Crash Investigation Data Research Articles

Deliberate fatal crashes involving a motor vehicle and a cyclist or pedestrian

IntroductionDeliberate crashes are caused by road users engaging in insurance fraud, attempting suicide, or “punishing” other road users. In this study, we investigated deliberate crashes that resulted in the deaths of “vulnerable” road users (cyclists and pedestrians). MethodsWe used in-depth road crash investigation data from the Finnish Crash Data Institute and court decisions for a selected number of cases in which the deceased had not been the main originator of the crash. ResultsIn 1997–2018, 96 pedestrians and five cyclists died in 101 deliberately caused crashes involving a motor vehicle. The majority of these crashes were caused by suicides (94/96 pedestrian and 3/5 cyclist crashes). Most of suicide crashes (79%) involved a heavy vehicle. Eighty percent of the victims were male. Previous suicidal thoughts and attempts, and a history of mental disorders/illness was prevalent around two thirds of the originators of the crashes. Four cases were caused by motor vehicle drivers. According to court rulings, the drivers in two of these cases were convicted of manslaughter. ConclusionsWe provide some possible reasons for this relatively high number of road suicides in Finland and discuss the legal implications of deliberately hitting pedestrians or cyclists with a motor vehicle.

Factors contributing to the severity of motorcycle rear-end crashes in Thailand

Objective Motorcycle (MC) rear-end collisions cause many serious injuries and deaths for MC riders. In Thailand, the MC crash investigation data revealed that 18% of all MC crashes were rear-end collisions, which accounted for 18% of all fatalities as well. The aim of this study was to investigate the causes of injuries and deaths from MC rear-end collisions and factors that contribute to their severity level. Between 2016 and 2020, 141 MC rear-end crashes were thoroughly investigated throughout Thailand. Method The ordinal logistic analysis was conducted to analyze factors contributing to severe injuries. The analysis to rear-end collision models comprised four categories: M1 (n = 141) is all types of rear-end collisions to MC, and M2 (n = 114) is the rear-end collision due to other vehicles (OV) collided by MC, M3 (n = 72) is the rear-end collisions for traveling OV collided by MC, and M4 (n = 42) is the rear-end collision for MC hitting the parked OV. The outcomes are verified by the likelihood and Pseudo R2. Result When a MC collides with the rear of another vehicle, there are more fatalities than when other vehicles collide with the rear of a MC. Furthermore, the probability of death is higher if MCs collide with the rear-end of parking vehicles. As for the primary crash contributing factor, motorcyclists’ perception failure was the most frequent. Experience, license status, driving conditions, speed, the time of the crash, the areas of the crash, and types of other vehicles involved significantly influence the severity of rear-end crashes. Conclusion In severe crashes, riders with perception failure are more likely to be involved. Based on the findings of this study, some policies and countermeasures can be drawn to prevent MC rear-end crashes and reduce their severity.

Comparing consequences of using two different definitions for body regions for the improvement of personal protective equipment for powered two-wheelers

Objective: Various definitions and uses of the term body region can be found in the literature. A definition of body regions using the Abbreviated Injury Scale (AIS) codes not strictly aligned with AIS chapters was developed for use in the European Commission–funded PIONEERS project (Protective Innovations of New Equipment for Enhanced Rider Safety). This work aims to examine the consequences of differently defined body regions on injury priority ranking using the percentage of patients showing at least moderate injury severity (AIS 2+) per regarded body region.Methods: Three different crash investigation data sets of injured riders and/or pillion riders of powered 2-wheelers (PTWs) were used for this analysis. The first contained data for 143 fatalities, the second contained data for 58 severely injured, and the last for contained data for 982 patients from a sample that was close to national representativeness. Frequency of injury was examined using body regions based on the AIS chapters (and first digit of the AIS Unique Identifier) and based on the PIONEERS definition.Results: Though different body region definitions did not result in different top-ranked body regions in terms of injury frequency, different definitions did provide different levels of information that impact priority within AIS chapter-defined regions. For PTW riders, cervical injuries are the highest priority spinal injuries. Thoracic and lumbar spinal injuries seem to occur together with other injuries in the thorax and abdominal region. Severe lower extremity injuries frequently involve the pelvis and the leg.Conclusions: Body regions need to be defined carefully to avoid misinterpretations. Publications that use body regions for their analysis to present injury frequencies should clearly define what they include in each region.

Driver distraction and inattention in fatal and injury crashes: Findings from in-depth road crash data

Objective: This study investigated the contribution of driver distraction and inattention within fatal and injury crashes using recent in-depth road crash investigation data. To assist in developing system-based solutions, this study also examined the wider context in which inattention-related crashes occurred and the characteristics of inattentive drivers.Methods: The sample included in-depth crash data from 186 fatal and injury crashes in South Australia investigated from 2014 to 2018. Crash case notes were reviewed to determine whether there was evidence that attentional failures contributed to the crash. Using an adapted taxonomy of inattention, 5 subtypes of driver inattention were defined: Misprioritized attention, neglected attention, cursory attention, diverted attention (distraction), and unspecified inattention. The characteristics of inattention crashes were also compared with those for non-inattention-related crashes.Results: Of the 160 crashes for which there was sufficient information to determine whether inattention was a factor, 31.3% showed evidence of driver inattention contributing to the crash. The most common subtypes of inattention were distraction (13.8% of all crashes) and driver misprioritized attention (8.1%). The distraction-related crashes included a variety of different distractions, the majority of which were not technology based (e.g., passenger interaction, searching for/adjusting objects, emotional stress, other road users), with those located in-vehicle the most prevalent. Distraction from mobile phone use was identified in 2.5% of all crashes. The majority of distractions were cognitive (64%) and voluntary (77%) in nature. Inattention crashes were most likely to involve right turn/angle or rear-end crash types and occur at intersections, in metropolitan areas, and in lower speed zones.Conclusions: The findings established that almost a third of fatal and injury crashes involved driver inattention and distraction and many of these could have been prevented. System-wide solutions that could mitigate or prevent distraction crashes include intervening vehicle safety technologies, infrastructure solutions to promote a forgiving road environment, blocking capabilities within technologies to prevent communications while driving, and interventions communicating the risks associated with inattention. Of significance, this study also demonstrated the importance of in-depth data for understanding the contribution of distraction and inattention errors in crash causation.

Suicide by crashing into a heavy vehicle: Focus on professional drivers using in-depth crash data

Objective: Road traffic suicides typically involve a passenger car driver crashing his or her vehicle into a heavy vehicle, because death is almost certain due to the large mass difference between these vehicles. For the same reason, heavy-vehicle drivers typically suffer minor injuries, if any, and have thus received little attention in the research literature. In this study, we focused on heavy-vehicle drivers who were involved as the second party in road suicides in Finland.Methods: We analyzed 138 road suicides (2011–2016) involving a passenger car crashing into a heavy vehicle. We used in-depth road crash investigation data from the Finnish Crash Data Institute.Results: The results showed that all but 2 crashes were head-on collisions. Almost 30% of truck drivers were injured, but only a few suffered serious injuries. More than a quarter reported sick leave following their crash. Injury insurance compensation to heavy-vehicle drivers was just above €9,000 on average. Material damage to heavy vehicles was significant, with average insurance compensation paid being €70,500. Three out of 4 truck drivers reported that drivers committing suicide acted abruptly and left them little opportunity for preventive action.Conclusions: Suicides by crashing into heavy vehicles can have an impact on drivers’ well-being; however, it is difficult to see how heavy-vehicle drivers could avoid a suicide attempt involving their vehicle.

Characteristics of the Severe Rollover Crashes in the UAE Using In-Depth Crash Investigation Data

Characteristics of the Severe Rollover Crashes in the UAE Using In-Depth Crash Investigation Data

Validation of the abrasion resistance test protocols and performance criteria of EN13595: The probability of soft tissue injury to motorcycle riders by abrasion resistance of their clothing

IntroductionMotorcyclists represent an increasing proportion of road users globally and are increasingly represented in crash statistics. Soft tissue injuries are the most common type of injuries to crashed motorcyclists. These injuries can be prevented through the use of protective clothing designed for motorcycle use. However, the quality of such clothing is not controlled in many countries around the world. A European Standard was developed to assess the performance of clothing but as this is not mandatory, clothing certified to this Standard is difficult to obtain. Given the importance of this Standard, and that it has been validated only once, further validation work is required. MethodsIn-depth crash investigation data were used to investigate the relationship between the abrasion resistance performance of clothing and real-world injury outcome. Clothing was collected from riders who crashed on public roads in Sydney and Newcastle, Australia. This clothing was tested according to the EU Standard and the time to hole was recorded. Hospital medical records were reviewed and the association between a rider suffering a soft tissue injury and the time-to-hole for the garment was examined. ResultsThe probability of soft tissue injury for Level 1 Standard garments was between 40–60%, but more than 60% of garments tested failed to meet the minimum requirement. ConclusionsThe findings of this study provide qualified support for the Standard, with a marginal association between time-to-hole and injury being found. Practical ImplicationsThis work supports the need for improved safety performance and an increased number of high performing garments being available to motorcyclists.

Exploring cycle crash characteristics in Malaysia

This paper explains the cycle road crash trend, characteristics and injuries in Malaysia. It analyses the in-depth road crash investigation data collected by the Royal Malaysian Police which was made available to MIROS crash database. Fatality data was utilized due to its consistency. Cycle casualties reflected a continual downward pattern for year 2009 to 2014 in which the number of cycle crash involvement reduced by 49% and fatalities dropped by 42%. Among the prevalent factors of cycle fatalities are >60 age group, federal and state roads and straight road sections, rural and small towns, evening peak hours, and mainly involving cars and motorcycles. It is hoped that all these information would spark interests to improve cycle safety in Malaysia.

Passenger Compartment Intrusion as a Predictor of Significant Injury for Children in Motor Vehicle Crashes

Passenger compartment intrusion, loss of integrity of the vehicle occupant compartment due to a motor vehicle crash, has frequently been used as a triage criterion. Data to support intrusion as a proxy for injury severity in child occupants are lacking. The purpose of this study was to examine the association between intrusion and injury to children in motor vehicle crashes. Crash investigation data were reviewed from the partners for child passenger safety database, a large, child-focused crash surveillance system. Data included: intrusion (centimeters), direction of impact, age of occupant, and Abbreviated Injury Scale (AIS) score. Analyses examined the relationship between the amount of intrusion and the risk of any AIS > or = 2, or > or = 3 injury. Data were available on 880 children, age 0 year to 15 years. AIS > or = 2 and > or = 3 injuries occurred in 40.3% and 12.6% of child occupants, respectively. Intrusion was strongly and positively associated with the odds of both an AIS > or = 2 and > or = 3 injury (p < 0.0001). The odds of at least one AIS > or = 2, or > or = 3 injury increased on average by 2.9% (95% CI = 1.9-3.8%), or 4.0% (95% CI = 2.7-5.2%), respectively, for each additional centimeter of intrusion, adjusting for age, restraint use, seating row, and direction of impact. The association between passenger compartment intrusion and injury in children supports its application in triage, and usefulness in injury predictive models. Future studies should determine methods for providing valid field information on intrusion to the trauma team.

FIA Score: A Simple Risk Index for Predicting Fatality in Aviation Crashes

Previous studies have identified a variety of risk factors for occupant fatality in aviation crashes. A simple composite index measuring the risk of fatality in a given crash, however, is lacking. The FIA Score is a four-point (0-3) index based on the number of three risk factors for occupant fatality present in a given aviation crash: fire, instrument meteorological condition, and being away from airport. We assessed the validity of this risk index using aviation crash investigation data from the National Transportation Safety Board for the years 1983 to 2005. Sensitivity, specificity, and area under the receiver operating characteristic curve according to the type of flight operations were computed. The analysis was first limited to pilot-in-command fatality and then replicated to any fatality. The study sample consisted of 44,828 aviation crashes, in which 7,889 (18%) pilots-in-command were fatally injured. The pilot crash fatality rate was 3%, 18%, 62%, and 89% for FIA Scores of 0 (none of the 3 risk factors present), 1, 2, and 3 (all 3 risk factors present), respectively. The FIA Score performed consistently well in predicting pilot fatality in crashes involving different types of flight operations. The area under receiver operating characteristic curve was 0.86 (95% confidence interval [CI]: 0.78-0.95) for major airline crashes, 0.83 (95% CI: 0.80-0.85) for commuter and air taxi crashes, and 0.81 (95% CI: 0.81-0.82) for general aviation crashes. The results were similar when the outcome was measured by whether or not the crash resulted in any fatality. The FIA Score appears to be a valid tool for measuring fatality risk in aviation crashes. Given its simplicity, the FIA risk index should be readily applicable to trauma research and prevention.

Do Initial Radiographs Agree With Crash Site Mechanism of Injury in Pelvic Ring Disruptions? A Pilot Study

Direction of injury force inferred from pelvic radiographs may be used in trauma care to predict associated injuries and guide intervention. Our objective was to compare injury direction determined from anteroposterior (AP) pelvic radiographs with injury forces determined from crash site investigation. We studied all 28 subjects from the Crash Injury Research Engineering Network (CIREN) database who met inclusion criteria of pelvic ring disruption, single-event crash, restrained front-seat occupant, diagnostic-quality pelvic radiography, and complete crash investigation data. Assessment of diagnostic quality of pelvic radiography was made by 2 radiologists who were blinded to all other subject information. Crash site investigation data included principal direction of force (PDOF), crash magnitude, and passenger compartment intrusion. An orthopedic trauma surgeon and a fellowship-trained emergency radiologist independently assessed the pelvic radiographs to determine the injury PDOF and the Young-Burgess and Tile fracture classifications, with disputes resolved by an additional emergency radiologist. Agreement between injury forces and pelvic radiographs was assessed using the kappa statistic. The PDOF was anterior in 9 (32%) and lateral in 19 (68%) subjects. The readers agreed with the crash primary direction of force in 21 (75%) subjects (kappa=0.42). In subjects with lateral PDOF, agreement was 89% (17/19) compared to 44% for anterior PDOF (4/9). Interobserver agreement for the Young and Tile classification schemes was moderate (weighted kappa 0.44 and 0.54, respectively). Crash site investigation and pelvic radiography may provide conflicting information about primary direction of injuring forces. Presumed anterior impact based on PDOF is not in consistent agreement with the pattern of injury evident on the AP pelvic radiograph.

Delta V as a Predictor of Significant Injury for Children Involved in Frontal Motor Vehicle Crashes

The objective of this study was to examine the association between delta V and risk of injury to children involved in frontal motor vehicle crashes. Previous studies, primarily focused on adult occupants, have demonstrated the relationship between crash severity, as measured by delta V and injury severity. As children have unique safety needs, these results cannot be directly applied to the pediatric population. Case series crash investigation data and clinical injury information were reviewed from a child-focused crash surveillance system. Analyses were performed examining the relationship between the estimated delta V and any AIS > or = 2 or any AIS > or = 3 injury. Detailed crash investigation and clinical data were available on 407 children involved in 235 frontal crashes. The average delta V for all crashes was 29 +/- 16.9 kph [18 +/- 10.5 mph (range, 5-123 kph)]. Delta V was strongly and positively associated with the odds of both an AIS > or = 2 and AIS > or = 3 injury (P < 0.0001). The adjusted odds of at least one AIS > or = 2 injury increased on average by 56% (95% confidence interval [CI], 33%-85%) for each 10 kph increase in delta V. Similarly, the adjusted odds of at least one AIS > or = 3 injury increased on average by 67% (95% CI, 40%-102%) for each 10 kph increase in delta V. The delta V at which 50% of child occupants would be expected to sustain any AIS > or = 2 injury was 37 kph [23.0 mph (95% CI, 32-45 kph)], and any AIS > or = 3 injury was 63 kph [39.1 mph (95% CI, 51-infinity kph)]. Delta V is strongly predictive of injury risk for child occupants. As many newer generation cars are now fitted with event data recorders, this information is increasingly available and may become useful as a clinical predictor.

Suboptimal restraint affects the pattern of abdominal injuries in children involved in motor vehicle crashes

Background Both solid and hollow visceral abdominal injuries have been associated with the use of seat belts in children involved in motor vehicle crashes. The relationship between the types of restraint used and the pattern of abdominal injury is unknown. Methods A probability sample of restrained children involved in crashes was enrolled in an ongoing crash surveillance system (1998 through 2002) linking insurance claims data to telephone survey and crash investigation data. Significant abdominal injuries were considered when the Abbreviated Injury Scale (AIS) score was ≥2 and were defined as hollow visceral (HV; intestine, bladder), or solid visceral (liver, spleen, pancreas, kidney). Restraint type was categorized as optimal restraint (OR) or suboptimal restraint (S-OR) based on the child’s age and size. Results For the 33 months of review, interviews were obtained for 13,558 restrained children aged 0 to 15 years, of which, 56% were OR (n = 7,591) and 44% were S-OR (n = 5,967). A significant abdominal injury was recorded in 78 children. A hollow visceral injury was recorded in 38 (9 OR and 29 S-OR), and a solid visceral injury in 32 (18 OR and 14 S-OR). Both hollow and solid visceral injuries were present in 8 children (2 OR and 6 S-OR). Suboptimally restrained children had a higher risk for hollow visceral injury when compared with optimally restrained children (Odds Ratio, 4.14 [95% Confidence Interval 1.33 to 13.22, P < .01]). Conclusions Among restrained children with intraabdominal injuries, those who were suboptimally restrained were 4 times more likely to have a hollow visceral than a solid visceral injury when compared with those who were optimally restrained. This suggests that the mechanism of injury for hollow viscus may be directly related to the improper positioning of the restraint.

The role of restraint and seat position in pediatric facial fractures.

Recently, head and brain injuries were identified as consequences of the inappropriate use of seat belts by children. The proposed mechanism of these injuries might also place a child at risk for facial fracture. A probability sample of children under age 16 involved in crashes were enrolled in an ongoing crash surveillance system (1998-2001) that links insurance claims data to telephone survey and crash investigation data (unweighted, n = 12,659; weighted, n = 131,717). Incidence of facial fracture was estimated and a series of cases were examined using in-depth crash investigation to identify the mechanisms of these injuries, specifically, the role of seating position and restraint use in the mechanism of injury. Ninety-two children suffered a fracture of the facial bones (0.07% of all children in crashes). Among restrained children with facial fractures (n = 68), those inappropriately restrained were at a 1.6-fold higher risk (95% confidence interval, 1.2-2.1; p = 0.001) of significant injury than those appropriately restrained for their age. The in-depth investigations revealed that excessive head excursion resulting from suboptimal torso restraint caused facial impact, which resulted in the facial injuries described. The potential for disfigurement associated with these facial injuries may resonate strongly with parents, and prevention of disfigurement may provide additional motivation for proper restraint, in particular, booster seats and rear seat location, for this pediatric population.

Trends in booster seat use among young children in crashes.

Booster seat use in the United States is extremely low among 4- to 8-year-old children, the group targeted for their use. However, more recent attention has been paid to the role of booster seats for children who have outgrown their forward-facing child safety seat. In particular, several states are currently considering upgrades to their child restraint laws to include the use of booster seats for children over 4 years of age. To examine recent trends in booster seat use among children involved in automobile crashes in 3 large regions of the United States. This study was performed as part of the Partners for Child Passenger Safety project, an ongoing, child-specific crash surveillance system that links insurance claims data to telephone survey and crash investigation data. All crashes occurring between December 1, 1998, and November 30, 2000, involving a child occupant between 2 to 8 years of age riding in a model year 1990 or newer vehicle reported to State Farm Insurance Companies from 15 states and Washington, DC, were eligible for this study. A probability sample of eligible crashes was selected for a telephone survey with the driver of the vehicle using a previously validated instrument. The study sample was weighted according to each subject's probability of selection, with analyses conducted on the weighted sample. The weighted study sample consisted of 53 834 children between 2 to 8 years old, 11.5% of whom were using a booster seat at the time of the crash. Booster seat use peaked at age 3 and dropped dramatically after age 4. Over the period of study, booster seat use among 4- to 8-year-olds increased from 4% to 13%. Among 4-year-olds specifically, booster use increased from 14% to 34%. Among children using booster seats, approximately half used shield boosters and half used belt-positioning boosters. Although overall booster seat use among the targeted population of 4- to 8-year-old children remains low, significant increases have been noted among specific age groups of children over the past 2 years. These data may be useful to pediatricians, legislators, and educators in efforts to target interventions designed to increase appropriate booster seat use in these children.

Partners for child passenger safety: a unique child-specific crash surveillance system

Insurance claims data were combined with telephone survey and on-site crash investigation data to create the first large scale, child-focused motor vehicle crash surveillance system in the US. Novel data management and transfer techniques were used to create a nearly real-time data collection system. In the first year of this on-going project, known as Partners for Child Passenger Safety, over 1200 children ≤15 years of age per week were identified in crashes reported to State Farm Insurance Co. from 15 states and Washington, D.C. Partners for Child Passenger Safety is similar in its design and overall objectives to National Automotive Sampling System (NASS), the only other population-based crash surveillance system currently operating in the US.

Vehicle safety in Australia using real world crash data

Representative crash investigation data has been collected for a number of years in Australia and used for various research studies, including estimating the benefits of new safety initiatives. This paper examines the use and role of real-world crash data for setting safety priorities, in evaluating the effectiveness of regulations and safety systems and identifying best practice for improving occupant protection, based on recent experience in Australia.

Update: Fatal Air Bag-Related Injuries to Children—United States, 1993-1996

Dual air bags will be required standard equipment in all new passenger cars sold in the United States beginning in 1997 and all light trucks sold in the United States in 1998 but are available now in many earlier-model vehicles. Air bags are designed to supplement the protection provided by safety belts in frontal crashes; when combined with lap and shoulder safety belts, air bags assist in preventing fatal and nonfatal injuries in motor-vehicle crashes. However, passenger-side air bags have been associated with injuries to children who, in almost all cases, were unrestrained or incorrectly restrained in the front seat. In 1993, approximately 1.4 million (0.8% of all vehicles registered) were equipped with passenger-side air bags, compared with an estimated 21.6 million vehicles (11.4% of all vehicles registered) in 1996 (National Highway Traffic Safety Administration [NHTSA], unpublished data, 1996). NHTSA, the National Transportation Safety Board (NTSB), and CDC collaborated with the American Academy of Pediatrics, the Children's Hospital of Philadelphia, The Air Bag Safety Campaign, the National Safety Council, the Brain Injury Association, the National Association of Governors Highway Safety Representatives, the National Association of Children's Hospitals and Related Institutions, and the Health Resources and Services Administration to examine crashes from the Special Crash Investigation Data File maintained by NHTSA, in which fatal injuries in children (aged < 12 years) were associated with passenger-side air bags. This report presents the findings of this review, which indicate that during January 1993-November 1996, annual increases occurred for both the number of fatal injuries to children resulting from air-bag deployments and the proportion of dual air bag-equipped vehicles (Table 1).