OVERVIEW OF SERIOUS THORAX INJURIES IN EUROPEAN … · OVERVIEW OF SERIOUS THORAX INJURIES IN EUROPEAN FRONTAL CAR CRASH ACCIDENTS AND IMPLICATIONS FOR CRASH TEST DUMMY DEVELOPMENT

OVERVIEW OF SERIOUS THORAX INJURIES IN EUROPEAN FRONTAL CAR CRASH ACCIDENTS AND IMPLICATIONS FOR

CRASH TEST DUMMY DEVELOPMENT

Jolyon Carroll1, Thorsten Adolph2, Cyril Chauvel3, Maxime Labrousse3, Xavier Trosseille3, Claus Pastor2, Andre Eggers2, Susannah Smith1, and David Hynd1

1: TRL (Transport Research Laboratory, UK), 2: BASt (Bundesanstalt für Straßenwesen, Germany),

3: GIE RE PR (Groupement Intérêt Economique de Recherches et Etudes PSA-Renault, France)

ABSTRACT For the EC 7th Framework Action COVER and to support the THORAX and THOMO projects, the objectives of this work were to: define the current state of knowledge on thorax injuries in frontal impacts; extend that knowledge to define in detail thorax injuries for diverse user groups; and recommend priorities for biomechanical testing, crash test dummy development, and injury risk functions that would be most relevant for future advanced frontal impact dummies. This paper brings together accident data analyses from the UK, Germany, and France to address these objectives. Based on the results of these analyses the authors observed that there was an increased risk for older occupants to sustain a torso injury. There also tends to be a greater torso injury risk for occupants seated in the front passenger seat compared with the driver’s seat. Fractures to the ribs and then the sternum were the most frequently occurring types of injury at the AIS 2 severity level. Injuries to the lungs were the most frequently occurring visceral injuries to the torso. Keywords: Accident Analysis, Biomechanics, Dummies, Thorax, Frontal Impacts THE ATTAINMENT of an ever-higher safety level on European roads is a long-term and ongoing process, which has seen significant progress already. Improvements in occupant protection (secondary safety) have contributed to this progress. For example, the combination of EU (European Union) legislation for crash test standards, improved consumer information through the Euro NCAP (European New Car Assessment Programme; www.euroncap.org), and safety developments made by car manufacturers has substantially raised the survivability for vehicle occupants in a crash. However, around 41,600 people were killed and more than 1.7 million injured in European road accidents in 2005. Therefore, whilst the number of road fatalities has declined by more than 17 % since 2001, greater efforts are still warranted. Although efforts are needed on all levels of road safety, the COVER (Coordination of Vehicle and Road Safety Initiatives) project has been set-up to develop a harmonised and consistent direction of research and to accelerate the implementation of the research findings of four complimentary initiatives in the field of crash biomechanics (including the THORAX {Thoracic injury assessment for improved vehicle safety} and THOMO {Development of a finite element model of the human thorax and upper extremities} projects). Motivated by findings of previous projects (including EC Framework projects) the THORAX and THOMO projects were set-up to study thorax injuries for a wide variety of car occupants and transfer results into test and design tools. BACKGROUND Initially, findings from previous research were collated to define the current state of knowledge on thorax injuries in frontal impacts. A summary of these findings is given here:

• Head and facial injuries have been greatly reduced following the introduction of frontal airbags. However, a concomitant reduction in the number of thorax injuries occurring in the accident case data was not evident (Knack et al., 2003).

IRCOBI Conference - Hanover (Germany) - September 2010 217

• Early data from a previous EEVC study (Beusenberg et al., 1996) suggested that the most frequent severe thorax injuries were fractured ribs, followed by lung contusions and lacerations.

• Increasing age has been associated with increasing injury severity (Siegel et al., 2004; Augenstein et al., 2004; etc.). Trends in occupant weight are not significant, but indicate that heavier males and lighter females are at increased risk of MAIS 3 to 6 injuries (McCarthy et al., 2001).

• Female front seat passengers had a higher proportion of chest injuries than female drivers. For front seat passengers most serious injuries are to the chest and these are mainly sustained by older women in low severity crashes (Frampton et al., 2005).

• The potential effects of tuning restraint systems for high-speed impacts or occupants of average size were shown in the AoARS (Assessment of Advanced Restraint Systems) work. Whilst occupants of different sizes were found to have different injury risks under the different impact conditions investigated it was also reported that some injury measures (including those for a thorax injury) could be higher in lower speed impacts (Smith and Couper, 2006).

• Occupants with a load limiter tend to have fewer serious (AIS ≥ 3) injuries but instead have more skeletal thorax injuries (AIS < 3) (Edwards et al., 2008).

METHODS Following on from the prior research, this paper brings together accident data analyses from the UK, Germany, and France to extend the knowledge from previous research with up-to-date in-depth European accident data. The in-depth car accident databases used in these analyses were the UK Cooperative Crash Injury Study (CCIS), the German In-Depth Accident data Survey (GIDAS; www.gidas.org – Otte et al., 2003 and Hautzinger et al., 2006), and the French GIE RE PR (Renault, and PSA Peugeot Citroën) database. The Abbreviated Injury Scale, 1990 Revision (AAAM, 1990), was used to code the injuries analysed, in all of the databases. Two phases of analysis are described. PHASE1: From a review of in-depth accident data, the COVER project provided an overview of the current situation with regard to thorax injuries resulting from frontal impact car accidents. Vehicle age was restricted to cars registered in 2000 or later. The accident data were controlled for impact partner, impact severity, overlap and intrusion, and type of restraint system used. Cases were selected if they had one significant frontal impact, had not rolled over at any point, the occupants were wearing a seat-belt, known to be 12 years old or older, and had a known overall Maximum Abbreviated Injury Scale (MAIS) score, whether injured or uninjured. The selection criteria generated samples of 2,148, 2,451, and 529 occupants from the CCIS, GIDAS, and GIE RE PR databases, respectively. PHASE2: Individual frontal impact accident cases from the CCIS and GIDAS in-depth accident studies, as used in the COVER work, were selected for further in-depth analysis. Within the THORAX Project, 34 cases, where the impact conditions were similar to the Euro NCAP frontal impact crash test (Euro NCAP, 2009), were analysed. This included 20 cases from the CCIS and 14 from the GIDAS. The number of cases was limited by the requirement for them to have impact conditions similar to those of a Euro NCAP test (including having been struck on the same side of the vehicle) and to involve a car for which Euro NCAP test results are available. A comparison was made between the thoracic injury outcome predicted from the test and observed in the real-world accident. Other impact types known to cause torso injuries (for instance, with single vehicle impacts with narrow objects, such as trees) were not included in the second phase. Additionally, GIE RE PR accident cases were reviewed with a particular focus on the efficacy of load-limiting restraint systems in mitigating thorax injuries. Torso definition: In frontal impacts, the loading to the thorax of a seat-belted occupant is likely to be influenced by the interaction of the seat-belt with the clavicle/shoulder. Also, the inferior margin of the thorax can be described as including organs of the upper abdomen depending on where the thoracic/abdominal transition is set. To include consideration of injuries to the shoulder, clavicle, and

218 IRCOBI Conference - Hanover (Germany) - September 2010

upper abdomen, alongside injuries to the thorax (as listed in the AIS), it was necessary to define key types and regions of injury to a wider thoracic or trunk area. Within this study the wider thorax is defined as the ‘torso’. Classes of torso injury were defined based on the AIS code for each injury and included injury to any one, or combinations of the following: sternum, shoulder (clavicle, acromion, scapula, acromioclavicular joint, glenohumeral joint), rib, lung, heart, other thorax (including thoracic spine), upper abdomen (gallbladder, kidney, liver, pancreas, spleen), lower abdomen (bladder, ovary, lumbar spine), other abdomen (colon, omentum, retroperitoneum, duodenum, jejunum, mesentery). All abdomen injuries were included in the initial CCIS analysis as it was considered to be easier to remove the lower abdomen and other abdomen injuries after the initial investigation of injury combinations. The precise thorax injuries used in the GIDAS analysis were defined with the location of injury (SITZ) coding, and included the injury codes 300 to 595. Due to space limitations, it is not possible to provide exact details of all injuries included in the GIDAS torso definition, within this paper. The following table (Table 1) shows the sizes of the samples used for Phase 1 of the study. This illustrates how the thorax and torso injury selections affected the number of injuries available for analysis. Within GIDAS all accidents are collected, whereas in the CCIS, for example, data collection is biased towards more severe accidents. This is the reason why there is this difference between the numbers of total occupants and occupants with severe torso injuries between those samples.

Table 1. Sample sizes available for analysis in Phase 1 Sample CCIS (TRL) GIDAS (BASt) GIE RE PR

Total occupants 2,148 2,451 529 front seat occupants

Thorax injured occupants

234 (AIS 2+, incl. AIS 1 rib fractures)

90 (AIS2+, incl. liver and spleen)

Thorax injuries 410 (AIS 2+, incl. AIS 1 rib fractures)

159 (AIS2+, incl. liver and spleen)

Torso injured occupants

320 (AIS 2+, incl. AIS 1 rib fractures)

Torso injuries 678 (AIS 2+, incl. AIS 1 rib fractures)

317 (AIS 1+) 57 (AIS 2+)

RESULTS IN-DEPTH ACCIDENT ANALYSIS: At the time of the 1996 EEVC analysis (Beusenberg et al., 1996), AIS 2 and ≥ 3 injuries to the head and pelvis represented a large proportion of the injuries at these severities. From the CCIS analysis, as shown in Figure 1, it can be seen that head and pelvis injuries now have a lower relative importance, compared with injuries to other body regions at the MAIS = 2 and MAIS ≥ 3 levels. The thorax has now superseded the head and the pelvis in terms of the number of occupants receiving an injury to that body region at any of the three severity levels (MAIS 1, 2, or ≥ 3). Within the UK CCIS sample there were a total of 2,148 occupants who were selected initially. Of these, 561 occupants suffered a MAIS ≥ 2 (or AIS 1 rib fracture) injury and were classified as Killed or Seriously Injured (KSI) by the emergency services; and 236 occupants suffered a MAIS ≥ 3 injury. There were 320 occupants who sustained MAIS ≥ 2 (or AIS 1 rib fracture) thorax injuries and 131 occupants with MAIS ≥ 3 thorax injuries. AIS 1 rib fractures are included in the first group because it is thought that they could lead to more severe complications for certain groups of the population (e.g. the elderly and frail) than the AIS 1 coding would first imply. Also, rib fracture patterns are of specific interest to the later biomechanical work packages within the EC Projects THORAX and THOMO. Of the 529 front occupants within the GIE RE PR sample, 90 sustained an AIS ≥ 2 thorax injury (17 %) and 42 sustained an AIS ≥ 3 thorax injury (8 %), where the thorax included spleen and liver injuries. Of the 2,451 occupants in the GIDAS sample, only 57 sustained an AIS ≥ 2 thorax injury. This difference in the rate of occupants sustaining AIS ≥ 2 thorax injuries illustrates one aspect of the variation in sampling strategies between the three databases and samples.


Occupants from the CCIS sample were grouped according to the combination of injuries they sustained. A large number of the older occupants received a thorax injury alone (over 25 % for occupants of 46 years and older).

2.0%0.5%

5.9%

2.2% 1.9% 0.8%

5.0%

0%

5%

10%

15%

20%

25%

30%

35%

40%

Head/Face Neck Thorax Upper Extremities

Abdomen Pelvis Lower Extremities

Percen

tage of o

ccup

ants

Body Region

MAIS = 1

MAIS = 2

MAIS 3+

Figure 1 – Body regions injured and MAIS injury level for all occupants from the CCIS frontal impact sample (n = 2,148 occupants)

From the combinations of injury groupings in the CCIS sample, it was evident that drivers had a particular risk of sustaining a thorax or a lower extremity injury. However, front seat passengers were at an even higher risk of sustaining a thorax injury and at a higher risk of sustaining an injury to an upper extremity. In 2006, Welsh et al. showed that lower extremity injuries followed by chest injuries formed the largest proportion of AIS 2+ injuries to front seat occupants. Based on the COVER analysis, when considering all occupants in slightly newer vehicles, then the thorax is the single body region most frequently injured; albeit, these data do include AIS 1 rib fractures. Torso Injuries in Frontal Impacts: There were 561 people in the CCIS sample who were Killed or Seriously Injured (KSI). For these people, 55 % sustained an injury which met the torso trauma criteria used in the study. Crash types: The GIDAS analysis indicated that AIS ≥ 3 torso injuries were more likely to occur in impacts with narrow objects (those objects with a diameter less than 40 cm) than in collisions with other types of object. A trend from the GIE RE PR torso injury data is that frontal impact accidents involving over two thirds of the vehicle front tended to produce proportionally more of the moderate to severe thorax injuries (AIS ≥ 2) than the other overlap categories. Despite differences in the data collection strategies this appears to be consistent with the findings from the UK CCIS sample. The distribution of the front seat occupants in the GIE RE PR sample by the Equivalent Energy Speed (EES) is shown in Table 2. From this table it can be seen that most of the frontal impact accidents in the GIE RE PR sample occurred with an EES between 26 to 65 km.h-1.


Table 2. Front seat occupants according to EES categories (GIE RE PR sample) EES (km.h-1) Number of front occupants Percentage (%)

< 15 4 1 16 to 25 37 7 26 to 35 98 18 36 to 45 121 23 46 to 55 108 20 56 to 65 120 23 66 to 75 31 6

> 75 11 2

Occupant characteristics: The sex distribution in the GIDAS dataset includes 2,451 persons, with 1,449 males, 948 females and 54 persons where their sex was unknown. Of the 948 female occupants, 181 received a torso injury (19 %); and of the 1,449 male occupants, 136 sustained a torso injury (9.4 %). To show certain GIDAS results graphically, contingency tables were used. Positive bars indicate an increased likelihood of a person being in that group, whilst negative bars show a reduced risk. The width of the bars relates to the number of occupants in that group. A scale shows the Pearson residual values used to define statistical significance and the colour coding to show those results. For instance, light grey bars are not statistically significant and coloured bars are significant, with either a positive (blue/up) or negative (red/down) correlation. Looking at Figure 2, where the distribution of torso injuries of male and female occupants is shown (including those occupants with no torso injury), it becomes clear that relatively more females had AIS 1 torso injuries and that males were overly represented in the group of uninjured. Both of these effects are significant. From the GIE RE PR sample it was shown that the risk of receiving a torso injury was greater for older than for younger occupants. The older occupants (over 52 years of age) were 3.7 times more likely to receive an AIS ≥ 2 torso injury, and 2.8 times more likely to receive an AIS ≥ 3 torso injury than the younger occupants (12 to 52 years). The GIDAS sample was able to show that occupants who were 150 to 180 cm tall were statistically more likely to have an AIS 1 torso injury than taller (180 to 220 cm) occupants. The analysis also showed that occupants weighing 40 to 60 kg were statistically more likely to have an AIS 1 torso injury. However, neither of these trends were significant at the AIS 2 or ≥ 3 injury severity levels. Additionally, the GIDAS sample showed that front seat passengers were statistically more likely to receive an AIS 1 torso injury than occupants in other seating positions. This finding was supported by the CCIS sample analysis. Restraint system: The majority of front seat occupants in the sample of cars and car-derivatives, from 2000 onwards, had combined seat-belt and airbag restraint. Within the CCIS sample selected for this work, 1899 occupants had a front airbag fitted, which accounted for 97 percent of the drivers and 78 percent of front seat passengers. When considering seat-belt pre-tensioners, it was found that 1758 occupants (82 %) of the CCIS sample had a pre-tensioning device fitted at their seating position. However, based on the distribution of torso injuries amongst these occupants, it seems as though the presence of a pre-tensioner did not have a large influence on the risk of sustaining a torso injury. Most occupants (57 %) who received an AIS ≥ 3 torso injury were in a restraint system consisting of seat-belt, airbag, pretensioner(s), and a load limiting device.


Figure 2 – Contingency table with AIS torso injury and sex (GIDAS sample) Specific injury analysis: Of the torso injuries from the GIE RE PR sample, soft tissue injuries predominated, although it should be remembered that these injuries include those at the AIS 1 severity level. Of the 440 torso injuries observed in the GIE RE PR sample (at the AIS ≥ 1 level), 14 % were injuries to internal tissues and organs (mainly pleura and lungs). In the CCIS data sample, ribs were the most frequently injured part of the torso at the AIS ≥ 2 (or AIS-1 rib fracture) severity level (n = 126), followed by sternum injuries (107). Of the sample with an injury to the torso, 35 % suffered an injury to one or both of these thorax regions. This equates to around 20 % of the killed or seriously injured population, for each injury type. Lung (102) and shoulder injuries (75) were also frequent, in this sample (even though lung injuries are AIS ≥ 3). Fractures of the sternum or ribs were also the most frequently occurring AIS ≥ 2 torso injuries in the GIDAS sample as well. Based on the distribution of torso injuries from the CCIS sample at the AIS ≥ 3 severity level, 18 % of all occupants who were killed or seriously injured received an AIS ≥ 3 injury to a lung. Of these occupants with a serious lung injury, about a quarter had a contusion only, whereas about a half had a penetrating lung injury only (here a penetrating injury is used to describe an injury where the pleura/lung has been penetrated – e.g. lung laceration, or a haemo- or pneumothorax). The remainder had a combination of the two injury types or an unspecified injury. The distribution of the AIS ≥ 2 torso injuries, according to type, from the GIDAS sample is shown in Table 3. This shows that at the AIS ≥ 2 level fractures were the most frequently occurring type of injury (33 {58 %}) followed by soft tissue injuries (16 {28 %}), injuries to an organ (6 {10 %}), vascular injuries (1 {2 %}), and other injuries (1 {2 %}). To investigate the fractures within the GIE RE PR sample of torso injuries, they were divided by body part. The ribs were the most frequently fractured part of the skeleton (accounting for 47 % of fractures to the torso region), followed by the sternum (38 %). This agrees with the findings at the AIS 2 severity level (including AIS 1 rib fractures) shown with the CCIS sample and also within the GIDAS sample for AIS ≥ 2 injuries. Fractures to the ribs and then the sternum therefore represent a priority injury type when considering AIS ≥ 2 torso injuries. As rib and sternum fractures were identified as a priority torso injury, the location of these fractures was investigated more closely using the CCIS database. It was interesting to note that for drivers there were more fractures to the lower ribs on the right than on the left. As the seat-belt in UK vehicles passes over the right shoulder and over the lower left thorax, one might have expected to see more rib fractures to the lower left thorax for drivers. Such an effect was not observed.


From the CCIS, GIDAS and GIE RE PR samples, injuries to the lungs were the most frequently occurring visceral injuries to the torso. In both the CCIS and GIDAS sample, the heart was the next most frequently injured torso organ. The GIE RE PR sample suggests that the liver and spleen are key torso viscera, with no injuries to the heart (only two injuries to the pericardium). The reason for the differences between the datasets with regard to heart injuries is not certain. Clearly, the priority for investigation and prevention are injuries to the lungs, followed by injuries to the heart, liver, and spleen. Exactly which of these becomes the second highest priority may be subject to considerations of the frequency of occurrence (and any regional variations) as well as the potential threat to life.

Table 3. Torso AIS ≥ 2 Injuries Separated by Injury Type (GIDAS sample) Type of Injury Location Number Total Percentage

(%) Fracture 33 57.9 Sternum 14 Ribs 8 Collarbone 4 Vertebra(e) 4 Shoulder blade 1 Acromioclavicular joint 1 Cubital artery 1 Bruises 16 28.1 Thoracic soft tissue 9 Chest muscles (mammae) 2 Shoulder 2 Bony thorax 1 Sternum 1 Lumbar spine, no further details 1 Contusion 4 7.0 Lungs, no further details 4 Perforation, tear 2 3.5 Aorta descending 1 Mesentery 1 Severance of ligament

1 1.8

Pulmonary pleura 1 Organ injury, not specified

1 1.8

Pulmonary pleura 1 Total 57 100 From the distribution of AIS ≥ 2 torso injury combinations among the age groups, within the CCIS sample, it was noted that younger occupants tended to receive either an abdomen injury alone or a lung injury alone. The young occupants tended to receive skeletal injuries less frequently than the older occupant groups. The CCIS percentage distribution of AIS ≥ 3 torso injury combinations for each age group is shown in Figure 3. It should be noted that this figure considers only AIS ≥ 3 injuries, therefore AIS 1 or 2 injuries could have occurred in combination with an AIS 3 injury and yet not be shown in Figure 3. It is again clear that skeletal injuries (rib fractures and associated other injuries) are more prevalent in older occupants. No younger occupants received an AIS ≥ 3 rib injury in isolation. This matches the findings of Schneider et al. (2004). They reported no skeletal-only torso injuries to occupants of 35 years and younger in their analysis of CIREN (Crash Injury Research and Engineering Network) accident data, when considering 54 occupants with an AIS ≥ 3 thorax injury. Wang and Rupp (2006) have also reported that rib fractures become the injury with greatest predicted risk at


around 55 years of age, which is supported by the data shown in Figure 3 and a later CIREN publication (CIREN, 2008).

Figure 3 – Percentage distribution of torso injury combinations (AIS ≥ 3) occurring in the three different age groups

Review of Load-limiter efficacy: The GIE RE PR database contains information about the force-limit used in different load limiting devices. This allowed GIE RE PR to carry out a global comparison between crash investigation outcomes from COVER and Euro NCAP tests in terms of shoulder belt force limitation efficiency. Since crash test data were available only for front seat occupants and shoulder belt force limiters are uncommon in the rear seats, only front seat occupants were considered in this study. The risks of AIS ≥ 2 and AIS ≥ 3 thoracic injuries as a function of the shoulder belt load limit for cars designed since 1990 and for all EESs (i.e. the number of cases with AIS ≥ 2 or AIS ≥ 3 divided by the total number of cases) are shown in Figure 4. The efficiencies of the 6 kN and 4 kN or 5 kN load limitations were calculated for EES > 45 km.h-1 (with regard to a baseline of 100 passengers without a load limiter). They were found to be 21% and 49% respectively for 6 kN and 4 kN or 5 kN. A sub-sample of the original data (cars designed since 1990) was extracted where the following information was available: position (driver or front passenger), sex, load limiter (none, 6 kN, 4 or 5 kN), EES, car manufacturer (French or not), mass of the car, overlap. The new sample consisted of 931 cases without limiter, 238 cases with a 6 kN limiter and 786 cases with a 4 or 5 kN limiter. A first logistic regression was performed with all the parameters. The effects of 6 kN load limitation (compared with no limitation), the sex (male compared with female) and the country of vehicle manufacturer (French compared with others) were not significant at the 5% level. The ratios between the standard error and the estimate of the variables did not indicate any risk of multi-co-linearity and validated the use of logistic regression. Another logistic regression was performed with the remaining parameters (4 or 5 kN load limitation, EES, age, position, car mass and overlap). The results are provided in Table 4. It can be observed that the use of 4 or 5 kN limiters and the increase of car mass decreased the risk of thoracic injuries. On the contrary, sitting in the passenger position and the increase of EES, age and overlap increased the risk.


Figure 4 - Evolution of the average thoracic injury risk for seat-belted front occupants

in frontal impacts at all EES

Table 4. Logistic regression AIS ≥ 3 versus load limitation, EES, and age Estimate Std. Error z value Pr(>|z|) (Intercept) -8.7272 0.7657 -11.398 2.00E-16 < 0.001 LIMIT (4 or 5 kN)

-0.8789 0.2176 -4.039 5.37E-05 < 0.001

EES 0.1031 0.0098 10.508 2.00E-16 < 0.001 AGE 0.0500 0.0056 8.879 2.00E-16 < 0.001 Position (Passenger)

0.4400 0.1924 2.287 0.0222 < 0.05

Car mass -0.0013 0.0005 -2.689 0.0072 < 0.01 Overlap 0.0086 0.0035 2.491 0.0128 < 0.05

Euro NCAP tests are crash tests performed at 64 km.h-1 against a deformable barrier with 40 % of overlap, which leads to an EES of 58 km.h-1 (Lenard et al., 1998). To allow for a comparison with this kind of test, the risks of AIS ≥ 3 thorax injuries were calculated from the logistic regression for a 45 year old, at 58 km.h-1, 40% of overlap and with a car mass of 1323 kg (mean of the cars of the Euro-NCAP sample) for different levels of load limit and for drivers or passengers. The estimated thorax injury risks are presented in Figure 5. The statistical significance of the load limiter and seating position are shown by the logistic regression outputs, in Table 4. The mean chest deflections obtained from Euro NCAP tests for each category of load limiter are presented in Figure 6 (including p-values from Mann-Whitney tests). They are provided for drivers, passengers and both of them. It must be observed that for the passengers, the chest deflection increased when the load limit increased, while for the drivers the chest deflection was almost constant for any levels of load limiter and only higher without a load limiter. The second observation was that the passenger chest deflections were always lower than the driver deflections (between 3 and 7 mm less). The effects of other available parameters (the mass of the car and the car manufacturer) were checked and were found not to be significant. As mentioned above, the risks calculated from Euro NCAP crash tests were compared with the same risks found from crash investigations for a 45 year old occupant, at 58 km.h-1, for 40 % of overlap and with a car mass of 1323 kg. Since the effect of 6 kN limiter was not found to be significant in the accident analysis, the comparison with Euro-NCAP was based on a 4 or 5 kN load limiter compared with no load limiter.


While accident investigations and Euro NCAP tests were coherent for the drivers, they differed markedly for the passengers. Indeed, the passengers had a higher risk of torso injury than the drivers in accidents but demonstrated less deflection in the Euro NCAP tests. This indicates that the risk of thoracic injuries is underestimated for the passengers in Euro NCAP tests. The underestimation in injury risk could be attributed to the differences in sex and age between the drivers and the passengers. Where, a lower chest compression to the passenger (if they were female and older) could have represented a higher risk of injury than for the driver (if they were male and younger). However, this hypothesis cannot be retained because the logistic regression demonstrated that the effect of sex was not significant and occupant age was considered in the calculation of the injury risk.

Figure 5 – AIS ≥ 3 thoracic injury risks from

accident investigations

Figure 6 – Mean deflections from Euro

NCAP tests for different load limitations CASE-BY-CASE ANALYSIS: The following section brings together findings from both the UK and German case reviews. Factors related to the occupant, dummy, and crash were investigated in particular. Tables are provided in the Appendix to summarise some of the vehicle and occupant information relating to the cases which were investigated. Due to the small number of cases available, which met the study specification, it was difficult to make conclusive statements based on the Case-by-case analysis. Instead many of the findings were only used to support observations from the review of in-depth accident data. Where this is the case, inferences have been included in the Discussion section rather than being reported here. The CCIS cases showed a wide range of occupant ages and sizes (at the extremes of the ranges there were two seventeen year old female occupants and one 84 year old woman). In the GIDAS cases the age distribution was similar with a spread of occupant ages from 19 years old to 82 years old. In the investigation quite a wide range of (well-documented) thorax injuries with different severities was found; for instance, a thorax bruise or contusion, sternum fracture, rib fracture, multiple rib fractures, and lung injuries. In the analysed GIDAS cases occupant factors seemed to dominate over crash factors. Sometimes even in the same crash the front seat passenger sustained higher severity injuries than the driver, which was in some cases contrary to the injury risk predicted by Euro NCAP. The cases in which the occupants sustained thorax injuries were not exact matches with the Euro NCAP collision conditions. In general the impact velocity was lower, sometimes much lower, than the test speed. The overlap in the cases reviewed was also more varied than in the crash test, although - like the crash tests - the off-side longitudinal and engine were usually loaded in the accident cases. The deformation pattern of the front structure and compartment resulting from the accident were similar to the deformation pattern of vehicles tested in Euro NCAP. In a few cases it could be observed, even though the compartment was stable, the occupants sustained severe injuries, in particular with elderly and female occupants. Compatibility issues could be observed in cases with old against new vehicles.


In several cases injuries of the spinal column were recorded, in particular the lower cervical or upper lumbar spine. Further investigation is needed to identify the mechanism responsible for these injuries. In most cases, the torso injuries were attributed to loading from the seat-belt. DISCUSSION Depending on the injury severity being investigated, it is possible to set different priorities for future biomechanical investigation and ultimately prevention or mitigation. At the AIS ≥ 2 severity level, then thoracic fractures occur most frequently. These occur to the ribs and sternum, and are observed often, particularly when AIS 1 rib fractures are counted. Lung injuries also occur frequently in frontal impact accidents (even though they are AIS ≥ 3) and are the most frequently observed injuries to an organ. The analysis of the rib fracture locations produced an interesting result in that the fractures were often distributed over several ribs close to one another. Also there was only limited influence of the lie of the shoulder belt. The mechanism by which these injuries occur is not clear from the retrospective accident information alone and requires further investigation. The results from the GIE RE PR sample, where load limiter force levels are known, suggest that load limiters (particularly with a limit of 5 kN or less) are extremely effective in reducing the severity of torso injuries in frontal impacts. However, the CCIS sample also indicated that female occupants and younger car occupants (considering all seating positions) are less likely to have a seat-belt equipped with load limiting technology, whereas in the GIE RE PR sample cars fitted with load limiters were likely to be involved in crashes with a higher EES. These differences in the groups of accidents and occupants, when considering load limiter effectiveness, may have a bearing on the efficacy results. Further analysis of the GIE RE PR data showed that 4 to 5 kN load limiters tended to reduce the risk of injury for most AIS ≥ 3 fractures and internal injuries for both older (over 52 years old) and younger occupants (12 to 52 years). The exception to this trend was the mediastinum AIS ≥ 3 injury risk for people over 52 years. The cut-off at 52 years reflects an effort to maximise the potential to observe age-related effects based on the sample size and the expectation for a change in thorax-related injury risk at around 50 years of age. The GIE RE PR authors offered the advice that the restraint systems in cars are designed to comply with Euro NCAP tests. As a consequence, the contribution of the airbag is limited in order to avoid any increase in the measured chest deflection. While biomechanical studies demonstrate a higher potential for restraint via the airbag, the over-sensitivity of the Hybrid III deflection to airbag loading discourages the use of this full potential. While this issue cannot be demonstrated by this accident analysis study, it is suspected that a different and more biofidelic sensitivity of the dummy to the belt and the airbags would lead to a different balance between the two devices (Petitjean et al., 2003). This should also emphasise a difference between accident investigations and crash tests. The general principle used within the case-by-case study was to use crash performance as determined through a crash test result to predict real world crash behaviour. This prediction was then compared with the outcome from a real world accident. Whilst cases were selected where the accident was close to the conditions of the test, they are never exactly the same. For instance, the impact severity might be somewhat lower, or the level of overlap somewhat different. As the accident cases never exactly matched the test configuration, there was, in each case, an element of extrapolation from the crash test to the real world accident prediction. This extrapolation is subject to a number of assumptions. For instance, it is assumed generally that at lower impact speeds less energy is transferred to the case vehicle and therefore the occupant should be subjected to lower acceleration levels and hence have a lower injury risk. However, there may be instances where the restraint system gives a sub-optimal performance at lower speeds. Under these circumstances the counter-intuitive result could be a greater injury risk at a lower impact severity. This effect was demonstrated by Smith and Couper (2006). They found that the risk of sustaining a serious thorax injury, as estimated through the Hybrid III dummy’s chest deflection, could be higher in tests at either 40 or 56 km.h-1 than in a test at 64 km.h-1.


It was noted within the in-depth accident analysis that at the AIS ≥ 3 level, young occupants tended to receive lung injuries with no or relatively minor (AIS 1 or 2) skeletal injuries. Within the case-by-case study there were examples that supported this trend. Another pattern of the torso injuries from the in-depth accident analysis was that occupants tended to sustain rib fractures or clavicle fractures, but rarely both. In the CCIS cases reviewed for this study this was again the general trend. However, for four occupants from 72 years to 84 years of age, rib fractures and a clavicle fracture occurred together (sometimes with other thorax injuries). It is known that two of these occupants subsequently died from their injuries. This indicates how rib and clavicle fractures can occur together, but it tends to happen for only the most frail of occupants. When such a combination of injuries does occur it seems to mark a poor prognosis for that occupant. Age seemed to be an important factor in the incidence of torso injuries. During the case-by-case analysis, it was interesting to note that young occupants tended to receive only slight injuries in some quite severe accidents, including some of the accidents with unexpectedly high intrusion. Older persons sometimes sustained severe injuries in accidents without compartment intrusion and at a relatively low crash severity. This illustrates the effect of age on the ability of the human body to tolerate loads applied through modern restraint systems in frontal crashes and is supported by results from Forman et al. (2006). This also suggests that protection in offset frontal crashes is generally good, but that there is scope for further improvement, particularly for elderly occupants even in impacts with a markedly lower impact speed than the Euro NCAP test. The GIDAS sample suggested that more females than males received torso injuries (of any severity). Whilst this was also suggested by the CCIS sample of AIS 1 torso injuries, such a trend was not seen with the AIS ≥ 2 injuries. This finding was again supported by the case-by-case analysis. Differences in the seating positions commonly occupied by males and females may go some way to explaining these results; optimisation of the restraint system may also contribute. It is suggested that future efforts should be targeted at dissociating these effects to try and isolate differences due to occupant sex alone. The groups of occupants currently at greatest risk of receiving a thorax injury in accident configurations similar to the Euro NCAP frontal impact test are elderly people and women. Neither of these groups is represented specifically by the dummy used in European regulatory frontal impact crash tests or the Euro NCAP frontal impact test. From the GIDAS analysis, it was suggested that having a larger distance between the occupant and the steering wheel, or fascia panel, seemed to be beneficial. Therefore, to test under sub optimal conditions, consideration should be given to testing with a closer seating position for the driver and front seat passenger. The Hybrid III dummy measures thoracic deflection at one point in one dimension. It is this chest compression, or the viscous criterion (V*C) based on the compression measurement, which is used in Euro NCAP tests to predict the probability of an AIS 3 (or 4) thorax injury occurring in an equivalent real world accident. It may be that the criteria based on this single point chest compression measurement are not able to assess the appropriate injury mechanisms for the full diversity of thorax injuries observed in these accident analyses. This is important because the different injury types could have vastly different implications regarding the prognosis for an occupant. Inability of the Hybrid III dummy to evaluate the probability of thoracic injury effectively with a single point chest deflection measurement system has been reported previously by, for example, Vezin et al. (2002). Additionally, no abdomen injuries can be predicted with the Hybrid III, as used in Euro NCAP testing. Sometimes abdominal injuries do occur in accidents with a high severity. This was indicated by the case-by-case review. This, therefore, represents a limitation of the Hybrid III.


CONCLUSIONS This study offers a contemporary analysis of accidents involving cars registered in 2000 or later. Based on UK CCIS data it can be observed that head and pelvis injuries have reduced in relative importance, compared with injuries to other body regions at the MAIS = 2 and MAIS ≥ 3 levels. The thorax is now the most frequently injured body region for all killed and seriously injured occupants in frontal impact accidents. In the CCIS sample a large number of the older occupants received a thorax injury alone. Younger occupants tended to receive a higher percentage of lower extremity and abdomen injuries. There is a greater propensity for older occupants to receive thoracic injuries than younger ones. The increased risk of older occupants sustaining a thorax injury was observed in all three samples. There also tends to be a greater torso injury risk for occupants seated in the front passenger seat than in the driver’s seat. Female occupants may be at an increased risk of sustaining a torso injury though such an effect was difficult to isolate at the AIS ≥ 2 injury severity level. Regardless of the database analysed, fractures to the ribs and then the sternum were the most frequently occurring types of fractures. They therefore represent a priority injury type when considering AIS ≥ 2 torso injuries. It is evident that injuries to the lungs were the most frequently occurring visceral injuries to the torso. In both the CCIS and GIDAS sample, the heart was the next most frequently injured torso organ. From the CCIS analysis it was noted that younger occupants would sustain AIS ≥ 3 lung injuries without an AIS ≥ 3 series of rib fractures. Of the occupants with an AIS ≥ 3 lung injury in the CCIS sample, a quarter had a contusion injury only (i.e. a non-penetrating injury). This may have implications regarding the mechanism of injury and the ability of an advanced dummy thorax to detect the loading which is responsible for the injury. There is little difference in the injury priorities from AIS ≥ 2 to AIS ≥ 3. Rib fractures and lung injuries still occur most frequently at both severity levels. The comparison of results from the GIE RE PR crash data and Euro NCAP tests demonstrated a good estimation of the benefits of the 4-5 kN shoulder belt load limitation compared with no limitation for the drivers. In almost all of the cases studied in depth, in which a front passenger was present, the front passenger suffered the more severe injuries, despite being on the non-struck side of the vehicle and therefore likely to be subjected to a less severe acceleration pulse. Thus, the restraint and protection system for the front passenger has potential for improvements. An updated dummy with enhanced risk curves could help to develop better protection for the front passenger. THE MAIN LIMITATION OF THIS STUDY is the difficulty in bringing together results from the different in-depth accident databases used in Europe. This means that depending on the result, there is the potential for bias caused by the specific sampling strategy used in that particular dataset. A standard European data collection protocol may help this for future studies. RECOMMENDATIONS FOR DUMMY DESIGN • When assessing load limiter effectiveness through physical testing, it will be important that the

dummy thorax is sensitive to changes in the load limit incorporated in the restraint system. o The utility of the Hybrid III dummy and the THOR (Test device for Human Occupant

Restraint) dummy chest deflection measurements for discriminating between standard and force-limiting belt systems was discussed by Kent et al. (2003).

o For future restraints it may be important to discriminate between different levels of load limit, which is likely to be an even more stringent requirement for a dummy thorax.

• As rib fracture was more common for older occupants than for younger occupants (and may be different for male and female occupants), injury risk functions used with crash test dummies should reflect this.

o Where a new test tool is introduced, care should be taken to set rib fracture based injury assessment thresholds at levels that will protect appropriate segments of the population. It should be noted that feasibility may make it unrealistic to try and prevent skeletal injuries in the most frail of vehicle occupants (or very severe accidents, etc.).


o In addition, the biofidelity targets used for the thorax should be set to represent the appropriate part of the population being protected.

o Biofidelity targets and injury risk thresholds should be set so as to refer to the same part of the population.

• Serious lung (and abdominal organ) injuries can be sustained by vehicle occupants in frontal impacts without rib fracture. This was particularly prevalent among the younger age groups defined in this study. The exact mechanism by which these injuries are caused is not certain. This is important as any test dummy designed to detect visceral injury risk needs to have the instrumentation required to accurately estimate that risk. Without knowing the mechanism that is responsible for such visceral injuries, it is difficult to determine the necessary instrumentation requirements. Therefore future biomechanical tests should be carried out to try and identify the predominant lung injury mechanism and develop an appropriate injury risk function.

• Ideally, an improved dummy thorax should predict injuries such as rib fractures (including those to the costal cartilage), sternum fractures, lung contusions and clavicle fractures.

o Also, spinal column injury mechanisms need to be analysed further. • The comparisons between crash investigations and Euro NCAP tests demonstrate that the central

deflection measured on the Hybrid III dummy is not able to predict the real world injury risk accurately. Improvements of the dummy (in particular a better relative sensitivity to the airbag and the shoulder belt) and/or injury criteria are therefore needed to express the full potential of protection systems.

• Injury risk curves for female occupants and elderly persons should be developed. o Consideration should be given to whether the dummy design (as well as injury risk functions)

needs to be specific to an elderly occupant. o A female dummy should be used on the front passenger seat or at least specific female injury

risk curves should be used for front seat passenger injury risk evaluation. • Further investigations are needed to identify:

o If the protection level afforded by the front passenger restraint system is equivalent or lower than the driver restraint system.

o Why female occupants are more severely injured than male occupants. ACKNOWLEDGEMENTS The authors would like to thank the European Commission, UK Department for Transport, and German Federal Ministry of Transport, Building and Urban Development for commissioning and funding this research. Thanks are also extended to the providers of the accident case data: the CCIS, the GIDAS, and GIE RE PR. This paper uses accident data from the United Kingdom Co-operative Crash Injury Study (CCIS) collected during the period 1998-2009. CCIS was managed by TRL Limited, on behalf of the United Kingdom Department for Transport (DfT) (Transport Technology and Standards Division) who funded the project along with Autoliv, Ford Motor Company, Nissan Motor Company and Toyota Motor Europe, Daimler Chrysler, LAB, Rover Group Ltd., Visteon, Volvo Car Corporation, Daewoo Motor Company Ltd. and Honda R&D Europe (UK) Ltd. Data were collected by teams from the Birmingham Automotive Safety Centre of the University of Birmingham; the Vehicle Safety Research Centre at Loughborough University; TRL Limited and the Vehicle & Operator Services Agency of the DfT. Further information on CCIS can be found at http://www.ukccis.org. At TRL, Richard Cuerden, David Richards, and Rebecca Cookson, all provided valuable support in the preparation of the data and CCIS analysis within the COVER and THORAX project work.


REFERENCES

Association for the Advancement of Automotive Medicine (AAAM). The Abbreviated Injury Scale, 1990 Revision. Des Plaines, Illinois, U.S.A.: AAAM. 1990.

Augenstein J S, Perdeck E, Stratton J, Phillips J, Labiste L, MacKinnon J, Digges K, Bahouth G, Mostafa K, Wang S, Schneider L. Sochor M and Weber P. Crash, vehicle and restraint factors and their influence on thoracic injury patterns. CIREN presentation. Available from the NHTSA internet site: http://www.nhtsa.dot.gov/portal/site/nhtsa/menuitem.1c5bf5af32c6dfd24ec86e10dba046a0/. 2004.

Beusenberg M, Wismans J, Faerber E, Lowne R, Cesari D, Bermond F, Nilsson C, Koch M, Ardoino P-L and Fossat E. EEVC recommended requirements for the development and design of an advanced frontal impact dummy. EEVC Working Group 12 Report. European Experimental Vehicles Committee (Available from the European Enhanced Vehicle-safety Committee (EEVC) internet site: http://www.eevc.org/wgpages/wg12/wg12index.htm). 1996.

CIREN, (Crash Injury Research and Engineering Network). Age related thresholds and thoracic injury. CIREN public meeting, 25 March 2008. Toyota – Wake Forest University, School of Medicine: North Carolina, U.S.A. Available from the NHTSA internet site: http://www.nhtsa.dot.gov/portal/site/nhtsa/menuitem.1c5bf5af32c6dfd24ec86e10dba046a0/. 2008

Edwards M J, Massie P, Thompson A, Richards D C, Goodache O and Cuerden R. Further work to support car to car compatibility – accident analysis (PPR 319). Published Project Report. Wokingham, Berkshire: Transport Research Laboratory (TRL). 2008.

Euro NCAP (European New Car Assessment Programme). Frontal impact testing protocol. Version 4.3, February 2009. Available from the Euro NCAP internet site: http://www.euroncap.com/files/Euro-NCAP-Frontal-Protocol-Version-4.3---b8b12883-bd24-4b6e-b663-7898cda98e56.pdf. 2009.

Forman J, Lessley D, Shaw C G, Evans J, Kent R, Rouhana S W, and Prasad P. Thoracic response of belted PMHS , the Hybrid III, and the THOR-NT mid-sized male surrogates in low speed, frontal crashes. Stapp car crash journal, 50 (2006) 191-215, Proceedings of the 50th Stapp car crash conference, 6-8 November 2006, Dearborn, Michigan, U.S.A.: The Stapp Association. 2006.

Frampton R, Morris R, Cross G and Page M. Accident analysis methodology and development of injury scenarios. PRISM (Proposed Reduction of car crash Injuries through improved SMart restraint development technologies) project report. Available from the PRISM Project internet site: http://www.prismproject.com/R3_5_New_Images_Final.doc.pdf. 2005.

Hautzinger H, Pfeifer M, Schmidt J. Data expansion of accident data from in-depth accident surveys. BASt-Report F 59. 2006.

Kent R, Lessley D, Shaw G, and Crandall J. The utility of Hybrid III and THOR chest deflection for discriminating between standard and force-limiting belt systems. Stapp car crash journal, 47 (2003) 267-297: Papers presented at the 47th Stapp car crash conference, 27-29 October 2003, San Diego, California, Technical paper 2003-22-0013: The Stapp Association. 2003.

Knack S, Schaefer R, Pastor C, Hynd D and Owen C. Final Report of Work Package 1: Frontal Accident Analysis Study. EC project report. FID EC Project GRD1-1999-10559: BASt and TRL Limited. 2003.

Lenard J, Hurley B, and Thomas P. The accuracy of CRASH3 for calculating collision severity in modern European cars. Proceedings of the 16th international technical conference on the Enhanced Safety of Vehicles (ESV), 31 May to 4 June 1998, Windsor, Ontario, Canada. Washington, D.C., U.S.A.: US Department of Transportation, National Highway Traffic Safety Administration (NHTSA; available from the NHTSA internet site: http://www-nrd.nhtsa.dot.gov/departments/esv/16th/). 1998.


McCarthy M G, Chinn B P and Hill J. The effect of occupant characteristics on injury risk and the development of active-adaptive restraint systems. Proceedings of the 17th international technical conference on the Enhanced Safety of Vehicles (ESV), 4-7 June 2001, Amsterdam, the Netherlands. Washington, D.C., U.S.A: U.S. Department of Transportation, National Highway Traffic Safety Administration (NHTSA; Available from the NHTSA internet site: http://www-nrd.nhtsa.dot.gov/pdf/nrd-01/Esv/esv17/Proceed/search.pdf). 2001.

Otte D, Krettek C, Brunner H, and Zwipp H. Scientific Approach and Methodology of a New In-Depth-Investigation Study in Germany so called GIDAS. Proceedings of the 18th international technical conference on the Enhanced Safety of Vehicles (ESV), 19-22 May 2003, Nagoya, Japan. Washington, D.C., U.S.A: U.S. Department of Transportation, National Highway Traffic Safety Administration (NHTSA; Available from the NHTSA internet site: http://www-nrd.nhtsa.dot.gov/departments/esv/18th/). 2003

Petitjean, A., Baudrit, P., and Trosseille, X. Thoracic injury criterion for frontal crash applicable to all restraint systems, Stapp Car Crash Journal 47. 2003.

Schneider L, Sochor M, Weber P, Ritchie N and Wang S. Patterns of skeletal and internal thoracic injuries from CIREN crash investigations of frontal and near-side impacts. Presentation for the CIREN Session, SAE Government / Industry meeting, 11 May 2004. Available from the NHTSA internet site: http://www.nhtsa.dot.gov/portal/site/nhtsa/menuitem.1c5bf5af32c6dfd24ec86e10dba046a0. 2004.

Siegel J H, Smith J A and Siddiqi S Q. Change in velocity and energy dissipation on impact in motor vehicles crashes as a function of the direction of crash: key factors in the production of thoracic aorta injuries, their pattern of associated injuries and patient survival a Crash Injury Research Engineering Network (CIREN) study (57 (4), pp. 760-778). The journal of trauma injury, infection and care. Lippincott Williams & Wilkins, Inc. 2004.

Smith T L and Couper G. Assessment of advanced restraint systems: Final report (PPR 102), Published Project Report. Wokingham, Berkshire: Transport Research Laboratory (TRL). 2006.

Vezin P, Bruyere-Garnier K, Bermond F, and Verriest J-P. Comparison of Hybrid III, THOR-α and PMHS response in frontal sled tests. Stapp car crash journal, 46 (2002) 1-26. Technical paper 2002-22-0001: The Stapp Association. 2002.

Wang S and Rupp J D. Alterations in body composition and injury patterns with aging. CIREN presentation. Available from the NHTSA internet site: http://www.nhtsa.dot.gov/portal/site/nhtsa/menuitem.1c5bf5af32c6dfd24ec86e10dba046a0/. 2006.

Welsh R, Morris A, Frampton R and Thomas P. A review of secondary safety priorities. Loughborough: Vehicle Safety Research Centre. 2006.


APPENDIX: Vehicle and occupant data for case-by-case review

MA

IS to

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0

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MA

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1 5 2 4

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now

n

5 (f

atal

)

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now

n

2 2 0 1 2 2 3 2 1 4 2 1 1 3 2 1 2 0

3 (f

atal

)

2 2 3

(fat

al 3

5 da

ys)

2 3 3 1 3

Wei

ght (

kg)

78

Unk

now

n

82

89

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now

n

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now

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now

n

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now

n

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now

n

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now

n

103

54

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now

n

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now

n

73

64

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now

n

86

82

98

64

84

57

105

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now

n

98

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57

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now

n

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Hei

ght (

m)

1.78

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1.77

1.85

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1.57

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1.45

1.75

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1.8

1.73

1.75

1.73

1.8

1.7

1.8

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1.83

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1.73

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now

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n

Age

78

72

32

48

53

17

25

26

67

69

33

17

75

73

55

27

75

39

43

46

21

25

24

70

45

69

73

72

81

84

30

57

62

60

Sex

M

F M

M

F F M

F M

M

F F M

F F M

F M

M

M

M

M

F F M

M

M

F M

F M

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M

F

Seat

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river

FSP

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FSP

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FSP

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FSP

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(L)

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FSP

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FSP

Driv

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Euro

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e Fr

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13 3 6 7 12 10 13 13 11 3 10 11

6 4 2 11 11 10

6 6

Com

partm

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Ove

rlap

(%)

77 63

47

74 37 41 45 50 47 30

44 30

40 53

50 60 52 60

26

52

Del

ta-v

(kph

) 27

33

34

37 31 28 37 18 23 27

34 41

30 30

31 33 30 42

38

36

EES

(kph

) - 33

29

- 39 32 - 19 23 25

33 47

- 36

- 42 26 45

34

33

TRL

Cas

e 1 2 3 4 5 6 7 8 9 10

11 12

13 14

15 16 17 18

19

20


MA

IS to

rso

1 1 - 2 - 0 4 0 4 2 3 1 2 2 2 4 0 4 3 4

MA

IS

1 2 - 2 - 1 4 1 4 2 3 2 2 2 2 4 1 4 3 4

Wei

ght (

kg)

90

117

70

66

64

82

60

70

Unk

now

n

Unk

now

n

50

82

80

58

107

67

68

53

73

86

Hei

ght (

m)

1,75

1,80

1,69

1,68

1,71

1,79

1,73

1,75

Unk

now

n

Unk

now

n

1,61

1,70

1,56

1,75

1,84

1,50

1,65

1,72

1,72

1,74

Age

34

19

72

74

30

29

20

60

26

28

22

76

70

60

72

71

41

52

69

82

Sex

Fem

ale

Mal

e

Mal

e

Fem

ale

Mal

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Mal

e

Fem

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Mal

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Fem

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Mal

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Mal

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Mal

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Mal

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Seat

Driv

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Pass

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Pass

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Euro

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12

11

10 10 11

12

6 12 12 11

10 9 13

9

Com

partm

ent i

ntru

sion

Slig

htly

Yes

No

Yes

Yes

No

Yes

Slig

htly

Slig

htly

No

Slig

htly

No

Slig

htly

Slig

htly

Ove

rlap

(%)

47

50

50 60 50

50

50

75 20 80

40 25

100

90

Del

ta-v

(kph

)

68

87

36 47 40

39

36

48 50 55

Unk

now

n

43

75

56

EES

(kph

)

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OVERVIEW OF SERIOUS THORAX INJURIES IN EUROPEAN … · OVERVIEW OF SERIOUS THORAX INJURIES IN EUROPEAN FRONTAL CAR CRASH ACCIDENTS AND IMPLICATIONS FOR CRASH TEST DUMMY DEVELOPMENT