Epidemiology of injury patterns for 4- to 10-year-olds in side and oblique impacts

<b>Objectives:</b> With regard to the pediatric population involved in vehicle side impact collisions, epidemiologic data can be used to identify specific injury-producing conditions and offer possible safety technology effectiveness through population-based estimates. The objective of the current study was to perform a field data analysis to investigate injury patterns and sources of injury to 4- to 10-year-olds in side and oblique impacts to determine the potential effect of updated side impact regulations and airbag safety countermeasures. <b>Methods:</b> The NASS-CDS, years 1991 to 2014, was analyzed in the current study. The Abbreviated Injury Scale (AIS) 2005–Update 2008 was used to determine specific injuries and injury severities. Injury distributions were examined by body region as specified in the AIS dictionary and the Maximum AIS (MAIS). Children ages 4 to 10 were examined in this study. All occupant seating locations were investigated. Seating positions were designated by row and as either near side, middle, or far side. Side impacts with a principal direction of force (PDOF) between 2:00 and 4:00 as well as between 8:00 and 10:00 were included. Restraint use was documented only as restrained or unrestrained and not whether the restraint was being used properly. Injury distribution by MAIS, body region, and source of injury were documented. Analysis regarding occupant injury severity, body region injured, and injury source was performed by vehicle model year to determine the effect of updated side impact testing regulation and safety countermeasures. Because the aim of the study was to identify the most common injury patterns and sources, only unweighted data were analyzed. <b>Results:</b> Main results obtained from the current study with respect to 4- to 10-year-old child occupants in side impact were that a decrease was observed in frequency of MAIS 1–3 injuries; injuries to the head, face, and extremities; as well as injuries caused by child occupant interaction with the vehicle interior and seatback support structures in 1998 model year passenger cars and newer. <b>Conclusions:</b> Results from this study could be useful in design advances of pediatric anthropomorphic test devices, child restraints, as well as vehicles and their safety countermeasure systems.

<b>研究目的：</b>针对卷入车辆侧面碰撞事故的儿童群体，可借助流行病学数据识别特定致伤情形，并通过基于人群的评估确定相关安全技术的潜在有效性。本研究旨在开展实地数据分析，针对4至10岁儿童在侧面及斜向碰撞中的损伤模式与损伤来源展开探究，以评估更新后的侧面碰撞法规及安全气囊安全防护措施可能产生的效果。<b>研究方法：</b>本研究对1991至2014年的国家汽车采样系统-碰撞调查数据集（NASS-CDS）进行分析。采用简明损伤定级标准（AIS）2005版-2008更新版来判定具体损伤类型与损伤严重程度。依据AIS词典及最高简明损伤定级（MAIS）标准，按身体部位分析损伤分布情况。本研究纳入4至10岁的儿童乘员，涵盖所有就坐位置：就坐位置按排次以及近侧、中部或远侧进行分类。纳入力的主要作用方向（PDOF）处于2:00至4:00以及8:00至10:00区间的侧面碰撞案例。约束装置使用情况仅记录为已约束或未约束，不区分约束装置是否正确使用。研究记录了按MAIS等级、身体部位及损伤来源划分的损伤分布情况，并按车辆生产年份开展乘员损伤严重程度、受损身体部位及损伤来源的分析，以评估更新后的侧面碰撞测试法规与安全防护措施的效果。鉴于本研究旨在识别最常见的损伤模式与损伤来源，仅对未加权数据进行了分析。<b>研究结果：</b>针对侧面碰撞中的4至10岁儿童乘员，本研究主要结果显示：1998年款及更晚款乘用车中，MAIS 1~3级损伤、头部、面部及四肢损伤，以及儿童乘员与车辆内饰、座椅靠背支撑结构碰撞导致的损伤发生率均有所下降。<b>研究结论：</b>本研究结果可用于儿童拟人试验装置、儿童约束系统以及车辆及其安全防护系统的设计优化。