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Empirical models are presented which predict the threespace position of the torso when responding to reaches with the right arm. Models were derived which specify torso position in terms of the spacial location of 10 surface markers. These markers were positioned over palpable skeletal points of the spine and shoulder girdle. The necessary data were obtained through photogrammetric procedures utilizing four orthogonal cameras. The independent (input) variables to these models are the coordinates of the reach target. A supplementary, slightly more accurate, set of models was also derived in which the set of independent variables was enlarged to include the anthropometric dimensions of the subject. The second, concurrent phase of the analysis resulted in the derivation of a set of models which describes the configuration of the internal, torso skeletal system.

The object of this study has been to develop a quantitative description of the mobility of the human torso, including the shoulder girdle, neck, thoracic and lumbar vertebral column, and pelvis. This has been accomplished by a systematic multidisciplinary investigation involving techniques of cadaver dissection and measurement, utilizing cineradiofluoroscopy for joint center of rotation location, anthropometry, radiography, and photogrammetry for selected positions and motions of living subjects, and computer analysis. Positional and dimensional data were obtained for 72 anthropometric dimensions on 28 living male subjects statistically representative of the 1967 USAF anthropometric survey of 3542 rated officers, including bone lengths of the extremities and vertebral landmarks. Normal excursion of these limbs was measured in the living, utilizing the landmarks established in initial cadaver dissection.

A study of the biomechanical factors concerned with the design of side structures and doors for crashworthiness has been made. Questions regarding optimum stiffness, location of reinforcing members, effect of armrests, and padding have been answered within the framework of injury criteria models. Results of animal studies, cadaver studies, and anthropometric dummies have been combined to produce injury criteria for lateral impacts to the head, thorax, and abdomen. Impacts were applied utilizing a specially designed “air gun” in a laboratory environment emphasizing reproducibility and control. Full-scale crash simulations were performed on an impact sled to verify the results of the more specialized tests and analyses. Scaled models of current production doors were used in the animal series. Scaling relationships for various species of animals have been developed and extrapolated to man. Significant differences in right and left side tolerances to impact were noted and detailed.

Human impact injury and survival tolerance levels for various crash conditions are presented on the basis of currently available biomedical and biomechanical knowledge. Consideration of physical factors influencing trauma-including body orientation, restraint system, magnitude, distribution, and time duration of deceleration-are summarized, as well as tabulations and sources of data for both whole body and regional impact tolerances. These biological data concerning human impact tolerances are provided as guidelines for improved engineering design of general aviation crashworthiness.

The Abbreviated Injury Scale (AIS) introduced in January 1968 has been widely used by the Medical Engineering Accident Investigation Teams of the NHTSA, by the General Motors ADAP, by the NATO Country Teams in Europe, and by the AMA Physician-Police Teams. The experience and problems involved in use of the AIS are reviewed. An extended and revised AIS has been developed. Validation studies revealed better than 80% accuracy by multiple users. The Comprehensive Research Injury Scale (CRIS) has been completed for all major medical specialties. The CRIS separates the various criteria (energy dissipation-ED, threat to life-TL, permanent impairment-PI, treatment period-TP, incidence-IN) used with variable quantities and frequencies in the AIS. The CRIS identifies and quantitates each scaling criteria permitting more meaningful and detailed application of the AIS.

This three-part paper deals with the medical aspects of driver protection in automobile racing. Part one presents the history of car safety equipment beginning with the development of helmets, belts, roll bars, and other devices to protect competition drivers. This paper describes the evolution from purely optional to mandatory equipment and how their design and accident records have contributed to increased safety in passenger cars. The investigation of injuries sustained in crash, fire, and loss of control caused by road hazards have contributed to the many improvements discussed here, almost all of which are readily adaptable to passenger car models. The second part presents a summary of the influence of racing on the design, testing and performance standards for protective headgear. The significance is indicated of applying basic principles of mechanics and dynamic systems testing to all fields in which head impact is a potential hazard.

Some 634 accidents occuring in races sanctioned by the Sports Car Club of America (SCCA) are reviewed. Shoulder harnesses were used in 275 of the accidents. Inverted “Y” or double, separately anchored, shoulder harnesses were used almost exclusively. A significant decrease in the frequency and severity of injuries occurred after harnesses were introduced. Injury from the restraint system was very infrequent; submarining occurred only once. Deep bucket seats, providing lateral support for the chest and forward support for the buttocks, appear to potentiate the effectiveness of restraint systems. The “Y” harness functions well in production seats without lateral support because lateral displacement of the shoulders and upper torso can occur without risk of neck injury.

Aircraft used for business (executive corporate transportation or personal business) and utility purposes now represent about one-third of the total United States aircraft inventory. Data from accident investigation of business aircraft involved in survivable accidents indicate serious injuries and fatality to the occupants occur most frequently as a result of the unprotected head and neck or chest flailing in contact with aircraft controls, instrument panel, or structure. Improvement of current aircraft to provide increased occupant safety and survival during crash impacts is both necessary and feasible. Design considerations include folding seat back locks to prevent collapse, increased seat tie-down to structure, instrument panels and glare shields designed to absorb energy through structural design and padding, stronger seat structure, lateral protection, design and packaging of knobs and projections to minimize injury in contact, and installation of upper torso restraint.

A widely accepted injury scale is urgently needed by medical engineering automotive accident investigation teams. An informal committee of physicians, engineers and other researchers has developed two scales. The Abbreviated Injury Scale (AIS) combines and details several existing scales including the DeHaven-Cornell scale, the commonly used police scale, and others. Injuries which are usually not fatal are rated with a 1 to 5 scale. Several scaling criteria were combined but with varying weights to establish the AIS rankings. The Comprehensive Research Injury Scale (CRIS) was developed to separate the criteria used in injury scaling. Five separate criteria are used: Energy Dissipation (ED), Threat-To-Life (TL), Permanent Impairment (PI), Treatment Period (TP), and Incidence (IN). The ED scale ranks energy dissipation in injury production, and will be of major value to vehicle designers concerned with human tolerance for injury.

An acceleration sled carrying living human subjects was used to measure the dynamic response of the head and neck to —G x impact acceleration. Seated volunteers with complete pelvic and upper torso restraint were subjected to increasing impact accelerations beginning at 2.7 g and increasing in 1 g increments. The volunteers were selected to encompass the 5th to 95th percentile distribution of sitting height according to a selected reference. Precision inertial transducers were used to determine the linear and angular acceleration of the head and the first thoracic vertebra. The inertial system consisted of a biaxial accelerometer and rate gyroscope on a bite-plate, a biaxial acceierometer over the bregma, and a biaxial acceierometer and rate gyroscope over the spinous process of the first thoracic vertebra. The transducers on the bite-plate and over the bregma were rigidly connected to one another.

Forty-eight lateral impact accidents were studied correlating vehicle damage and occupant injury. Side-swipe accidents produced serious injury only when the occupant's elbow was protruding through a window or when the occupant space of the vehicle was seriously compromised. Intersection impacts and drifting impacts, particularly when the impact was caused by a vehicle approaching from the opposite direction, caused the most serious injuries. Fractures of the acetabulum with intrapelvic protrusion of the hip and fractures of the pubic rami are characteristic of lateral impact accidents. The door was the most common injury-producing structure of the vehicle. Deep wrap-around seat designs and stronger doors, door frames, and chassis structures are necessary to reduce occupant space penetration and to absorb impact energy in lateral impact accidents.

Although it has been well established that the lap (seat) belt offers considerable protection against injury or death in crash environments, there has long been controversy over the injury potential to the pregnant female. This question is of importance in consideration of restraint and seat protective environments for both aircraft and automotive vehicles. Most of the 4 million pregnant women per year in the United States travel by automobile, with a large number traveling by Commercial Civil Aircraft or the Military Air Transport Service. Thus a sizeable population is involved. This combined study by the Civil Aeromedical Institute, F. A. A., 6571st Aeromedical Research Laboratory, Holloman AFB, and the University of Oklahoma School of Medicine, has been concerned with the clinical, experimental, and applied aspects.

A statistical study of sports car racing sanctioned by the Sports Car Club of America demonstrates the frequency of roll-over accidents and the infrequency of serious injury from such accidents. Detailed case studies from Watkins Glen Grand Prix Course are presented. Three similar rollover accidents taken from the author’s medical practice are presented for comparison. The use of roll bars for open cars is advocated.