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The William Lehman Injury Research Center has conducted multi-disciplinary investigations of one hundred seventy-eight crashes involving adult occupants protected by safety belts and air bags. In all cases, serious injuries were suspected. Nine cases involved serious heart injuries. These cases are not representative of crashes in general. However, when used in conjunction with National Accident Sampling System; Crashworthiness Data System (NASS/CDS) they provide insight into the most severe injuries suffered by restrained occupants in frontal crashes. Heart injuries are rare, but when they occur they are usually life threatening. NASS/CDS shows that heart injuries comprise about 0.2% of the injuries in frontal tow-away crashes. In the NHTSA file of Special Crash Investigations (SCI) of air bag cases, heart injuries are reported in 1% of the occupants over 15 years of age. Twenty-five percent of the fatally injured occupants had heart injuries, and 83% of those with heart injury died.

The William Lehman Injury Research Center has conducted multi-disciplinary investigations of fifty crashes involving drivers protected by air bags. In all cases, serious injuries were suspected. Nine cases involved fatal injuries. These cases are not representative of crashes in general. However, when used in conjunction with NASS/CDS they provide insight into the most severe injuries in crashes of vehicles equipped with air bags. A comparison with data from the National Accident Sampling System; Crashworthiness Data System (NASS/CDS) shows that head injury and abdominal injury make up a larger fraction in the Lehman data than in NASS/CDS. Examination of fatal cases indicates that head injuries are frequently caused by intruding structure or by unfavorable occupant kinematics among the unrestrained population.

This investigation addresses and evaluates: (a) the frequency of air bag deployments in comparison with belt only protection or no restraint, as a function of calendar year and model year; (b) injury and harm rates as a function of crash severity and restraint use and type; (c) restraint effectiveness in reducing fatalities and injuries as a function of restraint, crash severity, type of impact, and car size; (d) the confounding effects of crash severity; (e) injury patterns by injured body region, injuring contact, and injury severity; and (f) variation of injury patterns as a function of crash severity. It is found that restraints, irrespective of type, appear to be more effective at higher injury severities; the lowest casualty rates, and highest effectiveness values, are associated with the use of an air bag plus safety belt, or safety belt without air bag deployment; the air bag even without the concurrent use of a safety belt appears to offer a certain crash protection.

This investigation addresses and evaluates the injury patterns of car occupants, as a function of air bag deployment with or without belt use. A companion paper provides a comprehensive evaluation of air bag field performance, in comparison with the no restraint,or other restraint conditions,concerning: Cars, Exposure, Occupants, Restraints, & Protection provided by the restraints. The findings reported in this investigation are based exclusively on the data contained in the records of NHTSA's NASS/CDS1988-1992. The investigation focuses on car drivers. Because of the relatively late and limited introduction of air bags, all other light vehicle populations are either not represented, or represented by a very meager sample in the sources cited above.

This investigation encompasses a comprehensive evaluation of air bag field performance, in comparison with the no restraint, or other restraint conditions. The paper at hand addresses: Cars, Exposure, Occupants, Restraints, & Protection provided by the restraints. A companion paper addresses the injury patterns of car occupants. The findings of the investigation are based on two primary sources of national coverage: (i) the field crash experience contained in the records of NHTSA's NASS/CDS 1988-1992; and (ii) the fatal accident experience contained in NHTSA's FARS 1991-1993. The investigation focuses on car drivers. Because of the relatively late and limited introduction of air bags, all other light vehicle populations are either not represented, or represented by a very meager sample in the sources cited above.

A multidisciplinary, automobile crash investigation team at the Jackson Memorial Hospital/Ryder Trauma Center in Miami, Florida, is conducting a detailed medical and engineering study. The focus is restrained (seatbelts and/or air bag) occupants involved in frontal crashes, who have also been severely injured. More than 60 crashes have been included in the study to date. Analysis of the initial data indicates that restraint systems are working to reduce many of the head and chest injuries which unrestrained occupants suffer. However, internal injuries among air bag-protected occupants may be unrecognized in the field providing new challenges in triage and injury diagnosis. In other cases, survival in extremely high severity crashes presents trauma management challenges due to the extent and complexity of the multiple injuries which result. The paper provides case examples to illustrate types of chest and abdominal injuries associated with air bag cases.