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Introduction: Spine injuries pose a considerable risk to life and quality of life. The total number of road deaths in developed countries has markedly decreased, e.g. in Germany from over 20000 in 1970 to less than 4000 in 2010, but little is known how this is reflected in the burden of spine fractures of motor vehicle users. In this study, we aimed to show the actual incidence of spine injuries among drivers and front passengers and elucidate possible dependencies between crash mechanisms and types of injuries.
In Germany, in-depth accident investigations are carried out in the Hannover area since 1973. In 1999 a second region was added with surveys in Dresden and the surrounding area. Internationally, the acronym GIDAS (German In-Depth Accident Study) is commonly used for these surveys. Compared to many other countries, the sample sizes of the GIDAS surveys are much larger. The goal is to collect 1.000 accidents involving personal injuries per year and region. Data collection takes place by using a sampling procedure, which can be interpreted as a two-stage process with time intervals as primary units and accidents as secondary units. An important question is, to what extend these samples are representative for the target population from which they are drawn. Analyses show, for example, that accidents with persons killed or seriously injured are overrepresented in the samples compared to accidents with slightly injured persons. This means, that these data are subject to biases due to uncontrolled variation of sample inclusion probability. Therefore, appropriate weighting and expansion methods have to be applied in order to adjust or correct for these biases. The contribution describes the statistical and methodological principles underlying the GIDAS surveys with respect to sampling procedure, data collection and expansion. In addition, some suggestions regarding potential improvements of study design are made from a methodological point of view.
Since 2008, the authors inspected fatal traffic accidents on the spot every year, with the cooperation of Toyota police station in Aichi pref. In the jurisdiction, numbers of fatal accidents were 18 in 2008, 12 in 2009, 14 accidents in 2010, and 16 in 2011. We here report the results of our analysis of information obtained by detailed inspection for those that occurred from 2008 to 2010. We focused on vehicle-to-pedestrian accidents, which accounted for about 45% of all accidents in 2008. Because many accidents occurred on residential roads not far from pedestrians" homes, it was revealed that the decrease of the collision speed by traffic calming such as humps and zone speed management, was highly effective. On the other hand, pedestrian detection technologies seemed to be also effective as a countermeasure on vehicle side. Every pedestrian position against a vehicle was clarified and TTC (Time to Collision) was calculated provisionally. Pedestrian accidents in intersections were also examined. Among the intersection pedestrian accidents within the jurisdiction, compared with the national average in Japan, the ratio of intersections without a signal and the ratio without a pedestrian crossing were high. According to the comparison of the Japanese traffic accident patterns between 2001 and 2008, pedestrian accidents during turning right and turning left did not decrease much. For elderly drivers, these accidents occurred very often. Finally, single vehicle accidents were analysed with the accident pattern analysis methods used above. There were high numbers of single vehicle accidents against object on single roads. Although fatal accidents against guardrails decreased, the numbers of fatal accidents against a utility pole and a sign pole were nearly constant. As for the impact with narrow width objects such as utility poles, the fatality rate was very high, and countermeasures of both road infrastructure and vehicles seem to be effective.
Small overlap frontal crashes are defined by a damage pattern with most of the vehicle deformation concentrated outboard of the main longitudinal structures. These crashes are prominent among frontal crashes resulting in serious and fatal injuries, even among vehicles that perform well in regulatory and consumer information crash tests. One of the critical aspects of understanding these crashes is knowing the crash speeds that cause the types of damage associated with serious injuries. Laboratory crash tests were conducted using 12 vehicles in three small overlap test conditions: pole, vehicle-to-vehicle collinear, and vehicle-to-vehicle oblique (15-degree striking angle). Field reconstruction techniques were used to estimate the delta V for each vehicle, and these results were compared with actual delta V values based on vehicle accelerometer data. Estimated delta Vs were 50% lower than actual values. Velocity change estimates for small overlap frontal crashes in databases such as NASS-CDS significantly underestimate actual values.
Rear-end collisions are the most frequent same and opposite-direction crashes. Common causes include momentary inattention, inadequate speed or inadequate distance. While most rear-end collisions in urban traffic only result in vehicle damage or slight injuries, rear-end collisions outside built-up areas or on motorways usually cause fatal or serious injuries. Driver assistance systems that detect dangerous situations in the longitudinal vehicle direction are therefore an essential safety plus. In view of this, for ADAC, systems that alert drivers to dangerous situations and initiate autonomous braking complement ESC as one of the most important active safety features in modern vehicles. The aim of ADAC is to provide consumers with technical advice and competent information about the systems available on the market. Reliable comparative tests that are based on standardised test criteria may provide motorists with important information and help them make a buying decision. In addition, they raise consumer awareness of the systems and speed up their market penetration. The assessment must focus on as many aspects of effectiveness as possible and include not only autonomous braking but also collision warning and autonomous brake assist. The work of the ADAC accident research is the development of the testing scenarios with direct link to accident situations and the identification of useful test criteria for testing.
Bicyclists are minimally or unprotected road users. Their vulnerability results in a high injury risk despite their relatively low own speed. However, the actual injury situation of bicyclists has not been investigated very well so far. The purpose of this study was to analyze the actual injury situation of bicyclists in Germany to create a basis for effective preventive measures. Technical and medical data were prospectively collected shortly after the accident at the accident scenes and medical institutions providing care for the injured. Data of injured bicyclists from 1985 to 2003 were analyzed for the following parameters: collision opponent, collision type, collision speed (km/h), Abbreviated Injury Scale (AIS), Maximum AIS (MAIS), incidence of polytrauma (Injury Severity Score >16), incidence of death (death before end of first hospital stay). 4,264 injured bicyclists were included. 55% were male and 45% female. The age was grouped to preschool age in 0.9%, 6 to 12 years in 10.8%, 13 to 17 years in 10.4%, 18 to 64 years in 64.7%, and over 64 years in 13.2%. The MAIS was 1 in 78.8%, 2 in 17.0%, 3 in 3.0%, 4 in 0.6%, 5 in 0.4%, and 6 in 0.2%. The incidence of polytrauma was 0.9%, and the incidence of death was 0.5%. The incidence of injuries to different body regions was as follows: head, 47.8%; neck, 5.2%, thorax, 21%; upper extremities, 46.3%; abdomen, 5.8%; pelvis, 11.5%, lower extremities, 62.1%. The accident location was urban in 95.2%, and rural in 4.8%. The accidents happened during daylight in 82.4%, during night in 12.2%, and during dawn/dusk in 5.3%. The road situation was as follows: straight, 27.3%; bend, 3.0%; junction, 32.0%; crossing, 26.4%; gate, 5.9%; others, 5.4%. The collision opponents were cars in 65.8%, trucks in 7.2%, bicycles in 7.4%, standing objects in 8.8%, multiple objects in 4.3%, and others in 6.5%. The collision speed was grouped <31 in 77.9%, 31-50 in 4.9%, 51-70 in 3.7%, and >70 in 1.5%. The helmet use rate was 1.5%. 68% of the registered head injuries were located in the effective helmet protection area. In bicyclists, head and extremities are at high risk for injuries. The helmet use rate is unsatisfactorily low. Remarkably, two thirds of the head injuries could have been prevented by helmets. Accidents are concentrated to crossings, junctions and gates. A significant lower mean injury severity was observed in victims using separate bicycle lanes. These results do strongly support the extension or addition of bicycle lanes and their consequent use. However, the lanes are frequently interrupted at crossings and junctions. This emphasizes also the important endangering of bicyclists coming from crossings, junctions and gates, i.e. all situations in which contact of bicyclists to motorized vehicles is possible. Redesigning junctions and bicycle traffic lanes to minimize the possibility of this dangerous contact would be preventive measures. A more consequent helmet use and use and an extension of bicycle paths for a better separation of bicyclists and motorized vehicle would be simple but very effective preventive measures.
A total survey of road traffic accidents involving most severely injured, defined as sustaining a polytrauma or severe monotrauma (ISS > 15) or being killed, was conducted over 14 months in a large study region in Germany. Data on injuries, pre-clinical and clinical care, crash circumstances and vehicle damage were obtained both prospectively and retrospectively from trauma centers, dispatch centers, police and fire departments. 149 patients with a polytrauma and eight with a severe monotrauma were recorded altogether. 22 patients died in hospital. Another 76 victims had deceased at the accident scene. In 2008, 49 % of patients treated with life-threatening injuries were car or van occupants, 21 % motorcyclists, 18 % cyclists and 10 % pedestrians. Among fatalities at the scene, vehicle occupants constituted an even larger portion. The number of road users with life-threatening trauma in the region was extrapolated to the German situation. It suggests that 10 % among the "seriously injured" as defined in national accident statistics are surviving accident victims with a polytrauma or severe monotrauma.
Traffic accidents were ranked the third among the major causes of death in Thailand. About 13,438 deaths and the death rate from traffic accident was 21.5 per 100,000 of population in 2002. The deaths and death rate varied upon the economic situation. After the economic crisis, traffic accidents were increased as well as the period of the bubble economy. In the Central region of Thailand numbers of road traffic crashes were lower than Bangkok Metropolis, but the highest in the number of deaths, death rate and serious injuries in 2002. Men aged 15"29 years old had higher numbers of deaths than men in other age groups and higher than women. Deaths and injuries from road traffic crashes were the highest in April and January, because there was a long weekend in those months. About 80 percent of road traffic crashes were caused by private car and motorcycle. In 2000 about 51 percent of traffic accidents took place on the straight way, followed by the junction and curves. In 2002, about 97 percent of road traffic crashes were caused by human factors including improper passing, speeding and disregarding to traffic signal, however, the identification of causes of traffic accident needed to improve. Drunk driving, disregarding on safety equipment usage, inefficiency of law enforcement and discontinuing of road safety programs were the deepest causes of traffic accidents. Research based information, a broad coalition of stakeholder and urban planning policy were needed to incorporate for a comprehensive road safety policy formulation and actions.
Police records about traffic accidents like used by IRTAD (International Road Traffic and Accident Database) and CARE (Community Road Accident Database) do not represent all road injuries. For instance, road accidents of bicyclists without a counterpart are usually not reported. Furthermore, IRTAD-like data contains hardly any information on injury outcome and accident circumstances. This information gap leads to an under-representation of the safety concerns of the most vulnerable road users like children and the elderly both in accident research and safety promotion. Injury registration for the European Injury Database (IDB), in turn, combines details of accident causation with diagnostic information that can be used to assess injury severity and long term consequences. The IDB is collecting data from hospital emergency department patients and is being implemented in a growing number of countries. In this article IDB results on mode of transport and injury outcome are presented from a sample of nine EU member states.
The significant demographic changes are predicted for the European future. The age group over 65 years is permanently increasing and over next 30 years every fourth person will belong to this group. This development will continue so far that by 2050 in many countries will double the percentage of the population aged 65 and more. Many studies analyze the new phenomena of the ageing (graying) society during the last decade. Mobility is integrated part of the life of every citizen, even more it means for the elderly people. The adequate mobility is the precondition for their active life and for their social communication that contribute to their health and functional capacity and their autonomy and independency. The active seniors demand less public support. The mobility of the older citizens is closely linked with health and societal problems and creates an important public challenge. On the other side the participation of seniors in transport due to their limited physical and mental possibilities means for them an increased risk to be injured or killed. The main mobility spaces are roads that can be used not only as a traveler in a vehicle (driver or passenger) but also as a pedestrian or cyclist or even as a motorcyclist. The road traffic is then an opportunity and danger in the same time. The accident analyzes show specific risk features of seniors that are different compared with other age groups. First of all the older road users (65 and more) are facing to the higher risk (number of killed divided by the population size) to be killed in a road accident compared with the group of younger road users (0 - 64). More significant difference can be observed when comparing the road user groups. The fatality percentage of the older pedestrians is 2,5 times higher compared with the group 25 " 64. Similar frequency show the cyclist fatalities. On the other side the vehicle passengers in the younger group have more or less two time higher percentage compared to seniors and in the group of motorcyclists even achieved in 2008 almost five times higher compared with the older group. The share of the old road users fatalities (around 19%) didn"t practically change during the last 10 years in the European average. But comparing the gender involvement (2006) there is an interesting difference " female fatalities make 30, 2%, male fatalities 15, 3% of all fatalities in their groups. The risk of the senior users is more connected with their physical and mental limits than with their risk behavior. According to the Czech statistics (2007) the vehicle drivers over 65 years cause only 3, 6% of all accidents. The solution of the problem is to minimize the risk and to create a safe environment for the elderly people using the roads. In order to achieve this goal a deep knowledge of risk and of accident circumstances, full understanding of the behavior of the seniors and their limitations and accommodating approach of the whole society is necessary. Road risk of the ageing society has to be considered as a part of the health and social policy. These can build a creditable basis for the implementation of the measures that secure safe moving of seniors on the roads.