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INTRODUCTION: Age-related frailty leaves older drivers with the greatest fatality risk when involved in a crash compared with younger demographics. This study explored how vehicle features differed between crash-involved older and middle-aged drivers and estimated how those differences contribute to excess older driver fatalities. METHODS: We merged Florida's crash data from 2014-2018 with Insurance Institute for Highway Safety and Highway Loss Data Institute databases. We compared the distribution of passenger vehicle age, type, size, and safety features among crash-involved older drivers (ages 70 and older) with crash-involved middle-aged drivers (ages 35-54). From logistic regression models, we estimated declines in older driver fatalities if they drove vehicles like those driven by middle-aged drivers under all and side-impact crash scenarios. RESULTS: Older drivers in crashes were more likely to be in vehicles that were lighter, older, and without standard electronic stability control, standard head-protecting side airbags, and ratings of good in two IIHS crash tests than middle-aged drivers. In adjusted models, the fatality risk for older drivers in all crashes was significantly higher when ESC was not standard (odds ratio [OR], 1.37; 95% confidence interval [CI], 1.12-1.68) or when driving small passenger cars relative to large SUVs (OR, 2.02; 95% CI, 1.25-3.26); in driver-side crashes, the fatality risk doubled when vehicles did not have standard head-protecting side airbags (OR, 2.03; 95% CI, 1.58-2.62). If older drivers drove vehicles similar to middle-aged drivers, we estimated 3.3% and 4.7% fewer deaths in all and side-impact crashes, respectively. CONCLUSIONS: These results contribute to evidence suggesting that newer, more crashworthy vehicles with crash mitigation features benefit older drivers because of their heightened risk of crash-related fatality. PRACTICAL APPLICATIONS: At a minimum, older drivers should aim to drive equipped vehicles with widely available features proven to reduce fatalities.
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Conducción de Automóvil , Humanos , Persona de Mediana Edad , Anciano , Adulto , ElectrónicaRESUMEN
Studies on the effectiveness of thoracic side airbags (tSABs) in preventing thoracic injuries is limited and conflicting. This retrospective observational study aims to evaluate the effectiveness of tSABs in side-impact crashes based on data for motor vehicle occupants (MVOs) who visited an emergency department in Korea. The data were obtained from the Korean In-Depth Accident Study (KIDAS) database for patients treated at Wonju Severance Christian Hospital between January 2011 and April 2020. Of the 3899 patients with road traffic injuries, data for 490 patients were used. The overall frequency of tSAB deployment in side-impact crashes was found to be 8.1%. In the multivariate analysis, elderly age, near-side impact, colliding with fixed objects, non-oblique force, and higher crush extent were found to be factors associated with higher thoracic injuries (Abbreviated Injury Scale ≥ 2). MVOs in crashes with tSAB deployment were at an increased risk of injury compared with MVOs in crashes with no deployment, but no statistical difference was observed [adjusted odds ratios (AORs): 1.65 (0.73-3.73)]. Further, the incidence of lung injury and rib fractures increased with tSAB activation (p < 0.05). These results demonstrate the limited capability of tSABs in preventing thoracic injuries in motor vehicle crashes.
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Accidentes de Tránsito , Traumatismos Torácicos , Humanos , Anciano , Escala Resumida de Traumatismos , Vehículos a Motor , Traumatismos Torácicos/epidemiología , Traumatismos Torácicos/prevención & control , Bases de Datos FactualesRESUMEN
OBJECTIVE: Thoracic side airbags (tSABs) deploy within close proximity to the occupant. Their primary purpose is to provide a protective cushion between the occupant and the intruding door. To date, various field studies investigating their injury mitigation has been limited and contradicting. The research develops efficacy estimations associated for seat-mounted tSABs in their ability to mitigate injury risk from the German collision environment. METHODS: A matched cohort study using German In-Depth Accident Study (GIDAS) data was implemented and aims to investigate the efficacy of seat-mounted tSAB units in preventing thoracic injury. Inclusion in the study required a nearside occupant involved in a lateral collision where the target vehicle exhibited a design year succeeding 1990. Collisions whereby a tSAB deployed were matched on a 1:n basis to collisions of similar severity where no airbag was available in the target vehicle. The outcome of interest was an incurred bodily or thoracic regional injury. Through conditional logistic regression, an estimated efficacy value for the deployed tSAB was determined. RESULTS: A total of 255 collisions with the deployed tSAB matched with 414 collisions where no tSAB was present. For the given sample, results indicated that the deployed tSAB was not able to provide an unequivocal benefit to the occupant thoracic region, because individuals exposed to the deployed tSAB were at equal risk of injury (Thorax Maximum Abbreviated Injury Scale (Tho.MAIS)2+ odds ratio [OR] = 1.04, 95% confidence interval [CI], 0.41-2.62; Tho.MAIS3+ OR = 1.15, 95% CI, 0.41-3.18). When attempting to isolate an effect for skeletal injuries, a similar result was obtained. Yet, when the tSAB was coupled with a head curtain airbag, a protective effect became apparent, most noticeable for head/face/neck (HFN) injuries (OR = 0.59, 95% CI, 0.21-1.65). CONCLUSION: The reduction in occupant HFN injury risk associated with the coupled tSAB and curtain airbag may be attributable to its ability to provide coverage over previous mechanisms of injury. Yet, the sole presence of the tSAB showed no ability to provide additional benefit for the occupant's thoracic region. Future work should identify mechanisms of injury in tSAB cases and attempt to quantify improvements in the vehicle's ability to resist intrusion.
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Accidentes de Tránsito/estadística & datos numéricos , Airbags , Traumatismos Torácicos/prevención & control , Adulto , Estudios de Cohortes , Bases de Datos Factuales , Femenino , Alemania/epidemiología , Humanos , Masculino , Traumatismos Torácicos/epidemiologíaRESUMEN
OBJECTIVE: Insurance Institute for Highway Safety (IIHS) high-hooded side impacts were analyzed for matched vehicle tests with and without side airbags. The comparison provides a measure of the effectiveness of side airbags in reducing biomechanical responses for near-side occupants struck by trucks, SUVs, and vans at 50 km/h. METHOD: The IIHS moving deformable barrier (MDB) uses a high-hooded barrier face. It weighs 1,500 kg and impacts the driver side perpendicular to the vehicle at 50 km/h. SID IIs dummies are placed in the driver and left second-row seats. They represent fifth percentile female occupants. IIHS tests were reviewed for matches with one test with a side airbag and another without it in 2003-2007 model year (MY) vehicles. Four side airbag systems were evaluated: (1) curtain and torso side airbags, (2) head and torso side airbag, (3) curtain side airbag, and (4) torso side airbag. There were 24 matched IIHS vehicle tests: 13 with and without a curtain and torso side airbags, 4 with and without a head and torso side airbag, 5 with and without a side curtain airbag, and 2 with and without a torso airbag. The head, chest, and pelvis responses were compared for each match and the average difference was determined across all matches for a type of side airbag. RESULTS: The average reduction in head injury criterion (HIC) was 68 ± 16% (P < .001) with curtain and torso side airbags compared to the HIC without side airbags. The average HIC was 296 with curtain and torso side airbags and 1,199 without them. The viscous response (VC) was reduced 54 ± 19% (P < .005) with curtain and torso side airbags. The combined acetabulum and ilium force (7 ± 15%) and pelvic acceleration (-2 ± 17%) were essentially similar in the matched tests. The head and torso side airbag reduced HIC by 42 ± 30% (P < .1) and VC by 32 ± 26% compared to vehicles without a side airbag. The average HIC was 397 with the side head and torso airbag compared to 729 without it. The curtain airbag and torso airbag only showed lower head responses but essentially no difference in the chest and pelvis responses. CONCLUSION: The curtain and torso side airbags effectively reduced biomechanical responses for the head and chest in 50 km/h side impacts with a high-hooded deformable barrier. The reductions in the IIHS tests are directionally the same as estimated fatality reductions in field crashes reported by NHTSA for side airbags.