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Head injury is a serious threat to lives of people working around farm machinery. The consequence of head injuries are costly, paralytic, and often fatal. Clinical and biomechanical data on head injuries are reviewed and their application in the analysis of head injury risk associated with farm tractor discussed. A significant proportion of tractor-related injuries and deaths to adults, as well as children, is due directly or indirectly to head injury. An improved injury reporting program and biomechanical studies of human response to tractor rollover, runover, and falls, are needed to understand mechanisms of the associated head injury.

One of the leading causes of death and disability among young children is motor vehicle accidents. Although current child restraint systems (car seats) have significantly reduced mortality and morbidity, deaths and injuries still occur. Since it is not possible to correlate human child injury potential with the biomechanical devices used for high level impact testing using experimental methods, the acquisition and analysis of specific child injury data identifiable with real world automobile crashes is critical for input to biomechanical research, anthropometric test device (ATD) development and safety standard revisions. The purpose of this study was to analyze vehicular-related trauma that had occurred to children in known crash environments based on accident configuration and car seat design.

The automotive safety community has grown increasingly aware of the societal costs of injury impairment and disability resulting from automobile accidents. A significant portion of this impairment can be attributed to lower extremity trauma. An accident data study was conducted to determine lower extremity injury frequencies and mechanisms for restrained front-seat occupants in frontal collisions. A query of the 1988-1990 NASS (National Accident Sampling System) data provided information on pelvis, femur, knee, leg, and ankle and foot injuries. Age, gender, seating position, and delta-V were examined for their effect on the data. Lower extremity injury data were compared with injury data of similar severity (AIS ≥ 2) for the head, chest, thorax, and abdomen. The NASS data was supplemented with injury impairment information which, combined with anthropomorphic and biomechanical data, provides a prioritization scheme for the design of dummy lower extremities and instrumentation.

Lower limb injuries among motor vehicle occupants are relatively common and are one of the principle causes of permanent disability. The author has reviewed the current literature and his own experience as an orthopaedic surgeon and research accident investigator concerning lower limb injuries among motor vehicle occupants. An unreported series of knee, thigh, hip, pelvis injuries with indepth accident investigation is reported. Incidence rates for specific injury diagnoses are not available. Gross tabulations reveal that lower limb injury is second only to head injury in frequency among injured motor vehicle occupants. Lower limb injuries are possibly the commonest cause of permanent disability and impairment resulting from motor vehicle accidents.

The FMVSS were established to provide the public with uniform safety equipment and design standards based on sound research. Ongoing evaluation is essential to maintain the effectiveness and safety of FMVSS and to ensure that current technology is incorporated in standards development. Serious injury (AIS 3 or greater) reporting by NASS should be upgraded to facilitate standards evaluation and development. Although cost effectiveness is a mandated criteria for standards evaluation, the protection of human life and limb must remain the principle criteria for measuring effectiveness. A citizen's advisory panel, similar to the NMVSAC should be established to assist NHTSA in establishing priorities for standards evaluation, development and promulgation.

In a crash, impact against the steering assembly can be a major cause of serious and fatal injury to drivers. But the interrelationship between injury protection and factors of surface area, configuration, padding, relative position of the spokes, and number and stiffness of spokes and rim is not clear. This paper reports a series of high-G sled tests conducted with anesthetized animal subjects in 30 mph impacts at 30 G peaks. A total of eight tests were conducted, five utilizing pig subjects, one a female chimpanzee, one an anthropomorphic dummy, and one test with no subject. Instrumentation included closed circuit TV, a tri-axial load cell mounted between the steering wheel and column, seat belt load measurement, six Photo-Sonics 1000 fps motion picture cameras, and poloroid photography. Medical monitoring pre, during and post-impact was followed by gross and microscopic tissue examination.

Because of its flexibility and structure, the cervical spine is disposed to various mechanisms of injury: although not so common as injuries caused by head impacts, cervical fractures and/or fracture-dislocations have been reported without direct impact to the head. Some cervical injuries reported have been sustained by wearers of lap and shoulder belts in auto accidents; however, we do not consider belt use a potential hazard because ample evidence has accrued in the medical and engineering literature to document general injury and fatality reduction by use of seatbelts. We believe that in many instances occupants would be more seriously injured or killed were belts not worn. The present paper reviews reports of cervical injuries without head impact found in the literature and case histories of such injuries from the Highway Safety Research Institute of The University of Michigan, as well as experimental studies in animals, cadavers, and volunteer subjects.

Whiplash is a poorly defined term including ligamentous and muscle strains, hematomas, disc injuries, and less frequently, brain, eye and ear injuries. Diagnosis is difficult because clinical signs and Xrays, electromyography and electroencephalography findings are few. Protection and rest will cure most patients within a year but approximately 2/5th of patients have permanent symptoms and disability. Rear-end impact accidents cause the head and neck to hyperextend over the seat back. Whiplash occurs in 38% of exposed occupants. Head rests give protection but differential rebound may occur producing injurious hyperextension and whiplash. The larynx, trachea and esophagus, in front of the spine, are injured by impact against the dash or steering wheel. Airway obstruction may occur and cause death if not restored quickly. Permanent disability can occur because of scarring and partial airway or esophageal obstruction or vocal cord damage.

This paper presents an analysis of 67 neck injuries incurred in diving and sliding accidents in swimming pools. The accidents were investigated to establish the appropriate medical and mechanical factors involved. A mathematical model was developed to allow the prediction of the trajectory and velocity of the subjects prior to their injury. Nine of the accidents were selected for real life simulation. The simulation included the selection of test subjects of similar physical build to the accident victims who then performed the maneuvers leading to the injury, but in deeper water. High speed movies (200 frames per second) were taken, above and below the water, to measure the motion. A frame by frame analysis provided data to determine the trajectory and velocity profiles of the test subject. The maneuvers studied included diving from the pool edge, diving from various board types and sliding down various sliding board configurations.

Business and executive aviation represent a combined total of over 40% of the general aviation fleet, but (1977) accounted for only 8.37% of all general aviation accidents recorded. During the period 1964-1977 some 7,351 aircraft engaged in business flying, and 883 in corporate/executive operations, were involved in accidents reported by the NTSB. These accidents were reviewed utilizing the University of Michigan Computerized Accident Files to provide an overall view of the incidence and nature of business/executive aircraft accidents relative to occupant crash injuries. In addition more detailed case studies of selected accidents investigated including a Lear Jet 25B, Cessna 421, Beech Volpar Model 18, and Ted Smith Aerostar 601, are provided to illustrate specific types of crashworthiness, occupant protection, or post-crash emergency egress findings applicable to business/executive operations. Post-crash fire was reported in 29 cases (16.3%) during the 3-year period (1975-1977).

Statistics indicate that during the past decade (1967-1976) the number of general aviation aircraft involved in an accident is equivalent to at least 38% of the total U.S. production during that period. Estimates that an aircraft will be involved in an accident over a 20 year life range are as high as 60-70%. Recognition of this probability has led to crashworthiness and occupant survivability “packaging” design concepts as offering the most realistic approach to reduction of serious and fatal injuries when an accident occurs. This paper reviews and illustrates current general aviation aircraft accident experience relative to occupant impact injury and damage indexes, and provides new data relative to current-generation aircraft.

A study of free-fall accidents and resulting injuries was conducted to determine how useful these types of data could be in establishing human injury tolerance limits. “Tolerance” was examined primarily for children at two levels - reversible injury and threat to survival. The specific objectives were to investigate specific free-falls in sufficient depth to permit biomedical or mathematical reconstruction of the fall, simulate selected free-falls to estimate impact response, and compare predicted responses with observed injuries as a means of estimating human tolerance levels. From more than 2100 reported free-falls, 110 were investigated on-site. Seven head-first and three feet-first falls were then simulated using the MVMA 2-D Crash Victim Simulator. Newspaper reports of free-falls showed that males fell six times as often as females and most often while at work. Children fell from windows and balconies more often than from any other hazard.

The importance of crashworthiness and the role of restraint systems in occupant impact protection in U.S. civil aircraft design is being increasingly recognized. Current estimates of the number of fatalities which could be prevented annually in survivable accidents range from 33 to 94%. This study reviews the development of existing Federal Aviation Administration restraint system standards from the first requirement for safety belts in the Air Commerce Regulations of 1926 to present 14 CFR 1.1. The FAA and industry standards are critically evaluated for Parts 23 (small airplanes), 25 (air transports), 27 (rotorcraft), and 29 (transport category rotorcraft). State-of-the-art developments, including an overview of previous accident experience, results of experimental studies, comparison with other standards, and primary data sources are provided.

General aviation accident investigations can provide valuable data to the design engineer concerning the crash performance of current models and can indicate needed improvements for occupant protection in future aircraft. Current statistics and the historical background of major investigations during the past 65 years are provided. A five-year study of general aviation accidents occurring in the State of Michigan is used as a basis to illustrate recent findings relative to occupant injury mechanisms, relative crash protection, and crashworthiness performance of current models of aircraft. Results indicate that the degree of structural damage may not relate to the degree of occupant injury when the cabin area remains relatively intact. A primary requirement is documented for adequate upper-torso restraint for all occupants, and the excellent crash performance of such a system is described.

All of the rear-end impact accidents occurring in the city of Rochester, New York, in a three-month period were surveyed by tabulation of the police accident reports. Special police information forms, telephone interviews, and mail questionnaires were used for further data acquisition. Vehicle photographs and medical examinations were conducted for approximately every 20th vehicle. During the data collection period, 691 rear-end impacts occurred. Although a computer program revealed 1371 accidents, defects in the program accounted for the large difference. Whiplash injury frequency based on telephone interview and mail questionnaire data obtained one to seven days after the accident revealed a whiplash injury frequency of 38%, which was approximately twice that determined by on-scene police investigators. Head restraints reduced whiplash frequency by 14% and fixed head restraints appeared to be more effective.

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.