Monday, February 10, 2014

Low Speed/Impact Crash means no personal Injury? Fact or Fiction?


You hear it all the time in the medicolegal community, minimal property damage so no personal injury. It was a low impact collision, barely a scratch on the vehicle. Insurance adjusters typically consider a "low impact" accident one in which there was little or no visible physical damage to the vehicle. At best, there might be a dime-sized dent in the bumper and the estimated cost of repair was under a hundred dollars. Over the years insurance companies have expanded it to $100.00, $250.00, $500.00, $1,000.00, to $2,000.00 and more. Basically, a “low impact collision” is whatever the insurance company says it is, but that’s hardly the case.  Whether a person was injured, in a "low impact" accident is always a matter of opinion the doctors, the lawyers and the patients.
The question of at what speed do you get a soft-tissue injury has always been debated.  It is complicated by human and physical variables, which are difficult to define, and even more difficult to test.  Here are some of the human and physical variables that contribute soft tissue injuries.
·      Awareness of impending crash
·      Bracing for impact
·      Sex
·      Age
·      Position in Vehicle
·      Stature

Some of the dynamic and vehicle factors that contribute to soft tissue injuries:
·      Vehicles involved
·      Speed differential
·      Vehicle weight
·      Location of impact
·      Direction of impact
·      Head restraint location
·      Seat failure
·      Seat back angle
·      Seat back height

"Low-speed" impact refers to 1-2 miles per hour and goes up to 20-25 mph. "Moderate speeds" are 25-40 mph and "high speeds" are 40 mph and over”1.  In a study by Chapline et al the largest category of injury crashes were graded as having no damage.  In these, 38% of females and 19% of males had symptoms.  When damage was rated as minor, these percentages were 54% and 34%.  This study demonstrates that injury occurs when there is no damage to the vehicle.   Brault JR et al used human volunteer crash testing to produce injuries in 29% and 38% of the participants in 2.5 m.p.h. and 5 m.p.h.  It appears that the threshold for injury, even in adult healthy volunteers under ideal laboratory conditions, may be as low as 2.5 mph”5.  
There are many studies that confirm low speed collisions with minimal damage to the vehicle cause injuryto the operator and passengers.  Research quoted by White and Panjabe states that an eight mph rear-end collision may result in a two g force acceleration of the impacted vehicle and a five g force acceleration acting on the occupant's head within 250 msec of impact. (One g equals an acceleration of approximately 32 ft./sec.) Car crashes happen in literally a blink of an eye. The point is that the head and neck experience more g forces than the car in low-speed impacts1.  Research has shown that high impact forces are transmitted directly to the occupant in low-speed impacts and that the vehicle does not begin to crush until impact speed exceeds 15 or 20 mph.1  Bumpers are made in a variety ways, ie. gas shock absorbers and polystyrene, able to withstand 8.1 to 12.4 m.p.h. resulting in less damage to the vehicle and more g force to the occupants 7,8,9,10.  Basically vehicles of today are being built to withstand more impact, but humans are not.  It is a fact that low speed/impact crashes cause personal injury to the occupants.

1.  Jeffrey Tucker, DC, DACRB, Injury with Low-Speed Collisions, Dynamic Chiropractic  May 22, 1995, Vol. 13, Issue 11.

2. States JD, Balcerak JD, Williams JS, et al.: Injury frequency and head restraint effectiveness in rear end impact accidents. In Proceedings of 16th Stapp Car Crash Conference, Detroit, MI, 228-257, 1972.

3. Chapline JF, Ferguson SA, Lillis RP, Lund AK, William AF. Neck Pain and head restraint position relative to the drivers head in rear-end collisions.  Accident Analysis and Prevention 2000; 32:287-297.

4. Brault JR, Wheeler JB, Siegmund GP, Brault EJ. Clinical response of human subjects to rear-end auto collisions. Arch Phys Med Rehabil 79:72-80, 1998.

5. Croft A, Whiplash Injury Threshold: New Lower Speed Defined, Dynamic Chiropractic – March 23, 1998, Vol. 16, Issue 07.

6. White AA, Panjabi MM. Clinical Biomechanics of the Spine, New York, JB Lippencott, 1978, pp 153-158.

7. Romilly DP, Thomson RW, Navin FPD, Macnabb MJ: Low speed rear impacts and the elastic properties of automobiles. Proceedings: 12th International Conference of Experimental Safety Vehicles, Gothenburg, 1-14, May/June, 1989.

8. Bailey MN, King DJ, Romilly DP, Thomson RW: Characterization of automobile bumper components for low speed impacts. Proceedings: Canadian Multidisciplinary Road Safety Conference VII, Vancouver, British Columbia, 190-203, Jun, 1991.

9. Bailey MN, Wong BC, Lawrence JM: Data and methods for estimating the severity of minor impacts. SAE Tech Paper Series 950352 1339-174, 1995.

10. Szabo TJ, Welcher J: Dynamics of low speed crash tests with energy absorbing bumpers. SA 41. E Tech Paper Series 921573, 1-9, 1992.





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