (RR) and 95% confidence intervals (95% CI) for driver and right-front passenger deaths by air bag generation and crash, vehicle, and driver characteristics.

RESULTS

In frontal crashes, overall RRs were 0.89 for driver deaths (95% CI = 0.74-1.08) and 0.89 for right-front passenger deaths (95% CI = 0.74-1.07) in sled-certified vehicles compared with first-generation air bag-equipped vehicles. Child right-front passengers (ages 0-4, 5-9) in vehicles with sled-certified air bags had statistically significant reductions in risk of dying in frontal collisions, including a 65% reduced risk among ages 0-4 (RR = 0.35; 95% CI = 0.21-0.60). No differences in effects of sled-certified air bags were observed between drivers ages 15-59 and 60-74 in sled-certified vehicles, both of whom had RRs slightly below 0.90 (non-significant). Among occupants killed in sled-certified vehicles, police-reported belt use was somewhat higher than in first-generation vehicles.

CONCLUSIONS

No differences in risk of frontal crash deaths were observed between adult occupants with sled-certified and first-generation air bags. Consistent with reports of decreases in air bag-related deaths, this study observed significant reductions in frontal deaths among child passengers seated in the right-front position in sled-certified vehicles. Higher restraint use rates among children in sled-certified vehicles and other vehicle design changes might have contributed partially to these reductions.

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

OBJECTIVE

To estimate the efficacy of side airbags in preventing driver deaths in passenger vehicles struck on the driver side.

METHODS

Risk ratios for driver deaths per driver-side collision were computed for side airbag-equipped cars and SUVs, relative to vehicles without side airbags. Driver fatality ratios also were calculated for the same vehicles in front and rear impacts, and these were used to adjust the side crash risk ratios for differences in fatality risk unrelated to side airbags. Risk ratios were calculated separately for side airbags providing torso-only protection and side airbags with head protection; almost all head protecting airbags also had airbags protecting the torso.

RESULTS

Car driver death risk in driver-side crashes was reduced by 37 percent for head protecting airbags and 26 percent for torso-only side airbags. Car driver death risk was reduced for older and younger drivers, males and females, and drivers of small and midsize cars, and when the striking vehicle was an SUV/pickup or a car/minivan. Death risk for drivers of SUVs was reduced by 52 percent with head protecting side airbags and by 30 percent with torso-only airbags. The effectiveness of side airbags could not be assessed for pickups and minivans due to the small number of these vehicles with airbags involved in crashes.

CONCLUSION

Side airbags substantially reduce the risk of car and SUV driver death in driver-side collisions. Making side airbags with head protection available to drivers and right front passengers in all passenger vehicles could reduce the number of fatalities in motor vehicle crashes in the United States by about 2,000 each year.

An evaluation of the EuroNCAP crash test safety ratings in the real world

We investigated whether the rating obtained in the EuroNCAP test procedures correlates with injury protection to vehicle occupants in real crashes using data in the UK Cooperative Crash Injury Study (CCIS) database from 1996 to 2005. Multivariate Poisson regression models were developed, using the Abbreviated Injury Scale (AIS) score by body region as the dependent variable and the EuroNCAP score for that particular body region, seat belt use, mass ratio and Equivalent Test Speed (ETS) as independent variables. Our models identified statistically significant relationships between injury severity and safety belt use, mass ratio and ETS. We could not identify any statistically significant relationships between the EuroNCAP body region scores and real injury outcome except for the protection to pelvis-femur-knee in frontal impacts where scoring "green" is significantly better than scoring "yellow" or "red".

Factors influencing occupant-to-seat belt interaction in far-side crashes

Seat belt interaction with a far-side occupant's shoulder and thorax is critical to governing excursion towards the struck-side of the vehicle in side impact. In this study, occupant-to-belt interaction was simulated using a modified MADYMO human model and finite element belts. Quasi-static tests with volunteers and dynamic sled tests with PMHS and WorldSID were used for model validation and comparison. Parameter studies were then undertaken to quantify the effect of impact direction, seat belt geometry and pretension on occupant-to-seat belt interaction. Results suggest that lowering the D-ring and increasing pretension reduces the likelihood of the belt slipping off the shoulder. Anthropometry was also shown to influence restraint provided by the shoulder belt. Furthermore, the belt may slip off the occupant's shoulder at impact angles greater than 40 degrees from frontal when no pretension is used. However, the addition of pretension allowed the shoulder to engage the belt in all impacts from 30 to 90 degrees.

Automobile air bags: friend or foe? A case of air bag-associated ocular trauma and a related literature review

BACKGROUND

Although air bags are placed in automobiles to act as safety devices, they have been shown to carry a risk of injury themselves. Ocular injury, in particular, can often be a direct consequence of air bag deployment. A case of ocular air bag injury is presented. A discussion and review of the current literature on this issue follows.

CASE REPORT

A 63-year-old man was transferred to our clinic after sustaining injuries related to a motor vehicle accident, during which the automobile's air bag was deployed. Initial examination revealed many signs of blunt ocular trauma of the O.D., including iridodialysis, dislocated lens with traumatic cataract, and traumatic/inflammatory glaucoma. Initial B-scan showed an attached retina O.D. One month later, the patient underwent an attempted pars plana vitrectomy with lensectomy, iris repair, and insertion of an anterior chamber intraocular lens. Complications arose during the procedure, and a total retinal detachment developed. Resultant acuity is no light perception O.D.

CONCLUSIONS

Although ocular morbidity can be a direct consequence of air bag deployment, most eye injuries are minimal, and seem to be outweighed by the benefits of air bags. Drivers, as well as passengers, can minimize associated injuries by adhering to specific safety guidelines. This, as well as continual modification and improvement in air bag design, will maximize the safety of air bags and decrease the incidence of vision-threatening ocular injury caused by air bag deployment.

Restraint Use and Lower Extremity Fractures in Frontal Motor Vehicle Collisions

BACKGROUND

Seat belts and air bags have been shown to significantly reduce morbidity and mortality following MVCs. Research suggests that restraint use does not protect against lower extremity fracture; however, no population-based studies of this association exist. The purpose of this study is to compare the effectiveness of combined seat belt and airbag restraint systems with airbag alone, seat belt alone, and no restraints with respect to incidence and location of lower extremity fractures.

METHODS

A retrospective analysis of front seat occupants involved in police-reported, tow-away frontal MVCs was conducted using data from the 1995 through 2000 National Automotive Sampling System (NASS). Incidence and relative risk (RR) of fracture to specific bony regions were measured according to seat belt use and airbag deployment.

RESULTS

Compared with unrestrained occupants, occupants restrained with airbag only had significantly higher risk for all types of lower extremity fractures whereas those occupants restrained with either seat belt only or seat belt and airbag had lower risk of fracture. The greatest difference was seen with tibia/fibula fractures in airbag only (RR, 2.14) but this trend continued to be significant with femur and pelvic fractures (RR, 1.13 and 1.23, respectively).

CONCLUSION

While airbags may reduce the risk of death when used alone or in combination with seat belts, the results of this study demonstrate that air bags increase the risk of lower extremity fractures when used as the sole method of passenger protection. Also, they may do so differentially according to skeletal region. This data strongly support the consideration of developing accessory knee bolster airbags to prevent the "submarining" or sliding under the airbag that may be responsible for this finding.

Requirements for the crash protection of older vehicle passengers

This study compares injury outcomes in vehicle crashes involving different age groups of belted passengers. Two datasets were considered. Firstly, UK national data revealed that younger passengers are much more likely to be involved in crashes per million miles travelled compared to older passengers although older passengers are much more likely to be killed or seriously injured compared to younger passengers. Secondly, in-depth vehicle crash injury data were examined to determine some of the underlying reasons for the enhanced injury risk amongst older passengers. In crashes of approximately equal severity, the older passenger group were significantly more likely to be fatally injured in frontal crashes (p<0.001). However young passengers were as equally likely to be killed in struck-side crashes compared to the older group. The results also showed that older passengers sustained more serious injuries to the chest region in frontal crashes compared with the younger aged group (p<0.0001) and it is this body region that is particularly problematic. When the data were analysed further, it was found that a large proportion of passengers were female and that in the majority of cases, the seat belt was responsible for injury. Since by the year 2030, 1 in 4 persons will be aged over 65 in most OECD countries, the results suggest a need for intervention through vehicle design including in-vehicle crashworthiness systems that take into account reduced tolerance to impact with ageing.

Airbags & children: making correct choices in child passenger restraints

Countless numbers of young lives are lost each year due to motor vehicle crashes. One of the most effective means of reducing the number of children killed and injured as occupants in motor vehicles is through the use of child passenger restraints. Seat belts and child safety seats save lives and reduce the severity of injuries sustained by occupants in motor vehicle crashes. Nurses are in a unique position to educate and influence families on the proper way to safely transport all motor vehicle passengers. Therefore, nurses working with infants, children, and families have a moral and professional obligation to understand the basics of child passenger safety. At the very least, nurses should be able to direct families appropriately for specifics related to child passenger restraints. The intent of this article is to provide an overview of child passenger safety through a historical, theoretical, and clinical approach. Proper child restraint use is reviewed based on current recommendations for age and size. The potential hazards of child restraint misuse, with an in-depth discussion on airbags, is presented. The discussion on airbags serves to dispel any misconceptions that may be held about airbags. The article includes two case studies that illustrate the injury potential of relatively common misuse patterns. The clinical implications for maternal-child nurses include the recognition that child passenger deaths are primarily due to child restraint nonuse and misuse and the realization of nursing's role in the promotion of proper child passenger restraint.

Comparative strengths and structural properties of the upper and lower cervical spine in flexion and extension

The purpose of this study is to test the hypothesis that the upper cervical spine is weaker than the lower cervical spine in pure flexion and extension bending, which may explain the propensity for upper cervical spine injuries in airbag deployments. An additional objective is to evaluate the relative strength and flexibility of the upper and lower cervical spine in an effort to better understand injury mechanisms, and to provide quantitative data on bending responses and failure modes. Pure moment flexibility and failure testing was conducted on 52 female spinal segments in a pure-moment test frame. The average moment at failure for the O-C2 segments was 23.7+/-3.4Nm for flexion and 43.3+/-9.3Nm for extension. The ligamentous upper cervical spine was significantly stronger in extension than in flexion (p=0.001). The upper cervical spine was significantly stronger than the lower cervical spine in extension. The relatively high strength of the upper cervical spine in tension and in extension is paradoxical given the large number of upper cervical spine injuries in out-of-position airbag deployments. This discrepancy is most likely due to load sharing by the active musculature.

Air bags and ocular injuries

PURPOSE

This investigation retrospectively examined ocular injuries associated with air bag deployment to gain a better appreciation of potential risk factors in motor vehicle accidents. National statistics regarding the efficacy of air bags were reviewed.

METHODS

Review of the literature from 1991 to 1998 identified 44 articles describing 97 patients with air-bag-induced ocular injuries. Variables extracted from each case were age, sex, height, position in the car, eye wear, vehicle impact speed, visual acuity, and specific ocular injuries.

RESULTS

Corneal abrasions occurred in 49% of occupants, hyphemas in 43%, vitreous or retinal hemorrhages in 25%, and retinal tears or detachments in 15%. The globe was ruptured in 10 patients. Patients involved in higher-speed accidents (over 30 mph) sustained a greater percentage of vitreous or retinal hemorrhages and traumatic cataracts, while those at slower speeds were more prone to retinal tears or detachments. In a subset of 14 patients with serious ocular injuries, the impact speed of 11 patients was recorded at 30 mph or less. Slower speed may be a risk factor for some ocular injuries. Occupant height was not a significant factor. National statistics confirm that air bags reduce fatalities in motor vehicle accidents. However, children sitting in the front seat without a seat belt and infants in passenger-side rear-facing car seats are at risk for fatal injury.

CONCLUSION

Air bags combined with seat belts are an effective means of reducing injury and death in adults during motor vehicle accidents. However, this study has documented a wide variety of ocular injuries associated with air bag deployment. It is hoped that researchers can develop modifications that continue to save lives while minimizing additional harm.

Air bags: an update

Overwhelming evidence shows that air bags save lives and reduce morbidity associated with MVCs. The resulting benefits far outweigh the risks of air bag injury or death. Emergency nurses play a pivotal role in educating the public about active seat belt use in conjunction with passive restraint systems such as air bags. Air bags cannot be viewed as a single solution or panacea to occupant protection. Air bags are designed as supplemental devices to be used with seat belts and require the active participation of the user for maximum benefit and safety.

A parametric study of a side airbag system to meet deflection based criteria

A side airbag system comprising of 12 liter bag to cover the BioSid chest and the abdomen down to the arm rest level, and 75 mm of padding to cover the pelvic/thigh area was evaluated by a series of sled tests at two different velocities, 10 m/s and 12 m/s. The initial bag (over) pressure was varied from 0 to 80 kPa and the bag ventilation area was varied from zero to 1500 mm2. Compressed air was used to fill the bag. It was found that the ventilation of the bag reduced the maximum chest deflection by 30 percent and the maximum viscous criterion, VC, by 50 percent (comparison was made with the same bag without ventilation). A suitable initial bag (over) pressure was found to be about 50 kPa, when the loading of the abdomen was also taken into consideration. The results indicate that the chest deflection is proportioned to the door average velocity (during the first 20 ms of deflection) to the power of about 2 and that the VC is proportional to the same velocity to the power of about 4. It was also found that a 12 liter ventilated side airbag resulted in 30-40 percent lower chest deflection and about 60 percent lower VC than 50 mm of chest padding (Ethafoam 220).