title: Cannon Street rail disaster--lessons to be learned.
abstract: We studied the types and mechanisms of injury suffered by passengers involved in the Cannon Street rail crash, by a telephone and postal survey of all passengers attending St Bartholomew's Hospital for treatment of their injuries, and retrospective examination of their hospital records. There were 104 patients of whom 91 had complete data sets. Of the 91 patients included in the study, 63 (69 per cent) had suffered craniofacial trauma. Of the 63 patients with this type of injury, 50 had been standing at the time of impact and 48 of these were able to say exactly how they had sustained their injuries. Of these 48 passengers, 34 said that they had collided with the luggage racks (71 per cent). Of the 32 passengers who had been seated at the time of impact, only 13 sustained craniofacial injuries and none had hit the luggage racks (P = 0.0001). Craniofacial trauma was the commonest type of injury. Those patients who suffered these injuries were most likely to have been standing at the time of impact and to have sustained their injuries following collision with a luggage rack. The type of luggage racks on this train were particularly dangerous and we recommend that the internal design of new British Rail rolling stock addresses this problem. This specific recommendation is in support of the more general measures discussed in the recently published official report of the incident. In the meantime, we consider that passengers should be advised to remain seated until trains have come to a halt.
authors.affiliation: Department of Accident and Emergency Medicine, St Bartholomew's Hospital, London, UK.
authors.forename: H L
authors.initials: HL
authors.lastname: Cugnoni
authors.forename: C
authors.initials: C
authors.lastname: Fincham
authors.forename: D V
authors.initials: DV
authors.lastname: Skinner
mesh_terms: D000056:Accident Prevention; D000059:Accidents; D006259:Craniocerebral Trauma / Q000209:etiology*; D004190:Disasters; D006801:Humans; D008131:London; D008334:Mandible / Q000000981:diagnostic imaging; D008337:Mandibular Fractures / Q000000981:diagnostic imaging / Q000209:etiology; D011187:Posture; D011859:Radiography; D011890:Railroads; D012189:Retrospective Studies