An estimate of the effectiveness of an in-vehicle automatic collision notification system in reducing road crash fatalities in South Australia.

OBJECTIVES: The aim of this study was to estimate the potential effectiveness of an in-vehicle automatic collision notification (ACN) system in reducing all road crash fatalities in South Australia (SA). METHODS: For the years 2008 to 2009, traffic accident reporting system (TARS) data, emergency medical services (EMS) road crash dispatch data, and coroner's reports were matched and examined. This was done to initially determine the extent to which there were differences between the reported time of a fatal road crash in the mass crash data and the time EMS were notified and dispatched. In the subset of fatal crashes where there was a delay, injuries detailed by a forensic pathologist in individual coroner's reports were examined to determine the likelihood of survival had there not been a delay in emergency medical assistance. RESULTS: In 25% (N = 53) of fatalities in SA in the period 2008 to 2009, there was a delay in the notification of the crash event, and hence dispatch of EMS, that exceeded 10 min. In the 2-year crash period, 5 people were likely to have survived through more prompt crash notification enabling quicker emergency medical assistance. Additionally, 3 people potentially would have survived if surgical intervention (or emergency medical assistance to sustain life until surgery) occurred more promptly. CONCLUSIONS: The minimum effectiveness rate of an ACN system in SA with full deployment is likely to be in the range of 2.4 to 3.8% of all road crash fatalities involving all vehicle types and all vulnerable road users (pedestrians, cyclists, and motorcyclists) from 2008 to 2009. Considering only passenger vehicle occupants, the benefit is likely to be 2.6 to 4.6%. These fatality reductions could only have been achieved through earlier notification of each crash and their location to enable a quicker medical response. This might be achievable through a fully deployed in-vehicle ACN system.

Use of age-period-cohort models to estimate effects of vehicle age, year of crash and year of vehicle manufacture on driver injury and fatality rates in single vehicle crashes in New South Wales, 2003-2010.

A novel application of age-period-cohort methods are used to explain changes in vehicle based crash rates in New South Wales, Australia over the period 2003-2010. Models are developed using vehicle age, crash period and vehicle cohort to explain changes in the rate of single vehicle driver fatalities and injuries in vehicles less than 13 years of age. Large declines in risk are associated with vehicle cohorts built after about 1996. The decline in risk appears to have accelerated to 12 percent per vehicle cohort year for cohorts since 2004. Within each cohort, the risk of crashing appears to be a minimum at two years of age and increases as the vehicle ages beyond this. Period effects (i.e., other road safety measures) between 2003 and 2010 appear to have contributed to declines of up to about two percent per annum to the driver-fatality single vehicle crash rate, and possibly only negligible improvements to the driver-injury single vehicle crash rate. Vehicle improvements appear to have been responsible for a decline in per-vehicle crash risk of at least three percent per calendar year for both severity levels over the same period. Given the decline in risk associated with more recent vehicle cohorts and the dynamics of fleet turnover, continued declines in per-vehicle crash risk over coming years are almost certain.

Biomechanical studies in an ovine model of non-accidental head injury.

This paper presents the head kinematics of a novel ovine model of non-accidental head injury (NAHI) that consists only of a naturalistic oscillating insult. Nine, 7-to-10-day-old anesthetized and ventilated lambs were subjected to manual shaking. Two six-axis motion sensors tracked the position of the head and torso, and a triaxial accelerometer measured head acceleration. Animals experienced 10 episodes of shaking over 30 min, and then remained under anesthesia for 6h until killed by perfusion fixation of the brain. Each shaking episode lasted for 20s resulting in about 40 cycles per episode. Each cycle typically consisted of three impulsive events that corresponded to specific phases of the head's motion; the most substantial of these were interactions typically with the lamb's own torso, and these generated accelerations of 30-70 g. Impulsive loading was not considered severe. Other kinematic parameters recorded included estimates of head power transfer, head-torso flexion, and rate of flexion. Several styles of shaking were also identified across episodes and subjects. Axonal injury, neuronal reaction and albumin extravasation were widely distributed in the hemispheric white matter, brainstem and at the craniocervical junction and to a much greater magnitude in lower body weight lambs that died. This is the first biomechanical description of a large animal model of NAHI in which repetitive naturalistic insults were applied, and that reproduced a spectrum of injury associated with NAHI.

Integrated assessment of pedestrian head impact protection in testing secondary safety and autonomous emergency braking.

Pedestrian impact testing is used to provide information to the public about the relative level of protection provided by different vehicles to a struck pedestrian. Autonomous Emergency Braking (AEB) is a relatively new technology that aims to reduce the impact speed of such crashes. It is expected that vehicles with AEB will pose less harm to pedestrians, and that the benefit will come about through reductions in the number of collisions and a change in the severity of impacts that will still occur. In this paper, an integration of the assessment of AEB performance and impact performance is proposed based on average injury risk. Average injury risk is calculated using the result of an impact test and a previously published distribution of real world crash speeds. A second published speed distribution is used that accounts for the effects of AEB, and reduced average risks are implied. This principle allows the effects of AEB systems and secondary safety performance to be integrated into a single measure of safety. The results are used to examine the effect of AEB on Euro NCAP and ANCAP assessments using previously published results on the likely effect of AEB. The results show that, given certain assumptions about AEB performance, the addition of AEB is approximately the equivalent of increasing Euro NCAP test performance by one band, which corresponds to an increase in the score of 25% of the maximum.

Neuropathological changes in a lamb model of non-accidental head injury (the shaken baby syndrome).

Non-accidental head injury (NAHI), also termed the "shaken baby syndrome", is a major cause of death and severe neurological dysfunction in children under three years of age, but it is debated whether shaking alone is sufficient to produce brain injury and mortality or whether an additional head impact is required. In an attempt to resolve this question, we used a lamb model of NAHI since these animals have a relatively large gyrencephalic brain and weak neck muscles resembling those of a human infant. Three anaesthetised lambs of lower body weight than others in the experimental group died unexpectedly after being shaken, proving that shaking alone can be lethal. In these lambs, axonal injury, neuronal reaction and albumin extravasation were widely distributed in the hemispheric white matter, brainstem and at the craniocervical junction, and of much greater magnitude than in higher body weight lambs which did not die. Moreover, in the eyes of these shaken lambs, there was damage to retinal inner nuclear layer neurons, mild, patchy ganglion cell axonal injury, widespread Muller glial reaction, and uveal albumin extravasation. This study proved that shaking of a subset of lambs can result in death, without an additional head impact being required.

Optimising product advice based on age when design criteria are based on weight: child restraints in vehicles.

The motivation for this paper is the high rate of inappropriate child restraint selection in cars that is apparent in published surveys of child restraint use and how the public health messages promoting child restraints might respond. Advice has increasingly been given solely according to the child's weight, while many parents do not know the weight of their children. A common objection to promoting restraint use based on the age of the child is the imprecision of such advice, given the variation in the size of children, but the magnitude of the misclassification such advice would produce has never been estimated. This paper presents a method for estimating the misclassification of children by weight, when advice is posed in terms of age, and applies it to detailed child growth data published by the Centers for Disease Control and Prevention. In Australia, guidelines instructing all parents to promote their children from an infant restraint to a forward-facing child seat at 6 months, and then to a belt-positioning booster at 4 years, would mean that 5% of all children under the age of 6 years would be using a restraint not suited to their weight. Coordination of aged-based advice and the weight ranges chosen for the Australian Standard on child restraints could reduce this level of misclassification to less than 1%. The general method developed may also be applied to other aspects of restraint design that are more directly relevant to good restraint fit.

The effect of motor vehicle airbag deployment on tooth surfaces.

Motor vehicle airbag technology is directed at the reduction of injury to drivers and passengers however a number of researchers have reported cases of injuries caused by airbags. Injuries to tooth surfaces, particularly tooth wear following the deployment of motor vehicle airbags, have never been studied. A review of the literature and clinical experience does not suggest tooth enamel abrasion to be a likely outcome following airbag deployment. This in vitro pilot study was conducted to assess the effect on tooth surfaces following the deployment of motor vehicle airbags, and in particular to attempt to reproduce the injuries claimed in a case report published in the Journal of Forensic Odonto- Stomatology in December 2007. A sample of extracted upper anterior teeth (n = 20) were analyzed using unaided visual observation, photographic and microscopic observation pre- and post- airbag deployment. Teeth were mounted on a fabricated head form (similar to those used in crash test dummies) using dental putty. The tests were performed using a modified airbag test rig with airbags deployed in 5 different positions relative to the head, with respect to distance and angulations. The result of the tests showed no changes to the teeth with unaided observation, macro photography or under the microscope. Tooth wear patterns described in the case report were not observed. Although accurate reproduction of an in vivo situation is not possible, this study has given some insight into the effects of motor vehicle airbag deployment, and suggests that significant tooth wear is an unlikely outcome from airbag deployment.