Injuries from crashes

IV. Risk and post-crash injury outcome Different studies have shown that fatality rates are correlated with the level of medical facilities available in the country expressed in terms of population per physician and population per hospital bed, see (Jacobs Fouracre, 1977) and (Mekky, 1985). A review of a European study, in (WHO, 2004), showed that about half of deaths from road accidents occurred at the spot of the accident or on the way to the hospital. Noland (2003) concludes that medical care has led to reductions in traffic-related fatalities in developed countries over time (1970-1996). The variables used are infant mortality rates, physicians per capita, and average acute care days in hospital. 

Colonel Stapp, a career Air Force physician, used his own body for a lengthy series of tests over several years. His work led to a famous series of conferences on human physical tolerance and potential injuries from deceleration and automobile crashes. The conferences were called the Stapp Car Crash Conferences. ... 

One device that has reduced injuries from the second crash and saved lives is the seat belt. Seat belts became mandatory in 1968. Initially there was only a lap belt. By the 1980s a combined lap belt and shoulder harness became the standard. Eventually, lap belts expanded to rear seats. The combined lap belt and shoulder harness eventually became the standard for rear seats. The belt designs fit adults. Infant and child seats slowly evolved so that adult belts served as the primary restraints for them. Additional belts systems in child seats provided restraint to the seat for a child. 

American Association for the Advancement of Automotive Medicine http //www.carcrash. org/publications proceedings.htm (accessed September 3, 2010). Proceedings of the Annual Conference. Des Plaines, IE The Association. Papers focus ou motor vehicle crash injury prevention and control from a multidisciplinary perspective. Available in hard copy and on CD. 

Multiple independent analyses of seat belt effectiveness, using crash data from different countries, and different statistical methods have all yielded quite similar results, reducing fatalities and injuries by approximately 40-50 percent, as detailed in Table 10-1 (WHO, 2004). However, the exact numbers in the table, should be considered as potentially inflated estimates because they are based on police reports, and these are known to inflate the percent of belt use. This is because drivers - when they can get away with it - will report to the officer that they had their belt on (Li et al., 1999). Consequently as the injury severity decreases, the amoimt of over-estimation of belt use is most likely to increase. 

One very detailed analysis of pedestrian crash, injury, and fatality risk that considered the different exposure measures was conducted by Keall (1995). For his analysis he combined travel exposure data from the 1989- 1990 New Zealand Travel Survey with pedestrian accident data from the New Zealand national Traffic Accident Report files for the period 1988-1991. The travel survey data for children 5-9 years old were obtained from interviews with the parents or other adults in the same household. Their casualty data as a function of the pedestrian age is plotted in Figure 15-2. If we look first at the absolute numbers of pedestrians injured or killed as a function of age and gender we see the expected high numbers of young (5-19 years old) pedestrians. We also see that more males than females are injured or killed. 

Table 17-3, The association of car color with crash injury in Auckland, New Zealand (from Furness et al, 2003, with permission from BGJ Publishing Group Ltd.).

Blows, S., R. Q. Ivers, J. Connor, S. Ameratunga and R. Norton (2003). Does periodic vehicle inspection reduce car crash injury Evidence from the Auckland Car Crash Injury Study. Aust NZ J Pub. Health, 27(6), 323-327 (with comments on p. 656). 

American study showed similar male and female rates (288 vs. 331 injuries per million bicycle trips), using crash data from the Consumer Product Safety Commission s National Electronic Injury Surveillance System in 1990 and mobility data from the 1990 Nationwide Personal Transportation Survey [LI 96],... 

This study is among the first in France to study the risk of injury using crash and mobility data [GAB 05, MER 06, BER 11] and comparing road type nsers. This is one of the first studies that compares these risks based on crash data from the medical registry of the Rhone Coimty [LIC 11]. The Rhone road trauma registry is far more complete than the pohce crash data. The medical registry enables us to estimate the rates for various injury categories all-injury, hospitalization and serious-injury (MAIS 3+). 

Geller, E. S., Applications of behavior analysis to prevent injury from vehicle crashes, monograph published by the Cambridge Center for Behavioral Studies, Cambridge, MA, 1992a. 

However, many other aspects of driving are not followed naturally with feedback consequences, particularly those that can prevent injury from vehicle crashes. Although we get feedback to tell us our steering wheel, gas pedal, turn signal lever, and brakes work, we do not get natural feedback regarding our safe vs. at-risk use of such control devices. Therefore, as shown in Figure 8.9, feedback must be added to the driving situation if we want behavior to improve. 

The nanny staters chant the mantra of personal responsibility, but personal responsibility means more than considering only personal outcomes. Even in a single-vehicle crash the community bears disproportionate costs. If a motorcyclist, for example, wishes to refrain from wearing a helmet, he should either sign a waiver to forgo publicly funded treatment in the event of a head injury from a motorcycle crash or pay an insurance pranium commensurate with the likely cost of treatment. When exposure to risk is collective, there is a collective responsibility that cannot be abrogated. 

Johnston, I. Reducing injury from speed related road crashes. Injury Prevention, 2004, 10 257-259. 

Risk is the probability of harm or loss and can be considered to be a product of the probability and the severity of specific consequences. Risk, as it relates to hazardous wastes and groundwater contamination, may be defined as the chance that humans or other organisms will sustain adverse effects from exposure to these environmental hazards. Risk is inherent in the life of all organisms—humans, animals, and plants. Tornadoes, landslides, hurricanes, earthquakes, and other natural disasters carry a risk of injury or death to any living thing in their path. Similarly, human-caused risks such as automobile accidents, plane crashes, and nuclear disasters occur with varying levels of severity. 

Death 1,700 college students between the ages of 18 and 24 die each year from alcohol-related unintentional injuries, including motor vehicle crashes (Hingson, Heeren, Winter, Wechsler, 2005). 

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