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~of the data presented herein. The contents do not-cessarily reflect the official views or policy of . the

!..'partrnent of the Naivy. This report does not constitutestandArd, specification, or regulation.

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REPORT DOCUMENTATION PAGE 1:1 '''" 1(.)1(NVAIIN.I(R

ANAI*Y51IS OFJ NAVAr. AVIATION HIEAD AND NEC jINAL RFPMT.INJURIES (1969J-1978)HA171 MY07

______________ / 0249-78-81

Dynamic Sci~nce, IflC.611 C TR 02-3 R03-.

(1 .b./Tyndal A / NQ9014-71.-C-018 (.

R. 14.1 Carr-

N(I N~LI ( A011141 S AM MA I0I~~ I' I 1 f1NIP10 S

Dynaicn Vrirnia 22217

1 C 4140LLNG(1 6177.MA I N( A tI'E S 2 tI 11 P IC L T I I I'WJIA('d

Off~~~ ~ ~ ~ ii.C of Nap1 Ree l Ma 17

Doa tm n of thT Navy11

01 N.144 TI OF " P.1 .

OnlimjTitcsd Distribution Unlerth~hclassfie

Is. 1 A,%I ICA TIN P WNlWAIlrr

P71)flie ~istriutio 7S~ut beenI~d

~~~7,-;, al?: i.-. __ ___ _

~~' --.- - a.~.--

N~avy aircraft accidents; injuries to head and neck

tii '- Nva I a v ii at on c c id en t-s d u r i PlI I ho po ti od J (IIIIulry 169 It o t1ia r c I 0 1 tW(,?.( rovi owed( to st uly the flatuire aind] FseVe- ilty of i O1iu io! toP the hjild and1(

nck. Pe;itl, by aircr;'ft models and typos, were t, bij*at(,d alli an,-1 y7.fd

U ntwk , and c-ervi cal velrtvbra; this information was then~ tul:oi' to cot erinonSt hr iri mar y impact. fnrc- direct ion. The role of the helmet III in or y

d alil Ior rrevention was fal so -onsidered in the fin,-l directijinlal doff! -II mfina ion

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CONT ENTS

Paragraph 1.0 INTRODUCTION...............

1.1 objectives. ............... 62. 0 M1'iIUUU1LK. LUCY. ............. ....3.0 AIRCRAFT SUMMARIES (1969 - 1978) .9

3.1 Model Summaries. ............ 93.2 Type Summaries. .............. 47

ti3.2.1 Attack Aircraft ............. 573.2.2 Carqo Aircraft. .............. 573.2. 3 Fighter Aircraft. ............ 603.2.4 Heclicopters .............. 603.2.5 Patrol Aircraft ............ 603.2.6 Search Aircraft ............. 63

3.2. 7 Trainer Aircr~aft. ............ 63N 3.2.8 V/STOL Aircraft ............ 673.3 Analysis and Discussion . . . . 673.3.1 Protection Considerations . 693.3.2 Directional Considerations .. . 714.0 INJURY PROFILES .. .............. 744.1 Aircraft Type Fatal Injury

Profiles ................ 744.1.1 Attack Aircraft ............ 744.1.2 Fighter Aircraft. ............ 754.1.3 Trainer Aircraft. ............ 794.1.4 Helicopters...............814.1.5 Search Aircraft ............ 834.1.6 Patrol Aircraft. ....... 854.1.7 V/STOL Aircraft..............854.2 Analysis and Discussion . . . . 875.0 MOR REPORTING SYSTEM ............. 91

7.0 CONCLUSIONS ................. 966.0 RMMNCOSTS.................93

8. R C MM ND T ON ............. ...... ............

[, IA

FIGURES

Page

FIGURE 1. Attack Aircraft Injury Profile ...... .762. Fighter Aircraft Injury Profile 783. Trainer Aircraft Injury Profile 80 v4. Helicopter Injury Profile ........ .825. Search Aircraft Injury Profile ...... .84 46. Patrol Aircraft Injury Profile ...... .867. V/STOL Aircraft Injury Profile ...... .88

TABLES

TABLE I. Accident Injury Summary for A-2Aircraft .... ................ .i. 11

2. Accident Injury Summary for A-4Aircraft ... .............. ... 12

3. Accident Injury Summary for A- 5Aircraft .... ................ .. 13

4. Accident Injury Summary for A-6Aircraft .... ................ ... 141. 5. Accident Injury Summary for A-7Aircraft .... ............. ... 15

6. Accident Injury Summary for C-IAircraft. . ................ 16

7. Accident Tnjury Summary for C-2Aircraft ..... ............... ... 17

8. Accident Injury Summary for C-4Aircraft . . . . . . . . . . . . . . . . 18

9. Accident Injury Summary for C-9

Aircraft ..... ................ .1910. Accident Injury Summary for C-45

Aircraft ................ 20Il. Accident Injury Summary for C-47

Aircraft .... ................ ... 2112. Accident Injury Summary for C-117

Aircraft ..... ................ .2213. Accident Injury Summary for C-118

Aircraft ....... ........... .. 2314. Accident Injury Summary for C-121

Aircraft .... ............ .... 251.5. Accident Injury Summary for C-130

Aircraft ..... ............... ... 2616. Accident Injury Summary for C-131

Aircraft ..... ................ .2717. Accident Injury Summary for E-1

Aircraft. ............. . 2818. Accident Injury Summary for E-2

Aircraft ...... ................. 291~ 2'1I

, __ __f i i- _ i _ i___ ___ ___ I i i '

TABIS

TABLE 19. Accident Injury Summary for F-4Aircraft . . . . . . . . . . . . . . . . 30

20. Accident Injury Summary for F-8Aircraft ..... ................ . 31

21. Accident Ini ut y Summary for F-9Aircraft ....... .............. 32

22. Accident Injury Summary for F-14Aircraft . . . . . . . . . . . . . . . . 33

23. Accident Injury Summary for 11-1Aircraft. ............... 34

24. Accident Injury Summary fo l-r 11-2Ai rcraft ......... . . . . . ............. 36

25. Accident Injutry Summary for II-3

Aircraft ...... ................ 3726. Accident Injury Summary for 11-34

AircraI.t .......... ................ 3827. Accident. Injury Summary for 11-46

Aircraft. .......... ................ 3928. Accidnt Tllury Sum1mary for 11-53

Aircraft .......... ................ 4029. Accident Injury Sununary for 11-57

Aircraft ....... ............... 4130. Accident Injury Summary for P-2

Aircraft .......... ................ 4231. Accident lnjury Summary for P-3

Aircraft ...... ................ .4332. Accident Injury Summary for S-2

Aircraft ...... ................ ... 4433. Ac,:ident Injury Summary for S-3

Aircraft ...... ................ .4534. Accident In jury Summary for T-1

Aircraft ...... ................ 4635. Accident Injury Summary for T-2

Aircraft ...... ................ .4816. Accident Injury Summary for T-28

Aircraft ...... ................ 4937. Accident Injury Summary for T-33

Aircraft .......... ................ 5038. Accident Injury Summary for T-34B

Aircraft.. ."......... ... . . 5139. Accident Injury Summary for T-39

Aircraft .......... ................ 52-10. Accident Injury Summary for U-1i

Aircraft ...... .................41. Accident Injury Summary for U-I6

Aircraft ...... .................42. Accident Tinjury Sununary for AV-8

i ircraft ...... .................

3

TAlE. 4.3. Ac'cidont In tlly Suinlma ry for OV-1 0AirI'raft . . . . . . .

44. Ac' idelt In iu1y Sunumry for At t ackAiIfctI 58

45. ACC i idt'llt 1n 1 t'y IUmr y for C a :-q oAi rcr aft .. . . . ..

46. A'0idont Injury Summary for FiqhtcrAi rraft-................. t'l

17 . Ac i don t in iury S1m!n ryla forIlkl I ' | t (c I' . . . . . . . . .. ,

48. Acj idtnt nut y Sunuary for Patrol

4 ~ . Aer iko t d l IUit r iuut eioA i - I I.... . .. ................. .

-50. Ac'idet,' n l ury ,ttunt, lry for ,I-' h - i n -

,i1 l~l t...............................!'

.q0. Acc'ith'nit Ill illlry S k 1111111,l 1 "1 f 'llLl t ' I I

'. 1 . Accident III ilury Summary fo r V1,'l 11101

A i r f..i f t...................,1 k i i y 1"i at i t ll en by A tlul| I ty ti

l,. !ltld and Nt,,'k III ur y Sutull iry forot'l i0d J111. 1 9tW - 1a1. . ... . ..... 70

4 . Injury I'o., it im SnuuI."I y for Pt iod,an . 11)(1 - Mar. 197. ..... ......... 12

Att ack Ait r01 t , niu i.., ........... ..b I'i qht or Ai rc~if t 111 ju i o; T.........

'. Traiinr Aircrlt uI I it r i :........ 7%1.li" Ii 'opt Ill n i Ot............. . . .

',-. a'. 1 h A i ro:i tt Ii t it -- ..... . ....... .3('0. Pa t, oI A i r I I n i i c..........; ....... . ........ '

bl. Vi STOI, Air,'l t lniuri.. . ........... #(.2. See 10 t a 1 CO!"t ,Summary, .197"i .. .. .. 9

t%3. So, -'it t l Co, t'; of Navy ,at alit oi sIased oii A1S ...... .. . ............ 95

4

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iI11lit d I I v tilt tol e i o lit 110k I (~ ~ d 'A t ' k l u akAndli A0111 i shed *i

citI itII t I101,1\ it, kl aP ism \'vI't .iix'idt S A'I 101lto eavoide 'I'l IeP.I At 01

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1'tli t~ I 1t it s DOVt' o 11 0 t t Ioi I I t 1 A oraIlwo it It i mu 11 al 0 0~ -u11pli

11'.% t 1, 1 ut 11 i herI ll It, diwt'~ e I Id'' I Io -. v u e 11 I801

1 1 i 1 I't, V t 01I111li't A i VkO V AI t t Aloo doll t o 1 ii A' t I yd1' 'o

SIl I v i I I -a t', iii I y A1s .A tt -.iIt cof kuu .c t I v o s .1 l o r ir--

sil I i ~j I.8 "Im i.Io i W,' I kit'tl t A t 1 i t I i t pillil I I'0 A

Ilow I I'wh li In~ I Io I", e I s 11!t'st kn0o1 t I>7u,& ki'xu0L;:01 M

111011

The main thrust of the offort reported herein has been to

i(entify information which will denote where further research on

protection for the hem and neck should be conducted.

1. 1 OBJECTIVES

Navy aeromedical personnel have a historic devotion to im-

provinq survivability for all aircraft occupants, and have devel-

oped and maintained an accident reporting system which provides

extensive data on skull, face, eye, neck, and cervical injuries

as well as injuries to other body parts. Injury locations,

causes, diaqnoses, and contributing factors are computerized

and readily accessible in the data bank maintained by the Naval ISafety Center, Norfolk, Virginia. In addition, copies of Medic-l A

Officers Reports (MOR) are on file for analysis in either hard

copy or microfilm.

Using both computer data and MOR, the objectives of this ef-

fort were to: h

1. Determine directionality of injuries to the skull, face,eye, neck, and cervical vertebra, i.e., the location of Mthe external causal element with respect to the crew- ,man's position in the crash environment.

2. Identify data applications for further research.

'a'~ 1~thcio ~ involvk d oL'L. ivit pui~ touts of narrative

.UI %Ic ~'d ot .t kill AII NaIvy A ii i'rft AC Idett AWhiCh Ve I. klI tedII

fm'i I l iIvd iOvae itijur~. 1t1X~it- to It he' skiui I, tficv! eye nt'ck , uid

The a 'oI ~dom t pi, itt otit oocvo r v. t ho po r iod f ro J 1 1it. Il r t'y

to M.i It 1 "1 8 T e to& mowi lq ai %vIa tt wetk %. 1tivolvIeu uti. ill,)j Il -

A - -%

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i'\Vi'V.1 0 ot t he Ma'vw' .1 I I k, at t ark, n Ilk,~ ninvztr bt.

Wet~l' i Ilk, Iudedo , Iit i It i aI ly fov t ypt. s '11 1 xn .

e i t, e o w i doll 1si cm u t .111d oll t lit b 1zis of va il.11., 1it y

o f .1kit opsy r 0 Vit pee f SIt e MOR wte idthent j f ied, re t ve * tJ 1

s td Ili 'l i1 theit d I root I ooli ityt etmIi na~t io kil , t olvt . Tht I juii t. ,,,

s%:opr L3f t.hle proki vtl Il ui t Led t 1is ; 01f fo rt t o all .lIytzi ; o t 17 MO)R.

' I1 iin z*ta*t i -.t io,%I IMidineeee.pintoults tt t ht

* Number of injuries to five regions of concern.

* Fatality and injury totals.

0 Seating position totals.

For all aircraft models:

a Injury identification, location, cause, etc.

* Fatality and injury totals.......

3.0 AIRCRAFT SUMMARIES (1964 1978)

This section presents summarios (by aircraft model and typos)

*of injuries to skull, face, eye, neck, and cervical. vertebra and

fUrther shows where these injuries were sustained by seatinq po-

sition. The seating position information is presented in two

categories, cockpit and crew/passenger/unknown, which are thon

combined as total injuries (fatal and non-fatal). Much greaiter

* seatinJ position dotail is available from the data bank, but thev

* importance of cockpit survivability is recognized and stres,;cd in

this study. A total seating position study was beyond the scopo

of the progIram. Also, study of the MOR revealed a few cases where

covkpit personnel may fall in the unknown sub-category in catan-

trophic crash and burn accidonts. These are rare cases, howeVer,

and not statistically significant.

Most of the model and type data presented here show the( de-

crea se in in juries wh~i ch occurred as ,omba L opera I.ions decea sedl

*in Vietnam. This difference in combat and non-combat operat ional

environments is discussed later.

hoaircraft information presented is taken from "Jane's All1

The Wold's Aircraft" (The Trade Press Association Ltd. , London)

Anomaie eox is t betLween Jane da ta a nd d ata ftir n i shted f or t.he it n I -

ysi s, parti ctilarl y where aircraft are ci asse(l as singIle-so.at by

Jane and other-than-cockpit seating data were furnished.

3.1 MODIEL SUMMARIES

Analytical comnment-; for the a irc'ra ft model s~tiar ivs will

(Ic., wi th in-juries domintance and contribhut ion significance, with1

other (con'ints as!- appropriate.

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4,1 4' C C' 4 C' C' ~ C' ~-, I--'

-4 -' --4 -4 .--4 ,-I .-4 ,j .4 ~ (94-.

4-'

19 44

_ _ 'Li

__________ ________________ I-

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t a.

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C-121: A total of 34 injuriem are ropurtad for one umtau-Table trophic accidont in 1970, Skull (21) and face (10)14 account for th maJurlty (31 of 34). There ware 19

fatnlitioei throe occurred in the cockpit.

C-130: Skull (5) and neck (4) injuries (11) wore domnuin tTable for the C-130. Throe fatalitio occurred in the

15 cockpit and two wore in non-cockpit position.

C-131i No fatalitio rasultnd from one each face and cOr-Table vical injuries in the C-1311 both were in non-16 cockpit positions.

1,,-11: The F-1 is roportud out of inventory. IL aa(:ountvdTable for sovon injurian from 1969 to 19711. taoq (4)17 and skull (2) injuri wnru moot pruvalvnt. on.o

each fatality occurred in cockpit and non-vockpitpositions.

E-2: A coniintat skull and faca injury tranJ in ahownTible for thu L-.2. Thoy accounted for 17 of 21 injurt"M1.8 reported (okul 9, taco 8). Of 5 fatuLti.s, 4

occurred In tho cockpit-. L

1-4s 1 The V-4 Phantom doom not follow thu trund IndhndtodTable by mont of th. mromI ntudi-di It vontinu"P it 1', au19 sarious Jnjuriam attar tha cotnlbnt puriod (19r;V -

1970). fku11 (37) and nock (J) Injuries L.eJtid75 of the 110 injuriam reportdi th face had 26.Toguther, thay account for 01% of the total 110.'rho aor,1ptL to credited with 24 of 32 _astalilmjother position data arn sump ot,

-t The F-8 skull (8) and nook (6) injurion arv dom nantITable they account for 16 of the 26 reported injurion,20 Position data are ouppoct,

,e-91 Tho P-9 in roportetd out of invoultoryo, but It ac-T'tble counted for 1. Injurion, nioutly skull (6) and iitsvk21 (5). Of 10 total pouition data, 0 wuru otaLitlum.

F"-141 only ono fatality (vockpit) in. rolorted for theo V-14,Tnble obviouly from skull ijury (2) ('ontlibut nbi, tluoK

22 (4) und skull (3) were primary ootrilbutorma to 6non-fatal injuries.

If-II Th 11-1 inju-I .iu of 19(9 hlirouil, 197 acouciod (uI

Table 60 of thti 84 Inijulli's. Lkull (17) tind fm', (10)23 injurlon domrnmLIo thu i ,tnt i o 10-yunr !,uriod. )I

note, no orviual injurs u ale 101t( td, Cu'lI t(31) Injuribn acuountad for most position dal.al 11wnrn fatallI-i',s,

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~ 4~ 1' ~ C~ ~*'~ F

.4 .4 ~4 4 .4 4 4 .4 I.' r

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4 33

-~ -4

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H W 34

11-2: No fatalities are reported for the H-2, and faceTable injuries (7 of 12) are dominant.24

If-3: Skull injuries dominate for the 11-3 (14 of 24), andTable only one cockpit fatality is reported among 18 total25 position data.

11-34: The 11-34 is reported out of inventory, but it ac-Table counted for 15 injuries in 1969 through 1971; the26 skull received 12 of these. Cockpit fatalities are

high (5 of 7 total).

11-46: Like the 11-1 and 11-34, injuries for the 1969 throughTable 1971 period are hiqh (50 of 77 total); most of these

27 are contributed by the skull (35) and face (24). Of53 seating positions reported, 26 were fatalities; 5occurred in the cockpit.

H-53: The 11-53 has a consistently hiqh injury rate overTable the 10-year period. Like the 11-46, skull (37) and

28 face (21) dominate the total 82 reported. Thecockpit experienced 7 of the 25 fatalities.

11-57: Two fa ce injuries contributed to one non-fatal non-Table cockpit injury.

29

P-2: One accident in 1969 contributed most (13 of 15)Table of the P-2 injuries. Of the total 15, 9 were skull30 and 4 were face injuries. Two cockpit fatalities

are derived from the position data.

P-3: Neck (28) and skull (12) dominate the 43 reportedTable injuries. Only fatal injuries (13) were sustained

31 in the cockpit, half of the total 26.

S-2: Skull injuries dominate the data reportsd (12 ofTable 25), and fatalities in the cockpit (11) prevail in32 the total position data of 17. Also of particular

note, there was a total of 15 fatalities in theposition total of 17.

S-3: Like the S-2, skull injuries dominate the injuryTable distribution in the data for the S-3 (4 of 6).33 Cockpit fatalities are haqh also, accounting for

3 of 5 position data.

T-l: The T-I is reported out of invcntory, and the lit-Table tle data available are used only for total analysis.34

35

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* 461

T-2: As seen here and as will be shown later, skull in-Table juries dominate the data distribution for trainer

35 aircraft, 14 of 26 for the T-2. Cockpit fatalitiesaccount for near half of the position data (8 of 17).

T-28: Skull (11) and neck (9) account for most of theTable injury data (20 of 31). Cockpit fatalities are36 nearly half of the position data (11 of 24).

T-33: Inventory status of the T-33 is uncertain, and theTable little data available are used only for total37 analysis.

T-34B: Skull injuries account for 9 of 14 T-34 injury kTable data, and cockpit fatalities dominate the position -

38 data (6 of 8).

T-39: Skull injuries (10 of 11) and cockpit fatalitiesTable (6 of 11) dominate the T-39 data. A duplication39 of injury and position data occurred (1974 and

1977) which could be of interest.

U-11:Table40 Data furnished are useful only in total analysis.

U-16:Table

41

AV-8: Skull (7) and neck (6) dominate the AV-8 injuriesTable (13 of total 22). Cockpit fatalities account for42 half of the position data (5 of 10).

OV-10: Skull accounts for over half the injury distribu-

Table tion (9 of 17). Cockpit fatalities again account43 for a majority of the position data (8 of 13).

3.2 TYPE SUMMARIES

iIThe injury and position data presented for each aircraft model

in Section 3.1 is summarized and discussed by type in this !zection,

e.g., attack, trainer, helicopter, etc.

The following aircraft are not included in the type summaries

because of loss from inventory:

C-4 E-1 11-34C-45 F-9 T-1

!47

1-0 o I. o.1

S-4 -4 -4

4-

N4 V- 1

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n %D en1 1.1 -

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,-' 0 - r. r- r -. 4- -

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t-r

? I.

r4 c - r

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* o~49

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ii :-.

II -. ______________________________ ~ ~ -~- -~-- -~ - __ -~ ____________ - 71tz

P-I

- - - - - - - - - - - -. - - $1

~ 0 .0 ~~-' H -H

'.~ - - - - - - - -14Q)

.1'C0' 1-4 0H ~hJ 4:n. c'.

4-4~ U[ '---- --44

0 .ot-. 04:

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4:I-) '1 H

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.':

8 IIF'

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I, .t.. 0cr *c 444I.' H Ho u .- ' 44 4I~

~I4 iflt.:4' 4,1

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0

U)4 -- ----.---- --- -- 4

>4'4-

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z-- 0 1.1--- 0

HU

~- u

K 0 '1

K _____ -- -~ - - - - - - - -

H H'-4

'4.

'4 'C V4 4 '-4 4 'p 444 1 ii

9 r.4 f4 C' C~ '~ ' 44 ,.4 4 .1 .4 .4 44 ~4 41

4--~ 4

in,, O . ',0{1-- -0

- •I~ -1

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t- U- NP,

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56

I-. *. Lfl '9 *' 0m

The following aircraft are not treated because of insufficient

information on which to base type analysis:

E-2 U-l1 OV-10U-16

A

3.2.1 Attack Aircraft

Attack (and fighter) mission performance requirements are ------• -4

characterized by high velocities at all altitudes. Take-off and

landing speeds are also higher than most aircraft. Accidents

involving attack aircraft are thus more apt to result in high im-

pact forces, causing multiple severe injuries to occupants. Table

44 supports this, and shows that the skull, neck, and face receive pmost of the injuries (212 of 265 reported).

Of the 190 position totals, the cockpit accounts for -slightly

over half (97). Of these 97, 42 were fatal,

3.2.2 Cargo Aircraft

Cargo aircraft come in many sizes, and mission requirements

call for considerably more than cargo or personnel transport. Pro- ], ipulsion systems include radial, turbo, and jet engines. In gen-

eral, speed requirements for take-off, landing, and flight are much i]lower than attack or fighter aircraft. There is some basic simi-

larity in overall configuration, however, and it is believed that4

the C-type aircraft can be considered inclusively.

Table 45 shows that skull injuries dominate for cargo aircraft

(38 of 67, over half). This could be attributed to more persons 2not in flight system restraint; this contention is supported in the

position data. Also, cockpit fatalities are low in the overall

position data (6 of 50), perhaps another manifestation of the

slower operational environment.

57

iAin

rY wL)L

04

m C co r'D fn "i r- %0 -4 0V 04 -H~ L5nJ 4

1- -4

E-44

0- co r- 1-4 wn M MN~ -4 -- - 4

-L- I t

rA-4

0%i co r'( %D r= c f- CD in V (D 00

E-4

Pz EL 0) -4-'n1 4 r4 C

-j) HZ 1 0 L. n (N n 0 N Ln 0n C

re (7 -

I. - -

Z w~ 0 - (N c~ o ( H58

IA~ I Ol

0! 1,

-4 .le ** en4 C) C40 0 mI 0 -40

N

4. f.,

1 -4 m -4 N .en1 %00. j,, fn

0~' '0

o. I UN 0' CD 0 CD 0 4 0 0 D v-

U)>.2

HD , F 0 4 0 0 0 0 '-4 0) (1

-4 -4r *-4 (D** (** C) (** C) ') Q

.

N 0 0 0 0 -4 059

3.2.3 Fighter Aircraft

Fighter aircraft have mission and performance requirements

similar to attack aircraft. Injury distribution is similar also;

this is shown below:

Percent of Injuries -

Aircraft nuries Skull Face Eye Neck Cervical _AAttack 265 32 23 8 25 12

Fighter 149 33 23 6 33 5

Table 46 also shows an expected dominance of cockpit injuries

* (63 of 113), inclusive of 26 fatalities. j

3.2.4 Helicopters

* Helicopter accidents generally have a more pronounced verti-

cal component than fixed wing aircraft. This consideration and

the contribution of rotor blade strikes may account for the high

incidences of face injuries shown in Table 47 (89 of 281 total in-

juries, 31%). Of the aircraft types studied, skull and face in-

juries for helicopters are the highest combined injuries; skull

(124) and face (89) together account for 213 (75%) of 281 injuries.

Position data are as expected, reflecting (to some extent)

* troop-carrying missions during combat periods. The significance

of the drastic increase in injuries in 1977 would be of interest.

3.2.5 Patrol Aircraft

Patrol aircraft, like cargo aircraft, have a variety of mis- Usions, and low-speed, long-range characteristics typify both types.

Injury incidence is significantly different, however, as shown on

r" the following text page:

60

0 -4 0 0 ,-4 -4 N 0 a' p-- "

,-. l7 - U'A '0 0 0) r 0 0 ,-4 0 ,-4 m *

-4~

. "4 4 C

,,.,'-4 -4 :4

- t 4 N (n N t r-4 N co D 0

0 0

r 8 ' fn -4 -4 1- 0 .4 LA 0I

1-4

ca: -4 '0 0l -4 a%4 ~

(n r"

4 v 0 ,-i -'

-I--- N - -4 - c -

4

4- N1 .1

L) r- .-- N cc 04 in-- 4 m. o1 D C

I-.%4 -)

W

Ell 4 ND en. 0C 0 *- N 0-4 '

IJ n YN l N1L 4T) 00 ND 0 0

* 1-4

" 61

C4- 00H H

H- Ln 'kD o 14 %D N N1 -4~0

t- 0m N- Ln (n in 1- in V) -4A

314 0 - - L

I CC)

0

r42 f.'- -T in4 No % 0 (Nj r' 4el C1 NrH-4 -4 H4

ve 0,0

in i, L N co 0 1.0 N le in 0l 0 N-

-. 1-4 -

0u, to

C-4 r- % r M % M0 4-

0 ID 11.0 m (14 m r-4 -4 14 o -. *

0 U-

C144

0 1w OD-4 0 %0 0 H>4i

o 410 ' 0 m~ iA 0 H 0 (1 a>4 N

< N .4 Ho

-- ("I N (n al, - -T In co I"- N qT

EHH~ N N HH _ _0

4-4

62-

IFl

TotalAircraft injuries Skull Face Eye Neck Cervical

Cargo 67 38 17 2 6 4

Patrol 60 23 4 2 29 2

Table 48 shows the patrol aircraft data. The disproportionate

number of neck injuries is of great interest, but it may be attrib-

_ uted to the sparseness of the patrol data (only P-2 and P-3) as

compared to the 11 cargo aircraft studied.

Position data shows a very high fatality trend (32 of 46 posi-

tions). This fact coupled with the neck injuries is of great in-

terest.

3.2.6 Search Aircraft

There are great differences in the S-2 and S-3 aircraft, e.g.,

propulsion, range, speed, etc., but the mission and operating en-

vironment similarity is sufficient to permit combining data. When

done, as shown in Table 49, neck injuries again show some preva-

lence (as for patrol aircraft), but skull injuries dominate the

data (16 of 31).

Also like patrol aircraft, the fatality trend is high (18 of

22 position data; 14 in cockpit).

3.2.7 Trainer Aircraft

There are many configuration differences in the trainer air-

craft used as data sources for the information shown in Table 50.

Training performance requirements for the aircraft vary proportion-

ately, however, and the data combination is considered valid.

Skull (44) and neck (19) combine (63) to account for 73% of

Ithe total 86 injuries reported.

63i i

,i

I -4 0 0 v-4 r-4 0 0 0 0! V

0~ 0

% 0 0 0 0 0 40 0o 0n m

%04

.- 4

Lo r- 4 0 0 0) 0 0 U'4:4

4 k,I,. Lfl H 4 N 0

E4

0

N 4 0 0 0 0 0

0-r-

14* 1-0 ,4 0 0 0 0 0 N

IA

£1-~ ~ Re 0-A 0 0 0 0

-4 - - -

64

- S ~ -- - - - -

I')

9 '., , I'

b ' ,,I

,, I iI It

II,

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* ,o, I

P4 N, M) C4 474

in " m L I

elll

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--

?J N°M N m.......i *

ll 0 ~

I,,'

(14

it

I,' I A 1f I¢-4 OIJ N 00 0 M'

N 'H LA -iC i . I, ,

'4;

I"1(l,"'l ) N ,S " N €'- N IA 0. r- •n 4 '

l..oI ' ,,

IA IA LA C (IN N '

44 I

,,o, . ; , ,, ,T . .C'',,.,

N H I C' I .H C' 0 0 C' 0

IN.. .. .. .. .. .. .0 C' ,4 ,., '

:1 I ( , N Ii (N N I 'A ' a

4 4 " . . .. ri I . 0 . . 4 ' 1 .4 .0

I !

There are no major similarities with attack and fighter alr-

craft data, as shown below:

Percent of Injuries

-Aircraft -njuries --Skull .-Face Eye Neck Cervical IAttack 265 32 23 8 25 12

Fightei 149 33 23 6 33 5

Trainer 86 51 17 5 22 5T

Cockpit positions inderstandably account for most of th,

position data, and cockpit fatalities are also high (33 of 61

positions) .

* 3.2.8 V/srOL Aircraft

The V/.TOI, information is based entirely on the AV-8 air-

craft, and most of the data came from take-off and landinq 1- ci-

dents with catastrophic impacts/ejections and burns. Thuts, the

dominance of skull and neck injuries shown iv Table 51 can b,_

related to a specific environment.

The cockpit fatality trend (5 of 10 total positions) al ,o rattests to the type of accident and air/ground environment.1

3.3 ANAIY0,13; AND DISCMi;SION

iThe injury data presented in the type summaries (Soct ion 3,2)are shown by percentaqe contr ibut ion (per aircraft) ini Tablv 5,.

Since there are ei qht a i 'craf t types involved, there are pot on-

tially 800 percentaqe pointts. These are totalled and then di vid-d

by 8 to (lain overall in-jury mporta -ec de i ,vt ors. Those lcsiq -

nators art, shown iin ''abl e 52.

'he skiull, by far, has 1hw hivqh';t de,. i nator, 42. 'lh' neck

is next with 25, and the face follows with 20. Lye (6) and ec tvi- H

cal (7) tolother (1.3) do not. equal either of the othor desiquuat ,rn. Hb7:|I

--

1

00

-4-4 ,-

>44

,l

II

-)j

01' N

1.-I .-,1

tI 1- ,O -"- , ----------------------------------- 4 ---------

EA- (1 1*a

-, -- - - r-- t t - - - - 0

+ , ' + ,*+ *' .- , (% , ," .-" ,

'-4I,

! E-4||

TABLE 52. INJURY DISTRIBUTION BY AIRCRAFT TYPE

Total Percentage of Total injuries

Aircraft Injuries Skull Face Eye Neck Cervical

Attack 265 32 23 8 25 12

Cargo 67 57 25 3 9 6

Fighter 149 33 23 6 33 5

Helicopter 281 44 32 7 12 5

Patrol 60 38 7 3 49 3

Search 31 52 13 3 22 10

Trainer 86 51 17 5 22 5

V/STOL 22 32 18 14 27 9

TOTAL (%) 339 158 49 199 55

Designator 42 20 6 25 7

The designator rankings are supportive of the totals reflected

in the head and neck injury summary for the 1969 - 1978 period

shown in Table 53. The highest designator (42) accounts for the

most injuries of the 1,038 total, the skull with 430 injuries.

Neck (25) and face (20) designators account for a total of 476

injuries, leaving only 132 for cervical (7) and eye (6).

The designator can be used in several ways, but here only to

prioritize discussion and recommendations.

3.3.1 Protection Considerations

The military crewmen's helmets afford some degree of protec-

tion for all but one of the regions under study, i.e., eyes. The

eskull is completely enclosed; the peripheral extent of the face

is partly protected; the upper rear and the sidts of the neck are

partly protected; anid the upper cervical vertebra receives the

same protection as the neck rear. The eyes are exposed except for

visor attachments.

i69

- - i-~

___ ---. _ _ - _ ~ - - _ -~ T1-~

TABLE 53. IEAD AND NECK INJURY SUMMARY FOR PERIODJAN. 1969 - MAR. 1978

CE PV I-SKUIE, FACV' EYI: NIX'K CA TOTA i.

YE:AR (1) (2) (1) (4) (5) ( - ,

88 66 22 53 6 235

1910 34 51 7 34 13 189

371 33 32 2 20 12 99

56 18 6 18 7 105

|" 40 17 7 18 8 90

27 18 3 24 9 81

Il75 25 13 2 14 4 58

1)76 30 16 1 13 4 64

I r77 33 12 10 30 7 92

U)1T8 14 5 2 4 0 25

T(o1AI, 430 248 62 228 70 1038

! 42 20 6 25 7NATOR

1 0

" -

4

I[ " 70

I,

I ~7I

The skull, which receives the most protection from the helmet,

receives the most injuries as shown in Table 53. The face with a

designator of 20, the eyes with a 6, and the cervical vertebra with

a 7 receive comparatively minor protection, yet they sustain the

least injuries - a total of 380 in the data used. Together they

account for 50 less injuries than the skull, which has a designa-

tor of 42. -

The potentiality of the helmet for receiving localized impact

and then redistributing the impact to other regions must be con-

sidered. The neck and vertebra would probably be most involved

in secondary injuries from skull helmet primary impacts. Config-

uration design and weight of the helmet also plays an impact rolein helmet impact distribution. V

3.3.2 Directional Considerations

Table 54 provides a total distribution of the position data

used in this study. Nearly 46% of the data accounts for fatalities

(349 of 765). Cockpit fatalities (194) account for 25% of the

position data. There were 387 cockpit injuries involved, 51% of

the total 765.I"* The greatest majority of seats in cockpits face forward, so

occupants in most of the accidents used to provide the cockpit data

* must have been facing forward on initial impact. The fact that

the face and eyes sustain such lesser injuries in this environment

must mean that forward body rotation occurs and places the skull

in the primary impact position. Forces are concentrated first on

the frontal and parietal regions of the skull and then transferred

to the neck and vertebra. The helmet, while initially acting to

attenuate the force, would also serve to maintain a direct down-

ward transfer to the neck and vertebra.

71

A.i

it

TABLE 54. INJURY POSITION SUMMARY FOR 2PERIOD JA. 1969 - MAR. 1978

SEAT[NG POSITrON TOTAS-TOTAL, INJURI:S C LT CR F W/PSR. /UNK.

NON- NON- NON-FA'TAL FATAT, FATAL F'ATAI, I'A'rAL rATAL

72 ill 40 51 32 60

77 61 32 23 45 38

23 49 12 20 11 29

46 36 25 16 21 20

28 42 22 22 6 20

26 29 15 17 11 12L

16 22 11 12 5 10

20 22 13 14 7 8

33 35 17 15 16 20

8 9 7 3 A 6

349 416 194 193 155 223

387 378

765

72I-

7?

On the basis of data analyzed in this program, the primary :

direction of force initiation and interaction on the skull, face,

eyes, neck, and vertebra is believed to be centered on the frontal

Aadparietal regions of the skull. ...

Ii iI. 4 .I

I 1II

i 17

I :

1-

I I-

1;

1 4-A

I;II

II

I I]

E73 '

4.0 INJURY PROFILES

To further support the directional determination established' in Section 3.0, the following was accomplished:

9 All fatal skull, face, eye, neck, and cervical injurieswere tabulated by aircraft model and then combined toobtain type profiles.

* Autopsy comments taken from hard copy of MOR werescored on a drawing to obtain visual correlation withthe type profiles.

The number of MOR reviewed (37) was insufficient for complete - -

type profiling in some cases (patrol, search, and V/STOL air-craft)

but still supportive of overall trends. The MOR information was

adequate for the attack, fighter, trainer, and rotary-wing air-

craft profiles.

Professional assistance in developing the injury profiles

presented herein was provided by Dr. Brian D. Blackbourne, M.D., LI-

Deputy Chief Medical Examiner, Department of Human Resources,

Government of the District of Columbia, Washington, D.C. I411

4.1 AIRCRAFT TYPE FATAL INJURY PROFILES

4.1.1 Attack Aircraft

L-, Table 55 shows the result of tabulating 78 injuries for [1

attack aircraft. The skull sustained the majority (46 of 78);

the neck (16) and cervical vertebra (13) combined received 24.

The face accounted for only 3 and the eyes none. Considering the

* totals, decapitation and fractures have an apparent interrelation-

ship between skull and neck.

The nature and severity of the dominant diagnoses (compound/

comminuted, decapitation, and avulsion) are also illustrated in

jFigure 1 which is based on information from 9 MOR cases. The

7i

I,

TABLE 55. ATTACK AIRCRAFT INJURIES

Diagnosis Skull Face e Neck Cervical Total

-emorrhage 2 - 21'

Compound 5 1 6 jCompound Comminuted 11 1 12 2

Decapitation 7 10 17 1Evisceration 1 1

Fracture, Simple 4 3 3 1.0 1Avulsion 7 7

Comminuted 1 1 tCrushing 1 1

Depressed 1 1

Laceration 4 4

Transection 1 10 .11

Contusion 1 2 1 4

Dislocation 1 1

TOTAL 46 3 16 13 78I-I

tipper head and neck injuries are typically fatal or critical inseverity, while the facial injuries would be considered severe

but not life threatening for the most part.

4.1.2 Fighter Aircraft

* [Of 52 fatal injuries used for fighter aircraft, the .kiill

receivd 36 and the neck (1.1) and cervical vertebra (5) combined

received 16 as shown in Table 56. No injuries to the face iril

eyes were included in the prinrtout. Avulsion and decapitation

dominate the diagnoses on a part and total basis, ample evidence

of the sevcrity of the fighter aircraft crash environment.

rL

75* I

4.i- " -- -1-- -- ~ - - - -- -

2BIS UAGZ IS BEST QtIATd!TY PPMC?4AU

AVPN:EII' til, MWAIDI

FN F I 1 1

(5~. ) 1.-L)Al.

ANI' A'!. [Al Al __Act A

I I(A

tW W . , 'i - f'V

11 A I .1

IIA I I'M(1

I XI ll '*ID~ l

T!'S (IF A' tA~ (2)AT N '

AIl, '- l N !' ( NI';1 'l :

I' IN 'ON I '')N

"IN 1 A\ \ IN( 'N;

I' iqurC 1 ALIL ic!k Air'croft. Tn jut y Prof i le

76

TABLE 56. FIGHTER AIRCRAFT INJURIES

Diagnosis Skull Face Eye Neck Cervical Total

SAvulsionDepressed 1 1

Crushing 3 3

Comminuted 2 2

Copud2 2},Compound Comminuted 3 3

SDecapitration 6 9 is5i

Hemorrhage 5 5

Laceration 3 3

Asphyxia/Strangulation 1 1

Contusion 2 2

Fracture, Simple1 1

Compression 1 1

Rupture 1 1

Dislocation 1 1

Transection 3 3

TOTAL 36 11 5 52

Only two MOR cases were used for the profile shown in Figure

2, yet even this limited input supports the dominant skull injury

trend.

77

- -. ~ ~ - ~ - -

*~AA

FACIA " [3RATN (2

-pZ

r iqur 2 . Fi lJe Ai cr f I j l--i-fi

78'

'Ililisnty Val fai i'eqf tj~t~I iti o I It ittit, 1 .411 vc Art (T-1I j

TFINO 11il, T0-4, Nlld 1Tu I) nit whli='t the PutIr'a, dnt Wlt" himedI

iolot lii 111 v h,.l IV 11 1*0 ftit ' 1 $1 lit 1 O S-i i'ti t ,i d u 1NI'SW O~iii A -If

ta t] int I-P- I1 4 it'"i~ tit filip# fill tm-r fit PyP fhil" if~' w l1f

Ow. . I of I fit, 111Ifi'lI ho 9 I tif A I. l 't' luut Am! ti e- r too 1. 1w tlIw

ild 11II111,11 ileltit M II ' 114 11m~fi ItiAiititntt', IItNu

UP I)ILvW-Vill-I~ 14 -i

IA ', "I1,I IIAti liftII t I4tI'If

f= it A' c't

li]Ij iIi" i o I I

l i gqa; lf t L. )f I f .11 11 =II g 4 utI II II i

lit tt . + -I I t vg. 1 #, I !I li V I I ft

A~u~tIett 4

TIS T pAO! 1, gy4.T l11TYT C1A

4,

I I I' l /W

W "I 4" 41 11 1

11 li . A tol o1 4.

life threateningj) by thomselves, but when identified as additional

R Injuries involving the fatal skull primary injuries, the data again

points to the primary diractional influence on the skull.

4.1.4 H4elicopgters

As Table 58 shows, the skull is by far tho moot affeett'd ini-jury region for helicopters, accountingj for 35 of 42 injurivs.

The nook (4) and faice (3) account for the remainder (7).

Dilijnotsi Swfkul I Ava I Li t4'Lk Cervical Toptal

Compound Voiwitnutud J 1 4

AvuuI is o 10 1,0

Couffainutud 2 1 3

CO401d7 7

cru"Ilifl 3 2

*~ ~ A AqIII v

it ASifti of loll 2 1

Hum"iitj I IhlIB

TI~vAI6 4 4d

1ho. hi I ttell1 I l elI i t ,H ajl 4 i,1 ong.a I HIMl e', I.,

y J ee 0411i'liii u 111 111114li1.4 i t iji Im- a t, j li i 1 8111 Asi1"l Iap~iI~ IeI ~ ~ ~ ~ ~ ~ II I~ a ~'Vl'*j.i I'cucs'r Ii li'f11.1 nim sl',uJ 1I fmud t fiui l, .1

li11- II i l ' I V i a I ll i Iat I i of a (#%Icia I g1 1 1 litew c I-fit #-1114 1i P" ",

WAdbil.a ~ l'~ 111 1a w u I I9t, I Ii , I I IIII Inl 1 111uAl I It I, JA

Q-ALITY

NH To I I

!"LI; 'I O

II(A N WIII~ I'l :. '4

I"'NI' NIM

MA II I f!Jh, I,

It~

I VI I .I x

I'I A. II Af I

II

____ ___ ____ ___ ____it

4.1.5 Search Aircraft

As shown in Table 59, decapitation is singularly credited to

the neck for search aircraft, and it and avulsion dominate the

total data reported. The skull receives 10 of the 19 injuries

reported, and the neck (5) and cervical (3) together (8) account =1-

for all but one injury which was sustained by the face.

TAB3LE 59. SEhRCII AIRCRAFT INJUflIS

Diagnosis Skill Face Uc Neck Cervical Total

Decapitation 4 4

Avullion 3 3

Compound 1 1

Dupreonod 2 2

baceration 2 2

Cominutod 1 1

rractiurv, Himplu 1 1 2

Ilonatioa ! 1

TlOTAL 10 15 1

flout, 5 (hdnd oi F4 MOlt v'.,lp) NuH!oitP tilt ilum tial, i , VI---fratal nktill 1Inju llii, Nill nlno llowsl ,mov!I-i hlJ1111 P, tu !h,- O ,s,,

wii ht nit, #. llulilnlm ly li nvivElili,. Ili'ii iniIii t rdi' l ntinld till'

Itri isnly 1!';VIIl ly 111 n' lt o I, h flisll sl ileJiele of lipt uk,ll

S lnd A c i p t i -1 a' t'li u l Ili" li.uaA''u vit,'l a l' i lull,

iI

Oil PAZ IS 1195T QUAL ITY FRAC 1A"E 1 ~iv* IV

C N11:1(IN I1 u)I.110IIA:I: AVll.1 .1; rON 01 IWA IN (.1( U *. F 4 (' NI ll ' M A INI~ :~ I - _ __MWITHI I A Al AVIlk':I'N

ri )AH.I I AI il.M 1

ItN

At~~ I- ;. VI ItI IN

IDA I .I hoI A I INI I II iN

I CA-

i.11 '\\ ti l ,1*1i111

4.1.6 Patrol Aircraft

Only limited data were available for patrol aircraft, but

they continue to demonstrate the skull and neck/cervical region

interrelationship. Neck and skull dominance is shown in Table .

60.

4J

TABLE 60. PATROL AIRCRAFT INJURIES

DiagnosiB Skull Face e Neck Cervical Total

Compound Comminuted 2 2 -

Fracture, Simple 1 1 2 -4

A

llemorrhago 1 1

Decapitation 6 6 U

TOTAL 4 6 1 11 0

Figure 6 is based on only 2 MOR cabe.'ii all injuries shownwould be fatal or critical (survival uncertain).

4.1.7 V/1'TOL Airraft

As Tablo 61 shows for V/IT1. aircraft, injtriam arv alvin

group'd undor okull and neck/crrv.inl. Fi-rvtur'e dominata' tho ItotaJ 11 injurion rllozt td, niid n1o aI'ow lirvnltnvu in tho pro-

file, riguit' 7, whih oliA basud oil 4 MOlt cas .m.

For the V/IITOI, mi ruanrt, t |li-o is soImo dvimrture frum 4 h

trond ouiui rviii iii datri on otho, airi-rant. A Venural frntt lot-

ation uf thi, hi(nd (1,0M VfrltUH ditit-r11,t! 1 aI 1 iffnl ovidunt, 1 -o'

jumuilto tih,, I i kull-tD-nla.k/(QrvJu. l vtviat u hl,, Aloo, mutt fir

the IjUl l aw4 would h' miullVvalilp It t untu'd oil I 01i1(oul'i blali,

Jj I_ .i

SEVERE COMMINUJTED FR8ACTURES 4

(IF SKUla, WITHl AV1I IoN ul'BRA IN (PART IAL DFCAP ITAT ION)

AVLII,4 IWN 0~*ILARYNX t Cl I I'lXTV VAPIA I' ,

W I *I*lII A :: 1'I ClI.IdV I Al1,

0:11-:1HA AMHEA

4& N T I (AQ .1',(o AllatHK m K.flo

TABLE 61. V/STOL AIRCRAFT INJURIES

Diaqnosis Skull Face Eye Neck Cervical Total

Comminuted 1 i

Fracture, Simple 1 1

Compound 1 1

Contusion

Perforation

Dislocation 1 1 .v

Decapitation 1 1 2

Compound Comninuted 3 3

TOTAL 7 2 2 11

i44.2 ANALYSIS AND DISCUSSION

This discussion is made without consideration of injuries

which were sustained by parts of the body other than the skull,

face, eye, neck, and cervical vertebral the scope of the program

limited study to the parts named. Severe injuries to the hoadi and neck regions, ihowover, do limit the performance of other

body parts to the extent that their consideration would be of

secondary iniportance. ,

Thn datA pre~ontod in this section does not in all cas,'s

compleent. ouech othor. Vor examnple, the total-injury-by-aiicrnft

modal printout idotitified no face or eye injuries for the AV-SA

aircraft am I liptd in Tablo 61, yut race and eyv itijurioo w ,r

idotrtified In tho nutopliy tvnu lt roviviwod in thu 4 MOlt vn.,u

luntiat.Ld in Flitiq r 7. 'litin wnti found li coinly n f'w c,,'t i,

howuvoI, aii Llti taf, of Inc tdonvu Is not nuf ri'lunt to id lu, ',r.

, ttron.

IiA

I, |1- -- = I I I I I I iH i I i i i I i I I -- g

FV.-,N._ -41PAN

ATA I

vFA~~~jj, .F-T ON!~I UID I'A '~

ON~~1 AMPA' l AN1N All'i N I I A P l

*117j

UX I.C RIA Nt 'IE tI:PEA11

M O

L L

- ~I Nil

1w:

Considering all of the injury dominance discussed heretofore,

and knowing the injury areal effects, the following discussion

seeks to impart rationale for further research to decrease inju-

ries to the head and neck regions.

The data presented in this section are from fatal accident _J

injuries which obviously exceed human tolerance to impact where

skull fractionation, avulsion, decapitation, etc., occur and dom-

inate. To remove or reverse this dominance in the aircraft acci-

dent environment cannot be accomplished on an overall basis. In-

stead, the problem (3) must be technically addressed on an indi-

vidual aircraft model or type basis. Where there is a prevailingiiidirectional influence which can be identified on an overall basis,

however, and where direct causal relationship can be established

between the elements affected in the impact chain, such as the

helmet, head, and neck, then it is possible to identify and con-

centrate on a specific objective which will benefit and upgrade

survivability in all aircraft models and types.

The helmet is the only non-human device among the elements

of the helmet, head, and neck chain involved, and it has been the

subject of extensive developmental research. Existent configura-

tions have evolved on the basis of accident studying and materialrefinement made to obtain the most safety and yet satisfy and per-mit operational functions. However, knowing the certainty of more

fatalities and disabling injuries, which can be assumed on a sta-

tistical basis, then even more research and refinement appears as

a natural course of action.

The primary cause of the dominance of skull and neck/cervicalinjuries is due to impacts received as the upper body is undergoing

sevor(' duculerativa force while rvistrained in a relatively tiprJght

position, ntid the head, influenced by the weight of the helitet,

uncontrollably undergoes forward and downward floxion, Thin places

1!J

[7 "

i the frontal and parietal parts of the skull in position for sec-

ondary impact with any object in front of the head; primary im-

:pact will be on the portion of the helmet covering these skull .

parts. As the impact chain activates and functions, the forces

encountered by the helmet/head are transferred to the neck which

I ultimately must serve to diminish some of the head impact and -

accept near final force concentration.

If an interruption in the load transfer can be accomplished,

or if the initial impact force can be ameliorated, then the skull

and neck will benefit. Future research then should incorporate J.

these basic objectives:

* Investigate mechanical means in the helmet structurewhich will facilitate load interruption and/or atten-uation.

* Investigate lightweight energy-attenuating devices andmaterials which can become a part of the helmet exter-ior.

TI

I !-A

let,

90'

IIiI I

ii

5.0 MOR REPORTING SYSTEM 7

The Navy MOR system provides a very extensive and completely

detailed account of aircraft accidents. It provides information

on:

o Aircraft and personnel involved, and includes a narra-tive of the accident.

* Injuries incurred.

o Psychophysiological and environmental factors.

* Demographic and training proficiency data.

* Personal, survival, and escape equipment usage.

* Escape and egress information on each person.

* Ejection or bailout information, including helmet,restraint system,. and seat usage.

* Survival and rescue information.

* Flight surgeon's comments, analyses, and recommendations,including autopsy findings if appropriate.

Through analysis and using an in-depth EDP procedure, the acci-

dent information from the MOB is computerized and available for use

by Naval Safety Center personnel.+ii

The iinformation available in hard copy and from the data bank

are mocre than adequate for a study of this nature. The system's Icapability to provide both event and injury data is considered -1

excellent.

ii ;

The only information not found in the MOR system is enclineering

data which could be used for hardware-related medical determinations.

Examples would be drawings and/or photographs of areas and specific

structure/components which caused or coi tributed to injuries;. There

was some inclusion of this type of data in the older MOR reviewed.

91Ii~i • 1 LLi

In each MOR, the flight surgeon is asked to make comments,

analyses, and recommendations on the accident being reported.

The recommendations made for improving safety and procedures Iseemed sincere, reasonable, and conscientious in most of the MOR

hard copies reviewed. It was beyond the scope of this effort

to determine the effectiveness of the recommendations in "getting I

things done." A study devoted to this determination would be of•Iinterest if based on a period of long enough duration to yield

representative results.

92

I-.

t.

I --

I- -

ii::

g2 -

6.0 INJURY COSTS

The costs of injuries derived from accidents is now an impor-

tant element in determining information to support decisions for

new designs, making procurements, writing standards and specifi-

cations, etc. Such costs are also factors in making cost/benefit

determinations, and are considered essential for the rule making

process.

The military departments have assigned dollar loss values

based on grade, flight status, crewmanship, etc. In comparing 1

these values with values used by civil departments, it 'azi found

that the military values are much lower than civil values for

persons who have no professional or technical training.

'To illustrate the above, discussion on use of the Abbreviated

Injury Scale (AIS) used by the National Highway Traffic Safety

Administration (NHTSA) for motor vehicle accidents is presented.

The AIS was first published in 1971 by a joint Committee of tthe American Medical Association, the Society of Automotive En- Igineers (SAE), and the American Association of Automotive Medicine

(AAAM). The scale was devised in response to a research need for

a consistent scale for collecting and analyzing injury severity {data and, specifically, for use by multidisciplinary accident in- [vestigation teams, which were being set up by the National Highway I

Traffic Safety Administration. Since that time, AIS has gained -

acceptance in accident investigation research, and it is likely

that its use will increase in the future.

The AIS has undergone several revisions since its inception.

The most recent revision of AIS was done by the Subcommittee on

Injury Scaling of the SAE. The scale, as it now stands, is as

follows:

i

Ii 93

AIS Code Category

1 Minor2 Moderate

. -3 -Severe (not life threatening)4 Severe (life threatening, survival probable)5 Critical (survival uncertain)6 Maximum severity (currently untreatable)IA

Table 62 presents the average cost per fatality and injury by

AIS level.

TABLE 62. SOCIETAL COSTS, SUMMARY, 1975 (DOLLARS)

Injury Severity (AIS)

Cost Component 6 5 4 3 2 1 PDO

Product ion/Con-sumption:

Market 211,820* 126,650* 55,550* 1,645 865 65 -

11ome, familyand community 63,545* 37,995* 16,660* 425 310 20 -

Medical:

hospital 2'5 5,750 2,250 1,095 450 45 -Physician andothler 160 5,520 2,160 525 165 55 -Coroner-medicalexaminer 130 - - - -Rehabilitation - 6,075 3,040 . . . .

Funeral 925* - - - -

Legal and Court 2,190 1,645 1,090 770 150 140 7

Insurince Admin-istration 295 295 285 240 220 52 30Accident Inves-

tigation 80 80 70 45 35 28 6

Losses to Others 3,685 4,180 1,830 260 130 32 -

Vehicle Damage 3,990 3,990 3,960 2,920 1,065 1,5n5 315

Traffic Delay 80 60 60 160 160 160 160

TOTAL 287,175 192,240 86,955 8,085 4,350 2,190 520

*Sevon percent discount rate.

I.-L. 1 _ _ _ _____ _ _ _9_

- - " -: --Using the $287,175 loss-of-life value (AIS 6) in Table 62,

the costs of fatalities used in this analysis would be as shown

in Table 63.

TABLE 63. SOCIETAL COSTS OF NAVY FATALITIESBASED ON ATS 6 (1969 - 1978) 4

Number AYear Fatalities Societal Costs

1969 72 $ 20,676,600

1970 77 22,112,475

1971 23 6,605,025

1972 46 13,210,0501973 28 8,040,9001974 26 7,466,550

1975 16 4,594,800

1976 20 5,743,500

1977 33 9,476,775

1978 8 2,297,400

TOTAL 349 $100,224,075 i'i4-

If comparable Navy injury loss values for AIS 1 through 5

were computed for the 416 non-fatal injuries reported, the total

I' societal costs for the 10-year period would be appreciably

greater.

It is understood that societal costs for motor vehicle ac-

cidents can not reflect the worth of training, medical, and other

.. factors in a Naval injury. If values similar to the AIS levels

were formulated, however, they would prove to be a valuable corn-

mand tranaqement tool in training and other staff functions.

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j 7.0 CONCLUSIONS

On the basis of the study reported herein, the following

conclusions are made:

1. rhe principle directional influence on skull, face,eye, neck, and cervical injuries is centered in thefrontal and parietal regions of the skull.

2. Emphasis should be placed on personal safety and sur-vival equipment research in high-performance air-craft.

3. Specific aircraft models and types can be identified f

which warrant further engineering and/or analyticalresearch.

4. The flight surgeon's recommendations (made over along-term period) for improving aircraft safetyand search and rescue operations should be assessedfor effectiveness.

5. A simplistic cost value for fatalities and injuries,similar to the NIITSA AlS system, would be of consid-erable value to Naval safety engineering and manage- Bment and in conducting studies of the type reportedhere in.

6. Navy MOR and the Naval Safety Center data bank areefficient and responsive media for establishing andsupporting research objectives; availability of pinjury-related engineering information would furtherenhance research effort.

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8.0 RECOMMENDATIONS

4-:The following recommendations are made:

1. Further research should be devoted to the role thehelmet plays in:

e Preventing injuriesi 7-

* Causing injuries

I Distributing impact force received on the frontal

and parietal regions of the skull.

2. Cost benefit analysis should be made to determine the

extent to which life support systems should be refinedin high performance aircraft, if not already accom-plished. Trade-off parameters should include pointsat which refinement is directed to personal safety andsurvival equipment.

3. The causation for dominance anomalies of injuries incertain aircraft models/types should be determined, ifnot already known. Examples are:

e High cockpit fatality rates for the S-2 and S-3(14 of 22 position data)

* A 270% increase in injuries and a 200% increase infatalities in helicopters from 1976 to 1977

& High neck injury rates and fatality rates in patroland search aircraft.

4. A study be made of action taken on recommendations madeby flight surgeons in accident reports to determine thebenefits derived from implementation and the results ofnot implementing recommendations.

5. A costing system based on recent dollar values be de-veloped for injuries and fatalities.

6. Total fatality and injury profiles by aircraft modelsand types be developed from data in the Safety Centerdata bank. Such profiles could be used in programs toemphasize training proficiency attainment and accidentprevention. "Shock graphics" are considered effectivein both industry and government.

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