Euro NCAP Whiplash launch Presentations---f619c283-8120-4b09-9119-2a244f027a75

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Euro NCAP Whiplash launch Presentations---f619c283-8120-4b09-9119-2a244f027a75 Powered By Docstoc
					Euro NCAP Rear Impact (Whiplash) Launch 26th November 2008 at Thatcham A Preventable Cost to Society

Welcome Peter Roberts Chief Executive Thatcham

Thatcham’s Vision Globally, vehicles are repaired safely, Crash injuries are minimised and vehicle theft is eradicated. Thatcham’s Mission Setting the Standards Raising the Skills

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Safe Accident Repair: methods

Safe Accident Repair: validation

Safe Accident Repair: quality

Safe Accident Repair: skills

Euro NCAP Member

Hyper G Sled- funded by UK Insurers

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Why Euro NCAP has launched Rear Impact Ratings A preventable cost to the individual and society Professor Claes Tingvall, Chairman of Euro NCAP

Whiplash myth or misery? Dr Wolfram Hell, Head of Medical Biochemical Accident Analysis Unit MBU, Institute for Forensic Medicine Ludwig Maximilians University, Munich, Germany

Estimated societal Costs of CSD Injury

only Rear-end vehicle accidents

Whiplash myth or misery ? injuries from a medical perspective
Dr. Wolfram Hell

Netherlands: Great Britain: Switzerland: Germany: USA: Canada: Canada:

0.5 Billion Euro/year 600-800 Million Pounds/year >2 Billion SFR/year 1-2 Billion Euro/year (IFM-GDV) 10 Billion USD/year (IIHS) costs per vehicle- occupant 135 CDN$/year (cost reduction with better seats approx. 54 CDN$/year)

LMU Ludwig Maximilians University Munich Institute for Forensic Medicine Medical-Biomechanical Accident Analysis MBU
Background: Grandfathers of dynamic seat testing: Dr. Markus Muser ETH-Zürich, Dr. Harald Zellmer Autoliv Germany with HIII, RID3, and BIORID

Wealthy Countries with high compensation systems show very high economical loss (Swizerland, Norway, Canada)

Cervical Spine Distorsion Injury • 60- 80 % of all car claims with personal injury

1968 • no head-restraints

• significant problem in industrialized countries

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1988 • standard head restraint

1998 • intelligent seat concepts

IIWPG International Whiplash Prevention Group founded

seat test BioRid 2 for IIWPG

Injury reduction • if forces and moments on the cervical spine are reduced

Improved car seat

• decreased injury risk
Low Cost car seat

Euro NCAP • Very important that Euro NCAP adds a dynamic car seat testing • to motivate car manufacturers and controllers for improved seat concepts

Medical Trauma Biomechanics

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anatomy of the human spine
structured bar 24 vertebra (7 cervical, 12 thoracic, 5 lumbar) protection of the spinal cord shock absorbing function for the brain 7 cervical vertebra
C1 - C7

cervical spine elements
upper Atlas and Axis (C1, C2)

middle C3 to C5

12 thoracic vertebra

T1 – T12

5 lumbar vertebra

L1 – L5

lower C6 to C7 most frequent site of injury and symptoms

Source:Sobota

Quebec Task Force- Results
degree

QTF Injury Severity
clinical signs NO subjective or objective symptoms of the Cervical Spine Cervical Spine Symptoms (subjective: pain, stiffness) NO objective clinical signs MICROLESION Cervical Spine Symptoms AND MUSCULO-SKELETTAL SIGNS MACROLESION

• The initial diagnostics and documentation of CSD injuries is insufficient • Major Problem: different injury classification • Lit. Analysis of 10.000 Publications shows, that only 400 can withstand a critical View regarding Injury Definition and Comparability • Improved Medical Injury management (early detection and therapy strategies for chronic cases) important
source: Spitzer et al, SPINE 1995

0 1 2 3 4

Cervical Spine Symptoms AND
NEUROLOGICAL SIGNS NEURAL DAMAGE / IRRITATION

Cervical Spine Symptoms AND
FRACTURE or DISLOCATION

Pathological correspondent, QTF

QTF degree 1 and 2

MICROLESION
QTF 1 single or multiple (ultra-)microskopic lesions
lesion is too small to cause muscular spasms

muscular damage • muscular sprain/tear • healing within days/weeks • leaves scar, but no permanent damage
source: Foreman, Croft, Whiplash Injuries Williams & Wilkins, Baltimore, 1995

MACROLESION
QTF 2 ligaments, tendons and muscles)
Distorsion and soft tissue bleedings (joint capsules, Secundary muscle spasm after soft tissue injury

NERVE CELL DAMAGE/ IRRITATION
QTF 3
Injuries of the neural system caused by traumatic injury or secondary due to Irritation caused by bleeding and inflammation

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neck muscles deep muscles of the cervical spine might be primary site of injury Musculus semispinalis capitis/cervicis and multifidus

Three stages of Nerval Injury

Neuropraxia

1

Local demyelinisation (neurons intact) Complete recovery

Axonotmesis

2

Axons interrupted Recovery complete or nearly complete

Neurotomesis

3

Axons and sheaths both interrupted Recovery never complete

source: Foreman, Croft, Whiplash Injury Williams & Wilkins, Baltimore, 1995

Long Term CSD
Suspected Patholoy (Spine) • Zygapophysial joint
a c

Suspected Pathology (Spine) II
• Pressure gradient within spinal channel - injury of nerve cells within spinal ganglia (e)

a) Hemarthrosis b) Joint capsule rupture/tear • Intervertebral disc c) Tear of annulus • Upper cervical ligaments d) Tear of anterior ligament fibrosus

d b

Poorly seen in X-Ray and MRI hopefully in future higher resolution avaiable
source: Barnsley, Lord, Bogduk, Clinical Review, Whiplash Injury University of Newcastle,NSW, Australia 1994

spinal cord within spinal channel

e

space of cerebrospinal fluid

Visual Demonstration I
sled test (Clip) delta v 9,5 km/h

Injury mechanism at rear end collision
source: Felix Walz, modified

Phase 1 Translation and Extension

Phase 2 max

Phase 3 Flexion Rebound

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neck muscles during rear crash

EMG during volunteer tests, dv 9,5 km/h
EMG [mV] 120 100 80 60 40

Semi Sterno A(h-T1)

A(h-T1) [g] 10 8 6 4 2 0 -2

sternocleidomastoid muscle (neck front) and semispinalis capitis muscle (deep neck back) show: potential to influence kinematics to be primary site of injury due to excentric contraction

20 0 1 101 201 time [msec.] 301 401

-4 -6

maximum Amplitude of sternocleidomastoid muscle during head/head-restraint contact afterwards rising activity of semispinalis capitis muscle reaching Maximum at 200ms (Rebound Phase)

Many whiplash theories
not all are correct

Aggravation
• psycological factors • Insurance compensation expectancy • sometimes lawjer motivates the patient to visit a doctor • vary very much from Country to Country
Car versus Bus (with injured bus occupants) = energy too low • Swizerland Cars without engine to recieve high injury compensation • Side swipe collisions, breaking with near zero energy • after musculoreflex testing patients have told they have no complaints but they have tried to get compensation

Biomechanical non-plausible cases

neck collar
• wearing a neck collar for more than 3 days could induce muscular atrophy with musculoskelettal symptoms, PAIN and DECREASED RANGE OF MOTION • for CS Distorsion neck collars should be better not prescriped, they can elongate the healing processs or even start producing symptoms

CSD- Long-Term injury
LONG TERM INJURIES SHOULD JUSTIFY HIGH PREVENTION EFFORTS
if recovery takes more than 2 weeks for at least one passenger then for all occupants with CSD:

time to reach full recovery
Ra tio of pe rsons re aching full recovery n=253 persons in 208 cars
CSD and documented date of limit in earning capacity 1,0 ,9 ,8 ,7 ,6 ,5 ,4 ,3 ,2 ,1 0,0 0 100 200 300 400 500 600 700 800 900 function censored

in less than 70 days 50% will recover in 25% recovery will take >6 months in 8% chronic impairment
time until reduction of earning capacity reaches 0%, all 253 CS-Patients in 208 rear-end impacts (at least one occupant with documented CSD injury suffering for more than 14 days)

days after rear-end accident and diagnosis

Source: W2 Long Term Injury Analysis LMU The majority of complaints dissapear completely within a few weeks

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Rear-End Impact Car Performance Statistics
Injury rates at rear-end collisions divided by manufacturer and type („Long Term Injuries“ more than 6 weeks

Case example FATAL INJURY
seatback collapse after rear-end impact

Manufacturer B- France F- Germany G- Germany G - Germany G- Germany E- Germany B- France

Rear end collisions total 258 378 1087 523 229 177 252

With injured n 13 39 115 88 30 18 21 Per 1000 135 257 294 433 380 400 328

Long-term injured > 6 weeks n Per 1000 1 8 25 18 8 7 10 10 53 64 89 101 156 156

rating good medium

poor

lower middle class vehicles
SOURCE: IFM-GDV, statistics HuK Coburg Insurance 2000, damages

Child behind driver was killed Seatback collapse must be avoided

reason for higher velocity seatback test
Source: FS 90 IFM-GDV

Arguments against dynamic seat test
• We do not know the injury exactly, so a test does not make much sense • We also do also not know the exact lung cancer pathology, but nevertheless smoking is a serious risk factor • Neck movement and forces are also significant risk factors • If neck movement and forces are reduced, CSD injury logically must also be reduced

LAB test vs. Accidentiology
• Does the dynamic seat test really measure seat performance ? • Only real accident analysis can answer this: Seat test ranking should be comparable to real accident ranking. Serious basic research with high case numbers necessary • Continuous monitoring important

Outlook
• Females are the highest risk group • later female dummy should be added • Stiffer cars (more aggressive pulse) could compensate the effects from improved seats • Cervical Spine Distorsion is still a complex problem and should be research topic in the future

• Whiplash better Cervical Spine Distorsion complaints are neither myth nor misery

• There is a high potential that they can be significantly reduced due to better car seats and head-restraints and it is in general a low severity injury

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Thank you for your attention!
Whiplash prevention by design Anders Kullgren, Head of Research, Folksam, Stockholm, Sweden

Euro NCAP Whiplash Launch, 2008

Incidence – Swedish real-world data
• Whiplash accounts for approx 60% of all injuries leading to permanent medical impairment • Most occupants reporting initial whiplash symptoms recover within a month • Approximately 10% of those reporting whiplash symptoms sustain some degree of life-lasting symptoms with permanent medical impairment

Real-world experience of seat design
Anders Kullgren
Folksam Research

Seat concepts and rating programmes
• Whiplash design concepts, first ones introduced late 90’s – Reactive Head Restraint - RHR – For example Saab, Nissan, Mazda, Opel, VW, Audi, Skoda, Mercedes (Aclass) – Reactive seat back - WhiPS - Volvo, Jaguar – Passive seat - Toyota WIL + recent models from Audi – ProActive Head Restraint - PAHR – Mercedes, BMW • Consumer test programmes – Folksam/SRA (2003) – ADAC (2003) – IIWPG (2004) – Euro NCAP (2008)

Seat without whiplash system 24 km/h / 5g

RHR (Reactive Head Rest) Nissan Primera 24 km/h / 5g

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Real-world analysis of in depth data
Whips Volvo V50 24 km/h / 5g
• Correlation between crash severity and injury outcome => injury tolerance • Basic knowledge in the development of test procedures

WILS Toyota Corolla 24 km/h / 5g

Folksam crash recorder data
Example; ΔV 26 km/h, mean acc 5.6 g Symptoms > 1 month

•

Since 1992 260,000 cars fitted with crash recorders (100,000 for rearend collisions)
acceleration (g) / velocity (km/h)

Numbers of drivers and front seat passengers with different duration of symptoms and average crash severity
Numbers Driver Front seat pass. 62 33 23 6 Total Average crash severity Change of velocity (km/h) 10.9 9.0 11.8 17.8 Mean acceleratio n (g) 3.6 3.2 3.6 5.1

•

Summary of 174 crashes with 231 front seat occupants

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acceleration (g)
25 20 15 10 5 0 -5

All No neck injury
Symptoms < 1m Symptoms > 1m

174 108 43 23

231 136 66 29

change of velocity (km/h)

0

20

40

60 80 time (ms)

100

120

140

Numbers of occupants in intervals of change of velocity and mean acceleration
120 No neck injury (n=141) 100 Number of occupants 80 60 40 20 0 Symptoms < 1 (n=66) Symptoms > 1 m (n=29) Number of occupants 80 100 No neck injury (n=141) Symptoms < 1 m (n=66) Symptoms > 1 m (n=29)

Risk of symptoms > 1 month
1 0,8 0,6 Risk 0,4 0,2 0 0 Symptoms > 1 month (n=29/236)
1 0,8 0,6 Risk 0,4 0,2 0 0 2 4 6 Mean acceleration (g) 8 10 Symptoms > 1 month (n=29/236)

60

40

20

0-5

5-10

10-15 15-20 20-25 Change of velocity (km/h)

25-30

30-35 n=236

0

0-1

1-2

2-3

3-4 4-5 5-6 6-7 Mean acceleration (g)

7-8

8-9

9-10 n=236

5

10 15 20 25 Change of velocity (km/h)

30

35

10

Change of velocity and mean acceleration for occupants with different duration of symptoms
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Change of velocity and mean acceleration for occupants with different duration of symptoms
10

8 Mean acceleration (g)

Symptoms > 1 m (n=29) Symptoms < 1 m (n=66) No neck injury (n=141)
Mean acceleration (g)

8

Symptoms > 1 m (n=29) Symptoms < 1 m (n=66) No neck injury (n=141)
Euro NCAP/ Folksam/SRA high severity pulse IIWPG pulse Euro NCAP/ Folksam/SRA mid severity pulse Euro NCAP/ Folksam/SRA low severity pulse
0 5 10 15 20 25 Change of velocity (km/h) 30 35 n=236

6

6

Average for symptoms>1m
4

4

2

Average for Symptoms<1m

2

0

0

5

10 15 20 25 Change of velocity (km/h)

30

35 n=236

0

What is the correlation between realworld whiplash risk and;
• seat concepts aimed at protecting whiplash? • consumer crash test results? (IIWPG and Folksam/SRA)

Data material and risk calculation
Two different data sources were used – Two-car crashes in Sweden reported by the police between 1998 and 2007 (22505) => Relative risk of an injury reported by the police in rear-end crashes – Whiplash claims in rear-end crashes reported to the insurance company Folksam between 1998 and 2007 (8343). => Proportion of claims with symptoms lasting longer than one month => Proportion of claims leading to permanent medical impairment

Multiplying ”Relative injury risk” with ”Proportion” gives relative risk of a whiplash injury claim • with symptoms lasting longer than 1 month or • leading to permanent medical impairment

Seats with and without anti-whiplash system
Relative risk of symptoms >1m
18,0 16,0 14,0 12,0 10,0 8,0 6,0 4,0 2,0 0,0 Seats w ith w hiplash system Standard seats f rom MY 1998 Standard seats until MY 1997

Seat concepts
Relative risk of symptoms > 1 month
18,0 16,0 14,0 12,0

Relative risk of permanent medical impairment

-0%

-26% -47% -45%

-30%

10,0 8,0

-50%

6,0 4,0 2,0 0,0
WIL (Toyota) RHR other makes than Saab SA HR (Saab RHR) WhiPS (V olvo/Jaguar) Standard seats f rom MY 1998 Other seats

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IIWPG
Relative risk of symptoms > 1 month
18,0 16,0 14,0 12,0 10,0 8,0 6,0 4,0 2,0 0,0
18,0 16,0 14,0 12,0

Folksam/SRA
Relative risk of symptoms > 1 month

-33%

10,0 8,0 6,0 4,0 2,0 0,0

-35%

Good

Acce ptable

M arginal

Poor

Not te ste d

Green+

Green

Yellow

Red

Not tested

Summary and discussion
• Correlation between real-world injury outcome and efforts made so far; – Cars with whiplash protection: In average 50% reduction of occupants with life-lasting symptoms, but reductions vary between manufacturers – Car with best performance in existing rating programmes also better in real-world • Still areas for improvements • Positive initiative from Euro NCAP • Follow-up studies important

Thank you for your attention!
References: Kullgren and Krafft. Whiplash Research in Sweden: Results from Real-Life Crashes. EVU Conference, Nice, 2008. Kullgren and Krafft. Influence of Change of Velocity and Acceleration on Whiplash Injury Risk: Results from Real-World Crashes. Int. conf. Whiplash-Neck pain in car crashes, Munich, 2008.

Euro NCAP’s Aims Reduce Road Accident Casualties The Rear Impact (Whiplash) Results and Ratings Michiel van Ratingen, Secretary General, Euro NCAP
Consumer buying information Incentive to manufacturers Recognition of excellence Empower safety engineers

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Members

Achievements

The Problem with Whiplash Occurs in low speed, rear end crashes Injury caused by sudden neck distortion The most frequent injury in collisions Exact injury mechanism is unknown

Costs to Individual & Society
Annual cost in EU estimated at €10 billion Almost 1,200 claims every day in UK alone In 10% of cases leads to long-term medical problems and 1% to permanent disability

Costs of Whiplash

Reducing the Risk of Injury Improved seat and head restraint design show real world injury reduction

Farmer, C.M., Wells, J.K. and Lund, A.K. (2003). "Effects of Head Restraint and Seat Redesign on Neck Injury Risk in Rear-End Crashes." Traffic Injury Prevention 4 (2):83-90.

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Whiplash Objectives Reduce real world whiplash injuries Promote the best practice in seat design Increase consumer awareness

Outline Procedure
Rating based on geometric and dynamic assessment of “in-production” seats Focus on driver / front passenger Protocol encourages:
Good geometry: Height and Back set of HR Ease of use: Encourage no occupant adjustment Locking of HR: Prevent inadvertent adjustment Seat integrity: Prevent occupant ejection

Geometric Assessment (1) Good Geometry
The head restraint should be high enough to protect tall occupants and have a small back set

Geometric Assessment (2) Ease of Adjustment
The head restraint should be ideally placed for occupants of all sizes with no or minimum effort

Point score derived from static measurements on seat using the HRMD

Promotes
Automatically adjusting Head Restraint or Adjustable Head Restraint or Fixed Head Restraint

Dynamic Assessment

Three Sled Pulses

Seat mounted on sled BioRID II crash dummy with sensors Sudden movement of sled simulates the collision

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“Seat Evaluation Criteria”
Lower neck acceleration Neck loads (shear, axial) “Whiplash” criteria (NIC, Nkm) Head rebound velocity Seat back deflection*
*Assessed in high severity test only

Additional Aspects
Seat Back Opening
Seat back angle in the high severity pulse only To prevent occupant ramping To prevent compromise of rear seat space

Dummy artifact

Protocol Scoring Process
Medium pulse ≤3 pts Low pulse ≤3 pts High pulse ≤3 pts Ease of adjustment assessment
≤1/n point/seat

Ratings

Static geometry assessment
+1 to -1 pts

Whiplash raw score ≤ 11 pts

Dummy artefact modifier
-2 pts

Seat back deflection modifier
-3 pts (High pulse only)

Final Scaled Score ≤ 4 pts

Positive modifier Negative modifier

Overview of Cars Tested

Results
Seat Volvo XC60 Alfa Romeo MiTo Volkswagen Golf VI Audi A4 Opel Insignia Renault Koleos Lancia Delta BMW X3 Renault Kangoo 2 Renault Megane 3 Honda Accord Skoda Superb Hyundai i30 Points 3.54 3.35 3.31 3.15 3.06 2.94 2.62 2.44 2.38 2.38 2.26 2.22 2.21 Rating Good Good Good Good Good Marginal Marginal Marginal Marginal Marginal Marginal Marginal Marginal Seat Ford Fiesta SEAT Ibiza Mercedes M-Class Dacia Sandero Daihatsu Cuore Citroen Berlingo Hyundai i10 Citroen C5 Ford Kuga Suzuki Splash Daihatsu Terios Peugeot 308CC Points 2.21 1.96 1.82 1.58 1.10 1.04 0.94 0.57 0.44 0.00 0.00 0.00 Rating Marginal Marginal Marginal Marginal Poor Poor Poor Poor Poor Poor Poor Poor

25 Seats from 2008 released cars (except pick-ups and vans) Classes: Supermini, Small Family, Large Family, Small MPV, Small and Large Offroaders All driver seats

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25 Seats Tested

Conclusions Large range in scores achieved
Span from 0 to over 3.5 points (out of 4)

Five out of 25 seats tested are rated as good, 8 as poor All “good” seats have a specific “antiwhiplash” design but not all “anti-whiplash” designs were top scorers

Conclusions A pricey seat does not guarantee a good result Some new models are able to achieve a score of over 3 points - a promising trend! Significant room for improvement remains

Remember... A head restraint must be as close to the back of the head as possible (touching is best) The top of the restraint should be as high as the top of the head It is a head restraint - not a headrest!

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