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Overview of Serious Thorax Injuries in European Frontal Car Crash Accidents and Implications for Crash Test Dummy Development

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Overview of Serious Thorax Injuries in European Frontal Car Crash Accidents and Implications for Crash Test Dummy Development OVERVIEW OF SERIOUS THORAX INJURIES IN EUROPEAN FRONTAL CAR CRASH ACCIDENTS AND IMPLICATIONS FOR CRASH TEST DUMMY DEVELOPMENT Jolyon Carroll1, Thorsten Adolph2, Cyril Chauvel3, Maxime Labrousse3, Xavier Trosseille3, Claus Pastor2, Andre Eggers2, Susannah Smith1, and David Hynd1 1: TRL (Transport Research Laboratory, UK), 2: BASt (Bundesanstalt für Straßenwesen, Germany), 3: GIE RE PR (Groupement Intérêt Economique de Recherches et Etudes PSA-Renault, France) ABSTRACT For the EC 7th Framework Action COVER and to support the THORAX and THOMO projects, the objectives of this work were to: define the current state of knowledge on thorax injuries in frontal impacts; extend that knowledge to define in detail thorax injuries for diverse user groups; and recommend priorities for biomechanical testing, crash test dummy development, and injury risk functions that would be most relevant for future advanced frontal impact dummies. This paper brings together accident data analyses from the UK, Germany, and France to address these objectives. Based on the results of these analyses the authors observed that there was an increased risk for older occupants to sustain a torso injury. There also tends to be a greater torso injury risk for occupants seated in the front passenger seat compared with the driver’s seat. Fractures to the ribs and then the sternum were the most frequently occurring types of injury at the AIS 2 severity level. Injuries to the lungs were the most frequently occurring visceral injuries to the torso. Keywords: Accident Analysis, Biomechanics, Dummies, Thorax, Frontal Impacts THE ATTAINMENT of an ever-higher safety level on European roads is a long-term and ongoing process, which has seen significant progress already. Improvements in occupant protection (secondary safety) have contributed to this progress. For example, the combination of EU (European Union) legislation for crash test standards, improved consumer information through the Euro NCAP (European New Car Assessment Programme; www.euroncap.org), and safety developments made by car manufacturers has substantially raised the survivability for vehicle occupants in a crash. However, around 41,600 people were killed and more than 1.7 million injured in European road accidents in 2005. Therefore, whilst the number of road fatalities has declined by more than 17 % since 2001, greater efforts are still warranted. Although efforts are needed on all levels of road safety, the COVER (Coordination of Vehicle and Road Safety Initiatives) project has been set-up to develop a harmonised and consistent direction of research and to accelerate the implementation of the research findings of four complimentary initiatives in the field of crash biomechanics (including the THORAX {Thoracic injury assessment for improved vehicle safety} and THOMO {Development of a finite element model of the human thorax and upper extremities} projects). Motivated by findings of previous projects (including EC Framework projects) the THORAX and THOMO projects were set-up to study thorax injuries for a wide variety of car occupants and transfer results into test and design tools. BACKGROUND Initially, findings from previous research were collated to define the current state of knowledge on thorax injuries in frontal impacts. A summary of these findings is given here: • Head and facial injuries have been greatly reduced following the introduction of frontal airbags. However, a concomitant reduction in the number of thorax injuries occurring in the accident case data was not evident (Knack et al., 2003). IRCOBI Conference - Hanover (Germany) - September 2010 217 • Early data from a previous EEVC study (Beusenberg et al., 1996) suggested that the most frequent severe thorax injuries were fractured ribs, followed by lung contusions and lacerations. • Increasing age has been associated with increasing injury severity (Siegel et al., 2004; Augenstein et al., 2004; etc.). Trends in occupant weight are not significant, but indicate that heavier males and lighter females are at increased risk of MAIS 3 to 6 injuries (McCarthy et al., 2001). • Female front seat passengers had a higher proportion of chest injuries than female drivers. For front seat passengers most serious injuries are to the chest and these are mainly sustained by older women in low severity crashes (Frampton et al., 2005). • The potential effects of tuning restraint systems for high-speed impacts or occupants of average size were shown in the AoARS (Assessment of Advanced Restraint Systems) work. Whilst occupants of different sizes were found to have different injury risks under the different impact conditions investigated it was also reported that some injury measures (including those for a thorax injury) could be higher in lower speed impacts (Smith and Couper, 2006). • Occupants with a load limiter tend to have fewer serious (AIS ≥ 3) injuries but instead have more skeletal thorax injuries (AIS < 3) (Edwards et al., 2008). METHODS Following on from the prior research, this paper brings together accident data analyses from the UK, Germany, and France to extend the knowledge from previous research with up-to-date in-depth European accident data. The in-depth car accident databases used in these analyses were the UK Cooperative Crash Injury Study (CCIS), the German In-Depth Accident data Survey (GIDAS; www.gidas.org – Otte et al., 2003 and Hautzinger et al., 2006), and the French GIE RE PR (Renault, and PSA Peugeot Citroën) database. The Abbreviated Injury Scale, 1990 Revision (AAAM, 1990), was used to code the injuries analysed, in all of the databases. Two phases of analysis are described. PHASE1: From a review of in-depth accident data, the COVER project provided an overview of the current situation with regard to thorax injuries resulting from frontal impact car accidents. Vehicle age was restricted to cars registered in 2000 or later. The accident data were controlled for impact partner, impact severity, overlap and intrusion, and type of restraint system used. Cases were selected if they had one significant frontal impact, had not rolled over at any point, the occupants were wearing a seat-belt, known to be 12 years old or older, and had a known overall Maximum Abbreviated Injury Scale (MAIS) score, whether injured or uninjured. The selection criteria generated samples of 2,148, 2,451, and 529 occupants from the CCIS, GIDAS, and GIE RE PR databases, respectively. PHASE2: Individual frontal impact accident cases from the CCIS and GIDAS in-depth accident studies, as used in the COVER work, were selected for further in-depth analysis. Within the THORAX Project, 34 cases, where the impact conditions were similar to the Euro NCAP frontal impact crash test (Euro NCAP, 2009), were analysed. This included 20 cases from the CCIS and 14 from the GIDAS. The number of cases was limited by the requirement for them to have impact conditions similar to those of a Euro NCAP test (including having been struck on the same side of the vehicle) and to involve a car for which Euro NCAP test results are available. A comparison was made between the thoracic injury outcome predicted from the test and observed in the real-world accident. Other impact types known to cause torso injuries (for instance, with single vehicle impacts with narrow objects, such as trees) were not included in the second phase. Additionally, GIE RE PR accident cases were reviewed with a particular focus on the efficacy of load-limiting restraint systems in mitigating thorax injuries. Torso definition: In frontal impacts, the loading to the thorax of a seat-belted occupant is likely to be influenced by the interaction of the seat-belt with the clavicle/shoulder. Also, the inferior margin of the thorax can be described as including organs of the upper abdomen depending on where the thoracic/abdominal transition is set. To include consideration of injuries to the shoulder, clavicle, and 218 IRCOBI Conference - Hanover (Germany) - September 2010 upper abdomen, alongside injuries to the thorax (as listed in the AIS), it was necessary to define key types and regions of injury to a wider thoracic or trunk area. Within this study the wider thorax is defined as the ‘torso’. Classes of torso injury were defined based on the AIS code for each injury and included injury to any one, or combinations of the following: sternum, shoulder (clavicle, acromion, scapula, acromioclavicular joint, glenohumeral joint), rib, lung, heart, other thorax (including thoracic spine), upper abdomen (gallbladder, kidney, liver, pancreas, spleen), lower abdomen (bladder, ovary, lumbar spine), other abdomen (colon, omentum, retroperitoneum, duodenum, jejunum, mesentery). All abdomen injuries were included in the initial CCIS analysis as it was considered to be easier to remove the lower abdomen and other abdomen injuries after the initial investigation of injury combinations. The precise thorax injuries used in the GIDAS analysis were defined with the location of injury (SITZ) coding, and included the injury codes 300 to 595. Due to space limitations, it is not possible to provide exact details of all injuries included in the GIDAS torso definition, within this paper. The following table (Table 1) shows the sizes of the samples used for Phase 1 of the study. This illustrates how the thorax and torso injury selections affected the number of injuries available for analysis. Within GIDAS all accidents are collected, whereas in the CCIS, for example, data collection is biased towards more severe accidents. This is the reason why there is this difference between the numbers of total occupants and occupants with severe torso injuries between those samples. Table 1. Sample sizes available for analysis in Phase 1 Sample CCIS (TRL) GIDAS (BASt) GIE RE PR Total occupants 2,148 2,451 529 front seat occupants Thorax injured 234 (AIS 2+, incl. 90 (AIS2+, incl. occupants AIS 1 rib fractures) liver and spleen) Thorax injuries 410 (AIS 2+, incl. 159 (AIS2+, incl. AIS 1 rib fractures) liver and spleen) Torso injured 320 (AIS 2+, incl. occupants AIS 1 rib fractures) Torso injuries 678 (AIS 2+, incl.
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