Unintentional Injuries to the Lung: Motor Vehicle Crashes

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Unintentional Injuries to the Lung: Motor Vehicle Crashes


¾ The lifetime odds of dying from any unintentional injury are 1 in 36. The odds specific to motor vehicle crashes are 1 in 77

¾ Every 50 seconds, a child is killed or injured in a motor vehicle crash. In 2001, an average of 116 people were killed on the highways every day of the year—that’s one every 12 minutes, for a total of 42,443 fatalities


Motor vehicle crashes are the # 1 cause of unintentional injury deaths in


[3,797 deaths or 46.7% of all unintentional injury deaths in all ages]

¾ Motor vehicle crashes are the # 1 cause of unintentional injury deaths in US (42,443 deaths; 41.8% of unintentional injury fatalities). Motor vehicle crashes were responsible for 192,532 non-hospitalized injuries in 2001. In children ages 1 – 18 years, 62.4% of unintentional injury deaths in the US were due to motor vehicle crashes. [Centers for Disease Control and Prevention, CDC]

¾ Motor vehicle crashes are a leading cause of rib fractures, a marker of severe injury. In a 1994 Journal of Trauma article with 5 ½ years of data, 12% of those with rib fractures died, 32% had a hemothorax (collection of blood in the pleural cavity) or pneumothorax, and 26% had a lung contusion. Fifty-five percent required an immediate operation or ICU admission, where 35% developed a pulmonary complication [Ziegler DW, Agarwal NN, J Trauma 1994 Dec; 37(6): 975-9]

¾ Lateral crashes have a significantly higher incidence of lung injury, kidney injury, pelvic fractures, and need for extrication. Although the vast majority of crashes are not direct frontal, such crashes have a higher incidence of facial lacerations, facial fractures and brain trauma. [NHTSA Crash Injury Research & Engineering Network (CIREN) Program, 12/01] ¾ A pedestrian is injured in a traffic crash every six minutes, and one is killed every 107

minutes. Most pedestrian injuries occur in cities, at night, away from intersections. Alcohol is involved in nearly half the vehicle crashes involving pedestrians, and in 31% of these, it is the pedestrian who is legally drunk [US Department of Transportation, DOT, 11/01] ¾ From 1992 through 2001, there were 6,679 pedestrian fatalities among children ages 0 – 15

years. This number represents 12.6% of all pedestrian fatalities for that 10-year time period [US Department of Transportation, DOT, 11/03]

¾ Vehicle equipment failure causes a small number of fatal crashes (6% in a 1996 Australian study)

¾ 30% of Americans do not wear their seatbelts, and do not always buckle up their children [National Safety Council, NSC, 4/00]


¾ Safety belt use reduces front seat occupant fatality risk by 40-50%, and reduces moderate to critical injury risk by 45-55% [National Highway Traffic Safety Administration, NHTSA, 1989]

¾ Surveys have shown that child vehicle seats are misused by as many as 80% of users. Additionally, parents often do not recognize the need for booster seats for children who are too large for child seats, yet not large enough to be safely restrained in an adult lap-shoulder belt [CDC MMWR 1999;48(4):83-4]

¾ 47% of children killed in vehicle crashes are not in a back seat as recommended [CDC Injury Research Agenda, 6/02 p 44]

¾ The most significant category of crashes is the single vehicle run-off-road crash, accounting for 37% of all highway fatalities [Public Roads Magazine, 11-12/02]

¾ In 1998, 2,549 children age 14 or younger were killed in motor-vehicle crashes—an average of seven children killed and 866 injured every day of the year [NSC 4/00]

¾ Despite laws in every state requiring that children of certain ages be properly restrained in seat belts or child safety seats, 61% of the children killed in vehicle crashes in 1998 were unrestrained [NSC, 4/00]

¾ Speeding is a factor in one-third of all motor vehicle fatalities. Despite their low volume, almost half of all speeding fatalities occur on local and collector roads, which are the low speed roads found in residential and business areas [DOT, 6/99]

¾ Rural roads are especially hazardous for speeders and those who share the roads with them: almost 65% of all speeding-related fatalities take place on rural roads [DOT, 6/99]

¾ Falling asleep while driving causes at least 100,000 crashes, 40,000 injuries and 1,500 fatalities annually [Public Roads Magazine, 11-12/02]

¾ Intersection crashes represent 23% of fatalities [Public Roads Magazine, 11-12/02] ¾ Drivers running red lights are involved in 89,000 crashes a year, inflicting 80,000 injuries

and nearly 1,000 deaths. This number of fatal crashes at intersections increased 16% between 1992 and 1998, while all other fatal crash types only increased 5% [DOT 6/99]

¾ A DOT survey shows that most people (48%) run red lights because they are in a hurry—not, as hypothesized, because of “frustration” or “road rage” that have a combined response of 16% [DOT 6/99]

¾ We all pay when people do not buckle up. The cost of inpatient hospital care for an unbelted occupant of a vehicle in a crash averages $5,000 more than the cost of care for a belted occupant. The general public bears 85% of such costs [Public Roads Magazine, 11-12/02] ¾ Aggressive driving—such as speeding, excessive lane changes, following too closely, and

running red lights—is associated with one third of traffic crashes and two thirds of fatal crashes [CDC Injury Fact Book 2001-2002, page 74]

¾ Motor vehicle crashes are the leading cause of spinal cord injury (SCI) among persons under age 65. Secondary conditions from SCI include respiratory complications, pressure sores, urinary infection, spasticity, and scoliosis [CDC Injury Fact Book, 2001-2002, p. 96]


¾ Reaching for moving objects increases crash risk by nine times. Drivers often are unable to predict when it is safe to look away from the road to multi-task because the situation can change abruptly. The most common distraction is the use of cell phones. The number of crashes and near-crashes attributable to dialing is nearly identical to those talking or listening. Dialing is more dangerous, however it occurs less often than talking or listening. [National Highway Traffic Safety Administration, NHTSA, 2006]

¾ California Highway Patrol (CHP) statistics for 2005 show that more roadway crashes are caused by hand-held cell phones than the hands-free variety (1,098 vs. 102). A new state law goes into effect 7/1/2008 prohibiting the use of hand-held cellular phones while operating a motor vehicle in California. This is designed to protect public safety by removing potential distractions from the hands of drivers. The law involves fines and a prior major public education campaign. [California Highway Patrol Release, 9/06]

¾ Drinking alcohol increases the risk of a crash or near crash three fold. [NHTSA 4/20/06] Alcohol consumption is involved in 38% of traffic fatalities. [National Center for Injury Prevention and Control, NCIPC, 1998]



Motor vehicle crashes are




Safer driving suggestions:


Wear seat belts properly: buckle up before starting up for protection in all accidents including side impacts. Even when you are a good and alert driver, others around you may not be!

9 Position the front seats as far back as possible from an airbag before anyone sits in the front vehicle seats. This minimizes protective airbag injuries to chest, pelvis and lower extremities, especially in people with osteoporosis [NHTSA, American Academy of Pediatrics, and CDC]

9 Drowsiness increases the risk of crash or near crash at least four fold. Avoid driving when you are inattentive or drowsy: sleep is the only antidote to sleepiness. Scientific studies show common stopgap actions, such as getting out of a car briefly and engaging in some exercise, playing the music loudly, or drinking coffee are not effective remedies [Public Roads Magazine, 11-12/01]

9 If you frequently have excessive daytime sleepiness, realize this is a sign of sleep apnea, a respiratory sleep disorder that needs diagnosis and intervention to improve your health and to keep those around you safe if you drive

9 Pick vehicles for safety, not image. Avoid small cars, performance images that encourage speeding, trucks and sport utility vehicles that are more prone to roll over. Selecting

equipment wisely reduces the chances of a crash and offers better protection when crashes do occur

9 Don’t rush: excessive speed and running red lights are false economies that carry expensive consequences—in fines, substantial insurance increases, injuries and deaths. Allow slightly more travel time, and enjoy the scenery along the way


9 Reduce aggression and anger behind the wheel: use relaxation and other coping skills 9 Improve your driving—and living—skills by following basic safety recommendations while


¾ Keep a three second following distance (roughly the space of one car length for each 10 miles of speed)

¾ Move to the slower lanes if traffic is traveling faster than you (even if they speed to do it, do the right thing)

¾ Stay in one lane rather than weaving; it is less stressful, and lane speeds usually even out

¾ Signal your intention to change lanes or make turns

¾ Avoid distraction and other activities while you drive; a car is a potentially deadly weapon and operating it needs your full attention. Ask a local traffic officer how

frequently crashes occur because someone was changing a CD, reprimanding children, or using their hands for a mobile phone or eating

¾ Always stop for red lights and stop signs

¾ Avoid unprotected left turns into oncoming traffic whenever you can take a safer route. When a left without a light is necessary, use your directional signal and keep your wheels straight until you have safe clearance to compete the turn

¾ Protect yourself when driving near large trucks

9 Support research to evaluate how side airbags, mobile phones etc affect driving performance, crashes, injuries and deaths

9 By California law, any pick up truck passengers sitting in the cargo area must be in after-market, federally approved seats with safety belts

9 Promote community wide awareness, distribution or free loan of child safety seats and educational programs for proper use

9 Report a vehicle safety problem to DOT at either 1-888-DASH-2-DOT or www.ntsa.dot.gov: click on File a Defect Report on the left column

Be safe and sober:

9 Understand that even a little alcohol can cause problems. If you are taking any medication, realize it can interact with alcohol for even more serious harmful reactions. Evaluate your reactions to alcohol and medications carefully

9 Don’t drive—and don’teven be a pedestrian—if you even wonder that you are alcohol impaired: take a cab or bus, or call a friend for a ride—and arrive home safely

9 Because alcohol affects balance, movement, vision and judgment, its use represents higher risks for injury and death. Act responsibly and be sober to prevent alcohol-impaired driving injuries

9 In addition to major injuries, the costs of a first time misdemeanor conviction for driving under the influence (DUI) easily can be over $10,000 says the California AAA. See how the costs add upon its website:


9 Be a good example for your adolescents: don’t let friends drive after drinking, and don’t do it yourself

Keep children safe in and near vehicles:

9 Encourage improved supervision/parenting skills as a vital protective factor against many types of home and community injuries, including those in and around motor vehicles

9 Assure all infants, toddlers, and children under 12 are appropriately buckled in rear car seats, with those ages four to eight in booster seats and seat belts: buckle up before starting up.

These adaptations are necessary for children who are not old enough or large enough to properly fit in a vehicle’s safety belts. Rear seat placement is best because front seat airbags, which provide protection in head-on collisions, are too potent for delicate little bodies. See www.nhtsa.dot.gov for the best type of child seat by the child’s weight, and the best

booster seats by height

9 Whenever car or truck has a passenger-side airbag, never place infants in a rear facing child safety seat in the front seat

9 Children can suffer severe injury—or die—in only minutes when trapped in a hot vehicle or its trunk. Don’t leave kids (or pets) unattended in a car or truck

9 Children usually do not fit into adult seat belts until they are 4 feet 4 inches tall: encourage them to “sit tall” to see the passing sites better, and put them in a properly buckled booster seat to increase their crash safety

9 Teach children to play in safe areas without vehicles, not to chase a pet, ball or friend into a street or driveway, to look both ways before crossing a street and do it in the crosswalk, and to wear light or reflective clothes after dusk so they are more visible to motorists

Special topics for teens:

9 Talk with your pre-teens and teens: too many report they rode with a driver who had been drinking alcohol

9 Understand that because teens are novice drivers with limited driving experience and lower coping skills, they are more likely to be risk-takers behind the wheel. Improve the situation for you adolescents: review practical and effective ways at

www.iihs.org; click “Consumer brochures” and scroll down to “Beginning Teenage Drivers” and click for ways parents can realistically help teens be safer drivers

9 Teen drivers have the highest crash risk on any age group: per mile traveled, they have the highest rates in all types of crashes from only property damage to fatalities. Driver error, speeding, not wearing seat belts, three of more occupants, positive blood alcohol

concentrations (BACs), and night driving are high risk activities for beginners:

¾ Supervise your teen’s practice driving over at least six months, giving him time to work up to challenges such as night driving, driving in heavy traffic, on the freeway, or in snow. Continue to have an active role after the learner’s permit is upgraded to a restricted or full license

¾ Have teens be aware that passing others in a no passing zone, excessive speed or taking risks in traffic really don’t make driving more “fun”—unless they crave an expensive


ambulance ride, moving violation tickets and higher insurance costs! Better to save that “fun” money for an exciting day at an amusement park!

Related Links on the Internet:

These sites are not part of the California Thoracic Society or American Lung Association website, and we have no control over their content or availability. Link information is current as of 1/04.

AARP: See “55 Alive Driver Safety Program”


American Auto Association: Click on Driver’s School and select Walk Safely, Choose Courtesy; You Drink, You Drive You Loose. Provides student driver courses that meet state requirements (California requires 50 hours of supervised driving)


American College of Emergency Physicians: Click on “Fact Sheets” and select from numerous topics, including aggressive driving, air bag safety, alcohol and driving, protecting children in motor vehicles, seat belts, speed, teenage driving


Insurance Institute for Highway Safety: “Beginning Teenage Driving,” vehicle crash ratings, child restraint belt use laws, news releases concerning new studies such as mobile phone use by drivers.

www.hwysafety.orgINFOMACÍON EN ESPAÑOL Mothers Against Drunk Driving (MADD)


National Highway Traffic Safety Administration: Has charts for the best type of child safety seat (by child’s weight) and booster seats (by child’s height). Site includes crash test results, updates about air bags and the complaint form for vehicle safety problems.

www.nhtsa.dot.gov INFOMACÍON EN ESPAÑOL

DEVELOPED FOR THE CALIFORNIA THORACIC SOCIETY Prepared by Colleen H. Richardson, CAE, Executive Director

Approved by CTS Executive Committee and © CTS 2002, revised 2007

CTS fact sheets are developed to inform the lay public on topics of lung health. They should not be considered a substitute for personal medical opinion from a health care provider.

FAX: 714-730-4057 Š VOICE: 714-730-1944 Š E-MAIL: ctsinfo@alac.org

WEBSITE: www.thoracic.org/ca.html





or download ALA public and patient items at www.lungusa.org

Visit the ALA of California website for state activities & advocacy issues at www.CaliforniaLung.org

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