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Accident investigators are often required to determine if an occupant was using a seat belt during a collision. Substantial research has been conducted on the types of physical evidence generated on a seat belt by occupant loading during a collision. However, very little research has been conducted concerning the characteristics of physical evidence that is created when an occupant uses their seat belt improperly. Case studies with misused seat belts were reviewed showing tell-tales of atypical or improper restraint usage. Occupants also experienced injuries consistent with greater excursion and contact with vehicle interior surfaces. To compare the physical evidence of properly and improperly used restraints, automotive frontal sled tests were conducted with matched pairs of anthropomorphic test devices (ATD) with seat belts used both correctly and incorrectly. When the seat belt was used improperly, distinctly different marks were observed.

This study integrates data from multiple sources to obtain a more complete understanding of inertially-induced pediatric cervical spine injury risk and the role of impact severity and restraint type. Data from previously conducted frontal crash and sled tests using a variety of anthropomorphic test devices (ATDs) in various restraint configurations were compiled and compared to injury assessment reference values (IARVs). The data show that neck loads in frontal collisions increase with increasing delta-V. At high delta-Vs, the neck loads correspond to a relatively high risk of neck injury regardless of restraint configuration. Pediatric inertial cervical spine injury risk in frontal collisions is governed primarily by the energy involved in the collision.