Airbags Lead to a Decline in Maxillofacial Injuries in New York

Release: May 12, 2000
Contact: Kenneth Satterfield, 407-238-4161 (as of 5/12/2000)

AIRBAGS LEAD TO A DECLINE IN MAXILLOFACIAL INJURIES IN THE EMPIRE STATE

The benefits of airbags and seatbelts to New York state drivers lead to a significant drop in permanent injuries to the face and skull

Orlando, FL -- To date, no study has analyzed the effect of airbags on the incidence and severity of maxillofacial trauma. Now, researchers have demonstrated that in New York State, airbags have contributed to a decline in the incidence and severity of maxillofacial injuries in occupants of vehicles.

The authors of the study, "Impact of Airbags and Seat Belts on the Incidence and Severity of Maxillofacial Injuries in Automobile Accidents Within New York State," are Jason Mouzakes, MD, and Siobhan Kuhar, MD, PhD, both from the Albany Medical Center Hospital / Division of Otolaryngology--Head & Neck Surgery, Albany, NY; Peter J. Koltai, MD, The Cleveland Clinic Foundation / Department of Pediatric Otolaryngology--Head and Neck Surgery, Cleveland, OH: and Dan S. Bernstein, Paul Wing, and Edward Salsberg, all from the State University of New York / School Public Health, Albany, NY. Their findings were presented before the annual meeting of the American Society of Pediatric Otolaryngology, meeting May 16-18 in Orlando, FL.

Methodology: A review of the New York State Department of Health hospitalization data from 1990 -- 1996 was performed. Specifically, all maxillofacial injuries were tabulated, and those injuries resulting from motor vehicle accidents were selected based on ICD-9-CM Supplementary Classification of External Cause of Injury (e-codes). This data set contained the ICD-9-CM diagnoses recorded. Relevant ICD-9-CM diagnosis codes reflecting maxillofacial injures were chosen, and frequency tabulations were compared in a time-series. The second phase of the study included an epidemiological analysis of all automobile (passenger cars and light-trucks) accidents occurring in the year 1994 in New York State. All other vehicles were excluded, as current restraint laws and airbag installation requirements apply only to passenger cars and light trucks. The data was derived from the Crash Outcome Data Evaluation System (CODES) project of 1994. CODES consists of linked statewide crash and inju

Each occupant was then grouped based on the safety mechanism utilized at the time of accident: GROUP 1: No lap/harness restraint and no airbag (not activated or not present); GROUP 2: No lap/harness restraint and airbag deployed; GROUP 3: Lap/harness restraint in use and no airbag (not activated or not present); GROUP 4: Lap/harness restraint in use and airbag deployed. Each group was reviewed with regard to treatment status (outpatient vs. inpatient), extent of maxillofacial injury [none, minor ( abrasions, contusions, minor soft tissue trauma), moderate (lacerations, fractures not requiring open reduction and internal fixation), and major (maxillofacial trauma requiring open reduction internal fixation).
Results: The total of all maxillofacial fractures resulting from motor vehicular accidents over the span of time from 1990-1996 equals 9,763 cases. The average age of the accident victims was 38. Men comprised 63.2% of the auto accident victims. Analysis of the data demonstrates a decreasing trend of motor vehicular accident-related facial fractures over time. During this time period, population size and vehicle registration counts remained stable. Other findings included:

ï The total number of police reports on individuals involved in motor vehicle accidents in 1994 was 595,900. Of these, 377,054 cases were selected which involved cars, light trucks, vans, minivans, sport utility vehicles, and light trucks. From this total, only drivers (n=240,091; 63.7%) and right front occupants (n=69,843;18.5%) were selected for analysis. Ultimately, definitive identification of safety equipment status reduced the number of cases to 226,993 (164,238 drivers and 62,755 passengers). The male to female ratio was 55.4% male : 44.6% female. The greatest frequency of accidents occurred on Fridays (16.7%).

ï Further analysis of the right front occupants revealed only 2,374 cases involving airbag usage, reflecting the small number of vehicles possessing passenger-side airbags in 1994. While descriptive, this data was abandoned, due to the lack of power when comparing this small subgroup to the right front occupants of vehicles without airbags (> 60,000 cases). All subsequent analysis was directed at the driver position.

ï Drivers using airbags in combination with seat belts were found to have a significant decrease in the incidence and severity of facial injuries (rate of injury = 1 in 449) when compared to individuals using only seat belts (rate of injury = 1 in 217) or airbags alone (rate of injury = 1 in 148) or no restraint (rate of injury = 1 in 40).
ï Drivers of vehicles with airbags are 58% less likely to sustain a severe facial injury requiring hospital admission (when compared to drivers of vehicles without airbags). Drivers who wear seat belts are 77% less likely to sustain a severe facial injury requiring hospital admission (when compared to drivers who do not wear seat belts).

Conclusions: The data revealed a significant difference in maxillofacial trauma outcome comparing individuals using airbags and restraints versus no safety equipment. Specifically, drivers using airbags in combination with seat belts were found to have a significant decrease in the incidence and severity of facial injuries (rate of injury = 1 in 449) when compared to individuals using only seat belts (rate of injury = 1 in 217) or airbags alone (rate of injury = 1 in 148) or no restraint (rate of injury = 1 in 40) (p<.001).
Public response to issues such as the adverse effects of airbags has been the impetus behind changes in safety measures. Manufacturers are continuing efforts to de-power airbags and provide deactivated technology. However, an epidemiologic review of automobile accident-related injuries helps differentiate causation from anecdotal case report. In this study, airbags used in conjunction with seatbelts resulted in the least severe maxillofacial injuries. This supports the current recommendation by the National Highway Traffic Safety Administration that airbags should be used as an adjunct to seat belt restraint systems, and should not be viewed as a sole safety device.

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