When airbags deploy in the chest and face of a motorist, the entire process
happens in less than a second and is comparable in force and speed to
the detonation of an improvised explosive device. Similarly, the victim
may suffer temporary or permanent hearing loss, post-traumatic stress
disorder (PTSD), traumatic brain injury (TBI), and/or concussion and all
of the related consequences. About six million automobile accidents in
the United States each year result in airbag detonation.1
Even harmless, slow-speed bump-ups, representing little or no danger of
injury to occupants, may cause airbag eruptions.2 Upon investigation, up to 71 percent of front seat vehicle occupants may
have some form of unilateral hearing loss due to airbag explosions.3 Researchers at the Michigan Ear Institute found airbag-blast otologic/ear
injuries to include hearing loss, tinnitus, disequilibrium, tympanic membrane
perforation, aural fullness, and chronic pain.4 The next level of TBI and mild traumatic brain injuries (mTBI) are also
of emerging concern.
Airbag explosions send plastic materials and chemicals hurtling toward
motorists at about 200 mph, with noise levels of 170 decibels or more.5
Compare these noise levels:
- Conversations typically occur at about 60 dB, which is not loud enough
to cause damage.
- An idling bulldozer (not actively bulldozing) is loud enough at 85 dB to
cause permanent damage after only one day of work (eight hours).
- A personal music system with stock earphones at maximum volume can reach
a level of more than 100 dB, loud enough to begin causing permanent damage
after fifteen minutes per day.
A thunder clap (120 dB) or gunshot (140-190 dB depending on the weapon)
may both cause immediate damage.6
- Airbag explosion (170 dB or greater) — immediate hearing damage expected.
Dr. Gerard Gianoli of the Ear and Balance Institute in Covington7 points out that typically a car’s doors and windows are closed when
the airbag deploys, causing the atmospheric pressure in the car to increase
suddenly and dramatically. That pressure is applied to the entire body,
but the ear is the system most damaged.
Although airbags significantly reduce the severity of TBI, the same airbags
actually increase the overall incidence of mTBI, perhaps due to airbag-induced
concussions.8 Typically, airbags fully inflate in approximately twenty-five to fifty
milliseconds following initial onset of crash, which is about the speed
an alligator approaches a French poodle.9 The entire process of airbag inflation and deflation happens in only one-twenty-fifth
of a second.10
Although airbags save lives in perfect head-on, high-speed circumstances,
according to existing data and controlling for other factors, airbags
are associated with a higher probability of death in wrecks overall.11 This data must also extrapolate to increased rates of brain and hearing
injuries, even including those fast, “perfect,” head-on wrecks.
Without going into the physics, here is a brief analogy of the increased
danger of death and injury posed by airbags. In this case, using Chance
magazine’s allegory of cancer and radiation:12
If you look at people who have some types of cancer, you will see that
those who get radiation treatment have a better chance of surviving than
those who don’t. However, radiation is inherently dangerous, and
could actually cause cancer. If you give everyone radiation treatments
whether they have cancer or not, you will probably find an increased risk
of death in the general population. Making everyone have airbags and then
verifying the effectiveness using only fatal crashes is like making everyone
have radiation and then estimating lives saved by looking only at people
who have cancer. Overall, there will be more deaths if everyone is given
radiation, but in the cancer subset, radiation will be effective.13
Looking at the statistics, airbags save people in the perfect head-on,
high-speed collisions for which they were designed. However, airbags will
maim, injure, and kill more people overall since most wrecks are not perfect.
We need to protect our clients who have suffered head injuries and their
damages, and watch for future consequences.
Automobile air bladders as a safety device were conceived in the 1940s,
and airbags as we know them were designed by Germans in the early 1950s.
Federal Motor Vehicle Safety Standard 208 requires airbag engineering
and calibration to be capable of “saving” the life of an unbelted
fiftieth-percentile-size-and-weight male crash test dummy.14 Needless to say, this guy may be a regular driver, but he’s not
me and he’s certainly not the actual average driver or passenger.
By our own regulatory standards, airbags in the United States trigger much
more forcefully than in other countries, perhaps in deference to our relaxed
attitude toward seatbelt use and enforcement. Upcoming third generation
airbags recognize whether a seat is occupied, restraint status (seatbelt
use), size, weight, and position, and adjust airbag cushion deployment
Recent evidence led to the conclusion that airbag explosions may cause
blindness, hearing loss, broken bones, amputations and dismemberment,
lacerations, concussions, significant internal injuries, bleeding, burns,
scarring, paralysis, spinal cord injury, asthma, and death. Most harm
befalls children and small women.15 More and more, mTBI and TBI damages are being implicated after airbag
evidence is reviewed.
Ear, nose, and throat specialists are on the frontline of this investigation,
having first noticed ruptured eardrums, dislocated middle ear bones, major
inner ear damage, and permanent hearing loss following even bumper-benders
with airbag deployment; then the doctors began recognizing the striking
symptoms of mTBI.16
Post-Traumatic Vertigo — Three Common Diagnoses
In addition to hearing loss and tinnitus, airbags may cause post-traumatic
vertigo, which is often seen in head and neck injuries.17 Three common diagnoses applied to airbag blast victims are: 1) perilymphatic
fistula, 2) benign paroxysmal positional vertigo (BPPV), and 3) endolymphatic hydrops.18
Dr. Gianoli reports commonly seeing perilymphatic fistulas following motor
vehicle wrecks. Perilymphatic fistulas are leaking tears in the oval or
round windows of the middle ear. The symptoms are those of TBI and mTBI:
dizziness, vertigo, imbalance, nausea, vomiting, fullness in the ears,
hearing loss, altitude sensitivity, air pressure (weather) sensitivity,
and delicacy upon exertion. The most common cause of perilymphatic fistulas
are head trauma, including whiplash, and profound changes in intracranial
or atmospheric pressure, which may occur when an airbag suddenly explodes
in a closed vehicle.
BPPV is also common after TBI: Small calcium carbonate crystals, called
otoconia, may be displaced from the utricle of the vestibular system and
migrate around the ear, causing dizziness.19
Endolymphatic hydrops involves increased pressure of the endolymph within
the inner ear structure, which causes hearing loss, episodic vertigo,
tinnitus, and aural fullness.20 Endolymphatic hydrops is sometimes referred to as Meniere’s disease,
classically presenting with at least the following four symptoms:
- Minutes to hours of vertigo, but usually no more than twenty-four hours
in one spell, although the dizziness may last longer;
- Loss of hearing in lower frequencies, tinny and distorted hearing, or noise
- Unilateral or bilateral tinnitus; and
- Sensation of fullness or pressure in one or both ears.
After airbag blast injury, bleeding may cause endolymphatic hydrops to
interfere with the distribution of fluid transport in the inner ear. Endolymphatic
hydrops symptoms may present themselves over months or years.21
The alarming initial data presented at the First Pan American-Iberian Meeting
on Acoustics was:
- up to 79 percent with permanent tinnitus;
- up to 71 percent with unilateral hearing loss;
- up to 30 percent with vertigo, including BPPV;
- up to 9 percent with perforated tympanic membranes; and
1 percent to 2 percent with perilymphatic fistula.22
Additionally, airbag explosions may cause traverse fractures of the temporal
bone and the resultant severe vertigo or total hearing loss. Injuries,
such as labyrinthine concussions, may cause transitory auditory-vestibular symptoms.
Post-Traumatic Stress Disorder
It goes without saying that a sudden, large, deafening 200 mph explosion
in one’s face might come as quite a surprise on an otherwise normal
outing and could cause apprehension in the face of further exposure to
similar events, such as driving. In this case, all the classic symptoms
of PTSD often become apparent: intrusive memories, avoidance, emotional
numbing, anxiety, and increased emotional arousal.23 PTSD damages also deserve treatment and consideration in compensation planning.
When tallying your client’s damages, consider the possibility that
he or she very likely suffered temporary or permanent hearing loss, PTSD,
TBI, and/or mTBI and all of the related and downstream problems as a result
of airbag detonation.
1. Dancer, E.D. “Airbags and Ear Damage,”
Advance for Audiologists,
http://audiology.advanceweb. com/article/ airbags-and-ear-damage.aspx (2/5/2013).
Id. See also, “How Does Your Car’s Airbag System Work,”http://www.carsdirect.com/car-safety/how-does-your-cars-airbag-system-work (2/6/2013).
7. Dianoli, Dr. Gerard, Ear & Balance Institute, 1401 Ochsner Boulevard,
Suite A, Covington, LA 70433, 985-809-1111.
8. Dischinger, P., et al. “Causes and Outcomes of Mild Traumatic
Brain Injury: An Analysis of Ciren Data,”Annu. Proc. Assoc. Adv. Automot. Med., 47: 577-589 (2003); Loo, G.T., et al. “Airbag protection versus
compartment intrusion effect determines the pattern of injuries in multiple
trauma motor vehicle crashes,” J. Trauma, 41 (6): 935-951. (1996) [PubMed].
9. “How Does Your Car’s Airbag System Work,”
10. Brain, M. “How Airbags Work,”http://auto.howstuffworks.com/car-driving-safety/safety-regulatory-devices/
11. “Airbags Associated With Increased Automobile Accident Deaths,
According To New UGA Study,”
12. Meyer, M.C. and Finney, T. “Who Wants Airbags?,”
Chance, Vol. 18, No. 2, pp. 3-16 (June 2005).
Id., p. 15.
14. The National Highway Traffic Safety Administration has a legislative
mandate under Title 49 of the United States Code, Chapter 301, Motor Vehicle
Safety, to issue Federal Motor Vehicle Safety Standards and Regulations
to which manufacturers of motor vehicle and equipment items must conform
and certify compliance.
15. “Advantages and Disadvantages of Passenger Car Airbags,”
http://www.carsdirect.com/car-safety/disadvantages-of-having-passenger-car-airbags (2/5/2013); “Airbags Associated With Increased Automobile Accident
Deaths, According To New UGA Study,”
17. Dancer, E.D. “Airbags and Ear Damage,”
Advance for Audiologists,
http://audiology.advanceweb. com/article/ airbags-and-ear-damage.aspx (2/5/2013).
Id.; see also, Hickling, R. “Reducing Impulsive Sound Due to Airbag
Deployment in a Passenger Car,”
http://www. acoustics.org/press/144th/Hickling.htm (2/5/2013). (Treatments for perilymphatic fistulas include bed rest, certain
medications, and surgery.)