Rear-end impacts are the most frequent type of automotive collisions. The most common injuries associated with rear-end impacts are soft tissue neck injuries, often called whiplash injuries, which bring about a significant cost to society every year. A major factor in reducing the risk of a whiplash injury is the proper positioning of the head restraint (HR) relative to the seated occupant’s head at the time of impact. In fact, current research shows that the risk of serious whiplash injuries can be reduced by 35% through proper positioning of the HR. However, according to a 2002 Insurance Bureau of Canada (IBC) observational study of HR use, on average 86% of Canadian drivers had their HRs positioned “poorly” thus providing inadequate whiplash protection. This very low rate of proper HR positioning indicates a strong need for action to reduce the impact of whiplash injuries on society. The lack of proper HR positioning prompted the researchers at UBC to initiate an AUTO21 NCE sponsored initiative entitled the “Whiplash Prevention Campaign”. The main goal of this initiative is to increase awareness of the importance and use of whiplash prevention measures by educating the public via comprehensive social marketing strategies and vehicle safety awareness programs. To evaluate the effectiveness of these safety awareness programs, up-todate baseline statistics of proper HR usage were deemed necessary and a new observational study was initiated in 2010. This paper presents the updated findings of implementing this observational study method (methodology initially presented at CMRSC XXI) for assessing HR use in passenger vehicles on public roadways within BC. The observational study was initially implemented at various sites near intersections throughout Greater Vancouver (Vancouver, Burnaby, Richmond, UBC Campus, etc. - results presented at CMRSC XXII), with subsequent sites more recently being selected and sampled within the BC Interior (Kamloops, Kelowna), on Vancouver Island (Nanaimo), and in Northern BC (Prince George). This subsequent data collection provides a larger and more diversified dataset of passenger vehicles and occupants for comparison in this expanded BC Provincial study. As per the defined study protocol, collected images of vehicle occupants were obtained and computeranalyzed using customized software to provide quantitative assessment of the HR position relative to the occupant’s head. The relative position of the HR was then evaluated based on the Insurance Institute for Highway Safety (IIHS) static position ratings (i.e. Good, Acceptable, Marginal, or Poor). A sample set of 2770 analyzed observations was obtained at 31 different sites across the province which included 2572 drivers and 198 passengers. The results show that only 44% of drivers had their HR positioned in the “Good” rated position to prevent or reduce risk of whiplash injury (based on the IIHS static position rating). Only 61% of drivers had their HR positioned rated as “Adequate”, i.e. “Adequate” being either in the “Good” or “Acceptable” range. Drivers in the Greater Vancouver region were more likely to have their HRs “Adequately” positioned compared to elsewhere in the province, however, subsequent statistical analysis indicated that this result could be attributed to the different distribution of vehicle types in more rural versus more urban areas. Although there has clearly been an increase in the rate of proper HR use since the IBC study of 2002, this study finds that still more than half of the drivers in the sampled population are not optimally protected from whiplash injuries. The findings of this study provide baseline information valuable for assessing the impact of social marketing interventions directed towards increasing whiplash safety awareness and changing occupant behaviour regarding the proper positioning of vehicle HRs.
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