Category: Blog

NHTSA Reports on Increasing Injury Vulnerability of Crash Victims as We Age

May 22, 2013

Dear Care for Crash Victims Community Members:

NHTSA has put one of its finest statisticians to create a very detailed major report on the effects of aging and gender on fatality and injury risk of vehicle occupants in crashes. NHTSA is now seeking public comment with the following notice. In a nutshell as we age we become more vulnerable to crash forces.

 

Injury Vulnerability and Effectiveness of Occupant Protection Technologies for Older Occupants and Women (DOT HS 811 766):

This report quantifies the effects of aging and gender on fatality and injury risk of vehicle occupants, based on statistical analyses of crash data. Fatality risk, given similar crashes, increases by about 3 percent per year that people get older, starting around age 21. Risk is, on average, 17 percent higher for a female than for a male of the same age, but the added risk for females has substantially diminished in recent vehicles. Older people are susceptible to thoracic injuries, especially multiple rib fractures. Women are susceptible to neck and abdominal injuries and, at lower severity levels, arm and leg fractures. All of the major occupant protection technologies in vehicles of recent model years have at least some benefit for adults of all age groups and of either gender; none of them are harmful for a particular age group or gender.

 

You may view the Federal Register notice in PDF format at http://www.gpo.gov/fdsys/pkg/FR-2013-05-28/pdf/2013-12520.pdf or in text format at http://www.gpo.gov/fdsys/pkg/FR-2013-05-28/html/2013-12520.htm. Comments are due on September 25, 2013 and should be sent to Docket No. NHTSA-2013-0072. The notice explains how to send comments.

If you have any questions about this report, please feel free to contact the author and Chief of the Evaluation Division, Charles J. Kahane, Ph.D., 202-366-2560, chuck.kahane@dot.gov.

In a nutshell as we age we become more vulnerable to crash forces.

 

In a paper I co authored in 2005 published by NHTSA I tried to address how we could use occupant age in URGENCY software to expedite appropriate emergency medical care. See www.careforcrashvictims.com click on URGENCY.

 

One more comment as I skimmed this Report is I wish NHTSA would not refer to potentially fatal crash forces as “insults”.

 

See p. 43

TABLE 2FATALITY RISK, GIVEN SIMILAR PHYSICAL INSULTS, RELATIVE TO A 21 YEAR OLD OCCUPANT OF THE SAME GENDER IN THE SAME SEAT POSITION DRIVERS AND RF PASSENGERS, ALL CARS AND LTVs, BY OCCUPANT AGE Hopefully the next NHTSA Report will address potential remedies for all crash victims who are aging every year — and not use the word “insults” for injurious crash forces.

 

 

Afghan Troops Lose an Airlift Lifeline — U.S. Crash Victims Lose Lives, Limbs, and Livelihoods Too

May 22, 2013

Dear Care for Crash Victims Community Members:

 

May 21, 2013 is the anniversary of the day Clara Barton , Nurse, Humanitarian, held the first meeting in 1881 of what was to become the American Red Cross.

 

On May 20th this week, the front page Washington Post carried an important article from Afghanistan by Kevin Sieff that is relevant to all people concerned with timely, optimal, emergency medical care.

 

Tragic Losses of Withdrawal from Afghan War

“KANDAHAR, Afghanistan — As soon as the Taliban bullet struck 24-year-old Afghan Sgt. Nazir Moradi’s leg, the men in his unit began brainstorming a way to get him off the battlefield.

The roads were too dangerous for an army ambulance. The Afghan soldiers, in several calls to their commanders, repeated one plea: They needed a helicopter.

 

The Afghan air force didn’t have any working aircraft available. The U.S. military, in the midst of drawing down its air support, denied a request for help. Instead, Moradi was carried for miles and eventually put in an unarmored ambulance impeded by rough terrain and the threat of roadside bombs.

 

By the time Moradi arrived at the Kandahar Regional Military Hospital, more than three hours away, he had bled to death from a minor wound. Hospital workers carried him to the morgue in a flag-draped coffin, the ritual they perform each time a soldier arrives too late.

 

“We kept waiting for a helicopter, either American or Afghan. But it never arrived,” said Pvt. Morabuddin, Moradi’s best friend. “He did not have to die.”

 

Source:Without U.S. helicopters, Afghans struggle to save wounded

The tragedies in Afghanistan and the many crash victims in the U.S. each year that also do “not have to die” have something in common — lack of timely, optimal, emergency medical care.

 

Tragic Losses from the Invisible War on Crash Deaths

There has been an invisible war going on at least since Nixon held secret, but taped, meetings with Henry Ford II and Lee Iacocca fighting against safety and auto pollution regulations in the White House on April 27, 1971.

 

Source:Nixon And Detroit – Transcript | Rollover | FRONTLINE | PBS

https://www.pbs.org/wgbh/pages/frontline/shows/rollover/etc/script.html

I have worked on these issues since 1966 and served in this Invisible War on the side of safety. In the 1970s I fought against gutting pollution standards. In the 1980s I fought the Reagan Administration’s rescission of the air bag regulations and the cut of NHTSA staff by 300 workers — one third the agency. Thirty years later NHTSA still operates at that reduced staffing level. As a NHTSA veteran I can use the word war without exaggeration. The 1983 Supreme Court also used the term war.

 

In 1983 the U.S. Supreme Court ruled in a rare 9 to 0 decision that NHTSA’s rescission of its passive restraint standard had been arbitrary and capricious. In fact, the Court stated that: “For nearly a decade, the automobile industry waged the regulatory equivalent of war against the airbag and lost — the inflatable restraint was proved sufficiently effective.”

 

Since 1978 when I joined NHTSA, the number of crash victims who died of injuries counted in the U.S. now exceeds 1,500,000 Americans. In addition, the number seriously injured is estimated at about 6 million Americans.

 

Since 1991, I have worked to improve care for crash victims at NHTSA until 2007, and subsequently as an actively retired citizen researcher. I find that the numbers of crash victims who die of their injuries in the U.S. each year are both tragic and not covered by the media as well as was done by the Post in Afghanistan.

 

In the attached spreadsheet of crash deaths by year, we find that NHTSA counted 32,315 crash victims died of their injuries in 2011 with emergency medical treatment that too often, was too little, too late. Of that number of crash fatalities there were 17,972 Americans (56%) that were “Not Taken to Hospital” . The number of crash fatalities that year that died after transport to some facility for some level of medical treatment was 14,343 Americans (44%). Source: Fatalities by State attached.

 

In 2012, crash fatalities increased to a daily rate of nearly 100 per day and 400 serious injuries.

NHTSA crash fatality statistics do not count the number of survivors who live with serious disabilities caused by brain injuries, spinal cord injuries (paraplegia and quadriplegia), amputations, burns, and disfigurements.

 

It is DOT policy to attribute dollar values to a statistical life lost and serious injuries. Applying those figures to the current rates of American crash losses of life and serious injuries amount to about $1 Billion per day.

 

Lessons from Afghanistan

During President Obama’s first term, 132,250 Americans died of crash injuries in the U.S.A. — more than died in the Afghanistan, Iraq, and Viet Nam wars combined.

 

As I wrote in my attached January 2013 Report, President Obama needs to apply the lessons learned in Afghanistan right here in America.

 

“Imagine a goal that the nation will achieve Golden Hour medevac for serious crashes of 1 hour or less by the year 2020 here in the U.S.A. President Obama’s Secretary of Defense Robert Gates has already set and met that goal in Afghanistan.

 

“JIM LEHRER: Mr. Secretary, much has been written and said about your last four and a half years as secretary of defense. And a lot of people have been assessing your performance. What do you think of the way you’ve performed as secretary of state the last – secretary of defense the last four and half years?

 

ROBERT GATES: “I will say that I think that the thing I’m proudest of is what I’ve been able to do for our troops, giving them these heavily armored vehicles, these Mine Resistant Ambush Protected vehicles; giving them one-hour medevac or less in Afghanistan… trying to do whatever was necessary to help them accomplish their mission and come home safely.” (Emphasis added)” Source:http://www.pbs.org/newshour/bb/politics/jan-june11/gates_06-23.html

 

We can do this in America. NHTSA published a paper in 2005 on what we can do to improve emergency care for crash victims. Seehttps://www.careforcrashvictims.com/urgency.php“

 

But as can be seen by the recent reports the President seems to have lost his “juice.” And despite the gun violence tragedies — legislation has stalled. Thus citizens need to arm themselves with facts and reasons to gain more bipartisan support for helping crash victims.

 

Citizen Action Tool

To help citizens gain congressional support for doing more to help crash victims receive timely, optimal, emergency medical care I offer a free new tool.

 

We just published a new Crash Death Mapping Tool for citizens to easily learn how many people have died of crash injuries in their 2013 Congressional District over the past decade. This enables citizens to show their representatives, with just a click, the magnitude of the problem of crash deaths in their District. The Crash Death Mapping Tool is available at www.careforcrashvictims.com under U.S.A. Crash Death Clock. ESRI also published the tool under the title Mapping Traffic Fatalities by Congressional District at storymaps.esric.om/partnerstories/

 

I hope this tool helps us reduce the number of tragedies of people who “do not have to die” because the emergency medical care they receive is too little, too late. When crash victims are seriously hurt, we have a moral obligation to care enough to send the very best rescue resources — in time to save lives and prevent disabilities.

 

Dear Care for Crash Victims Community Members:

Elections do have consequences. Life or death consequences.

One can grade the performance of care for crash victims in each State and the national average. I used 2010 data on crash fatalities per 100,000 population for each State.

Source: NHTSA Data on crash fatalities by State in 2010, Table 110 in NHTSA Report 811659 attached.

I categorized State Grades as follows:

A = 0 to 5 fatalities per 100,000 populationB = 5 to 10 C = 10 to 15D = 15 to 20F = >20 fatalities per 100,000 population

National average for 2010 was 10.63 = C

In attached Spreadsheet Ranking the States, I graded each State and used current NYTimes 538 blog map for identifying in Red (Republican leaning States). Source: http://fivethirtyeight.blogs.nytimes.com/

Fatality rates in Red States averaged a grade of D, while Blue States averaged a grade of B.

A total of 12,123 Americans died of crash injuries in 2010 (latest data available) in the 19 Red States.

Then I looked up how many medical doctors held office in this past Congress, their State Grade caring for crash victims, and their political affiliation.

Below are the elected officials that were medically trained (and presumably took the Hippocratic Oath), their political affiliation, and their State Grade for Care for Crash Victims.

Medically Trained Senate Incumbents

1. 1. Tom Coburn (R, Republican), Oklahoma, family physician and ob-gyn Grade D
   2. John Barrasso (R, Wyoming), orthopedic surgeon New Senator Grade F
   3. Rand Paul, (R, Kentucky), ophthalmologist Grade D

Medically Trained House Incumbents

1. 1. John Boustany ( R, Louisiana), cardiovascular surgeon Grade D
   2. John Fleming (R, Louisiana), family physician Grade D
   3. Bill Cassidy (R, Louisiana), gastroenterologist Grade D
   4. Tom Price, (R, Georgia), orthopedic surgeon Grade C
   5. Paul Broun (R, Georgia), family physician Grade C
   6. Phil Gingrey(R,Georgia), Ob-Gyn Grade C
   7. Ron Paul (R, Texas), Ob-Gyn Grade C
   8. Michael Burgess(R, Texas), Ob-Gyn Grade C
   9. David “Phil” Roe (R, Tennessee), Ob-Gyn Grade D
   10. Jim McDermott (D, Washington), psychiatrist Grade B

Medically Trained New House members

1. 1. Larry Bucshon (R, Indiana), thoracic surgeon Grade C
   2. Andy Harris (R, Maryland), anesthesiologist Grade B
   3. Dan Benishek (R, Michigan), general surgeon Grade B
   4. Nan Hayworth (R, New York), ophthalmologist Grade B
   5. Scott DesJaris (R, Tennessee), family physician Grade D
   6. Joe Heck (R., Nevada). emergency room physician Grade B Source: http://thehealthcareblog.com/blog/2011/01/13/doctors-in-congress/

Note that motorists in the worst State, WY, have more than a 5 times higher crash fatality rate than MA, the State with the lowest crash fatality rate. And WY (Grade F) has Republican Senator Barrasso, a surgeon, that is up for re-election next week. MS (Grade F) has Republican Senator Wicker up for re-election. Both of these States are projected by 538 blog to re-elect these Republican Senators.

Montana (Grade D) has Democrat Senator Tester who recently was projected to have a 64% probability of being defeated next week.

Clarification: This is a factual report of what I found on the 2010 crash fatality rate in Montana and what the NY Times 538 Blog projected when I accessed it on Oct. 31, 2012. No criticism of Sen. Tester was intended. I am told that Sen. Tester has been a supporter of auto safety and voted for the legislation enacted in 2012. Sorry for any misunderstanding my original wording may have caused.

Noteworthy is one Senator who is a medical doctor, but not up for re-election this year. Republican Sen. Tom Coburn “represents” the people of OK — and the nation. OK was the State with the 6th highest crash fatality rate in 2010. The year Dr. Coburn was last elected to the Senate was 2010. In December 2010, with 99 Senators agreeing to unanimous consent to pass auto safety legislation, Sen. Coburn single handedly stopped passage of the Auto Safety Act. It took another 2 years — and tens of thousands more crash deaths — to enact a weaker Auto Safety law.

So as Americans go to the polls this year, will enough of them consider whether they want their Nation and their State to suffer crash fatality rates as good as Grade A Massachusetts and Grade B Blue States? Or do voters want to continue dying in States as bad as Grade F States of Wyoming and Mississippi and Grade D States such as Alabama, Arkansas, Kansas, Kentucky, Louisiana, Montana, North Dakota, Oklahoma, South Carolina, South Dakota, Tennessee (Sen. Corker), and West Va.?

For the most recent projections in each of these Red States for Senate races see: http://fivethirtyeight.blogs.nytimes.com

From candidate Romney we hear lots of rhetoric that he and his party are against more police and firefighters. Yet these jobs are critical to saving crash victims. These jobs are needed to rescue people in serious crashes — especially in rural areas in both Red and Blue States. Red States typically vote Republican. Rescue too often depends on “volunteer” fire fighters 24 hours each day and 7 days each week. Time and rescue teams are a matter of life or death. How can a Presidential candidate, or any responsible person, deny the need for police and firefighters?

Source: http://www.youtube.com/watch?v=LoSmWK_-x4g

So in this election, the American people have a chance to do better at saving lives and livelihoods from crash injuries.

Hopefully, this information will help more people vote for a safer future by better protecting American motorists currently dying from crash injuries at the rate of nearly 100 every day. We can do better than to live and die at the rates of Grade D States — if we get political

Let us help Republican and Democrat and Independent representatives know that there is benefit from auto safety government policies aimed at saving lives in all States.

Documents Attached:

• • Traffic Safety Facts 2010
  • State Fatality Rates 2010

(iStockphoto)

The political rhetoric over health care this election season may leave voters confused, but they can be sure of at least this much: One of America’s more egregious public health afflictions, deaths and injuries in car crashes, is being massively ignored.This commentary also published by:
The Sacramento Bee
TucsonSentinel.com
Industrial Safety & Hygiene News

This should be a warning sign to the American people, since political leaders and their families, like the rest of us, are not immune from firsthand encounters with highway tragedies. President Clinton’s biological father died after being ejected in a car crash in the 1940s. As a teenage driver in the 1960s, Laura Bush struck and killed a family neighbor in a crash.  President Obama’s father died in a car wreck in 1982. In 1972, Vice President (then U.S. Senator)Joseph Biden’s wife and infant child were killed in a car-truck collision. Republican presidential nominee Mitt Romney, as a young Mormon missionary, was severely injured in a collision in France that killed another passenger. These experiences mirror those of millions of ordinary Americans, yet they have failed to prod the nation’s policy leaders into aggressive action to stem the carnage.

Despite more than 30,000 deaths and more than 2.2 million crash injuries per year, highway safety has largely fallen off the political radar screen.  Since 1965, when President Lyndon Johnson publicly confronted a hostile auto industry by demanding, and getting, new laws governing the safety of automobiles, more than two million Americans have died of crash injuries. Since then no president has taken a forceful public stand in favor of strong government action to counter the death toll.

The laws promoted by Johnson and subsequent regulations and policies have helped,  leading to safer auto designs, better roads, and drunk driving and seat belt laws – proving that good government can save lives and livelihoods. But crash injuries are still the leading cause of death to children, teenagers and young adults, and a major cause of violent death for all age groups.

Since 1981 — when the Reagan administration put coal industry lobbyist Ray Peck in charge of the National Highway Traffic Safety Administration, attempted to revoke air bag regulations, and cut the agency staff by one-third — the agency has been increasingly captive to the industry it was formed to regulate.

In place of decisive action, the government’s severely underfunded, industry- influenced highway safety efforts are routinely reactive, accomplishing too little, too late, for too many Americans.  When the auto industry began marketing unstable, top-heavy SUVs in the 1980s, NHTSA, part of the U.S. Department of Transportation, refused to adopt vehicle regulations limiting the rollover risk of such vehicles – which ended up contributing to some 10,000 deaths a year in rollover crashes. When Toyota drivers experienced  sudden unintended acceleration episodes, NHTSA lacked the resources and expertise to address the complex but foreseeable risks of sudden acceleration from sophisticated electronic controls now standard in new vehicles.

Although current Transportation Secretary Ray LaHood and NHTSA Administrator David Strickland have highlighted the perils of driver distraction, car companies still are racing to add infotainment features to new models – some of them featuring video display screens on their instrument consoles – that are bound to further divert drivers’ eyes and attention from the road. The mounting safety risk from infotainment systems seems to be widely viewed as inevitable and beyond society’s ability to control. Meanwhile, Texas has adopted an 85 mph speed limit for a soon-to-open toll road, a move likely to be copied by other states, but that would be off the table if safety was a prime concern.

What underlies the widespread toleration of highway mayhem by politicians, regulators, and the public?  Political indifference has a high cost in lost  lives, livelihoods and wellness. If the commitment were there, we believe that hundreds, if not thousands, of lives could be saved by a single measure: making electronic automatic crash notification systems standard, thus reducing delays in treating seriously injured crash victims.

But for whatever reasons, this country lags far behind other advanced nations in coming to grips with the problem. According to World Health Organization estimates, per capita road deaths in many countries are well below the U.S. Yet there is no demand to draw lessons from other countries to take tough steps that would protect American motorists.

From 2008 until early this year, U.S. road deaths fell substantially – in part due to the great recession — setting the stage for further complacency. But in the first quarter of this year the deaths turned upward, doubtless signaling an increase in driving as the economy began to modestly improve. If the upward trend continues, it will be a further signal to policymakers that the U.S. needs to be doing much more to curb lethal violence on its highways.

(Ben Kelley, a former Department of Transportation official, is on the board of the nonprofit advocacy group Center for Auto Safety. Louis Lombardo is an auto safety researcher who retired from NHTSA after 27 years and now writes on the subject at www.CareForCrashVictims.com)

Dear Care for Crash Victims community members:

Gov. Romney is campaigning with a Dollar Debt Clock named “Our National Debt”. The readout is approaching $15.7 Trillion after 235 years of accumulation – much of which is owed to institutional investors.

Source: http://firstread.msnbc.msn.com/_news/2012/05/16/11732547-romney-presses-obama-on-debt-with-aid-of-prop-clock

Let’s compare that with a Crash Death Dollar Debt Clock. The U.S.A. Crash Death Clock now reads out 3,562,858 auto crash deaths after 112 years of accumulation.

Sources: https://www.careforcrashvictims.com/death-clock/Attached NHTSA Report 811346, page 27. Applying DOT current value of a statistical life of $6.2 million to the U.S.A. crash deaths = $22 Trillion. Note that this does not include any value for people who suffered serious crash injuries but survived.

Now let us imagine a president of the people concerned about people campaigning against a presidential candidate of the powerful concerned about dollars.

Imagine if NHTSA would provide the public (and the President):

* a U.S.A. Crash Death Clock. Anyone can have this one free.

** a U.S.A. Crash Death Dollar Clock.

*** a U.S.A. Crash Lives (and Dollars) Saved Clock. NHTSA has some numbers in attached NHTSA Report 811402 at p. 217. Note that these numbers grossly underestimate benefits of airbags, NCAP, serious injuries mitigated and prevented and more. But it would be a start.

Would this be too much for people to ask for of NHTSA Administrator Strickland and DOT Secretary LaHood? They have the power. And as my grandson at age 7 told me “With great power comes great responsibility.”

And as one insurer likes to ask: “What’s your policy?”

People or Money?

Dear Care for Crash Victims Community Members:

Why is this Conference important?

Since 1971, when the first ESV Conference was held, the total crash death count is now approaching 2 million Americans in the U.S.A. The number seriously injured is estimated to be approaching 10 million. The dollar costs exceed many Trillions in current dollars.

Currently, during the Great U.S. Recession, fatalities occur at the rate of about 90 per day, 400 serious injuries per day, and cost about $650 million per day in dollars (not in tears).

See http://www.nhtsa.gov/PR/NHTSA-05-11

For associated costs and consequences, click here.

For conference Info: http://www-esv.nhtsa.dot.gov/

Excellent Vision Zero article on the history of the ESV Conferences see p. 28 at http://viewer.zmags.com/publication/5abecb69#/5abecb69/1

Who to look for at the Conference

• • 1,000 leading international auto safety researchers discussing future safety technologies will be there.
  • But how many crash victims will be there?
  • How many political leaders will be there? Imagine if President Obama would address the conference and urge the scientists and engineers to do better. He could cite that in his time in office more Americans died of their crash injuries in the U.S.A. than in the entire Viet Nam, Iraq, and Afghanistan wars combined.
  • How many members of the media will be there? Will there be coverage commensurate with the magnitude of the problem?

This is an important opportunity for us to do more to protect the people from loss of life, disabilities, and tragic injuries.

Dear Care for Crash Victims Community Members:

“Liz and Andrew Warner of Littleton lost their 17-month-old daughter, Taylor.

It was head trauma. The seat hit her in the face and that’s what caused the brain bleed they couldn’t stop,” Liz Warner said.

Taylor was in her car seat when the Warners’ 2010 Honda Odyssey was rear ended.  The driver’s seat collapsed on impact and struck Taylor in the face. She never regained consciousness.

“That was it. We didn’t get to know her anymore,” Liz Warner said.

After the Warners buried their baby girl, they realized they were not alone. According to the Center for Auto Safety, 898 children have been killed in rear-end collisions in the past 15 years, all of them sitting in the back seat.”  See  http://kdvr.com/2016/04/28/front-seat-hidden-danger-kills-children-in-cars/