TRAUMA REDUCTION IN MOTOR SPORT: SCIENCE AND SAFETY A public health and historical perspective Michael Henderson C h a i r m a n, A u s t r a l i a n I n s t i t u t e F o r M o t o r S p o r t S a f e t y F e l l o w, F I A I n s t i t u t e F o r M o t o r S p o r t S a f e t y 2 0 0 9 A n n u a l C o n f e r e n c e I n t e r n a t i o n a l C o u n c i l F o r M o t o r s p o r t S c i e n c e s
Aims of the presentation Review how public health approaches have been applied to safety in motor sport Highlight how success has followed the application of scientific method to injury causation and prevention Consider recent trends in motor sport injury Review priorities for motor sport injury reduction in the future
Three eras in motor sport safety 1900 to 1960 The pre-scientific era Carnage at Le Mans, 1955
Three eras in motor sport safety 1960 to 1995 The emergence of a science Jackie Stewart, with early attempts at fire protection 1966
Three eras in motor sport safety 1995 to the present The modern era Cutting edge crash protection
The three eras: total driver deaths, worldwide, 1895-2008 An emerging science The pre-scientific era The modern era Data source: www.motorsportmemorial.org
The pre-scientific era: were driver deaths an inexorable trend? Features of the era: Fatalism survival from death or injury was simply a matter of luck Many famous drivers killed - death and injury were seen as an acceptable consequence of the sport Also, disastrous events caused mass spectator deaths and often caused suspension of motor racing, at least temporarily
The era of an emerging science Features of the era A stimulus for change brought about by recurrent disasters An acceptance that injury can be reduced through research and scientific method A new conceptual model for injury control, going beyond human error and into multifactorial aetiology The generation of a research imperative The successful application of results Lorenzo Bandini 1967: no belts, hay-bail barriers, poor rollover protection, postcrash fire, poorly protective driving suit, untrained and ill-equipped track staff: a preventable death
The era of an emerging science: the early days 1942: seminal paper of Hugh De Haven: 1949: Gordon and Gibson placed injury control within the public health framework, 1952: De Haven introduced the concept of safety packaging the vehicle occupant 1956: first automobile barrier crash tests reported by Severy and Mathewson 1957: Dr John Paul Stapp personally confirmed that human tolerance levels approached 100 g deceleration for very short applications Stapp being prepared for rocket-propelled ride at 1,017.5 km/h, coming to dead stop in 1.4 seconds
An emerging science: the concept of managing energy, the agent of injury Crash prevention: Prevent energy transfer to human body Human Vehicle Environment Behaviour Performance Training Experience Braking Handling Maintenance Driver aids Road and track surfaces and layouts Signalling and warning systems Injury prevention: Modify the way that energy transfer occurs Personal protection systems: choice and use Restraint system installation Supplementary restraints Cockpit, seats and surrounds Roadside and trackside design and installations After the crash: Counter and minimise damage caused by the energy transfer Physical fitness Recovery potential Fuel system integrity Fire extinguishing Access and egress First intervention efficiency and speed Patient transport Trauma services and care The matrix of Dr William Haddon Jr, 1972
An emerging science: epidemiology in motor sport and the need for good data Examples of the gradual collection of data on rates, factors and injury mechanisms: 1968 (Henderson): year s sample of crashes in Britain; 1972: (Jim Clark Foundation): study of Formula One cars 1966-1972 seasons; 1990: (Trammel and Olvey): data from Indy-car racing, 1981 to 1989 1999 (Chesser et al): five-year study of 521 medical centre attendances at a British circuit 2004 (Minoyama and Tsuchida): study of professional racing in Japan Crash prevention: Prevent energy transfer to human body Injury prevention: Modify the way that energy transfer occurs After the crash: Counter and minimise damage caused by the energy transfer Human Vehicle Environment Behaviour Performance Training Experience Personal protection systems: choice and use Physical fitness Recovery potential Braking Handling Maintenance Driver aids Restraint system installation Supplementary restraints Cockpit, seats and surrounds Fuel system integrity Fire extinguishing Access and egress Road and track surfaces and layouts Signalling and warning systems Roadside and trackside design and installations First intervention efficiency and speed Patient transport Trauma services and care
An emerging science: the biomechanics of motor sports injury and a new literature 1998 (Melvin et al): in the US, instrumentation of Indy cars 2000 (Wright): for Formula One, the first analysis of instrumented cars 2000 (Mellor): Formula One in-depth crash investigations examined head injury, scientific basis for new helmet designs 2006 (Melvin et al): extended study of impact recorders in stock car racing
An emerging science: the competition car Pininfarina/Ferrari Formula One safety concept: the 1969 Sigma Grand Prix
An emerging science: the competition car, developments since 1969 Built-in fire protection and extinguishers - F1 regulations starting 1969 Six-point restraint harness - F1 regulation 1972 Head restraint system - F1 regulation 2003 Driver s safety cell with surrounding collapsible structures - F1 regulations from 1981 Crash data recording system Indy cars 1990; FIA F1 cars 1997 Rear wheel over-ride protection - No FIA regulation as of 2009
An emerging science: tracksides and barriers A slow evolution of measures to protect competitors and spectators, with contrasts between road and track events
An emerging science: advances in medical services Louis Stanley and the International Grand Prix Medical Service Professor Sid Watkins and the FIA medical teams Many other clinicians in recent years
The modern era: 1995 to present How successful have we been?
The modern era saving lives in the most severe crashes in professional motor sport Luciano Burti, Hockenheim 2001 Schlegelmilch/Corbis Ryan Briscoe, Indianapolis 2005 LAT Colin McRae, WRC Finland 2003 Robert Kubica, Montreal 2007 Speed TV
The modern era: drama in world championship rallying Jari-Matti Latvala, WRC Portugal 2009
The modern era: drama at the 2009 WRC Championship round in Portugal Jari-Matti Latvala, WRC Portugal 2009 "I realised we were going to crash... and then it rolled and rolled... I thought I was going to die. It was my biggest accident ever. I have to thank the team and the FIA for saving my life and building such a strong car. www.autosport.com, April 9 2009
The modern era: has science been successful in all fields of motor sport? Compare two periods for changes in patterns of worldwide fatality: 1964-1970 (the worst period ever) versus 2000-2007 (the modern era) Data source: www.motorsportmemorial.org
Worldwide motor sport fatalities: absolute numbers Data source: www.motorsportmemorial.org
Worldwide motor sport fatalities: absolute numbers Data source: www.motorsportmemorial.org
Worldwide motor sport fatalities: absolute numbers Data source: www.motorsportmemorial.org
Worldwide motor sport fatalities: absolute numbers Data source: www.motorsportmemorial.org
Total reported deaths in motor sport, all participants world wide, 1895-2008 What s going on here? Data source: www.motorsportmemorial.org
Drivers and co-drivers, annual deaths by year and category, 1990-2008 (Three-order polynomial smoothed data Data source: www.motorsportmemorial.org
Other participants, annual reported deaths by year and category, 1990-2008 Spectators Track officials Journalists
The modern era and its implications Worldwide figures show that while safety is improving for competitors in circuit racing, the situation is very different for rallying Competitor protection for professional circuit racing is now so good that it may be recognised as a successful application of the vision zero concept now being used in highway safety The concept means that no motor sport participant should be exposed to forces above tolerance levels for death or serious injury However, safety advances in professional racing have so far been applied essentially irrespective of cost and although costs have so far been borne, it becomes ever harder to reduce the risk of injury even further The data presented here show that major problems remain for the application of this concept to other kinds and levels of motor sport without adversely affecting competition by cost pressures or loss of challenge and excitement for competitors and other participants
Summary and conclusions A public health perspective on the reduction of injury in motor sport recognises that: Trauma results from the complex interaction of man (the host), machine (the vector), the environment, and the agent of injury (energy) The ultimate goal is to prevent death and severe injury by ensuring that exposure to energy does not exceed tolerable levels Available data show that the application of science-based measures has brought huge reductions in trauma and rapidly reversed trends that could have meant the end of motor sport Improvements, however, have been very unevenly distributed throughout the sport, with professional circuit racing showing the greatest benefits and arguably leading to a degree of complacency A continuing flow of good data on crash rates, contributory factors and injury mechanisms is essential for the priority implementation of affordable safety measures, perhaps with associated cost-benefit analysis, especially at club and national level