BMI and Risk of Serious Upper Body Injury Following Motor Vehicle Crashes: Concordance of Real-World and Computer-Simulated Observations

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Background:
Men tend to have more upper body mass and fat than women, a physical characteristic that may predispose them to severe motor vehicle crash (MVC) injuries, particularly in certain body regions. This study examined MVC-related regional body injury and its association with the presence of driver obesity using both real-world data and computer crash simulation.

Methods and Findings:
Real-world data were from the 2001 to 2005 National Automotive Sampling System Crashworthiness Data System. A total of 10,941 drivers who were aged 18 years or older involved in frontal collision crashes were eligible for the study. Sex-specific logistic regression models were developed to analyze the associations between MVC injury and the presence of driver obesity. In order to confirm the findings from real-world data, computer models of obese subjects were constructed and crash simulations were performed. According to real-world data, obese men had a substantially higher risk of injury, especially serious injury, to the upper body regions including head, face, thorax, and spine than normal weight men (all p<0.05). A U-shaped relation was found between body mass index (BMI) and serious injury in the abdominal region for both men and women (p<0.05 for both BMI and BMI²). In the high-BMI range, men were more likely to be seriously injured than were women for all body regions except the extremities and abdominal region (all p<0.05 for interaction between BMI and sex). The findings from the computer simulation were generally consistent with the real-world results in the present study.

Conclusions:
Obese men endured a much higher risk of injury to upper body regions during MVCs. This higher risk may be attributed to differences in body shape, fat distribution, and center of gravity between obese and normal-weight subjects, and between men and women.

: Please see later in the article for the Editors' Summary

Vyšlo v časopise: BMI and Risk of Serious Upper Body Injury Following Motor Vehicle Crashes: Concordance of Real-World and Computer-Simulated Observations. PLoS Med 7(3): e32767. doi:10.1371/journal.pmed.1000250
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pmed.1000250

Souhrn

Zdroje

1. National Center for Injury Prevention and Control 2006 Injury fact book 2006. Atlanta (Georgia) Centers for Disease Control and Prevention

2. NHTSA 2005 Traffic safety facts 2005: a compilation of motor vehicle crash data from the fatality analysis reporting system and the general estimates system. Washington (D.C.) US Department of Transportation (DOT HS 810631)

3. ZhuS

LaydePM

GuseCE

LaudPW

PintarF

2006 Obesity and risk for death due to motor vehicle crashes. Am J Public Health 96 734 739

4. VagueJ

1996 Sexual differentiation. A determinant factor of the forms of obesity. 1947. Obes Res 4 201 203

5. EnziG

GasparoM

BiondettiPR

FioreD

SemisaM

1986 Subcutaneous and visceral fat distribution according to sex, age, and overweight, evaluated by computed tomography. Am J Clin Nutr 44 739 746

6. RossR

ShawKD

RissanenJ

MartelY

de GuiseJ

1994 Sex differences in lean and adipose tissue distribution by magnetic resonance imaging: anthropometric relationships. Am J Clin Nutr 59 1277 1285

7. LarssonI

Berteus ForslundH

LindroosAK

LissnerL

NaslundI

2004 Body composition in the SOS (Swedish Obese Subjects) reference study. Int J Obes Relat Metab Disord 28 1317 1324

8. NHTSA 2000 National Automotive Sampling System (NASS), Crashworthiness Data System (CDS), Analytic User's Manual. Washington (D.C.) US Department of Transportation

9. NHTSA 2000 National Automotive Sampling System (NASS) Crashworthiness Data System (CDS), Coding and Editing Manual. Washington (D.C.) US Department of Transportation

10. Association for the Advancement of Automotive Medicine 1990 The abbreviated injury scale: 1990 revision. Des Plaines (Illinois) Association for the Advancement of Automotive Medicine

11. BailarJC3rd

MostellerF

1988 Guidelines for statistical reporting in articles for medical journals. Amplifications and explanations. Ann Intern Med 108 266 273

12. ShenW

ChenJ

2008 Application of imaging and other noninvasive techniques in determining adipose tissue mass. Methods Mol Biol 456 39 54

13. ShenW

PunyanityaM

WangZ

GallagherD

St-OngeMP

2004 Total body skeletal muscle and adipose tissue volumes: estimation from a single abdominal cross-sectional image. J Appl Physiol 97 2333 2338

14. ToddBA

ThackerJG

1994 Three-dimensional computer model of the human buttocks, in vivo. J Rehabil Res Dev 31 111 119

15. FidanzaF

KeysA

AndersonJT

1953 Density of body fat in man and other mammals. J Appl Physiol 6 252 256

16. KentRW

FormanJL

BostromO

2009 Is there really a “cushion effect”?: a biomechanical investigation of crash injury mechanisms in the obese. Obesity. In press

17. RouhanaSW

BedewiPG

KankanalaSV

PrasadP

ZwolinskiJJ

2003 Biomechanics of 4-point seat belt systems in frontal impacts. Stapp Car Crash J 47 367 399

18. KiuchiT

1998 A simulation study on inflation induced injury and NCAP with depowered airbag. 2518 2525 Proceedings of the 16th International Technical Conference on the Enhanced Safety of Vehicles; 1998; Windsor (Ontario): National Highway Traffic Safety Administration.

19. EppingerR

SunE

KuppaS

SaulR

2000 Supplement: development of improved injury criteria for the assessment of advanced automotive restraint systems - II, National Highway Traffic Safety Administration, Technical Report. Washington (D.C.) US Department of Transportation

20. TagliaferriF

CompagnoneC

YoganandanN

GennarelliTA

2009 Traumatic brain injury after frontal crashes: relationship with body mass index. J Trauma 66 727 729

21. BoulangerBR

MilzmanD

MitchellK

RodriguezA

1992 Body habitus as a predictor of injury pattern after blunt trauma. J Trauma 33 228 232

22. MoranSG

McGwinGJr

MetzgerJS

WindhamST

ReiffDA

2002 Injury rates among restrained drivers in motor vehicle collisions: the role of body habitus. J Trauma 52 1116 1120

23. MockCN

GrossmanDC

KaufmanRP

MackCD

RivaraFP

2002 The relationship between body weight and risk of death and serious injury in motor vehicle crashes. Accid Anal Prev 34 221 228

24. ArbabiS

WahlWL

HemmilaMR

Kohoyda-InglisC

TaheriPA

2003 The cushion effect. J Trauma 54 1090 1093

25. ZhuS

MaX

ShenW

McGinleyE

LaudP

2008 Does body composition play a role in motor vehicle injury? Abstract of the 8th International Symposium on In Vivo Body Composition Studies; New York, New York; 87-P

26. StoohsRA

GuilleminaultC

ItoiA

DementWC

1994 Traffic accidents in commercial long-haul truck drivers: the influence of sleep-disordered breathing and obesity. Sleep 17 619 623

27. Teran-SantosJ

Jimenez-GomezA

Cordero-GuevaraJ

1999 The association between sleep apnea and the risk of traffic accidents. Cooperative Group Burgos-Santander. N Engl J Med 340 847 851

28. PericasJ

MunozA

FindleyL