Lessons from car crashes

Studies reveal lasting harm in minor injuries

March 10, 2001|By Marcia Myers | Marcia Myers,SUN STAFF

A new collaboration of physicians and engineers at the University of Maryland and eight other research centers is revealing that auto accidents can be far more devastating than previously believed. Teaming up in studies of human crash victims instead of test dummies, they are looking at long-ignored injuries, rethinking safety standards for cars, and producing a revolution in auto-safety design and in medical treatment for accident victims.

Dr. Ricardo Martinez, who launched the program as head of the National Highway Traffic Safety Administration five years ago, says it corrects a "fatal flaw" made around 1980, when researchers began depending almost exclusively on crash dummies to understand injuries.

"The same crash that occurs in the lab every day at 1 p.m. to a 170-pound dummy that goes back to work the next day doesn't exist in the real world," he says. "A physician should know what happens to people in crashes. And engineers should understand the real-world conditions they have to meet."

Already, the teamwork between physicians and engineers is breaking new ground. Doctors are discovering that injuries can be predicted with virtual certainty in specific types of accidents. Researchers are finding that some child safety seats that perform well in head-on crashes don't adequately protect babies from head injuries in side-impact collisions. Engineers are learning that seat belts that work well for middle-aged drivers don't necessarily keep more frail, elderly bodies safe.

"It is changing the way both engineers and doctors think," says Val Bellora, a safety engineer with Johnson Controls Inc., which builds car interiors for auto companies worldwide. Bellora and his colleagues meet monthly with physicians at the University of Michigan Medical Center in Ann Arbor, a participant in the study.

As a result, Johnson has initiated numerous redesigns and improvements.

"It has caught on like wildfire in our own company and has affected every product I've worked on," Bellora says. "Together we're starting to understand the interactions of a human injury in a car crash."

Lingering effects

In Maryland, George Tenly's case was No. 96 of 200 studied so far, and it is typical. The driver who crashed into Tenly's Chevrolet Blazer at 70 mph nearly three years ago caused a broken wrist, fractured leg and dislocated hip in the Aberdeen man.

Only a few years ago, when air bags were less common and seat belts less effective, a driver in Tenly's circumstances probably would have died. Head and chest injuries killed motorists, and doctors paid little attention to lower-extremity damage in such serious crashes.

Tenly's air bag and seat belt saved him Sept. 6, 1998. But as the collision occurred, his knees and lower legs projected forward and up into the instrument panel. Measured by a few broken bones, many people would consider Tenly's injuries minor. But for the 68-year-old retired mechanic, they were tough to overcome.

They still limit his ability to perform everyday tasks such as dressing, bathing and retrieving cans from his kitchen cupboards. Although he was insured, the crash cost Tenly $50,000 and depleted a retirement account. His wife did not survive the accident, leaving him emotionally drained and depressed.

Exhaustive research

Those are the sorts of injuries no crash test dummy can reveal. Tenly agreed to become a subject in the national Crash Injury Research and Engineering Network. Besides studies in Baltimore and Ann Arbor, similar work is under way and being shared by centers in Washington, Miami, Newark, N. J., San Diego, Seattle, Falls Church, Va., and Birmingham, Ala.

In each case, researchers begin by recreating the crash, photographing and measuring every centimeter of damage to the vehicles, and documenting every physical injury. The injuries are then studied against the facts of the crash.

"We start to estimate exactly how this bone broke or this wound occurred, and we wonder and quiz each other about the success or failure of the safety features in the car," says Dr. Andrew R. Burgess, director of orthopedic surgery, who heads the Maryland study through the university's National Study Center for Trauma and Emergency Medical Systems.

But the study goes further, with a social worker monitoring the economic, physical and emotional toll of the accident for a year.

In Maryland, it has yielded surprising findings. Six months after their accidents, crash victims with what have been regarded as "minor" lower-extremity injuries reported median expenses of $43,000, according to Burgess and his team. A year after being injured, 80 percent regarded the experience as "life-altering," nearly half were still in litigation, two thirds were in pain, and more than a third had cognitive problems. Such injuries "have a major impact on quality of life," the report concludes.

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