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

Date Published: March 30, 2010

Publisher: Public Library of Science

Author(s): Shankuan Zhu, Jong-Eun Kim, Xiaoguang Ma, Alan Shih, Purushottam W. Laud, Frank Pintar, Wei Shen, Steven B. Heymsfield, David B. Allison, Emmanuel Lagarde

Abstract: Shankuan Zhu and colleagues use computer crash simulations, as well as real-world data, to evaluate whether driver obesity is associated with greater risk of body injury in motor vehicle crashes.

Partial Text: Motor vehicle accidents are the leading cause of injury-related death in the United States. In 2005, approximately 45,000 persons died and more than 3 million persons were injured in motor vehicle accidents in the United States [1]. The estimated economic cost of motor vehicle accidents in 2005 was approximately 230 billion dollars [2]. Establishing the mechanisms, risk factors, and potential preventive strategies for motor vehicle accidents is a major goal of public health efforts.

The characteristics of the drivers, crashes, and environment of the crash by sex are shown in Table 1. Male drivers had on average higher mean BMI than female drivers. A greater proportion of female drivers than male drivers were driving passenger cars, were wearing seatbelts, and were in vehicles in which an airbag deployed. Female drivers were also driving relatively newer cars. Male drivers were driving vehicles with a higher vehicle weight and ΔV during the crash and were more likely to be involved in crashes involving alcohol use, ejection, and rollover. Male drivers were also more likely to have single-vehicle collisions than were female drivers. More male drivers had MVCs on roads with speed limits of 80 to 105 km/h, whereas more female drivers had crashes on roads with speed limits of 48 to 80 km/h. In addition, male drivers were involved in MVCs more frequently at night than were female drivers.

This study used both real-world and computer crash simulation data to examine injury patterns in MVCs, associations between BMI and regional body injury, and the differences in these associations by sex. From the real-world data, we found that obese male drivers have a substantially higher risk for injury, especially serious injury, to the upper body regions of the head, face, thorax, and spine. Obese female drivers, by contrast, have a slightly increased risk for injury to the thorax, abdomen, and lower extremities but a decreased risk for injury to the face. In addition, we found a U-shaped relation between BMI and serious injury in the abdominal body region for both men and women. The sex difference in the association between BMI and risk of injury and serious injury was found in head, thorax, and spine. In the high BMI range, male drivers were more likely to be seriously injured than were female drivers for all body regions except for extremities and abdominal region. The computer simulation crash test results confirmed the findings from real-world observations showing that obese men experienced a higher risk of upper body injury than did nonobese men.



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