Air Bag–Related Injuries
[National Highway Traffic Safety Administration. Air bag–related injuries. Ann Emerg Med. 2003;42:285-286.]

The National Highway Traffic Safety Administration (NHTSA) recently published the latest in a series of papers on the results of investigations of air bag injuries. The paper presents information from NHTSA’s Special Crash Investigations program concerning injuries in air bag–equipped vehicles. The paper provides the most recent information and findings from the investigations,
updating and expanding findings from 2 previously published papers.

Topics include physical characteristics of occupants fatally injured by a deploying air bag and an overview of special case studies available for review on NHTSA’s Web site (http://www-nrd.nhtsa.dot.gov/departments/nrd-30/ncsa/sci.html).

NHTSA performs research and develops safety programs and standards in an effort to reduce the toll of deaths, injuries, and property damage from traffic crashes. In-depth field investigations on crashes with an air bag deployment are conducted to develop anecdotal data for examining and evaluating the latest safety systems. Conducted at NHTSA by the Special Crash Investigations program, these investigations play a vital role in providing information on real world events.

From 1972 to 1990, the Special Crash Investigations program investigated all crashes reported to
NHTSA that involved an air bag–equipped vehicle. However, because of the rapid growth in the marketplace after 1990, the Special Crash Investigations program shifted to investigating air bag–related crashes involving serious or fatal injuries, air bag performance, interaction between
air bags and child safety seats, air bag–nondeployment crashes, inadvertent air bag deployments,
side air bags, “redesigned” air bags, and advanced occupant protection systems. Information
resulting from these investigations has been used by NHTSA and by the automotive safety community to better understand real world performance of new and emerging air bag systems.

These investigations have been instrumental in influencing improvements to new generations of
air bag technologies. The first driver air bag–related fatality was confirmed through these investigations in 1991. In 1993, the first air bag deployment–related child fatality was confirmed.

Investigations were expanded in 1996 to document all air bag–related life-threatening or fatal injuries. That year, NHTSA began publishing summary tables for each confirmed air bag–related fatality and seriously injured occupant.

In these investigations, children are defined as occupants aged 12 years and younger, serious injury is that at a level sufficient to be a threat to life, minor severity crashes are those with a speed change of less than 19 mph, and moderate severity crashes are those with a speed change between 19 and 24 mph.

To be fatally injured by an air bag, the deployment energy of the air bag must be imparted to the occupant who is in the deployment path of the air bag or its cover flap. In crashes of minor to moderate severity, the occupant is most typically out-of position and in the path of a deploying
air bag in one of the following scenarios:

1. The occupant’s initial seating position places him or her in the air bag–deployment path. Initial positioning may include: small or short stature occupants who have moved their seat forward and are seated in close proximity to the air bag, or occupants who have fallen asleep, passed out, or are leaning into the deployment path. This scenario includes both belted and unbelted occupants.

2. Just before air bag deployment, the occupant has moved to a location that puts him or her in the deployment path. This movement into the path takes place as a result of a pre-impact or at-impact event that repositions the occupant, such as pre-impact braking that throws the occupant forward, multiple closely spaced near-deployment events, running off the road, or long crash pulses, which also result in late air bag deployments. Unbelted or improperly belted occupants are most likely to become out-of-position in this scenario.

As of April 1, 2003, NHTSA’s investigations program had a total of 244 cases (229 confirmed and 15 unconfirmed) where the deployment of the driver or passenger air bag resulted in a fatal injury in a minor-to-moderate severity crash. Of these, 143 of the confirmed cases were children, of which 121 were children not in a rear-facing child safety seat and 22 were infants in rear-facing child
safety seats. There have been 76 adult driver and 10 adult front passenger confirmed fatalities. The
Special Crash Investigations files are believed to contain a near census of all air bag–related fatalities in crashes of minor to moderate severity in the United States.

For a complete copy of “Air Bag Crash Investigations,” Enhanced Safety of Vehicles Paper No. 299, visit NHTSA’s Web site at http://www-nrd.nhtsa.dot.gov/departments/nrd-01/esv/esv.html.