Abstract
The objective of the paper is to give an overview of the road injuries issues in France in the 2010’s by determining the frequency and the severity of injuries sustained by car occupants, and to infer the implications in terms of vehicule safety. Three types of analysis are conducted. First, we present a time series analysis at a macro statistical level showing a dramatic decrease of injured and fatally injured occupants in passenger cars compared to other modes of road transport. Secondly, we propose a descriptive statistical analysis of the injuries (frequency and severity) sustained by car occupants, by body regions, using the AIS. Finally we propose some insights into the effectiveness of some safety features. French National crash census (BAAC) is used for a general overview of injury frequencies and raw severity scores (fatal, hospitalized, slighty injured) in car crashes. In-depth crash investigations data are used to specify the body regions and the severity of the injuries sustained by car occupants. Data show that car occupants mortality and morbidity decreased more over the last decade than other road modes: −58 % fatalities and −64 % hospitalized (compared to −39% and −55% for pedestrians, and −21% and −44% for motorcyclists for example). In crashes for which at least one person has been injured, 19 % of occupants are uninjured, 49 % of occupants sustain MAIS 1 injuries, 15 % MAIS2, 8% MAIS 3, and 9 % MAIS 4+. Regardless of seat belt use, the body regions most often injured are head, upper and lower extremities and thorax. However, at least two third up to 92% of involved persons sustain no injury at each of these body regions. The frequency of severe injuries is low, often less than 10 % and concern head and thorax mainly. Finally, the frequency and severity of injuries decrease for belted occupants in newer cars compared to older cars, whatever body regions. The frequency of severe injuries decreased by almost 50 % in these newer cars.
INTRODUCTION
In France, over the last 10 years, road fatalities decreased dramatically (7,643 fatalities in 2000 and provisionnally 3,970 in 2011, i.e. 48% overall). In Europe, fatalities reductions over the same period is close to −40% on average (ONISR, 2011).
During the decade, many safety measures were implemented and they undoubtedly produced some safety benefits (Page et al, 2011). Vehicle safety measures are one kind of these safety measures. The automobile industry already made remarkable progress with regard to safety in the second part of the 20th century: improvement in safety of vehicle elements, introduction of specific safety restraint devices such as the 3-point seat belt and airbags, enhanced crashworthiness of the vehicle, improved integrity of the occupant compartment, and increased effectiveness of restraint systems (Page et al., 2009)
Model years 2000 and above offer an unprecedented level of safety improvement, due to a series of recent measures: Directive 96/79/CEE and ECE.R94 about frontal impact performance standard; Directive 96/27/CEE and ECE.R95 about side impact standard; introduction of the Euro NCAP consumer tests, mainly oriented towards crashworthiness and the efficiency of passive safety measures; as well as voluntary large fitment of Antilock Braking Systems (ABS), Electronic Stability Control (ESC) and Emergency Brake Assist (EBA). In parallel, some luxury car brands after the mid-2000’s started fitting active safety devices such as lane departure warning systems, anti-collision systems, and night vision systems, made possible by the availability of embedded technology, such as radars, lidars, ultrasonic sensors and cameras. Progressively, medium-size models start being equipped with such devices as well, whereas the maturity of the technologies improves and their costs decrease.
All over the world, most car crashes occur at very low speeds and mainly produce property damage rather than serious or fatal injuries. In France, in 2010, insurance companies counted about 2 millions property-damage crashes and the Government official statistics claim 67,300 injury crashes, that count for 3.4 % of all crashes. 6 % of the injury crashes are fatal, i.e. 0.2% of all crashes (ONISR, 2011).
In 2005, the definitions of fatalities and serious injuries were modified (ONISR, 2011). Prior to 2005, a fatality was a person who died within 7 days after the crash and a severely injured person was someone who was admitted as an in-patient in a hospital more than 6 days after the crash. After 2005, a fatality is a person who dies up to 30 days after the crash and a severely injured (‘hospitalized’) is a person who is admitted in a hospital for more than 1 day. The consequence of this change is approximately 5% more fatalities (Table 1 shows a jump in fatalities from 2004 to 2005, which is actually due to the change in definitions). As for the relationship between hospitalized, severely injured and slightly injured, INRETS proposed this formula, based on a crash injury register carried out in the ‘Rhone’ region of France:
| (1) |
Table 1 shows official time series for fatalities and hospitalized figures, both overall and for car occupants only. Up until 2004, hospitalized data were reconstructed (in grey) from the initial severely and slightly injured figures available from the BAAC database (ONISR, 2011) and according to formula (1).
Table 1.
Fatalities and hospitalized in France (2000–2010). Source: road crash national database (BAAC)
| All injury crashes | As passenger car occupants only | |||
|---|---|---|---|---|
| Fatalities | Hospitalized | Fatalities | Hospitalized | |
| 2000 | 7,643 | 61,478 | 5,005 | 34,349 |
| 2001 | 7,720 | 58,502 | 4,998 | 32,753 |
| 2002 | 7,242 | 52,856 | 4,599 | 29,257 |
| 2003 | 5,721 | 43,328 | 3,509 | 22,335 |
| 2004 | 5,226 | 40,250 | 3,185 | 20,207 |
| 2005 | 5,318 | 39,811 | 3,065 | 18,295 |
| 2006 | 4,709 | 40,662 | 2,626 | 18,084 |
| 2007 | 4,620 | 38,615 | 2,464 | 16,486 |
| 2008 | 4,275 | 34,965 | 2,205 | 14,127 |
| 2009 | 4,273 | 33,323 | 2,160 | 13,593 |
| 2010 | 3,992 | 30,393 | 2,117 | 12,454 |
Apart from overall fatalities, it shows a decrease in the number of hospitalized as well as a decrease in the number of car occupant fatalities (−58%) and hospitalized (−64%). Reductions were relatively large in 2003, and to a lesser extent in 2004, 2006 and 2008. These high reductions can be compared to (respectively for fatalities and hospitalized) −39% and −55% for pedestrians, and −21% and −44% for motorcyclists. This shows higher decreases for car occupants.
The French population (including overseas inhabitants) was 64.3 millions inhabitants on January 2009 (last data available from census). Therefore, the road fatality rate is 6.2 for 100,000 inhabitants and the road morbidity rate is 47.2 (hospitalized only).
Fatal and severe crashes are often examined for the identification of accident or injury prevention strategies whereas crashes with slightly injured are often left apart because prevention is supposed to address mainly life-threatening injuries. This is understandable even though the slightly injured also deserve to be addressed, not because of their severity of course but because of their frequency.
For year 2010, we counted in France 54,068 slightly injured persons, 24,656 of them being slightly injured as car occupants. Overall, for one person fatally injured in a road crash in France, there are 7.6 hospitalized and 13.5 slightly injured. If we consider only car occupants, for every person fatally injured, there are 5.9 hospitalized and 11.6 slightly injured.
This holds true if we do not consider any under reporting or under recording of injury crashes in France, which is not the case. Rates of under reporting vary a lot among studies and countries, we have used the official figures in this paper.
Considering this, the objective of the paper is to give an overview of the road injuries issues in France in the 2000’s and especially to:
emphasize the frequency and the severity of injuries sustained by car occupants.
assess the effectiveness of car protection technologies overall (structure and restraint systems) and infer the implications in terms of vehicule safety for the future.
We focus our analysis on crashes involving at least one passenger car exclusively since we have only access to an in-depth accident database targeting passenger car crashes.
DATA
We use two crash databases for this study:
- the so-called (French) national BAAC database which contains annually all recorded road crashes involving at least one injured person since 1957. This database is held by the Ministry in charge of Transport (Road Safety Department).
- An in-depth crash database constituted from investigations carried out in France by car manufacturers since the early seventies (Labrousse et al., 2011). They consist in two types of crash data collection: the first type is devoted to collect information concerning all types of crashes (all severities, all types of impact on all types of roads) in a specific region in the West of Paris whereas the second type of data collection targets crashed newer vehicles all over France, preferably at high impact velocities. These two data collections are complementary and give insights into the magnitude of the car crahes overall as well as the possibility to evaluate the effectiveness of technological innovations concerning body structure and protection systems.
The sample we use is made of injury crashes involving at least one injured occupant in a passenger car. All collected information (vehicles, damages, occupants, injuries, etc.) is coded and anonymously included in the database.
For the sake of this current study, we restrained our investigations to crashes recorded between 2000 and 2010. They are collected in such a way to be representative of injury car crashes occurred in France during the period.
The final sample consists of 2,250 occupants, belted or not, seated in the front or in the rear seats, whatever the severity of the injuries, involved in car crashes from 2000 to 2010. They sustained 6,217 injuries of all severities. 152 occupants were fatally injured out of these 2,250 included in our sample (6.8%). Fatalities are nevertheless excluded from analysis since we rarely have access to the detailed injury report for fatalities (who are rarely autopsied after a road crash in France). Consequently, the nature and body regions sustaining injuries are most of the time unknown for fatalities.
METHOD
The principles of the paper are very simple. We wish to draw a picture of the reality of injuries sustained by car occupants. It is mainly a descriptive analysis and intends to target the priorities in terms of body regions that are injured, and the frequency, nature and severity of injuries.
First, we present frequencies of injuries with breakdown by body regions (i.e. the risk to be injured for a car occupant conditionally to the occurrence of an injury crash). An involved person can therefore be uninjured in a injury crash if somebody else involved in the crash sustain injuries. Then we present distributions of injuries according to their severity, with breakdown by body regions (i.e., amongst the injuries, what and where are those which are severe or less severe).
We finally assess the effectiveness of vehicle protection technologies by comparing severe injuries risk, also by body regions and for various car model years, taking one type of crash (frontal impact) as an example.
Injuries severity measure uses the Abbreviated Injury Scale (AIS 1998©), which is an anatomically-based, threat to life severity scoring system that classifies each injury by body region according to its relative importance on a 6-point ordinal scale:
Minor
Moderate
Serious
Severe
Critical
Maximal (currently untreatable).
As fatalities are (almost all) excluded from analysis, statistical tables are mainly presented for AIS 1 to AIS 5.
RESULTS
Risk sustaining injuries in an injury crash. All injury crashes, all occupants
In crashes for which at least one person has been injured, 19 % of involved persons are uninjured, 49 % of occupants sustain MAIS 1 injuries, 15 % MAIS2, 8% MAIS 3, and 9 % MAIS 4+.
Table 2 displays the risk of injury by body regions and injury severity for belted occupants for all crashes(actually very close to the risk sustained by all occupants, belted and non belted).
Table 2.
Risk of injury to a certain level of severity for belted car occupants involved in an injury crash Source: LAB in-depth investigations
| Body Region | Not Injured | AIS 1 | AIS2+ |
|---|---|---|---|
| Head - Face | 66 % | 22 % | 12 % |
| Neck | 75 % | 23 % | 2 % |
| Thorax | 66 % | 23 % | 11 % |
| Abdomen | 92 % | 5 % | 3 % |
| Dorso Lumbar Column | 86 % | 11 % | 3 % |
| Upper Limbs | 66 % | 25 % | 9 % |
| Lower Limbs | 73 % | 20 % | 7 % |
| Pelvis | 91 % | 6 % | 3 % |
For each of the body regions, from 66 % to 92% of involved persons sustain no injury. About 20% to 25 % of the involved sustain AIS 1 injury (except for abdomen, dorso lumbar column and pelvis, for which AIS 1 frequency is much less) and the most severe injuries being rare, often less than 10 %.
If we compare the above injury risk to the same risk for occupants involved in newer cars, both the frequency and severity of injuries decrease for occupants in newer cars, for all body regions (table 3). The AIS2+ injury risk decreases by more than 50%! That’s the first evidence of better protection offered by newer cars.
Table 3.
Risk to sustain an injury to a certain level of severity for belted car occupants involved in an injury crash in newer cars. Source: LAB in-depth investigations
| Body Region | Not Injured | AIS 1 | AIS2+ |
|---|---|---|---|
| Head - Face | 71 % | 24 % | 5 % |
| Neck | 76 % | 23 % | 1 % |
| Thorax | 72 % | 24 % | 4 % |
| Abdomen | 94 % | 5 % | 1 % |
| Dorso Lumbar Column | 92 % | 7 % | 1 % |
| Upper Limbs | 70 % | 24 % | 4 % |
| Lower Limbs | 82 % | 15 % | 3 % |
| Pelvis | 95 % | 5 % | 0 % |
Distribution of injuries (All injury crashes, all occupants)
In our sample, 6,217 injuries for 2,250 car occupants mean that, on average, each occupant sustains 2.8 injuries in a crash.
We have also emphasized that 19 % of occupants involved in an injury accident do not suffer any injury, consequently, if we put apart those who do not suffer any injury, those who sustain injuries suffer 3.4 injuries on average.
1. Distribution of injury severity
Figure 1 shows that most of the injuries (69 %) are minor injuries (AIS 1) whereas the most severe injuries are much less frequent. This is partially due to the exclusion of fatalities from the sample, but still, this would hold true also if we had included them in the analysis. Overall, we can state that road safety issues are largely, for car occupants, a matter of minor and moderate injuries
Figure 1.
Distribution of the severity of all injuries in car crashes for car occupants
2. Distribution of injuries by body regions
When we look at injuries according to body regions, lower limbs and upper limbs, and head and thorax are regions more often injured than other regions (figure 2).
Figure 2.
Distribution of injured body regions for all severity levels
Pelvis and Abdomen are body regions less likely to be injured in car crashes.
3. Distribution of injuries by body regions and injury severity
Tables 4 and 5 show the distribution of severity by body regions and also the distribution of injured body regions by severity levels. As already stated in tables 2 and 3, Head and Thorax as well as Abdomen and Pelvis are relatively more likely to sustain higher levels of injuries than other body regions. It is clear from table 5 as well as from figure 3 that head, thorax and, to a lesser extent abdomen, are body regions mostly injured at higher severity levels.
Table 4.
Distribution of injury severity for each body regions
| Body Region | AIS 1 | AIS 2 | AIS 3 | AIS 4 | AIS 5 | AIS 6 | Total |
|---|---|---|---|---|---|---|---|
| Head | 59.7% | 21.2% | 7.6% | 6.5% | 4.5% | 0.6% | 100.0% |
| Face | 84.2% | 13.6% | 1.9% | 0.3% | 0.0% | 0.0% | 100.0% |
| Neck | 99.8% | 0.2% | 0.0% | 0.0% | 0.0% | 0.0% | 100.0% |
| Thorax | 57.9% | 11.1% | 22.9% | 7.4% | 0.6% | 0.1% | 100.0% |
| Abdomen | 49.1% | 22.9% | 19.3% | 8.7% | 0.0% | 0.0% | 100.0% |
| Dorso Lumbar Column | 62.8% | 30.0% | 5.7% | 0.2% | 1.3% | 0.0% | 100.0% |
| Upper Limbs | 72.2% | 22.2% | 5.6% | 0.0% | 0.0% | 0.0% | 100.0% |
| Lower Limbs | 73.3% | 16.5% | 10.2% | 0.0% | 0.0% | 0.0% | 100.0% |
| Pelvis | 54.2% | 30.8% | 14.7% | 0.3% | 0.0% | 0.0% | 100.0% |
| Total | 69.1% | 18.0% | 9.3% | 2.5% | 0.9% | 0.1% | 100.0% |
Table 5.
Distribution of injured body regions for each AIS level
| Body Region | AIS 1 | AIS 2 | AIS 3 | AIS 4 | AIS 5 |
|---|---|---|---|---|---|
| Head | 14.0% | 19.0% | 13.1% | 41.4% | 77.6% |
| Face | 15.4% | 9.6% | 2.6% | 1.3% | 0.0% |
| Neck | 9.4% | 0.1% | 0.0% | 0.0% | 0.0% |
| Thorax | 12.6% | 9.2% | 36.7% | 43.9% | 10.3% |
| Abdomen | 2.5% | 4.5% | 7.2% | 12.1% | 0.0% |
| Dorso Lumbar Column | 7.9% | 14.6% | 5.3% | 0.6% | 12.1% |
| Upper Limbs | 17.1% | 20.2% | 9.8% | 0.0% | 0.0% |
| Lower Limbs | 17.5% | 15.1% | 18.1% | 0.0% | 0.0% |
| Pelvis | 3.6% | 7.9% | 7.2% | 0.6% | 0.0% |
| Total | 100.0% | 100.0% | 100.0% | 100.0% | 100.0% |
Figure 3.
Distribution of injured body regions for AIS 4+ severity level
Table 6 in the annex shows the most frequent injuries, per nature and severity level, sustained by car occupants in car crashes.
The previous analysis stands from a general point of view regardless of the fleet composition, conditions of crashes (type of impact, type of obstacle, velocity at impact, energy dissipated, etc.) and conditions of restraint by car occupants (belt usage, airbag fitment, etc.). To a certain extent, it gives insights into the outcomes of crashes in terms of injuries but does not reflect what kind of crash produces what kind of injuries.
We first looked at distribution of injuries for belted occupants only, for all severity levels and for AIS4+. It does not change the injury distribution much compared to the distribution for all occupants since belt usage is relatively high in crashes (close to 80 % for persons involved in crashes).
We then looked deeper into severe injuries produced by the two main crash types (front and side impacts), which count for approximately 75% of all severe injuries. Distributions of injured body regions for all severities are displayed in figure 4 for frontal impact and figure 5 for side impact. Sample sizes are unfortunately too small for estimating the distributions for AIS4+ levels.
Figure 4.
Distribution of injured body regions for all severities for belted occupants in frontal impacts (N=2321)
Figure 5.
Distribution of injured body regions for all severities for belted occupants in side impacts (N=845)
Figures 4 and 5 show differences between the two distributions for frontal and side impacts. Lower limbs and thorax are the most injured regions in frontal impacts whereas upper limbs, head and thorax are more likely to be injured in side impacts.
Effectiveness of car technologies in preventing injuries
We showed in tables 2 and 3 that, overall, the risk to sustain injuries AIS2+ by body regions is lower for occupants in newer cars, designed after year 2000 (a car designed after 2000 has been launched for the first time after 2000. Thus a car can have a Model year (year of registration) after 2000 but having been designed in its first version prior to 2000). This is valid when we take into account all types of crashes and for belted occupants. Of course, this result may vary among crash types and among crash violences. We propose in this section another way of assessing the protection performance of newer cars, by looking at the evolution of risk to sustain injuries of a certain severity (say, AIS3+) by body regions, for belted drivers and front seat passengers, in a specific crash configuration (i.e. frontal impacts in a range of EES – 45 km/h up to 75 km/h close to the NCAP test at 64 km/h). The results are summarized in Figure 6 for drivers and front passengers injury risks. The blue line (respectively red) represents the evolution of the mean MAIS3+ injury risk for the driver (respectively front passenger). The seated driver and passenger drawings show the evolution of the same risk, but by each body region, with a similar iconography as the one used by EuroNCap releases. The driver is the one having a dashed steering wheel between hands. Different injury colors show different levels of MAIS3+ risk.
Figure 6.
Evolution of the risk to suffer AI3+ injuries for belted front seat occupants with breakdown by body regions and designed model years. EES Between 45 km/h and 75 km/h
Overall, mean injury risks decreased with later model vehicles over time in this crash configuration. This comes as no surprise since car safety in frontal impacts has been a priority. The increase for passenger risk between the first two periods is explained the following way. It became obvious at the beginning of the nineties that many severe injuries were due to intrusion. Car structure was then made stiffer but induced an increase of the deceleration applied to the occupant. As the only restraint system was the seat belt, the deceleration load mostly applied on the thorax. Consequently, the thorax injury frequency increased. Between 1990 and 1994, this increase has been limited for the driver thanks to the airbag implementation (playing an additional role in the restraint) even if their volume was small (∼ 30l.). On the other hand, the situation for the passenger was different. First, the airbag fitment rate for the passenger was low, and, secondly in case the passenger airbag was fitted, the position of the passenger was not as close to the dashboard as the driver, therefore the airbag was less effective in preventing thoracic injuries.
Driver injury MAIS3+ risk decreased by more than 50 % and passenger injury risk by 30 % between 1980 car generation and 2000 car generation, for this type of crash.
Furthermore, all body regions benefited from the decrease in injury risk, but the abdomen for the front seat passengers. In the 1980’s, this body region was significantly affected, for both driver and front-seat passenger, due to the intrusion of the passenger compartment (and in particular, for the driver, by impacts against the lower part of the steering wheel). As vehicle structure became stiffer and stiffer in the 1990’s, the above-mentioned intrusion/deceleration phenomenon led to increased submarining1. With the high intrusions in the 1980’s, lower extremities rapidly came into contact against the dashboard limiting the submarining phenomena. The limitation of intrusion reduced this effect of retention by lower limbs and a countermeasure became essential to impede submarining. Double pretensioning, reinforcement of seat structures, seat airbags and knee airbags progressively produced effects, but mainly for the driver, longer distance of passenger to dashboard combined to a more relaxing position on the seat (out-of-position) and to higher level of deceleration led to less effective countermeasures for the front seat passenger.
On the other hand, considerable decrease in injury AIS3+ risk for (almost) all body regions is easily explainable since the whole car is henceforth designed to offer an overall protection. Car structure is stiffer than in the past in order to avoid intrusion in the compartment, which was shown to be one of the major causes of injuries. Load limiters prevent injuries from the belt webbing; airbags prevent injuries to the head and the chest from hitting the steering wheel or another hard element of the compartment; pretensioners couple the occupant to his seat in order to reduce submarining and a hump on the seat cushion frame and under the base also prevent the pelvis from rotating under the belt. In some cases, knee airbags also prevent submarining by stopping the legs and then the occupant body displacement under the belt during the crash. Other devices such as padding and non-aggressive structures in the door panel, the dashboard, the windshield, the seats and the headrest also provide improved protection.
CONCLUSION & DISCUSSION
This paper had two objectives:
Emphasize the frequency and the severity of injuries sustained by car occupants.
Assess the effectiveness of car protection technologies overall and infer the implications in terms of vehicule safety for the future.
As for the first objective, the outcomes of the study are:
- Car occupants mortality and morbidity dramatically decreased over the last decade, i.e. −58 % fatalities and −64 % hospitalized.
- Overall, for every person fatally injured in a road crash in France, there are 7.6 hospitalized and 13.5 slightly injured. If we consider only car occupants, for every person fatally injured, there are 5.9 hospitalized and 11,6 slightly injured.
- In crashes for which at least one person has been injured, 19 % of occupants are uninjured. 49 % of occupants sustain MAIS 1 injuries, 15 % MAIS2, 8% MAIS 3, and 9 % MAIS 4+ injuries.
- Injured car occupants suffer 3.4 injuries on average.
- About 20% to 25 % of the involved sustain AIS 1 injury at each body region (except for abdomen, dorso lumbar column and pelvis, for which AIS 1 frequency is less)
- The most severe injuries frequencies are rare, often less than 10 % for each body region.
- Lower limbs and upper limbs, and head and thorax are regions more often-injured than other regions (all severities).
- Head, thorax and abdomen and pelvis are relatively more likely to sustain higher levels of injuries than other body regions.
As for the second objective, the outcomes of the study are:
- Both frequency and severity of injuries decrease for occupants in newer cars (designed in 2000’s) compared to older cars, whatever body regions. Especially AIS2+ injuries risk decrease by more than 50 %!
- Particularly, in frontal impacts and EES (between 45 km/h and 75 km/h) driver injury MAIS3+ risk decreased by more than 50 % and passenger injury risk by 30 % between 1980 car generations and 2000 car generations.
Implications for injury prevention
It is clear that considerable efforts in passive safety in the late 1990’s and the 2000’s produced unprecedented outcomes in terms of occupant protection. Head and thorax remain the most life-threatening body regions and even though they benefited the most from car safety measures, they should be still targeted for better improvements. The abdomen is still an issue too.
To a lesser extent, and even though the injury severity at these body regions is not that high (AIS2 or AIS3), the frequency of injuries at the lower limbs and upper limbs should also be addressed.
The question is now: what kind of car safety improvements could address these remaining issues? There are certainly some improvements to be brought to car structure and restraint systems to further reduce all kinds of injuries, but the more relevant way to eradicate injuries, slight or severe, is to avoid crashes or mitigate their violence. Vehicle technology is more and more addressing alert of rescue services and driving assistance systems. Thus, it potentially contributes to aid drivers in their driving tasks and to make these tasks being performed better and safer. This is the case if the technology addresses appropriately most the frequent crash configurations, risk factors and human failures.
Given the complexity and sometimes unpredictability of human behavior, it is understood that technology can not act as a human-being and it is then limited in its capacity to detect dangers, comprehend their nature, decide the best actions to be undertaken and realize the actions accordingly. Nevertheless, technologies progressively gain in maturity, reliability, accuracy, affordability, and the safety systems that are developed upon these technologies increase constantly their capacity to cover crash configurations, risk factors and human failures.
Even though current safety systems address detectability of (some) obstacles, speed management, enhanced vision and impact mitigation, accident mechanisms are complex and the contribution of technologies, even unquestionable, could be further enhanced.
- The real-life usage of the safety systems is still unknown, even studied via FOT’s in western countries for example. In terms of future research and system development, we must pay attention in the future to this real-life usage and acceptance and improve the systems accordingly,
- As for over-vision, information or warning systems, and because the mechanisms of failures are complex, HMI (Human Machine Interface) is to play a major role. Understanding of Human Factors in driving, avoiding overload of messages, displaying the right message at the right moment, without generating distraction or false interpretation, avoiding false alarm, etc. are the biggest challenges for efficiency of safety systems.
- The current technology is exclusively stand-alone technology, embedded in passenger cars and without any communication with outside world (except for navigation systems). It has, by nature, limitations. Radars, cameras, bending lights, etc. cannot see through an obstacle. And yet, one accident mechanism is visibility masking. Vehicle-to-X communication would then be a good candidate to detect masked objects, especially in intersection and especially at night,
- Finally, as fatal crash risk is still linked to alcohol impairment and speeding, technologies should focus on these issues in priority.
In conclusion, vehicle technology does bring safety. Its potential is very high but efforts are still needed to increase capacities of detection in as many situations as possible, with high accuracy and low cost, and capacities of technology to address directly perception and comprehension failures. The crucial issue is the intelligence of the interaction between the technology and its user.
Annex 1.
Most frequent injuries sustained by car occupants in car crashes, for each severity level
| AIS 1 | AIS 2 | AIS 3 | AIS 4 | AIS 5 | AIS 6 | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| zone | Injury | zone | Injury | zone | Injury | zone | Injury | zone | Injury | zone | Injury | |
| HEAD (CRANIUM AND BRAIN) | CRANIUM soft tissue | contusion | CEREBRUM | loss of consciousness | CEREBRUM | loss of consciousness | SUBDURAL | hematoma | CEREBRUM | loss of consciousness | HEAD | crush injury |
| CRANIUM soft tissue | wound-laceration | CRANIUM soft tissue | wound-laceration | CEREBRUM | contusion | CEREBRUM | loss of consciousness | CEREBRUM | edema | BRAIN STEM | crush injury | |
| CRANIUM soft tissue | abrasion | TEMPORAL BONE | fracture | FRONTAL BONE | fracture | CEREBRUM | contusion | SUBDURAL | hematoma | BRAIN STEM | hemorrhage | |
| HEAD (FACE) | FACE soft tissue | wound-laceration | FACE soft tissue | wound-laceration | ORBIT | fracture | MAXILLA | fracture | ||||
| FACE soft tissue | contusion | MANDIBLE | fracture | MAXILLA | fracture | |||||||
| FACE soft tissue | abrasion | MALAR BONE | fracture | ORBIT | open fracture | |||||||
| NECK | NECK soft tissue | contusion | NECK soft tissue | wound-laceration | ||||||||
| NECK soft tissue | abrasion | |||||||||||
| NECK soft tissue | burn | |||||||||||
| THORAX | THORAX soft tissue | contusion | STERNUM | fracture | LUNG | contusion | LUNG | contusion | RIBS | fracture | AORTA | rupture |
| RIB | fracture | RIBS | contusion | PLEURA | pneumothorax | RIBS | fracture | |||||
| THORAX soft tissue | abrasion | THORAX soft tissue | other injury | PLEURA | hemothorax | PLEURA | hemothorax | |||||
| ABDOMEN | ABDOMEN soft tissue | contusion | LIVER | contusion | LIVER | contusion | SPLEEN | rupture perforation | ||||
| ABDOMEN soft tissue | abrasion | SPLEEN | contusion | LIVER | fracture | BLADDER | rupture perforation | |||||
| ABDOMEN soft tissue | wound-laceration | RETROPERITONEUM | hematoma | KIDNEY | contusion | KIDNEY | fracture | |||||
| SPINE | CERVICAL SPINE | sprain | LUMBAR VERTEBRA | fracture | CERVICAL VERTEBRA | fracture | CERVICAL CORD | compression | CERVICAL CORD | contusion | ||
| THORACIC SPINE soft tissue | contusion | THORACIC VERTEBRA | fracture | CERVICAL VERTEBRA | dislocation | THORACIC CORD | contusion | |||||
| LUMBAR SPINE | contusion | CERVICAL VERTEBRA | fracture | LUMBAR VERTEBRA | fracture | CERVICAL CORD | rupture | |||||
| UPPER EXTREMITY | SHOULDER soft tissue | contusion | CLAVICLE | fracture | RADIUS | open fracture | ||||||
| HAND AND WRIST soft tissue | contusion | RADIUS | fracture | ULNA | open fracture | |||||||
| HAND AND WRIST soft tissue | wound-laceration | ULNA | fracture | HUMERUS | open fracture | |||||||
| LOWER EXTREMITY | KNEE soft tissue | contusion | MALLEOLI | fracture | FEMUR (shaft) | fracture | ||||||
| LEG soft tissue | contusion | METATARSAL BONE | fracture | FEMUR (proximal) | fracture | |||||||
| THIGH soft tissue | contusion | KNEECAP | fracture | FEMUR (distal) | fracture | |||||||
| PELVIS | PELVIS soft tissue | contusion | PELVIC RING | fracture | PELVIC RING | fracture | PELVIC RING | fracture | ||||
| PELVIS soft tissue | abrasion | COTYLE | fracture | COTYLE | fracture | |||||||
| PELVIS soft tissue | wound-laceration | HIP | dislocation | PUBIC SYMPHYSIS | fracture | |||||||
Footnotes
Submarining is a tendency to slide out under the lap belt in an frontal accident; this lap belt rises up on the abdomen and sinks in strongly leading to grave or mortal injuries.
REFERENCES
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