Neck pain and head restraint position relative to the driver's head in rear-end collisions.

This two-year investigation was designed to estimate the incidence of driver neck pain in rear-struck vehicles involved in two-vehicle collisions and to determine the relationship between neck pain and specific vehicle, human, and environmental factors. Neck pain percentages were significantly higher for female (45%) than for male (28%) drivers. For female and male drivers, neck pain likelihood increased as head restraint height decreased below the head's center of gravity, although this effect was significant only for females. Head restraint backset, the horizontal distance measured from the back of the driver's head to the front of the head restraint, was not found to be related to neck pain for female drivers. Backset trends for male drivers could not be evaluated because few male drivers had head restraints that were high enough for backset to be relevant. Reported neck pain decreased for older drivers (females only), drivers in less severe crashes, and drivers in heavier cars (females only); all head restraint analyses were adjusted for these characteristics. Women, and most likely men, in the United States would benefit greatly from international harmonization to European head restraint standards. Until then, both women and men should be encouraged to adjust their adjustable head restraints, if possible, behind their heads' centers of gravity and to sit with the backs of their heads as close as possible to their head restraints.

Deaths from motor vehicle crashes: patterns of injury in restrained and unrestrained victims.

A time comparison study of motor vehicle crashes in Monroe County, New York, from 1983 to 1986 was completed. Using a database of police accident reports, hospital logs, and autopsy reports from the county coroner, the hospital and autopsy reports of 91 unrestrained and 27 restrained fatally injured victims were reviewed. The hypothesis was that safety belts do not change patterns of injury in fatally injured victims. Patient data, seating position, and direction of impact were the same for both groups, while ejections occurred only in the unrestrained group (19.8%). Injury Severity Score (ISS), major injuries in AIS-85 categories for the Head, Thorax, Abdomen, and in AIS-85 Code 5 or 6 categories for the Head, Thorax, Abdomen were the same in unrestrained and restrained victims, except for the greater incidence of cerebral contusions in the unrestrained group (71% vs. 37%, p = 0.002). Cranial injuries were the most likely cause of death in nearly two thirds of the victims in both groups. The incidence of major head (other than cerebral contusion), thoracic, and abdominal injuries in unrestrained and restrained fatally injured victims was the same. This suggests that severe collisions with crushing, intrusion, or significant deceleration exceed the ability of restraints to prevent many fatal injuries.

Changes in alcohol consumption by 18-year-olds following an increase in New York State's purchase age to 19.

A household-based telephone survey of 1800 16- to 20-year-old New Yorkers was conducted during November 1982, approximately one month before New York's minimum legal purchase age for alcoholic beverages was raised from 18 to 19. A second sample was surveyed during December 1983, approximately one year following the change. Comparisons between 1982 and 1983 of prevalence measures for various drinking levels for each age group were made. The prevalence of all drinking levels decreased significantly for 18-year-olds as well as 17-year-olds. Decreases for 19- and 20-year-olds were significant for less than half the measures and were less in magnitude than decreases for 18-year-olds. Prior to the purchase age change, prevalence measures for 18-year-olds were similar to those for 19- and 20-year-olds. Following the increase, measures for 18-year-olds were significantly lower than those for 19- and 20-year-olds. Analysis by sex showed that prevalence measures for 18-year-old men and women generally declined significantly. The public health implications of these findings as well as the highway safety aspects are discussed.