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Technical Paper

Biomechanical Response of the Pediatric Abdomen, Part 1: Development of an Experimental Model and Quantification of Structural Response to Dynamic Belt Loading

The abdomen is the second most commonly injured region in children using adult seat belts, but engineers are limited in their efforts to design systems that mitigate these injuries since no current pediatric dummy has the capability to quantify injury risk from loading to the abdomen. This paper develops a porcine (sus scrofa domestica) model of the 6-year-old human's abdomen, and then defines the biomechanical response of this abdominal model. First, a detailed abdominal necropsy study was undertaken, which involved collecting a series of anthropometric measurements and organ masses on 25 swine, ranging in age from 14 to 429 days (4-101 kg mass). These were then compared to the corresponding human quantities to identify the best porcine representation of a 6-year-old human's abdomen. This was determined to be a pig of age 77 days, and whole-body mass of 21.4 kg.
Technical Paper

The Effect of Pretensioning and Age on Torso Rollout in Restrained Human Volunteers in Far-Side Lateral and Oblique Loading

Far-side side impact loading of a seat belt restrained occupant has been shown to lead to torso slip out of the shoulder belt. A pretensioned seat belt may provide an effective countermeasure to torso rollout; however the effectiveness may vary with age due to increased flexibility of the pediatric spine compared to adults. To explore this effect, low-speed lateral (90°) and oblique (60°) sled tests were conducted using male human volunteers (20 subjects: 9-14 years old, 10 subjects: 18-30 years old), in which the crash pulse safety envelope was defined from an amusement park bumper-car impact. Each subject was restrained by a lap and shoulder belt system equipped with an electromechanical motorized seat belt retractor (EMSR) and photo-reflective targets were attached to a tight-fitting headpiece or adhered to the skin overlying key skeletal landmarks.
Journal Article

Headform Impact Tests to Assess Energy Management of Seat Back Contact Points Associated with Head Injury for Pediatric Occupants

Head injuries are the most common injuries sustained by children in motor vehicle crashes regardless of age, restraint and crash direction. Previous research identified the front seat back as relevant contact point associated with head injuries sustained by restrained rear seated child occupants. The objective of this study was to conduct a test series of headform impacts to seat backs to evaluate the energy management characteristics of relevant contact points for pediatric head injury. A total of eight seats were tested: two each of 2007 Ford Focus, Toyota Corolla, 2006 Volvo S40, and 2008 Volkswagen Golf. Five to six contact points were chosen for each unique seat model guided by contact locations determined from real world crashes. Each vehicle seat was rigidly mounted in the center track position with the seatback angle adjusted to 70 degrees above the horizontal.
Technical Paper

Advanced Safety Technology for Children and Young Adults: Trends and Future Challenges

Data presented in this paper demonstrated that the landscape for child occupant protection - the children and their restraints, vehicles, and crashes - is changing rapidly. Children are not small adults but are rather rapidly growing, developing, and changing and so too are their restraint needs. The past several years witnessed a growing awareness of these biomechanical challenges with the emergence of increased use of size-appropriate restraints for children under age 9 years and differences in patterns of injury by age. Vehicles involved in crashes with children reflect the trend overall: less passenger vans and cars and more light trucks, the majority of which are equipped with second generation air bags. The majority of crashes occurred on roads with posted speed limits below 45 miles per hour. The age group of particular concern is the newly driving teenage years (16-19) in which the crash and fatality rates are the highest among all age groups.
Technical Paper

Anterior-Posterior Thoracic Force-Deflection Characteristics Measured During Cardiopulmonary Resuscitation: Comparison to Post-Mortem Human Subject Data

Comparative data of thoracic compression response between live vs. post mortem human subjects (PMHS) has been reported, but the live subject tests are often at low deflections and include the effects of muscle tensing. Novel technology has been developed that overcomes several of these limitations. Specifically, a load cell and accelerometer has been integrated into a clinical monitor-defibrillator to measure chest compression and applied force during live human cardio-pulmonary resuscitation (CPR). The sensor is interposed between the hands of the person administering CPR and the sternum of the patient. The objective of this study was to compare the thoracic force-deflection measured during adult CPR to that measured during hub-based loading of adult PMHS. CPR represents a unique setting in which to study the mechanics of the chest as the thorax is loaded to a maximum chest deflection similar to that seen in a frontal crash environment and the effects of muscle tensing are minimized.
Technical Paper

Biomechanical Response of the Pediatric Abdomen, Part 2: Injuries and Their Correlation with Engineering Parameters

This paper describes the injuries generated during dynamic belt loading to a porcine model of the 6-year-old human abdomen, and correlates injury outcomes with measurable parameters. The test fixture produced transverse, dynamic belt loading on the abdomen of 47 immediately post-mortem juvenile swine at two locations (upper/lower), with penetration magnitudes ranging from 23% – 65% of the undeformed abdominal depth, with and without muscle tensing, and over a belt penetration rate range of 2.9 m/s – 7.8 m/s. All thoracoabdominal injuries were documented in detail and then coded according to the Abbreviated Injury Scale (AIS). Observed injuries ranged from AIS 1 to AIS 4. The injury distribution matched well the pattern of injuries observed in a large sample of children exposed to seatbelt loading in the field, with most of the injuries in the lower abdomen.
Technical Paper

Methods for Determining Pediatric Thoracic Force-Deflection Characteristics From Cardiopulmonary Resuscitation

Accurate pediatric thoracic force and deflection data are critical to develop biofidelic pediatric anthropomorphic test devices (ATDs) used in designing motor vehicle safety systems for child occupants. Typically, postmortem human subject (PMHS) experiments are conducted to gather such data. However, there are few pediatric PMHS available for impact research; therefore, novel methods are required to determine pediatric biomechanical data from children. In this study, we have leveraged the application of chest compressions provided in the clinical environment during pediatric cardiopulmonary resuscitation (CPR) to collect this fundamental data. The maximum deflection of the chest during CPR is in the range of chest deflections in PMHS impact experiments and therefore CPR exercises the chest in ways that are meaningful for biofidelity assessment. Thus, the goal of this study was to measure the force-deflection characteristics of the thorax of children and young adults during CPR.
Technical Paper

Neck Pendulum Test Modifications for Simulation of Frontal Crashes

Pediatric Anthropomorphic Test Devices (ATDs) are valuable tools for assessing the injury mitigation capability of automotive safety systems. The neck pendulum test is widely used in biofidelity assessment and calibration of the ATD neck, and neck moment vs. angle response requirements are the metrics typically derived from the test. Herein, we describe the basis and methods for modifying the neck pendulum such that it more closely reflects base of the neck accelerations observed by a restrained three-year old ATD in a frontal crash. As a measure of base of the neck acceleration, the x-direction chest acceleration from thirty-one restrained Hybrid III three-year-old ATDs in vehicle frontal crash tests were analyzed. The standard neck pendulum yielded a mean peak acceleration that is 1.2x the peak of vehicle base of the neck accelerations, 1.6x the average, and 0.24x the duration.
Technical Paper

Predictors of Pediatric Abdominal Injury Risk

Although previous research has linked poor seat belt fit to abdominal organ injury for children, few have studied the pattern of pediatric abdominal injuries and its relationship to key characteristics beyond this primary association. In this study, data were obtained from a probability sample of 19,125 children, representing 243,540 children, under age 16 years who were enrolled in an on-going crash surveillance system which links insurance claims data to validated telephone survey and crash investigation data. The risk of AIS2+ abdominal injury was estimated for various crash, restraint, vehicle and child correlates and multivariate logistic regression was used to identify the relative importance of these predictors. Children 4–8 years of age were at the highest risk of abdominal injury: they were 24.5 times and 2.6 times more likely to sustain an AIS2+ abdominal injury than those 0–3 years and 9–15 years, respectively.
Technical Paper

Regional Differences in Mechanical Properties of the Porcine Central Nervous System

Computational modeling is a potentially powerful tool to provide information about the mechanisms of traumatic brain injury. In order to ensure that the estimates calculated by these computer models provide the most useful information, it is essential that these models contain accurate central nervous system (CNS) tissue properties. Previous material property measurements lack strict control over crucial experimental parameters that may influence material properties and tail to examine any regional variation in the measured response. To address these issues, we measured the material response of two regions of the CNS, the brainstem and the cerebrum. Specifically, adult porcine tissue was subjected to high loading rate mechanical deformation using a custom designed oscillatory shear device. Complex shear moduli were calculated over a range of frequencies (20-200 Hz) at two engineering strain amplitudes (2.5%, and 5.0%).
Technical Paper

Upper Extremity Fractures in Restrained Children Exposed to Passenger Airbags

Restrained children between the ages of 3 to 15 years in crashes were identified in an on-going crash surveillance system (1998-2002) which links insurance claims data to telephone survey and crash investigation data. The risk of upper extremity injury associated with airbag deployment was estimated and a series of cases was examined using in-depth crash investigation to identify the mechanisms of these injuries. This study found that 3.5% of children who were exposed to a passenger airbag (PAB) received an upper extremity fracture, making them 2.5 times as likely to sustain an upper extremity fracture than children in similar crashes who were not exposed to a PAB. Female children were 2.2 times as likely to receive an isolated upper extremity fracture when exposed to a PAB than male children. The incidence rate, gender difference, and injury mechanism in children all appear to be similar to those of adults.
Technical Paper

Pediatric Pelvic Fractures in Side Impact Collisions

Little is known about the mechanism of pelvic injury in the pediatric population, an age range over which the pelvis undergoes tremendous structural change. We hypothesize that these structural changes influence pelvic fracture injury mechanisms. A probability sample of children under age 16 years in crashes were enrolled in an on-going crash surveillance system which links insurance claims data to telephone survey and crash investigation data. 15,725 children in side impact collisions were studied. Risk of pelvic fracture in side impact collisions was estimated and factors associated with these injuries were identified. Eight cases were examined using in-depth investigation to identify the injury mechanisms. Of our study sample, 0.10% of children suffered a pelvic fracture. The typical child with a pelvic fracture was a 12-15 year old female front row occupant of a passenger car involved in a struck side collision with intrusion.
Technical Paper

Pediatric Facial Fractures: Implications for Regulation

On-site, in-depth investigations were conducted on 14 crashes involving 15 children who sustained facial fractures. Of the 23 facial fractures documented, the most frequent were the nose (n=8), orbit (n=6), zygoma/maxilla (n=6), and mandible (n=3). The most frequent contact point of those seated in the rear was the rear of the front seat; of those seated in the front, the instrument panel. 11/15 had sub-optimal torso restraint resulting from placing the shoulder belt behind their back or sitting in a position only equipped with a lap belt. The data suggest that these injuries resulted from high-energy impact with interior vehicle components. Revision to FMVSS 201 to account for vehicle interior structures typically contacted by child occupants and enhancement of pediatric dummies to measure facial impact forces should be considered.
Technical Paper

Occupant Kinematics and Shoulder Belt Retention in Far-Side Lateral and Oblique Collisions: A Parametric Study

In far-side impacts, head contact with interior components is a key injury mechanism. Restraint characteristics have a pronounced influence on head motion and injury risk. This study performed a parametric examination of restraint, positioning, and collision factors affecting shoulder belt retention and occupant kinematics in far-side lateral and oblique sled tests with post mortem human subjects (PMHS). Seven PMHS were subjected to repeated tests varying the D-ring position, arm position, pelvis restraint, pre-tensioning, and impact severity. Each PMHS was subjected to four low-severity tests (6.6 g sled acceleration pulse) in which the restraint or position parameters were varied and then a single higher-severity test (14 g) with a chosen restraint configuration (total of 36 tests). Three PMHS were tested in a purely lateral (90° from frontal) impact direction; 4 were tested in an oblique impact (60° from frontal). All subjects were restrained by a 3-point seatbelt.
Technical Paper

The Effect of An Acoustic Startling Warning On Take-Over Reaction Time And Trunk Kinematics for Drivers in Autonomous Driving Scenarios

The Acoustic Startling Pre-stimulus (ASPS, i.e. a loud sound preceding a physical perturbation) was previously found to accelerate action execution in simple flexion exercises. Therefore in this study we examined if ASPS can accelerate take-over reaction times in restrained teen and adult drivers who were asked to reach for the steering wheel while experiencing sled lateral perturbations simulating a vehicle swerve. Results showed that adult drivers lift their hands toward the steering wheel faster with the ASPS versus without (161 ± 23 ms vs 216 ± 27 ms, p<0.003). However this effect was not found in teens or in trials where the drivers were engaged in a secondary task. Adults also showed reduced lateral trunk displacement out of the seat belt with the ASPS. The ASPS could represent a novel warning that reduces take over time and out-of-position movements in critical autonomous driving scenarios.
Technical Paper

Comparison of Kinematic Responses of the Head and Spine for Children and Adults in Low-Speed Frontal Sled Tests

Previous research has suggested that the pediatric ATD spine, developed from scaling the adult ATD spine, may not adequately represent a child's spine and thus may lead to important differences in the ATD head trajectory relative to a human. To gain further insight into this issue, the objectives of this study were, through non-injurious frontal sled tests on human volunteers, to 1) quantify the kinematic responses of the restrained child's head and spine and 2) compare pediatric kinematic responses to those of the adult. Low-speed frontal sled tests were conducted using male human volunteers (20 subjects: 6-14 years old, 10 subjects: 18-40 years old), in which the safety envelope was defined from an amusement park bumper-car impact.