Do motor vehicle airbags increase risk of ocular injuries in adults?

Abstract

Purpose This study was undertaken to evaluate the risk of eye injury in motor vehicle accidents in which airbags deploy. An attempt was made to assess the possible associations between eye injuries and eyewear in these accidents. Design Retrospective observational case series and literature review with analysis. Participants/methods We conducted a literature review of 62 case reports and articles describing 110 adult cases of eye injury after deployment of an airbag and examined two Finnish accident cohorts. The fatal accident series (FAS; fatal injuries with one or more cars involved) included 121 individuals sitting behind an airbag that deployed (65 survivors), and the Airbag study (AB; nonfatal, relatively serious accidents) included 210 individuals (survivors). Main outcome measures The type of eye injury, eyewear, and crash dynamics were studied in each of the reviewed case reports. The fatal accident series and AB studies were analyzed to disclose the eye injuries and use of eyewear and to estimate their possible relation to deployment of airbags. Results Analysis of the published reports revealed that airbag-induced eye injuries were not more frequently reported among wearers of eyeglasses than among nonwearers. However, open-eye injuries were reported three times more often among eyeglass wearers ( P = 0.04), whereas all injuries from airbag chemicals occurred among nonwearers. With the exception of one orbital fracture with hyphema, all eye traumas (n = 7) in the FAS and AB cohorts were mild (eyebrow laceration, lid contusion, bruising). The risk of airbag-related eye injury was 2.5% for any eye injury and 0.4% for severe eye injury. In single accidents when seat belts were used, the risks were 2.0% and 0.5%, respectively. In the accidents from the FAS data no difference was observed in the risk for eye injury between survivors in incidents involving airbag deployment and incidents not involving airbags. This risk was not found to be greater among eyeglass wearers. Conclusions Despite reported cases in the literature, we found that the risk of severe eye injury from airbags was very low (0.4%) in fatal or relatively serious accidents. Eyewear did not seem to increase this risk but might interfere with the injury pattern.