Front Seat Passengers Research Articles

Epidemiology of injuries sustained by rear-seat passengers in frontal motor vehicle crashes

Abstract Objective Advanced occupant protection systems in motor-vehicles (e.g., seat belts and airbags), while widely adopted for front-seat passengers, are either absent or offer disproportionally lower safety to rear-seat passengers in similar crashes. Optimization of advanced restraint systems for the rear-seat environment will require a detailed understanding of epidemiology and associated risk factors for injuries sustained by rear-seat passengers. Thus, the objective of the study is to use national level motor-vehicle travel and crash data to quantify rear-seat travel exposure, and determine the descriptive characteristics and the injury outcomes for rear-seat passengers involved in frontal collisions. Methods While U.S. travel data from the 2009 National Household Travel Survey was used to determine rear-seat travel estimates, crash data from 2001 to 2010 National Automotive Sampling System Crash Worthiness Data System was used to enroll rear-seat passengers injured in a frontal crash. The descriptive epidemiology of rear-seat crash victims was separately done for the three age-groups: children (8–15 years old), adults (16–59 years old), and senior adults (60+). Results The study indicated that senior adults in rear-seats were associated with a significantly higher rate of sustaining fatal (6%) and severe injuries (16% for MAIS 3+ injuries) in comparison to the younger cohorts. The distribution of severe injuries further indicated that the thorax was the most frequently injured region across all age groups irrespective of the belt-use status. Conclusions Findings of the study conclude that while rear-seat travel in the U.S. is still very low and improving belt usage is a primary concern among rear-seat passengers; however, the epidemiology supports the need for adapting rear-seat restraint performance for effective protection for all groups of rear-seat passengers.

Effects of a front-seat passenger on driver attention: An electrophysiological approach

The human attention system is limited in capacity, and when performing two concurrent tasks there is competition for cognitive resources. This is particularly important in dangerous scenarios, such as driving on sharp curves where deficits in performance can be caused by various sources of distraction, including the presence of a passenger in the vehicle. In the present study, a dual-task paradigm was employed to examine the nature of attentional limits while operating a driving simulator in the presence of a passenger. The primary driving task had two levels of difficulty and event-related potentials (ERP) were collected from a secondary auditory task. In addition to several driving performance measures, our main ERP of interest was the P300. In dual-task studies, increases in primary task difficulty have been shown to reduce the amplitude of the P300 elicited by a secondary task. This presumably occurs because attentional resources initially dedicated to the secondary task are consumed by the primary task. The present results showed that compared to driving solo, the presence of a passenger was associated with a decrease in P300 amplitude in the more difficult driving conditions. These results suggest that in-car passengers may consume valuable resources in difficult driving situations that require more attentional focus in the first place.

Facial bone fracture with dental injuries from a 4-WD air bag deployment: A case report in Qatar

Background: Injuries from air bag deployment have long been documented and studied like orbital blowout fractures, auditory injuries, etc. However, we report here a case of an alveolar process fracture associated with dental injuries and clear history of face-to-air bag impact only, which has rarely been documented and hence important to be reported. Case report: A 25-year old female front-seat passenger was involved in a head-on collision between her large four-wheel drive vehicle and another similar-sized vehicle. She was unrestrained and suffered facial and dental pain after the air bag was deployed. She denied hitting the dashboard or losing her consciousness. On examination, there was mild skin erythema associated with marked tenderness over her left maxilla and left upper jaw. Her upper left medial incisor was missing, while the lateral incisor and adjacent canine seemed to have been pushed upwards and embedded in their respective sockets. No other injury was elicited and she remained vitally stable. X-ray and CT scan imaging confirmed an alveolar bone fracture with upward displacement of the alveolar margin of the maxilla. Loss of medial upper left incisor, and impaction of the adjacent lateral incisor and canine teeth in the soft tissues at the left naso-labial fold, antero-lateral to the left nasolacrimal bones were also noted. Discussion: It is important to report these to be included in the potential range of injuries associated with air bag impact MVC. It will help widen the physicians range of possible injuries while evaluating an air bag impact MVC patient, hence aiding diagnosis and management. It will also help in the ongoing research for further modifying the techniques and types of protective devices currently used in vehicles to help prevent such injuries, as well as further highlighting the use of restraint along with use of such devices.

Interior Head Impact Analysis of Automotive Instrument Panel for Unrestrained Front Seat Passengers

This study presents the numerical and experimental interior head impact analysis of automotive instrument panel according to the United Nations Economic Commission for Europe Regulation 21 (ECE R21). To minimize the possible injury risk for unrestrained front seat passengers due to the interior head impact with the instrument panel, the panel design needs to meet the ECE R21 standard which defines a pendulum-type head form as the impactor. The measured acceleration response of the head form should not exceed 80g continuously for more than 3ms. Motivated by the need to develop a simulation-based technique to evaluate the design of the instrument panel, a numerical model based on the explicit dynamic finite element analysis (FEA) by using the commercial FEA solver, LS-DYNA, is developed. To minimize the experimental cost, a gravity-based impactor with a smaller impact speed is develop as the test apparatus for verification purpose. The simulated results agree well with the experimental data; the average accuracy for the maximum value of impact acceleration at the head form is 95.4%. After the verification, the standard test conditions (with higher impact speed) are performed to evaluate the design. The outcome of this study can provide an efficient and cost-effective method to predict and improve the design of the instrument panel for interior head impact protection.

Evaluating the Effectiveness of a Front Windshield Sticker Reminder in Reducing Texting while Driving in Young Adults.

Texting while driving is a dangerous activity that is on the rise in the United States (U.S.). Since 2011 there has been a 17% increase in the number of people injured in a motor vehicle crash involving a distracted driver. Bans on the act of texting and driving have already taken place in 46 states in the U.S., but studies have shown that they are ineffective. An unstudied method of reducing texting while driving is sticker reminders. Sticker reminders have already been proven to be an effective intervention in the realm of driver safety; one study found that a “Buckle-Up” dashboard sticker doubled the use of safety belts by front seat passengers. In this study, 104 medical students aged 21 - 29, from the University of Central Florida (UCF) College of Medicine were randomly divided into two groups, an interventional group receiving a “Drive in the Moment” windshield sticker, and a control group not receiving the sticker. Both groups took a pre- and post-survey that recorded self-reported texting and driving frequency. The results showed that the sticker intervention significantly reduced reported rates of sending texts while driving, reading texts while driving, and using social media while driving (p < 0.05). The results of this study suggest that a novel sticker-intervention could potentially serve as a point of attack when addressing the growing and dangerous texting while driving the epidemic.

Development of New-type Weight Classification System

In order to comply with the Federal Motor Vehicle Safety Standard(FMVSS) No. 208 that has been in force since September 2003, an automatic airbag suppression system has become an essential option for detecting and protecting infants and children seated in the front passenger seat of vehicles in the U.S. market. MOBIS has developed the world’s first weight-based OCS under the name NWCS. NWCS is composed of two sensors and ECU. It is sub-packaged in order to minimize the seat structure deviation. In this paper, technical features, robustness and performance of NWCS are summarized and discussed.

A Rare Case of Isolated Auricular Injury Caused by a Tree Branch During a Traffic Accident

This study was presented at XI. National Emergency Medicine Congress 16-19 April 2015 Antalya, Turkey Address for Correspondence: Selvet Erdogan, Department of Otorhinolaryngology, Kocaeli University School of Medicine, Kocaeli, Turkey E-mail: sel-erdogan@hotmail.com ©Copyright 2016 by Emergency Physicians Association of Turkey Available online at www.jemcr.org Introduction Traffic accidents represent an important component of emergency admissions, and many different injuries are noted. The average number of traffic accidents has been about 1.1 million annually over the last 5 years in Turkey; of these, approximately 140.000 were fatal (1). Head and neck injuries are the most common cause of death. In cases of head and neck injuries that cause morbidity, most involve drivers and frontseat passengers (2, 3). In the present report, we present a rare isolated example of a penetrating neck trauma caused by a tree branch during a car accident, commencing in the temporal region and extending from the external auditory canal and retromandibular area.

Restraint use in the Eastern Province of the Kingdom of Saudi Arabia

ABSTRACTObjectives: This study set out to examine seat belt and child restraint use in the Dammam Municipality of the Kingdom of Saudi Arabia, based on the premise that an increase in seat belt use would significantly reduce personal injury in traffic crashes. It was expected that local data would help identify intervention strategies necessary to improve seat belt use in the region.Methods: The research involved 2 methodologies. First, 1,389 face-to-face interviews were conducted with male and female adults in regional shopping plazas regarding their own and their children's restraint use in their vehicles and reasons for these attitudes and beliefs. Second, 2 on-road observation studies of adult and child restraint use were conducted by trained observers. Occupants of approximately 5,000 passenger vehicles were observed while stopped at representative signalized traffic intersections.Results: The findings showed front seat belt use rates of between 43 and 47% for drivers and 26 to 30% for front seat passengers; rear seat belt use rates were lower. While there seemed to be some knowledge about the purpose and reasons for restraining both adults and children in suitable restraints, this failed to be confirmed in the on-road observations.Conclusions: Reasons for these rates and findings are discussed fully, and recommendations for improving seat belt use in the Dammam Municipality are included.

Underutilization of occupant restraint systems in motor vehicle injury crashes: A quantitative analysis from Qatar

ABSTRACTIntroduction: Restraint systems (seat belts and airbags) are important tools that improve vehicle occupant safety during motor vehicle crashes (MVCs). We aimed to identify the pattern and impact of the utilization of passenger restraint systems on the outcomes of MVC victims in Qatar.Methods: A retrospective study was conducted for all admitted patients who sustained MVC-related injuries between March 2011 and March 2014 inclusive.Results: Out of 2,730 road traffic injury cases, 1,830 (67%) sustained MVC-related injuries, of whom 88% were young males, 70% were expatriates, and 53% were drivers. The use of seat belts and airbags was documented in 26 and 2.5% of cases, respectively. Unrestrained passengers had greater injury severity scores, longer hospital stays, and higher rates of pneumonia and mortality compared to restrained passengers (P = .001 for all). There were 311 (17%) ejected cases. Seat belt use was significantly lower and the mortality rate was 3-fold higher in the ejected group compared to the nonejected group (P = .001). The overall mortality was 8.3%. On multivariate regression analysis, predictors of not using a seat belt were being a front seat passenger, driver, or Qatari national and young age. Unrestrained males had a 3-fold increase in mortality in comparison to unrestrained females. The risk of severe injury (relative risk [RR] = 1.82, 95% confidence interval [CI], 1.49–2.26, P = .001) and death (RR = 4.13, 95% CI, 2.31–7.38, P = .001) was significantly greater among unrestrained passengers.Conclusion: The nonuse of seat belts is associated with worse outcomes during MVCs in Qatar. Our study highlights the lower rate of seat belt compliance in young car occupants that results in more severe injuries, longer hospital stays, and higher mortality rates. Therefore, we recommend more effective seat belt awareness and education campaigns, the enforcement of current seat belt laws, their extension to all vehicle occupants, and the adoption of proven interventions that will assure sustained behavioral changes toward improvements in seat belt use in Qatar.

Identifying factors for traffic safety support in older drivers

The present study aimed at identifying factors for traffic safety support in older drivers. This was achieved by studying the co-operation between older drivers and their ordinary front seat passenger (co-driver). The knowledge emerging from such study can enhance the understanding of what kind of support an older driver needs and also help facilitate proper design of in-vehicle support systems and intervention training programs for older drivers. A within group field study was carried out, using a mixed-methods evaluation design. Four elderly couples participated in the study. The drivers included in the study requested and received on-going directional support, traffic -and driving strategic help, help with look-out and reminding of current speed limit. It was evident from comparisons between interview data and field data that how the participants themselves described their need of support differed from what support they requested (drivers) and gave (co-drivers) in real driving. Furthermore, data revealed that three out of four drivers were given a score of 2 in the Useful Field Of View test (UFOV). It was evident that there are areas in which older drivers need and request support. The results from the present study could be used in the design process, and in evaluation of, in-vehicle support systems as well as in developing intervention training programs customised for older drivers.

Characteristic of the fractures of the cervical, thoracic and lumbar vertebrae in the victims of a traffic accident found in the passenger compartment of a modern motor vehicle

The objective of the present work was to study peculiar features of the injuries to three spinal regions in the victims of a head-on car collision found in the passenger compartments of modern motor vehicles equipped with seat belts and other safety means. It was shown that most frequent fatal injuries to the driver include the fractures of the cervical, thoracic, and lumbar vertebrae. These injuries are much less frequent in the passengers occupying the front and the right back seats. The multilayer and multiple character of the fractures in different parts of the spinal column in the car drivers is attributable to more pronounced spine flexion and extension associated with injuries of this kind. The fractures of the lower cervical vertebrae in the front seat passengers occur more frequently than injuries of a different type whereas the passengers of the back seats most frequently experience fractures of the upper cervical vertebrae. The passengers of the left back seat less frequently suffer from injuries to the thoracic spine than from the fractures of the cervical and lumbar vertebrae. The passengers of the central back seat most frequently experience fractures of the thoracic part of the vertebral column and the passengers occupying the right back seat fractures of the lumbar vertebrae.

Seatbelt Use and Related Factors Among Drivers Involved in Road Crashes in Southeast Iran

Background: Seatbelts are a relatively low-cost safety device that provides easy basic protection for occupants of 4-wheeled vehicles. Objectives: This study investigates frequency of seatbelt use and its related factors among drivers involved in a vehicle crash. Materials and Methods: In this cross-sectional study, all crash profiles recorded in a province from March 2010 to March 2011 were reviewed. Necessary information was extracted from crash reports in which at least one 4-wheeled vehicle was involved. Data were analyzed using binary and multinomial logistic regression. Results: Of a total of 1427 motor vehicle crashes, a seatbelt was used by 58.2% of drivers. In the univariate analysis, the following were significantly associated with seatbelt use: driver age, education, and occupation along with front seat passenger's sex and seatbelt use, type and make of vehicle, speed, road surface condition, and type of road. In the multivariate model, the following remained significant: driver education, seatbelt use by front seat passenger, and type of road. Furthermore, a restraining seatbelt protected drivers from severe injury and death. Unbelted drivers were 7 and 17.4 times more likely to experience injury and death respectively than belted drivers. Conclusions: The seatbelt wearing rate among the study participants was much lower than the 90% rate reported among Iranian drivers in 2010. Mandating seatbelt use, as in most countries, will be more effective if a combination of factors such as changes in vehicle design, road safety, and driver and passenger behavior are taken into account.

Characteristics of on-road driving by persons with central vision loss: Learning to drive with a bioptic telescope

ABSTRACTThere is limited research on the driving performance and safety of bioptic drivers and even less regarding the driving skills that are most challenging for those learning to drive with bioptic telescopes. This research consisted of case studies of five trainee bioptic drivers whose driving skills were compared with those of a group of licensed bioptic drivers (n = 23) while they drove along city, suburban, and controlled-access highways in an instrumented dual-brake vehicle. A certified driver rehabilitation specialist was positioned in the front passenger seat to monitor safety and two backseat evaluators independently rated driving using a standardized scoring system. Other aspects of performance were assessed through vehicle instrumentation and video recordings. Results demonstrate that while sign recognition, lane keeping, steering steadiness, gap judgments, and speed choices were significantly worse in trainees, some driving behaviors and skills, including pedestrian detection and traffic light recognition were not significantly different from those of the licensed drivers. These data provide useful insights into the skill challenges encountered by a small sample of trainee bioptic drivers which, while not generalizable because of the small sample size, provide valuable insights beyond that of previous studies and can be used as a basis to guide training strategies.

Texting at the light and other forms of device distraction behind the wheel.

BackgroundCell phones are a well-known source of distraction for drivers, and owing to the proliferation of text messaging services, web browsers and interactive apps, modern devices provide ever-increasing temptation for drivers to take their eyes off the road. Although it is probably obvious that drivers’ manual engagement of a device while their vehicles are in motion is potentially dangerous, it may not be clear that such engagement when the vehicle is at rest (an activity broadly labeled “texting at the light”) can also impose risks. For one thing, a distracted driver at rest may fail to respond quickly to sudden changes in road conditions, such as an ambulance passing through. In addition, texting at the light may decrease so-called “situational awareness” and lead to driving errors even after the device is put down. To our knowledge, the direct comparison of the rate of device usage by drivers at rest with the rate of device usage by drivers in motion has not been reported.MethodsWe collected information on 2000 passenger vehicles by roadside observation. For the first group of 1000 passenger vehicles stopped at a traffic light, device usage (“texting”, “talking”, “none”), gender of the driver, vehicle type, seatbelt usage and presence of front seat passengers were recorded. For a second set of 1000 vehicles in motion, device usage alone was noted. Statistical significance for differences in rates was assessed with the chi-square test.ResultsWe found that 3 % of drivers in motion were texting and 5 % were talking. Among the stopped drivers, 14.5 % were texting and 6.3 % were talking. In the stopped-vehicle set, gender and vehicle type were not associated with significant differences in device usage, but having a front seat passenger and using seatbelts were.ConclusionsDevice usage is markedly higher among drivers temporarily at rest compared with those in motion, and the presence of a front seat passenger, who may help alleviate boredom or reprimand bad behavior, is associated with lower device usage rates among vehicles stopped at a light. These observations may help identify suitable steps to decrease distracted driving and thereby minimize traffic trauma.

Restraint use in motor vehicle crash fatalities in children 0 year to 9 years old.

Despite improvements in child passenger safety legislation and equipment, motor vehicle crashes (MVCs) continue to be the leading cause of death in children younger than 10 years. The objective of this study was to describe factors associated with restraint use in fatal MVC in children 0 year to 9 years old. The Fatality Analysis Reporting System, maintained by the National Highway Transportation Safety Administration, was used to obtain data on MVC fatalities from 2001 to 2010 in children 0 year to 9 years old. The main outcome was restraint use. Demographic information (age, sex, and race) and crash characteristics including vehicle type (sedan, van, truck, sports utility vehicle) and seat position in the vehicle were analyzed with the χ statistic to evaluate these factors for any restraint use compared with no restraint use in MVC fatalities. There were 7,625 MVC fatalities in children 0 year to 9 years old from 2001 to 2010.Among these fatalities, 4,041 (53%) had any restraint use. Front seat passengers accounted for 20.9% (1,595 of 7,625) of the fatalities. Children 0 year to 3 years old had a higher proportion of restraint use than children 4 years to 9 years old (p < 0.001). White children compared with black children had higher use of restraints (p < 0.001). Children riding in sedans/vans compared with sport utility vehicles/trucks and those riding in the rear seats of the vehicle compared with those in front seats were significantly more likely to use restraints (p < 0.001). Overall, only half of children 0 year to 9 years old who died in an MVC were wearing any child restraint in the vehicle, and 20% were sitting in the front seat. Continued efforts must be made to enforce legislation and educate the public about best practices regarding child passenger safety to improve proper restraint use and to decrease MVC fatalities in children. Prognostic/epidemiologic study, level II.

Risky Driving Behaviours among Medical Students in Erbil, Iraq.

This study aimed to assess risky driving behaviours among medical students in Erbil, Iraq, and to explore the relationship between risky driving behaviours and perceptions of risky driving. This self-administered questionnaire-based survey was conducted from January to May 2014 among a random sample of 400 medical students at Hawler Medical University in Erbil. The questionnaire was designed to assess the frequency of engagement in 21 risky driving behaviours, the perceived risk of each behaviour and the preference for each behaviour as ranked on a 5-point scale. A total of 386 students responded to the survey (response rate: 96.5%). Of these, 211 reported that they currently drove a vehicle (54.7%). Drivers most frequently engaged in the following behaviours: playing loud music (35.9%), speeding (30.4%), allowing front seat passengers to not wear seat belts (27.9%) and using mobile phones (27.7%). Least frequent driving behaviours included not stopping at a red light (3.9%), driving while sleepy (4.4%), driving after a mild to moderate intake of alcohol (4.5%) and drunk driving (6.4%). Mean risky driving behaviour scores were significantly higher among males (P <0.001) and those who owned a car (P = 0.002). The mean risk perception score was higher among >20-year-olds (P = 0.028). There was a significant positive relationship between the preference for risky behaviours and risky driving behaviours (beta = 0.44; P <0.001). Medical students in Erbil reported high frequencies of several serious risky driving behaviours. The preference for risky behaviours was found to be an important predictor of risky driving behaviours among medical students in Erbil.

Distraction effects of navigation and green-driving systems – results from field operational tests (FOTs) in the UK

Navigation systems and green-driving advisory systems are now a common feature in modern vehicles. The interaction of drivers with such systems when driving must be considered to minimise distraction whilst maintaining the benefits provided. This research investigates the glance behaviours of drivers, assessed from video data, when using a navigation device (study 1) and a green-driving advisory device (study 2). The main research question addressed was ‘Does the device cause visual distraction that might be detrimental to safety?’ The main focus was to establish the number of glances of 2 s or more to the systems and relate this to driver safety (as stipulated in new guidelines for use of in-vehicle systems proposed by the National Highway Traffic Safety Administration (NHTSA) in the US). Study 1 tested a Blom Ndrive G800 navigation device whilst study 2 tested the Foot-LITE device; a Smart’ driving system which incorporates Green Driving Support (GDS). In study 1, the subjects were specifically requested to drive a prescribed route of approximately 25 km and were directed by an experimenter who was present in the front passenger seat (baseline condition phase). After approximately 8 months, the same 10 subjects were requested to perform the same drive but using the navigation device to guide them around the route (experimental condition phase). In study 2, all subjects were asked to drive a prescribed route first without using the Foot-LITE device (baseline condition phase) and then some days later, with the Foot-LITE device (experimental condition phase). In study 1, the percentage of eyes off road time for drivers was much greater in the experimental (with device) condition compared to the baseline condition (14.3 % compared to 6.7 %) but whilst glances to the navigation device account for the majority of the increase, there are very few which exceed 2 s. Drivers in study 2 spent on average 4.3 % of their time looking at the system, at an average of 0.43 s per glance; no glances exceeded 2 s. In study 1, whilst glances to the personal navigation device account for the majority of the increase in eyes off road time (in accordance with intuitive expectations), when the durations of the glances are analysed, there were very few which are 2 s or more in duration. The average glance was 0.76 s which compared with average duration of glances to other target areas of 0.6 s, well below the proposed NHTSA guidelines. In study 2, the main outcome was that the total number of glances made was similar for each condition, at approximately 1100. Therefore glances to the in-vehicle Smart driving system during the experimental condition must have been reallocated from a different location. Around 75 % of the glances were between 0.2 and 0.6 s – also well below the NHTSA proposed guidelines. The results of the study have important design implications for future in-vehicle information systems.

Injury risk for matched front and rear seat car passengers by injury severity and crash type: An exploratory study

BackgroundThe risk of serious injury or death has been found to be reduced for some front compared to rear seat car passengers in newer vehicles. However, differences in injury severity between car occupants by seating position has not been examined. This study examines the injury severity risk for rear compared to front seat car passengers. MethodA retrospective matched-cohort analysis was conducted of vehicle crashes involving injured rear vs front seat car passengers identified in linked police-reported, hospitalisation and emergency department (ED) presentation records during 2001–2011 in New South Wales (NSW), Australia. Odds ratios were estimated using an ordinal logistic mixed model and logistic mixed models. ResultsThere were 5419 front and 4588 rear seat passengers in 3681 vehicles. There was a higher odds of sustaining a higher injury severity as a rear-compared to a front seat car passenger, with a higher odds of rear seat passengers sustaining serious injuries compared to minimal injuries. Where the vehicle occupant was older, travelling in a vehicle manufactured between 1990 and 1996 or after 1997, where the airbag deployed, and where the vehicle was driven where the speed limit was ≥70km/h there was a higher odds of the rear passenger sustaining a higher injury severity then a front seated occupant. ConclusionRear seat car passengers are sustaining injuries of a higher severity compared to front seat passengers travelling in the same vehicle, as well as when travelling in newer vehicles and where the front seat occupant is shielded by an airbag deployed in the crash. Rear seat occupant protective mechanisms should be examined. Pre-hospital trauma management policies could influence whether an individual is transported to a hospital ED, thus it would be beneficial to have an objective measure of injury severity routinely available in ED records. Further examination of injury severity between rear and front seat passengers is warranted to examine less severe non-fatal injuries by car seating position and vehicle intrusion.

Rear seat safety: Variation in protection by occupant, crash and vehicle characteristics

ObjectivesCurrent information on the safety of rear row occupants of all ages is needed to inform further advances in rear seat restraint system design and testing. The objectives of this study were to describe characteristics of occupants in the front and rear rows of model year 2000 and newer vehicles involved in crashes and determine the risk of serious injury for restrained crash-involved rear row occupants and the relative risk of fatal injury for restrained rear row vs. front passenger seat occupants by age group, impact direction, and vehicle model year. MethodData from the National Automotive Sampling System Crashworthiness Data System (NASS-CDS) and Fatality Analysis Reporting System (FARS) were queried for all crashes during 2007–2012 involving model year 2000 and newer passenger vehicles. Data from NASS-CDS were used to describe characteristics of occupants in the front and rear rows and to determine the risk of serious injury (AIS 3+) for restrained rear row occupants by occupant age, vehicle model year, and impact direction. Using a combined data set containing data on fatalities from FARS and estimates of the total population of occupants in crashes from NASS-CDS, logistic regression modeling was used to compute the relative risk (RR) of death for restrained occupants in the rear vs. front passenger seat by occupant age, impact direction, and vehicle model year. ResultsAmong all vehicle occupants in tow-away crashes during 2007–2012, 12.3% were in the rear row where the overall risk of serious injury was 1.3%. Among restrained rear row occupants, the risk of serious injury varied by occupant age, with older adults at the highest risk of serious injury (2.9%); by impact direction, with rollover crashes associated with the highest risk (1.5%); and by vehicle model year, with model year 2007 and newer vehicles having the lowest risk of serious injury (0.3%). Relative risk of death was lower for restrained children up to age 8 in the rear compared with passengers in the right front seat (RR=0.27, 95% CI 0.12–0.58 for 0–3 years, RR=0.55, 95% CI 0.30–0.98 for 4–8 years) but was higher for restrained 9–12-year-old children (RR=1.83, 95% CI 1.18–2.84). There was no evidence for a difference in risk of death in the rear vs. front seat for occupants ages 13-54, but there was some evidence for an increased relative risk of death for adults age 55 and older in the rear vs. passengers in the right front seat (RR=1.41, 95% CI 0.94–2.13), though we could not exclude the possibility of no difference. After controlling for occupant age and gender, the relative risk of death for restrained rear row occupants was significantly higher than that of front seat occupants in model year 2007 and newer vehicles and significantly higher in rear and right side impact crashes. ConclusionsResults of this study extend prior research on the relative safety of the rear seat compared with the front by examining a more contemporary fleet of vehicles. The rear row is primarily occupied by children and adolescents, but the variable relative risk of death in the rear compared with the front seat for occupants of different age groups highlights the challenges in providing optimal protection to a wide range of rear seat occupants. Findings of an elevated risk of death for rear row occupants, as compared with front row passengers, in the newest model year vehicles provides further evidence that rear seat safety is not keeping pace with advances in the front seat.

The forensic medical evaluation of the injuries to the cervical spine in the driver and the front-seat passenger of a modern motor vehicle after the frontal crash

The objective of the present study was to elucidate the specific features of the lesions of the cervical spine in the driver and the front-seat passenger of a modern car after the frontal crash. We made use of the archival materials of forensic medical expertises concerning the traffic accidents carried out in the city of Moscow during the period from 2005 to 2012. The study was focused on the analysis of the character of the fractures of cervical vertebrae in the drivers (n = 55) and the front-seat passengers (n = 85) of a modern motor vehicle involved in a traffic accident. It was shown that the drivers most frequently suffer bending-extension fractures of the cervical vertebrae, with the II-IV vertebrae being especially frequently subject to multiple fractures resulting in the damage to the anterior support column, sometimes to both the anterior and posterior columns, and much rarer to the posterior column. The front-seat passengers also suffer bending-extension fractures. The IV-VI vertebrae are most frequently affected in them with isolated damages to either the anterior or the posterior support column of the neck vertebrae.