Evaluating a Virtual Reality Game to Enhance Teen Distracted Driving Education: Mixed Methods Pilot Study.

Background: Inexperienced adolescent drivers are particularly susceptible to engaging in distracted driving behaviors (DDBs) such as texting while driving (TWD). Traditional driver education approaches have shown limited success in reducing motor vehicle crashes among young drivers.

Objective: We tested an innovative approach to help address the critical issue of DDB among teenagers.

Field effectiveness of general motors advanced driver assistance and headlighting systems.

This study examined the field effectiveness of General Motors advanced driver assistance and headlighting systems. A total of 8,311,707 Model Year 2013-2019 vehicles were matched to police-reported crashes from 12 states. The quasi-induced exposure method was used to compare system-relevant and system-irrelevant (control) crash counts for equipped and unequipped vehicles.

Assessing tether anchor labeling and usability in pickup trucks.

Objective: The objective of this study was to investigate vehicle factors associated with child restraint tether use and misuse in pickup trucks and evaluate 4 labeling interventions designed to educate consumers on proper tether use.

Methods: Volunteer testing was performed with 24 subjects and 4 different pickup trucks. Each subject performed 8 child restraint installations among the 4 pickups using 2 forward-facing restraints: a Britax Marathon G4.

Predictors of restraint use among child occupants.

Objectives: The objective of this study was to identify factors that predict restraint use and optimal restraint use among children aged 0 to 13 years.

Methods: The data set is a national sample of police-reported crashes for years 2010-2014 in which type of child restraint is recorded. The data set was supplemented with demographic census data linked by driver ZIP code, as well as a score for the state child restraint law during the year of the crash relative to best practice recommendations for protecting child occupants.

The Impact of Michigan's Partial Repeal of the Universal Motorcycle Helmet Law on Helmet Use, Fatalities, and Head Injuries.

Objectives: To evaluate the impact of the partial repeal of Michigan's universal motorcycle helmet law on helmet use, fatalities, and head injuries.

Methods: We compared helmet use rates and motorcycle crash fatality risk for the 12 months before and after the April 13, 2012, repeal with a statewide police-reported crash data set. We linked police-reported crashes to injured riders in a statewide trauma registry.

Rating child passenger safety laws relative to best practice recommendations for occupant protection.

Background: State laws regarding child passenger protection vary substantially.

Objectives: The objective of this study was to develop a scoring system to rate child passenger safety laws relative to best practice recommendations for each age of child.

Methods: State child passenger safety and seat belt laws were retrieved from the LexisNexis database for the years 2002-2015.

Observation of motorcycle helmet use rates in Michigan after partial repeal of the universal motorcycle helmet law.

Motorcycle crashes result in a significant health burden, including many fatal injuries and serious non-fatal head injuries. Helmets are highly effective in preventing such trauma, and jurisdictions that require helmet use of all motorcyclists have higher rates of helmet use and lower rates of head injuries among motorcyclists. The current study examines helmet use and characteristics of helmeted operators and their riding conditions in Michigan, following a weakening of the state's universal motorcycle helmet use law in April 2012.

Real-world effects of using a phone while driving on lateral and longitudinal control of vehicles.

Introduction: Technologies able to augment human communication, such as smartphones, are increasingly present during all daily activities. Their use while driving, in particular, is of great potential concern, because of the high risk that distraction poses during this activity. Current countermeasures to distraction from phone use are considerably different across countries and not always widely accepted/adopted by the drivers.

Integration of Active and Passive Safety Technologies--A Method to Study and Estimate Field Capability.

The objective of this study is to develop a method that uses a combination of field data analysis, naturalistic driving data analysis, and computational simulations to explore the potential injury reduction capabilities of integrating passive and active safety systems in frontal impact conditions. For the purposes of this study, the active safety system is actually a driver assist (DA) feature that has the potential to reduce delta-V prior to a crash, in frontal or other crash scenarios. A field data analysis was first conducted to estimate the delta-V distribution change based on an assumption of 20% crash avoidance resulting from a pre-crash braking DA feature.

Modeling the injury prevention impact of mandatory alcohol ignition interlock installation in all new US vehicles.

Objectives: We estimated the injury prevention impact and cost savings associated with alcohol interlock installation in all new US vehicles.

Methods: We identified fatal and nonfatal injuries associated with drinking driver vehicle crashes from the Fatality Analysis Reporting System and National Automotive Sampling System's General Estimates System data sets (2006-2010). We derived the estimated impact of universal interlock installation using an estimate of the proportion of alcohol-related crashes that were preventable in vehicles < 1 year-old.

Factors affecting tether use and correct use in child restraint installations.

Introduction: Field studies show that top tethers go unused in half of forward-facing child restraint installations.

Method: In this study, parent volunteers were asked to use the Lower Anchors and Tethers for Children (LATCH) to install child restraints in several vehicles to identify tether anchor characteristics that are associated with tether use. Thirty-seven volunteers were assigned to four groups.

Comparing the effects of age, BMI and gender on severe injury (AIS 3+) in motor-vehicle crashes.

Background: The effects of age, body mass index (BMI) and gender on motor vehicle crash (MVC) injuries are not well understood and current prevention efforts do not effectively address variability in occupant characteristics.

Objectives: (1) Characterize the effects of age, BMI and gender on serious-to-fatal MVC injury. (2) Identify the crash modes and body regions where the effects of occupant characteristics on the numbers of occupants with injury is largest, and thereby aid in prioritizing the need for human surrogates that represent different types of occupant characteristics and adaptive restraint systems that consider these characteristics.

Modeling the impact of rescinding Michigan's primary and secondary seat belt laws on death and injury from passenger vehicle crashes.

Background: Seat belts are the most effective method of decreasing fatal and nonfatal motor vehicle crash injury. Advocacy groups have recently been successful in enacting repeals of mandatory motorcycle helmet laws in several states. In some states, this has prompted renewed efforts aimed at repealing mandatory seat belt laws.

Effects of child restraint system features on installation errors.

This study examined how child restraint system (CRS) features contribute to CRS installation errors. Sixteen convertible CRS, selected to include a wide range of features, were used in volunteer testing with 32 subjects. Subjects were recruited based on their education level (high or low) and experience with installing CRS (none or experienced).

Vehicle LATCH system features associated with correct child restraint installations.

Objective: Lower anchors and tethers for children (LATCH) was intended to standardize the attachment between child restraints and vehicle seats. However, LATCH implementations vary, resulting in differences in ease of attachment of child restraint connectors. Identifying vehicle characteristics associated with correct child restraint installations can provide guidance for designing vehicle LATCH systems that increase correct child restraint installations.

Effects of BMI on the risk and frequency of AIS 3+ injuries in motor-vehicle crashes.

Objective: Determine the effects of BMI on the risk of serious-to-fatal injury (Abbreviated Injury Scale ≥ 3 or AIS 3+) to different body regions for adults in frontal, nearside, farside, and rollover crashes.

Design And Methods: Multivariate logistic regression analysis was applied to a probability sample of adult occupants involved in crashes generated by combining the National Automotive Sampling System (NASS-CDS) with a pseudoweighted version of the Crash Injury Research and Engineering Network database. Logistic regression models were applied to weighted data to estimate the change in the number of occupants with AIS 3+ injuries if no occupants were obese.

Association between weight and risk of crash-related injuries for children in child restraints.

Objective: To determine the association between weight and the risk of injury in motor vehicle crashes (MVCs) for children 1 through 8 years of age who were using child restraints.

Methods: This was a cross-sectional study of children 1 to 8 years of age in MVCs, in which cases from the National Automotive Sampling System Crashworthiness Data System were used. Abbreviated Injury Scale scores of ≥2 indicated clinically significant injuries.

Factors associated with abdominal injury in frontal, farside, and nearside crashes.

The NASS-CDS (1998-2008) and CIREN datasets were analyzed to identify factors contributing to abdominal injury in crash environments where belt use and airbag deployment are common. In frontal impacts, the percentage of occupants sustaining abdominal injury is three times higher for unbelted compared to belted front-row adult occupants (p<0.0001) at both AIS2+ and AIS3+ injury levels.

Identification and validation of a logistic regression model for predicting serious injuries associated with motor vehicle crashes.

A multivariate logistic regression model, based upon National Automotive Sampling System Crashworthiness Data System (NASS-CDS) data for calendar years 1999-2008, was developed to predict the probability that a crash-involved vehicle will contain one or more occupants with serious or incapacitating injuries. These vehicles were defined as containing at least one occupant coded with an Injury Severity Score (ISS) of greater than or equal to 15, in planar, non-rollover crash events involving Model Year 2000 and newer cars, light trucks, and vans. The target injury outcome measure was developed by the Centers for Disease Control and Prevention (CDC)-led National Expert Panel on Field Triage in their recent revision of the Field Triage Decision Scheme (American College of Surgeons, 2006).

Effects of osteoporosis on AIS 3+ injury risk in motor-vehicle crashes.

Older occupants in motor-vehicle crashes are more likely to experience injury than younger occupants. One possible reason for this is that increasing age is associated with increased prevalence of osteoporosis, which decreases bone strength. Crash-injury data were used with Bayes' Theorem to estimate the conditional probability of AIS 3+ skeletal injury given that an occupant is osteoporotic for the injury to the head, spine, thorax, lower extremities, and upper extremities.

Appropriate analysis of CIREN data: using NASS-CDS to reduce bias in estimation of injury risk factors in passenger vehicle crashes.

The Crash Injury Research Engineering Network (CIREN) database contains detailed medical and crash information on a large number of severely injured occupants in motor vehicle crashes. CIREN's major limitation for stand-alone analyses to explore injury risk factors is that control subjects without a given injury type must have another severe injury to be included in the database. This leads to bias toward the null in the estimation of risk associations.

Injury risk curves for the skeletal knee-thigh-hip complex for knee-impact loading.

Injury risk curves for the skeletal knee-thigh-hip (KTH) relate peak force applied to the anterior aspect of the flexed knee, the primary source of KTH injury in frontal motor-vehicle crashes, to the probability of skeletal KTH injury. Previous KTH injury risk curves have been developed from analyses of peak knee-impact force data from studies where knees of whole cadavers were impacted. However, these risk curves either neglect the effects of occupant gender, stature, and mass on KTH fracture force, or account for them using scaling factors derived from dimensional analysis without empirical support.

An injury risk curve for the hip for use in frontal impact crash testing.

To facilitate the assessment of hip injury risk in frontal motor-vehicle crashes, an injury risk curve that relates peak force transmitted to the hip to the probability of hip fracture was developed by using survival analysis to fit a lognormal distribution to a recently published dataset of hip fracture forces. This distribution was parameterized to account for the effect of subject stature, which was the only subject characteristic found to significantly affect hip fracture force (X(2)(1)=6.03, p=0.

Comparison of distributions of key predictor variables in CIREN and NASS-CDS cases meeting CIREN inclusion criteria.

Objective: The Crash Injury Research and Engineering Network (CIREN) database contains data from occupants who are seriously injured in motor vehicle crashes. Because of the number of injured occupants and the level of detail in CIREN, a number of previous studies have attempted to use CIREN data to estimate injury risk or relative risk by comparing the frequencies of CIREN occupants with an injury of interest to those without that injury. However, these comparisons provide little useful information because CIREN case occupants cannot provide the control and exposure information that is needed to appropriately estimate injury risk.