1. BIOMECHANICAL EPIDEMIOLOGY
A fresh approach to data gathering and injury reduction in motor sport:
an Australian perspective
Dr Michael Henderson, Fellow, FIA Institute for Motor Sport Safety and Sustainability
ICMS Annual Congress, Orlando, November 30-December 1, 2011
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2. Background What is “biomechanical epidemiology”?
Incorporates the approach of multiple disciplines into injury research
Requires that issues relevant to all disciplines are addressed at outset
Includes inception, design, execution, analysis and application of research
Intended to overcome approaches that differ between disciplines and foster collaborative studies
Concept developed by Johns Hopkins Center for Injury Research and Policy; courses sponsored by George Snively Foundation
Wholly adaptable to motor sport injury research

3. The problem defined Different languages and approaches
Disciplines have unique languages and approaches to research and publication
Particularly applies to basic sciences of injury control: biomechanical engineering, epidemiology and clinical medicine
Epidemiological and medical studies usually lack mechanical data needed by the engineers
Clinical and biomechanical injury studies that lack epidemiological input usually cannot be applied validly to groups

4. A different framework An integrated approach
So-called collaborative research often simply means that one discipline presents its results to another discipline
That worked when simple changes led to big improvements (the “silver bullets”)
But future improvements in injury control require a more subtle and sophisticated approach
This involves applying biomechanical principles to the epidemiological study of injury
Incorporates expertise of engineers, epidemiologists, clinicians and other relevant disciplines

5. The application of biomechanical epidemiology in motor sport Data collection and analysis may be applied at three levels
Level 1: mass data collection
For overview, surveillance, trend analysis; important for priority setting and review
Level 2: data collection for research
More detailed data, sampled over time on a defined basis such as hospitalisation or crash severity
Level 3: detailed analysis for data on injury causation and prevention
Crash-specific analysis requiring expert medical, engineering, biomechanical and legal input – focussed on fatal and catastrophic injury

6. Incident data collected at events Mostly generated by event officials
Completed forms, diagrams, photos where possible

7. Injury data collected at event by medical and paramedical teams

8. Use of mass data collection at events An example of a “snapshot” analysis - example from CAMS incident and injury data collection
Comparison of the incidence, in closed car circuit racing and rallies, of serious injury (with hospitalisation) in reported incidents in (from Gibson et al, AIMSS 2008)

9. Fatality data from www.motorsportmemorial.org
An international mass data collection A unique collection of fatality data, including narratives and enabling trend analysis
Annual motorsport fatalities worldwide, , by competition category
Fatality data from

10. Mass data collected at events Problems and deficiencies
Data specific to sanctioning body
Quality of data often suspect
Lax approaches to form-filling
Injury data rarely complete or confirmed
Little enthusiasm in sanctioning bodies for financing routine data analysis

11. Mass injury data collected by hospitals
Injury data more accurate than that collected at events
Useful guide to the bigger picture
Over-simple categorisation: e.g. “wheeled motor sports”
No mechanical incident data
No biomechanical input and rarely AIS coding
Capacity for injury reduction research limited

12. Injury Research and Statistics Series Number 27
Mass injury data collected by hospitals Example of public data analysis – a first base for research
Hospitalisations from wheeled motor sports injury and all sports injury, by principal body region injured, Australia,
From Flood L and Harrison JE 2006 ,Hospitalised sports injury, Australia 2002–03
Injury Research and Statistics Series Number 27

13. Data collection for research Steps towards biomechanical epidemiology

14. In-depth crash investigation
Crash video when available

15. In-depth crash investigation
On-scene photographs

16. In-depth crash investigation
Detailed vehicle and personal protective
equipment photographs

17. In-depth crash investigation Links medicine, biomechanics, engineering and legal aspects
Statements
witnesses
event officials
medical and paramedical personnel
Review ADR data where available
possible contribution to FIA database
Panel of Inquiry
legal
technical/biomechanical
medical/paramedical
official (track worker)
driver adviser

18. Towards a multidisciplinary framework for biomechanical epidemiology
Where are the linkages?
Medicine
Engineering
First intervention
Extrication
Survey
Treatment
Injury mechanisms
Injury tolerance
Personal protection
Rehabilitation
Anti-doping
Energy management
Vehicle protective systems
Roadside and trackside, features and design
Epidemiology
Mass data – accident databases
In-depth serious crash investigation
Data collation and analysis

19. Building a multidisciplinary framework for biomechanical epidemiology The application of biomechanical principles to the epidemiological study of injury
Medicine
Engineering
THE LINKS
Epidemiology
From Winston FK et al, Biomechanical epidemiology: a new approach to injury control research, J Trauma, 1996, 40(5):820-4

20. Summary The application of biomechanical epidemiology to motor sport
A researcher identifies a motor sport injury problem relevant to their discipline
Epidemiologists study the prevalence of the injury pattern in their databases
Engineers describe the real-world data needed to address the problem
Clinicians describe the pathology of the injury pattern
THEN
Epidemiologists design a study incorporating the engineer’s study needs
Clinicians identify cases for inclusion in the study
Engineers reconstruct circumstances leading to the injury
Epidemiologists implement the study and analyse the data

21. Summary The application of biomechanical epidemiology to motor sport
THE POTENTIAL BENEFITS
Engineers can apply knowledge of the injury mechanisms to improved safety technology
Clinicians can improve response, reaction, triage and emergency care of the injury pattern
Epidemiologists can generalise the results to other injury patterns
AND
Rule-makers can where appropriate apply new regulations based on evidence
Behavioural scientists can study behaviours that put individuals at risk of sustaining the injuries
Economists can put a cost on the injury pattern(s) and on the measures designed to address them

22. Finally . . .
Things don’t always end badly:

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