title: Energy attenuation performance of impact protection worn by motorcyclists in real-world crashes.
abstract: Laboratory studies have demonstrated that impact protectors (IP) used in motorcycle clothing can reduce fracture severities. While crash studies have reported IP are associated with reduced likelihood of soft tissue injury, there is little evidence of their effectiveness in reducing fracture likelihood. This discrepancy might be related to IP quality. There are mandatory requirements for IP supplied with protective clothing in Europe, but not elsewhere. This study examines the energy attenuation performance of IP used by Australian riders.
  
  
  
  IP were harvested from clothing worn by crashed riders admitted to hospital. The IP were examined and energy attenuation properties were determined using EN 1621-1 test procedures. Impact injury was identified from medical records and defined as fractures, dislocations, and avulsions that occurred following impact to the rider's shoulders, elbows, hips, and/or knees. Fisher's exact test was used to examine the relationship between meeting the EN 1621-1 energy attenuation requirements and impact injury. The association between the average and maximum transmitted force, and impact injury was examined using generalized estimating equations. Motorcycle riders were recruited as part of an in-depth crash study through three hospitals in New South Wales, Australia, between 2012 and 2014. Riders were interviewed, and engineers conducted site, vehicle, and clothing inspections. Clothing was collected, or identical garments were purchased.
  
  
  
  Clothing was inspected for 62 riders. Of these, 19 wore clothing incorporating 76 IP. Twenty-six of these were impacted in the crash event. Almost all impacted IP (96%) were CE marked, and most (83%) met Level 1 energy attenuation requirements of EN 1621-1 when tested. Of the 26 impacted IP, four were associated with impact injuries, including midshaft and distal clavicle fractures and a scapula and olecranon fracture. No associations between meeting EN 1621-1 requirements and impact injury were found (p = 0.5). There was no association between average force transmitted and impact injury (95% CI: 0.91-1.24); however, as maximum force transmitted increased, the odds of impact injury increased (95% CI: 1.01-1.2). These results indicate a high probability of impact injury at 50 kN, the limit of maximum transmitted force specified in EN 1621-1.
  
  
  
  The allowable transmitted force of EN 1621-1 may be too high to effectively reduce the probability of impact injury. This is not surprising, given human tolerance levels that are reported in literature. Reducing the force limit below the reported fracture tolerance limits might be difficult with current technology. However, there is scope to reduce the EN 1621-1 maximum limit of 50 kN transmitted force. A reduction in the maximum force limit would improve rider protection and appears feasible, as 77% of tested IP recorded a maximum force <35 kN. This level of transmitted force is estimated to be associated with <20% probability of impact injury. While the performance of IP available to Australian riders is not regulated, most IP was CE marked. The results indicate a significant association between maximum transmitted force, tested according to EN 1621-1 procedures, and impact injury. Further investigation of the EN 1621-1 requirements may be warranted. This work will interest those targeting protective equipment for motorcyclists as a mechanism for reducing injury to these vulnerable road users.
authors.affiliation: a Neuroscience Research Australia , Sydney , Australia.
authors.forename: Bianca
authors.initials: B
authors.lastname: Albanese
authors.affiliation: b Human Impact Engineering , Sydney , Australia.
authors.forename: Tom
authors.initials: T
authors.lastname: Gibson
authors.affiliation: b Human Impact Engineering , Sydney , Australia.
authors.forename: Tom
authors.initials: T
authors.lastname: Whyte
authors.affiliation: a Neuroscience Research Australia , Sydney , Australia.
authors.forename: Lauren
authors.initials: L
authors.lastname: Meredith
authors.affiliation: c University of Florence , Florence , Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Savino
authors.affiliation: d Neuroscience Research Australia , University of New South Wales , Sydney , Australia.
authors.forename: Liz
authors.initials: L
authors.lastname: de Rome
authors.affiliation: e Centre for Automotive Safety Research , University of Adelaide , Adelaide , Australia.
authors.forename: Matthew
authors.initials: M
authors.lastname: Baldock
authors.affiliation: f Accident Research Centre , Monash University , Melbourne , Australia.
authors.forename: Michael
authors.identifier: 0000-0002-3691-6868
authors.initials: M
authors.lastname: Fitzharris
authors.affiliation: a Neuroscience Research Australia , Sydney , Australia.|g School of Medical Science , University of New South Wales , Sydney , Australia.
authors.forename: Julie
authors.initials: J
authors.lastname: Brown
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000328:Adult; D005260:Female; D006801:Humans; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D009049:Motorcycles; D009517:New South Wales; D011336:Probability; D011481:Protective Clothing / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000517:prevention & control*; D055815:Young Adult
keywords: Motorcycle; crash protection; energy attenuation; impact protectors; injury protection; protective equipment