October 7, 1997
Media Contact: Karen Infeld
Phone: (410)955-1534

Using air bags and shoulder restraints in passenger aircraft could reduce deaths from head injuries sustained in airplane crashes, according to a study led by researchers at Johns Hopkins. Such injuries account for up to a third of all aviation-related deaths in the United States.

The study, which was supported by the Centers for Disease Control and Prevention, is published in a September 1997 issue of The American Journal of Forensic Medicine and Pathology.

The researchers examined injury patterns among the 2,554 people who died in airplane crashes in the United States in 1980 and 1990. Despite a 34 percent reduction in the number of aviation-related fatalities between 1980 and 1990, injury patterns were fairly stable.

About 42 percent of those who died in the crashes suffered multiple injuries as the immediate cause of death, followed by head injury (22 percent); internal injury of the thorax, abdomen or pelvis (12 percent); burns (4 percent); and drowning (3 percent). Eighteen percent of the victims sustained a single injury, nearly a third of whom died from head injuries. Head injuries also were the most common cause of death among children.

"The currently used lap belt is insufficient in protecting passengers from decelerative injuries in aviation crashes," says Guohua Li, M.D., Dr. P.H., associate professor of emergency medicine at Hopkins and lead author of the study. "To prevent serious head injuries, more effective restraint systems as well as crash worthy seats, airframes and superstructures must be considered."

Li says studies of small aircraft have shown that pilots with shoulder harnesses were more likely to survive in crashes than those with only lap belts. In addition, studies of air bags in aircraft from the late 1960s showed promising results in preventing serious thoracic and head injuries.

"Because of the large crash forces and inadequate protection, aviation crashes usually result in very serious injuries with a case fatality rate of 42 percent, compared with 0.1 percent for motor vehicle crashes," said Susan P. Baker, M.P.H., co-author of the study and professor of health policy and management. "Findings from this study suggest that 87 percent of victims sustained injuries so severe that they either died at the crash scene or on arrival at the hospital."

Emergency medicine could play a greater role in improving passenger survival if the mechanical forces transmitted to passengers in aviation crashes were significantly reduced by air bags and better restraint systems, the researchers concluded.

-- JHMI --
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