Taking the Lash Out of Driving

What is the most frequent injury suffered in car crashes – broken bones, head trauma, paralysis? No, it is soft tissue injuries like whiplash. According to many insurance sources, whiplash and related disorders account for 60%-70% of all reported injuries. With more than 200,000 auto accident-related injuries each year in Canada, that is a lot of lives disrupted by something so preventable.

The message from safety experts today is that a properly adjusted headrest can reduce the risk of whiplash-related injuries, often by as much as 40%. The problem is that many drivers do not know much about headrests. A recently released Insurance Bureau of Canada (IBC) study suggest that more than half of all drivers (53%) have their headrests adjusted to an inadequate position, providing no protection in a rear-end collision.

Given that about 75% of the headrests in vehicles today are adjustable, as opposed to fixed, that can mean a huge difference in the rate of whiplash injuries and costs to the health system and insurers. A poorly adjusted headrest can actually worsen the effects of a rear-end collision on the neck and spine.

But what exactly is the proper position? Experts say there are two measurements – vertical and horizontal or, in other words, how high your headrest is and how far it is from the back of your head (backset). The generally accepted measurement for the proper height is the ear. For this study, researchers rated headrests good if they were above the ear, marginal if between the top and bottom of the ear, poor if below the ear and very poor if the headrest was not visible at all.

The other factor is how far the head is horizontally from the restraint. The acceptable to good rating for proper backset is two to four inches, while if the distance was more than half the width of the head, restraints were rated poor and if greater than a full head’s width, very poor.

Are drivers really paying attention to their headrests? That is what the national study aimed to find out in various parts of Canada. Through videotapes filmed in seven provinces from Newfoundland to British Columbia during June and July of 2002, the researchers found that only 14% of drivers had their headrests in a “good position”. But this number does not tell the whole story.

There are a number of factors involved in proper headrest positioning, such as driver characteristics and adjustment, restraint type, vehicle model, gender and even regional differences across Canada. For example, the study showed that B.C., Alberta and Newfoundland saw the highest percentage of headrests in good positions. Conversely, New Brunswick and PEI drivers had the lowest rate of good restraint positioning, with the other provinces in the middle.

WHIPLASH COST

The IBC-sponsored study also found that females were three times more likely than males to have their headrests adjusted in the good position. Large cars and pick-up trucks showed the poorest positioning of headrests, with drivers of these vehicles showing just 23%-22% of good or marginal adjustment.

Why is this issue so important? The incidence and cost of whiplash-related injuries have increased in countries around the world in recent years. In B.C. alone, the government estimated that whiplash from car accidents accounts for about 68% of reported injuries and costs $350 million every year. In fact, the provincial government insurer notes that whiplash contributes about $135 to each insurance policy per year.

In the U.S., the Insurance Institute for Highway Safety (IIHS) says whiplash and neck sprains represent 66% of all bodily injury insurance claims, costing an average of $7 billion each year. Studies done in the U.S. show an even poorer rate of headrest adjustment than in Canada.

Most people are familiar with the term whiplash – the motion of the neck snapping back from a sudden movement – but there is considerable confusion about its exact medical definition. One of the leading research projects on the subject was the Quebec Task Force on Whiplash-Associated Disorders, which published a report in 1995. It defined whiplash as “an acceleration-deceleration mechanism of energy transfer to the neck. It may result from rear-end or side-impact motor vehicle collisions, but can also occur during driving and other mishaps. The impact may result in bony or soft-tissue injuries (whiplash injury).”

The Quebec task force devised a rating scale for four grades of whiplash, depending on severity. Victims of whiplash can experience anything from stiffness or tenderness to decreased range of motion to fracture or dislocation. Aside from neck and joint pain, symptoms may include headaches, deafness, memory loss, dizziness and difficulty in swallowing. Beyond the substantial costs to the healthcare system and the insurance industry, whiplash clearly has a significant impact on peoples’ lives, families and jobs.

AUTO DESIGNS

Auto manufacturers have improved headrest designs over the past decade (remember the bench seats on many older station wagons that offered no head support at all?). In 1995, the IIHS rated only 7% of the headrests in vehicles either adequate or good. Today, the majority of head restraints in current models have achieved at least acceptable, and often good, ratings.

Now it is increasingly up to drivers to get the message. As the researchers for the head restraint study noted: “What are also needed are changes to the awareness, attitude and behaviors of drivers and passengers with respect to head restraint usage. That is, regardless of the design capability, a minimum level of risk will likely remain unless motorists become more knowledgeable.”

The next time you get into your car, take a minute before turning the key in the ignition. Draw a line straight back from the top of your ear to the headrest. Is there anything that would stop your head from moving back if the car was suddenly jolted? Is there minimal space between your head and the actual restraint? Have you even noticed if your seat has an adjustable or fixed restraint? If the answer to any of these questions is no, you or your passengers could suffer a serious whiplash-related injury in a rear-end or side collision, even at low speeds. Taking that extra minute to properly adjust your headrest may mean the difference between walking away from an accident or living with the pain and disruption of whiplash.