The Lack of Sex, Age, and Anthropometric Diversity in Neck Biomechanical Data.

Gabrielle R Booth,Peter A Cripton,Gunter P Siegmund

doi:10.3389/fbioe.2021.684217

Abstract

Female, elderly, and obese individuals are at greater risk than male, young, and non-obese individuals for neck injury in otherwise equivalent automotive collisions. The development of effective safety technologies to protect all occupants requires high quality data from a range of biomechanical test subjects representative of the population at risk. Here we sought to quantify the demographic characteristics of the volunteers and post-mortem human subjects (PMHSs) used to create the available biomechanical data for the human neck during automotive impacts. A systematic literature and database search was conducted to identify kinematic data that could be used to characterize the neck response to inertial loading or direct head/body impacts. We compiled the sex, age, height, weight, and body mass index (BMI) for 999 volunteers and 110 PMHSs exposed to 5,431 impacts extracted from 63 published studies and three databases, and then compared the distributions of these parameters to reference data drawn from the neck-injured, fatally-injured, and general populations. We found that the neck biomechanical data were biased toward males, the volunteer data were younger, and the PMHS data were older than the reference populations. Other smaller biases were also noted, particularly within female distributions, in the height, weight, and BMI distributions relative to the neck-injured populations. It is vital to increase the diversity of volunteer and cadaveric test subjects in future studies in order to fill the gaps in the current neck biomechanical data. This increased diversity will provide critical data to address existing inequities in automotive and other safety technologies.

Highlights

Injuries to the head and neck, which house and protect the brain and upper spinal cord, are some of the most catastrophic consequences of motor vehicle collisions
Both values were higher than the proportion of males in the United States population (49%) and in the AIS1+, AIS12+, and AIS13+ neck injury groups (48, 60, and 63%, respectively), but landed on either side of the proportion of males seen in United States automotive fatalities (70%)
More biomechanical data are needed for females throughout the neck injury spectrum—from whiplash injury to neck fractures— the optimum sex distribution of volunteers and post-mortem human subjects (PMHSs) may vary for different neck injuries

Summary

Introduction

Injuries to the head and neck, which house and protect the brain and upper spinal cord, are some of the most catastrophic consequences of motor vehicle collisions. Over the past 7 decades, improvements in roads, vehicles, safety equipment, safety regulations, and enforcement have significantly reduced the injury, morbidity, and mortality burden associated with head and neck injuries Despite these considerable achievements, many injury prevention approaches, including the computational models and anthropometric test devices (ATDs) used to design and evaluate safety equipment, have focused on 50th percentile adult male occupants (Linder and Svensson, 2019). European and United States traffic safety regulatory standards are used worldwide, with minor alterations, to assess a vehicle’s ability to prevent serious injuries for the occupants and other road users These standards specify the use of 50th percentile adult male ATDs and representations of the 95th percentile male and 5th percentile female, which have been scaled from the 50th male by weight and height. Many ATDs used in traffic safety regulatory standards have been derived from a representation of a ‘median-sized’ adult male

Objectives

Methods

Results

Discussion

Conclusion