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Airbags Can Save Lives, But Can Also Cause Injuries

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.

Airbag Evolution

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 accordingly.

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:

  1. Minutes to hours of vertigo, but usually no more than twenty-four hours in one spell, although the dizziness may last longer;
  2. Loss of hearing in lower frequencies, tinny and distorted hearing, or noise sensitivity;
  3. Unilateral or bilateral tinnitus; and
  4. 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.

Endnotes

1. Dancer, E.D. “Airbags and Ear Damage,” Advance for Audiologists, http://audiology.advanceweb. com/article/ airbags-and-ear-damage.aspx (2/5/2013).

2. Id.

3. Id.

4. Id.

5. 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).

6.http://www.dangerousdecibels.org/education/information-center/noise-induced-hearing-loss/ (2/5/2013).

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,” http://www.carsdirect.com/car-safety/how-does-your-cars-airbag-system-work (2/6/2013).

10. Brain, M. “How Airbags Work,”http://auto.howstuffworks.com/car-driving-safety/safety-regulatory-devices/ airbag1.htm (2/6/2013).

11. “Airbags Associated With Increased Automobile Accident Deaths, According To New UGA Study,” http://www.sciencedaily.com/releases/2005/06/050602011343.htm (2/6/2013).

12. Meyer, M.C. and Finney, T. “Who Wants Airbags?,” Chance, Vol. 18, No. 2, pp. 3-16 (June 2005).

13. 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,” http://www.sciencedaily.com/releases/2005/06/050602011343.htm (2/6/2013).

16. http://www.hearinglossweb.com/Medical/Causes/airbag.htm (2/5/2013).

17. Dancer, E.D. “Airbags and Ear Damage,” Advance for Audiologists, http://audiology.advanceweb. com/article/ airbags-and-ear-damage.aspx (2/5/2013).

18. Id.

19. Id.

20. Id.

21. Id.

22. 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.)

23. http://www.mayoclinic.com/health/post-traumatic-stress-disorder/DS00246/METHOD=print&DSECTION=all (2/6/2013).

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