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Objectives: The interplay between marijuana legislation, perceptions of risks associated with marijuana use, and marijuana-related risk behaviors is an ever changing and complex issue. Marijuana impaired driving is of concern as legalization continues to expand in the United States. While driving after using marijuana has been shown to be prevalent among adults, little research has examined the behavior in adolescents. The aim of the present study was to examine the prevalence of driving after using marijuana among U.S. adolescents, with an examination of the relationship to age of marijuana initiation and marijuana usage patterns.Methods: We analyzed data from the 2017 Youth Risk Behavior Survey, a nationally representative sample of high schools students in the U.S. The sample was current marijuana users, defined as past 30 day use. Driving after using marijuana was the main outcome variable, with analyses examining the association between the outcome and age of initiation and patterns of use. Prevalence ratios were obtained by modeling Poisson regression to examine factors associated with driving under the influence of marijuana.Results: Nearly half of all marijuana users reported driving after use during the past 30 days, and did not differ between males and females. Prevalence of driving after using marijuana was significantly higher among heavy users (PR = 2.8; 95% CI 2.1-3.6). A higher prevalence of driving after drinking alcohol (PR = 1.7; 95% CI 1.5-1.9) was also found among those who had driven after using marijuana.Conclusions: Among adolescent marijuana users, the prevalence of driving after using marijuana was high. Enhanced surveillance, prevention, and control measures are necessary to mitigate the negative impacts of marijuana consumption and related behaviors. [ABSTRACT FROM AUTHOR]

WHO mortality statistics overlook land motor-vehicle accident (LMVA)-related drowning. The aim of the study was to provide an overview of the prevalence and trends of fatal LMVA-related drowning in Finland, plus the main crash settings, victims' demographic characteristics, and contributing factors leading to such deaths. A descriptive, retrospective, population-based study of drowning deaths associated with LMVA among Finnish residents of all ages, 1971–2013. LMVA-related drownings and applicable variables were extracted from the Statistics Finland (SF) mortality database by cross-analysis of ICD injury- and external cause-of-death codes. During the study period, 538 LMVAs leading to drowning occurred among Finnish residents (2.5/1 000 000/year; 4.9% of all unintentional drownings, 3.7% of all LMVA). Three main settings, ones responsible for over 95% of LMVA-related drownings, were recognized: traffic vehicle accidents involving a passenger car; non-traffic vehicle accident involving a snowmobile; and non-traffic accidents involving agricultural, industrial, or construction vehicles. Alcohol use was a contributing factor for death in > 40% of the victims, whereas severe injuries were reported in less than 6%. Because transport safety is crucial to prevent any vehicle entering the water, placing LMVA-related drowning in the category of transport accidents is warranted. Once the vehicle becomes submersed, however, prevention measures to avoid death by drowning remains decisive. [ABSTRACT FROM AUTHOR]

Objectives: This study examined a multicommunity alternative transportation program available 24 hours a day, 7 days a week, for any purpose, offering door-through-door service in private automobiles to members who either do not drive or are transitioning away from driving. Specific aims were to describe the characteristics of members by driving status and ride service usage of these members.Methods: Data came from administrative records maintained by a nonprofit ride service program and include 2,661 individuals aged 65+ residing in 14 states who joined the program between April 1, 2010, and November 8, 2013. Latent class analysis was used to group current drivers into 3 classes of driving status of low, medium, and high self-regulation, based on their self-reported avoidance of certain driving situations and weekly driving frequency. Demographics and ride service use rate for rides taken through March 31, 2014, by type of ride (e.g., medical, social, etc.) were calculated for nondrivers and drivers in each driving status class.Results: The majority of ride service users were female (77%) and aged 65-74 years (82%). The primary method of getting around when enrolling for the transportation service was by riding with a friend or family member (60%). Among the 67,883 rides given, nondrivers took the majority (69%) of rides. Medical rides were the most common, accounting for 40% of all rides.Conclusions: Reported ride usage suggests that older adults are willing to use such ride services for a variety of trips when these services are not limited to specific types (e.g., medical). Further research can help tailor strategies to encourage both nondrivers and drivers to make better use of alternative transportation that meets the special needs of older people. [ABSTRACT FROM AUTHOR]

Objectives: The circumstances and causes of death of 129 cyclists registered in the Olomouc and the Zlín regions, the Czech Republic, between 2005 and 2013 were the subject of this study.Methods: We analyzed the autopsy reports, where the principal cause of death was stated, and obtained a detailed description of the circumstances recorded by the police officers.Results: Eighty-three cases (64.3% of the set) were collisions involving a motor vehicle. The driver was the guilty party in 57 cases (68.7%) and the cyclist in the remaining 26 cases (31.3%). The most frequent cause of the crash was connected with right of way (29 cases). Cars were involved in 52 cases; heavy vehicles, including buses, in 26 cases; and motorcycles in 5 cases. Single-vehicle crashes consisted of 43 (33.3%) cases. We divided this group into 3 subgroups based on whether the particular case could be attributed to a cyclist having lost control of the bicycle (31 cases) or to other particular causes. Sixty-eight cases (52.7%) of fatal outcomes were directly linked to intracranial injuries. Multiple injuries were the principal cause of death in 19 cases (14.7%), followed by hemorrhagic traumatic shock (12 cases, 9.3%). Seventy-two (55.8%) cyclists died immediately after the crash and 23 (17.8%) cyclists died within a day of the accident.Conclusions: Trucks were more dangerous to cyclists than cars at intersections, whereas cars were more dangerous on straight sections. The most important pattern was identified as a motor vehicle hitting a cyclist from behind on a straight road section. We identified a strong underestimation of natural death as a cause of cycling fatalities in the official police reports. [ABSTRACT FROM AUTHOR]

Objective: To determine details of road traffic suicides in Switzerland between 2000 and 2010 and to look at our results in relation to studies from other countries.Methods: Retrospective data analysis of road traffic suicides extracted from the database of all suicides investigated by Swiss institutes of forensic medicine between 2000 and 2010 using a standardized assessment sheet.Results: Out of 4,885 suicides in Switzerland, we identified 76 cases (1.56%) of road traffic suicide. Twenty-three cases had to be excluded because, although the forensic medical experts suspected suicide, they could not establish it for sure. That left 53 cases (1.02% of all suicides), mostly unmarried men, who were on average 9 years younger than the study population as a whole. Most collided with other vehicles, mainly other cars, and usually on main highways or country roads. In most cases, the cause of death was multiple injuries. Other persons were killed 4 times more often than with other suicide methods. Toxicology screening was performed significantly more frequently than with other methods but more often proved negative. Acute psychiatric problems were commonly assumed to be the underlying reasons. Suicide notes were left by only 20%, a lower proportion than in the study population as a whole.Conclusions: Road traffic suicides account for approximately 1% of all suicide methods used in Switzerland, although unclassifiable cases indicate that the rate might be higher. Every road traffic crash should therefore be routinely investigated by an interdisciplinary team and suicide should be considered as the possible cause. [ABSTRACT FROM AUTHOR]

Objective:Legislation is an effective strategy for reducing road-related fatalities and injuries. Public opinion can be an impetus for passing new laws and can affect the success of their implementation, but little is known about the current state of public opinion toward existing and proposed road-related policies in the United States. This review describes the scope and results of research on public support for state- and local-level evidence-based motor vehicle– and bicycle-related policies. We identify gaps in our understanding of public support for these policies. Methods:Published U.S. literature and all reports from the NHTSA from the past decade (2003–2012) were searched for data on opinions about existing or proposed policies related to motor vehicle or bicycle injury prevention. Twenty-six studies fulfilled the inclusion criteria. In all, studies reported public opinion about 7 injury prevention topic areas: all-terrain vehicles (n= 1), automated enforcement with red light and speed cameras (n= 5), distracted driving (n= 4), drinking and driving (n= 5), graduated driver licensing (n= 7), helmets (n= 7), and seat belts (n= 4). Twenty-three studies focused only on one topic, and 3 sought public opinion about multiple topic areas. Results:The studies revealed generally high levels of support for injury prevention policies in all topic areas. Fifteen studies collected information from national samples, and only 7 studies reported data from the state (n= 5) or local (n= 2) level. Conclusions:There is a relatively small evidence base on public opinion related to motor vehicle– and bicycle-related evidence-based policies; even less is less known for state- or county-specific policies. The findings of this review suggest that the public's opinion toward injury prevention legislation is generally favorable. This information can be used to communicate with the media and policy makers to reinforce the need for effective policy solutions to continuing motor vehicle injury problems. More research is needed to understand the perspectives of those who do not hold favorable opinions, to understand opinions toward local or state-level policies, and to monitor trends in public opinion over time. Supplemental materials are available for this article. Go to the publisher's online edition ofTraffic Injury Preventionto view the supplemental file. [ABSTRACT FROM AUTHOR]

Objective:To examine the impact of text messaging and other in-car behaviors on driving performance under simple and naturalistic road conditions in a driving simulator. Methods:Data from 28 healthy individuals (12 female) are presented. Participant age ranged from 18 to 28 (mean = 21.0). Average driving experience was 3.8 years (SD = 2.5). Participants completed a baseline loop condition in which they drove normally through a realistic virtual environment. Next, participants drove an identical loop, and at 3 specified points during this drive, participants were required to (1) complete a radio-tuning task; (2) type and send a text message containing “Drexel University”; and (3) type and send “I am driving to the store.” Driving performance and task duration was compared between conditions. Results:Across all tasks, both lane management, F(1,27) = 11.1, P = .002, and velocity, F(1,27) = 10.3, P = .003, varied significantly more while task-engaged. Average lane deviation was significantly greater during a text messaging task than during the baseline drive of the same road segment, t(27) = −2.9, P = .007. Comparison of task durations indicated that both texting tasks took significantly longer to complete than the radio task, with the “Drexel University” text (118 s) taking almost twice as long as the radio-tuning task (60 s). Unexpected and novel findings emerged in the evaluation of duration of texting tasks using the varying text-entry methods, with touch-screen modality taking significantly longer than others. Conclusions:Engaging in secondary tasks while operating a motor vehicle may have deleterious effects on driving performance and increase risk, even under the simplest of driving conditions. Text messaging may constitute a “perfect storm” of risk compared to other in-vehicle tasks such as tuning the car radio. The current investigation demonstrated detrimental effects of text messaging on driving behaviors such as lane maintenance, speed maintenance, and shifts of attention, even under relatively ideal and naturalistic driving conditions (e.g., familiar route, good weather, no traffic). [ABSTRACT FROM PUBLISHER]

Objective: Around the world, a substantial proportion of motor vehicle crash deaths are recognized as “hidden” suicides. This project sought to progress understandings of drivers who used a motor vehicle to die by suicide in Queensland, Australia, during the period 1990 to 2007. Methods: Data for this study were derived from the Queensland Suicide Register and forensic crash investigation case records. Analysis focused on life circumstances and events preceding the death, physical and mental illnesses, past suicidality, and indication of suicide intent (e.g., suicide notes or statements). Results: Compared to cases using other methods, confirmed driver suicides were more likely to be males aged between 25 and 44 years who were employed at the time of death. A large proportion of driver suicides had consumed alcohol immediately prior to the crash and experienced a number of life events, including relationship conflict, legal or criminal issues, and financial problems. Conclusion: These exploratory results indicate the need to educate crash investigators about the characteristics of those who use a motor vehicle to die. Improving the information available on the mental and physical health and background life-related factors of crash victims can help coroners and researchers determine whether these deaths were intentional. Further investigation is needed in order to formulate intervention strategies for those who may be vulnerable to driver suicide. [ABSTRACT FROM AUTHOR]

Objectives: To compare the crash reporting system of National Highways & Motorways Police (NH&MP), Pakistan, with the World Health Organization (WHO) injury surveillance guidelines. Methods: Based on information collected from field observations, key informant interviews, and review of official documents, this note firstly describes the reporting system according to the components of a surveillance system. Then the reporting is compared with WHO criteria for designing and building an injury surveillance system and attributes of such a system. Results: After a crash, a patrol officer communicates the information to the higher police authorities by wireless, fax, and on paper in the first 24 hours. Microcomputer Accident Analysis Package (MAAP) Performa filed by the officers are collected at a central location in the following 4 days, and reports are published biannually. Notable deficiencies in the reporting were nonidentification of stakeholders for data utilization and limited prospects of data recording process modification and its monitoring. Moreover, crash and injury definitions do not conform to international standards practiced elsewhere. Conclusion: NH&MP crash reporting needs to be simplified and standardized, and steps should be taken to improve its utilization for prevention purposes. [ABSTRACT FROM AUTHOR]

Objective: Head injury is the most common cause of death for child occupants in motor vehicle crashes (MVCs). The morbidity associated with nonlethal MVC-related head injuries is of great clinical consequence as well. The purpose of this study was to identify the frequency of, and risk factors for, clinically significant head injury (CSHI) in child occupants in MVCs. Methods: A large, child-specific crash surveillance system linking insurance claims data to telephone survey data was utilized. Qualifying crashes involved model year 1990 or newer vehicles in crashes with one or more child occupants (age 4 to 15 years) occurring in 15 U.S. states. Data were accrued between March 2000 and December 2007. A probability sample of crashes was selected for telephone survey with the driver of the insured vehicle. A clinically significant head injury, as reported by the child's parent using a validated survey, included concussions, skull fractures, and intracranial hemorrhages. Multivariate logistic regression was used to identify factors associated with a CSHI. Results: During the period of study, completed interviews were obtained on 19,075 children aged 4-15, representing 318,527 children involved in 219,511 crashes. The overall rate of CSHI in child occupants was 1.08 percent. Factors associated with an increased risk of head injury included rollover (odds ratio [OR] = 8.60, 95% confidence interval [CI] 6.40-11.57) and near-side impact crashes (OR = 2.39, 95% CI 1.73-3.30) vs. frontal impact; lack of restraint (OR = 3.13, 95% CI 2.26-4.33) vs. restrained; and driver age < 25 years (OR = 1.43, 95% CI 1.12-1.81) vs. driver age ≥ 25 years. Some factors varied based on occupant age, and younger child age had a protective effect on the risk for head injury. Conclusion: The risk of CSHI for 4- to 15-year-old child occupants was 1.08 percent. Several demographic and crash factors were associated with CSHI in child occupants. This information may help inform design safety initiatives. [ABSTRACT FROM AUTHOR]

Objectives: To estimate the costs of motor vehicle-related fatal and nonfatal injuries in the United States in terms of medical care and lost productivity by road user type. Methods: Incidence and cost data for 2005 were derived from several data sources. Unit costs were calculated for medical spending and productivity losses for fatal and nonfatal injuries, and unit costs were multiplied by incidence to yield total costs. Injury incidence and costs are presented by age, sex, and road user type. Results: Motor vehicle-related fatal and nonfatal injury costs exceeded $99 billion. Costs associated with motor vehicle occupant fatal and nonfatal injuries accounted for 71 percent ($70 billion) of all motor vehicle-related costs, followed by costs associated with motorcyclists ($12 billion), pedestrians ($10 billion), and pedalcyclists ($5 billion). Conclusions: The substantial economic and societal costs associated with these injuries and deaths reinforce the need to implement evidence-based, cost-effective strategies. Evidence-based strategies that target increasing seat belt use, increasing child safety seat use, increasing motorcyclist and pedalcyclist helmet use, and decreasing alcohol-impaired driving are available. [ABSTRACT FROM AUTHOR]

Objective. To obtain prevalence estimates of seat belt use among adults with and without at least one child in the household and to examine whether having at least one child in the household is associated with adult seat belt use. Methods. The Second Injury Control and Risk Survey (ICARIS-2) was a nationwide cross-sectional, list-assisted random-digit-dialing telephone survey of individuals who were at least 18 years old and who spoke either English or Spanish. ICARIS-2 was carried out from 2001 to 2003; a similar study, ICARIS-1, had been conducted in 1994. National estimates were calculated for the prevalence of adult seat belt use and stratified according to the presence or absence of children in the household. Prevalence estimates for the two ICARIS surveys were compared using t-tests. Multivariable logistic regression was used to explore the association between having at least one child in the household and self-reported adult seat belt use. Results. Based on the 9,684 completed household interviews in ICARIS-2, an estimated 15.9% (13 million) of drivers with children in their households did not always wear their seat belt when driving, and 17.5% (15 million) of adult passengers with children in their households did not always wear their seat belt while riding. The prevalence of drivers and passengers who did not always wear their seat belt decreased between ICARIS-1 and ICARIS-2. Both driver and passenger seat belt use were associated with the respondent's age, sex, ethnicity, level of education, current marital status, and self-reported alcohol-impaired driving or riding with an alcohol-impaired driver. Drivers with children in the household, living in the Northeast, North Central, and Southern census regions of the country were significantly more likely than those in the West to report wearing their seat belt less than always. Conclusions. While seat belt use rates are increasing, many more lives could be saved by more complete restraint use. Effective strategies for increasing seat belt use rates and decreasing the number of both fatal and nonfatal motor vehicle injuries include primary enforcement laws, enhanced enforcement of seat belt use laws, and child safety-seat distribution combined with education programs. [ABSTRACT FROM AUTHOR]

Objective. Motor vehicle crashes are the leading cause of death for 15-to 20-year-olds. In 2004, nearly 8,000 15to 20-year-old drivers were killed in crashes. Epidemiologic studies repeatedly identify overrepresentation of young males in fatal crashes. Recent studies of young females and risk-taking behaviors (drug use, violent crime, risky sexual behavior) show unfavorable trends. The objective of this study is to study the extent of contribution of young female drivers to national fatal crashes over and to uncover unfavorable trends linked to risky driving behavior. Methods. Data from the National Highway Traffic Safety Administration's Fatal Analysis Reporting System (FARS) on drivers in crashes with one or more fatalities during 1995-2004 were studied. Five age groups were used: 16, 17, 18, 19-20, and 21-24 years. Linear regression was used to measure trends over time. The regression results represent differences in proportions and changes in proportion of crashes that fell into specified categories. The FARS multiple imputation data sets was used to estimate the proportion of drivers with positive blood alcohol, and variance estimates were corrected for the imputation procedure. Results. In all, 139,000 fatal crashes involving the noted age groups occurred over 10 years. Safety restraint use: Females had more safety restraint use (by 17.8%) but a smaller increase in use over time. Driver's license validity: The percentage of valid licensure decreased over the study for young males and females both in the general population and among drivers in fatal crashes. Single-vehicle crashes: A lower proportion of female drivers (8.9% fewer) were involved in single-vehicle fatal crashes. This proportion changed little over the study period. Alcohol use: Females had a 16.7% lower proportion than males of alcohol involvement in fatal crashes. This lower proportion was seen throughout the age groups. When accounting for change over the study period, female drivers had a similar to male increase in alcohol-involved fatal crashes. Presence of peer passengers: Female drivers were less likely to have age peers as passengers. Conclusions. While young male drivers surpass young females in number of fatal crashes, there are unfavorable trends linked to crash fatalities in young females. Our results suggest a smaller increase in safety restraint use, proportional decrease in license validity, and an increase in rate of alcohol-involved fatal crashes that approaches that seen in young males. These findings have considerable implications for future traffic safety social marketing campaigns, programs, and interventions. [ABSTRACT FROM AUTHOR]

Road rage has generated increasing public concern. Research has shown that victimization and perpetration of road rage is more common among males and younger drivers. We aimed to extend the understanding of determinants of road rage to driving exposure and vehicle factors, based on a 2002–2003 population survey of 1,631 regular drivers in Ontario, Canada. Regression analyses revealed that number of times drivers reported experiencing road rage in the previous 12 months was significantly greater for males, younger respondents, and those residing in Toronto. Also, victimization was significantly greater for drivers who did all their driving on busy roads and increased with number of kilometers driven on a typical week; however, type of vehicle driven was not significant. Number of times road rage perpetration was reported in the past 12 months was significantly greater for males, younger respondents, and those residing in Toronto, and lower for those in the Eastern and Northern region. Road rage perpetration increased significantly with number of weekly kilometers driven and was significantly greater for drivers who are always on busy roads and lower for those who never drive on busy roads, and higher for high-performance vehicle drivers. Even after controlling for driving exposure, road rage victimization and perpetration were highest for drivers in Toronto, where the pace of life may be more demanding. As expected, high-performance vehicle drivers reported more road rage perpetration. These individuals may experience more frustration when they are prevented from using the full performance capacities of their vehicles by crowded urban roadways. [ABSTRACT FROM AUTHOR]

Drivers and passengers who drown while trapped in their vehicles or exiting from vehicles account for most flood-related deaths in the United States, yet little has been known about crash circumstances or risk factors for flood-related motor vehicle injury. We conducted a case-control study of all occupants of single-vehicle crashes in flood-affected North Carolina counties where drowning deaths occurred on 15, 16, and 17 September 1999 (the days before, during, and after landfall of Hurricane Floyd); a descriptive study of deaths using medical examiner records; and a survey of proxy respondents for persons who drowned. In 66 crashes vehicles hit puddles and went off the road, went off the road in rain, drove into water and stalled, hit trees in the road, or drove into collapsed sections of road; 19 of these vehicles were partially or fully submerged in water. Occupants of submerged vehicles were more likely to have drowned if their vehicles were fully submerged (14 of 19, 73.7%) than if their vehicles were partly submerged (0 of 8, 0%). According to proxy informants, most of the persons who drowned were familiar with the roads traveled during the study period, and all 16 had received severe weather warnings. Motor vehicle occupants in weather-related crashes are more likely to drown if their vehicles are submerged or swept away. Vehicle submersion may often be a consequence of deliberately driving into flooded roadways. However, in flood-affected areas, crashes and injuries may also occur when motorists encounter flooded roadways unexpectedly. [ABSTRACT FROM AUTHOR]

Objective. The purpose of this article was to examine the use of seat belt by motor vehicle users in the various provinces in South Africa. Methods. Data were abstracted from published reports of the national Department of Transport. Percentage distribution and correlation of road safety variables and seat belt wearing rates for motor vehicle users were calculated for the different provinces. Results. High seat belt wearing rates by the drivers (between 75.1% and 88.1%, national rate was 81%). The seat belt wearing rates for the front and back seat passengers were much lower than for the drivers. The seat belt wearing rates for front seat passengers (44.5% to 60.5%, national - 50.1%) and back seat passengers (1% to 16%, national - 7.6%) were much lower than for the drivers. The national seat belt wearing rate for all vehicles between 1982 and 1995 was between 46.9% and 69.2%, but this has generally declined. Conclusion. There is a need for the implementation of strategies to increase the use of seat belts to reduce injuries and fatalities. [ABSTRACT FROM AUTHOR]

Objective: This study aims to identify the association, if any, between prehospital scene time, prehospital transport time, and Injury Severity Score (ISS) with in-hospital mortality.Methods: A retrospective analysis was performed on patients at least 18 years of age who arrived to the hospital alive via emergency medical services (EMS) after a motor vehicle collision (MVC) between 1992 and 2016. These patients were divided into groups based on minutes spent at the scene and in transport. The ISS of the in-hospital mortalities, as well as the entire patient sample for each time frame, was collected. Patients without documented scene time, transport time, or ISS were excluded.Results: Four thousand one hundred ninety-four patients were captured when analyzing scene time, though only 3,980 met inclusion criteria. In addition, 4,177 patients were captured when analyzing transport time, though only 3,979 met inclusion criteria. Scene time and transport time were not statistically significant predictors of in-hospital mortality (P = .31 and P = .458, respectively). ISS was found to be a statistically significant predictor of in-hospital mortality (P < .001).Conclusions: ISS predicts mortality independent of scene time or transport time for patients who arrive to the hospital alive following an MVC at Guthrie Robert Packer Hospital. Limitations of our study include inability to capture prehospital deaths and inability to correlate ISS with prehospital injury severity scores. [ABSTRACT FROM AUTHOR]

Objective:Rollover crashes account for more than 33% of all motor vehicle–related fatalities and have the highest fatality risk of all crash types, at 1.37% in the United States. There is increased awareness of the high fatality rate associated with this crash type, but there is very limited pediatric-specific data related to rollover crashes in the United States. Recent focus on rollover mitigation has resulted in implementation of countermeasures, making it important to evaluate injury causation for child occupants in rollover crashes with a more current data set. Methods:We queried the Crash Injury Research and Engineering Network (CIREN) from case years 1998 through 2013. Rollover crashes for passenger vehicles of model year 1998 or newer with at least one restrained occupant (excluding drivers) between 0 and 19 years of age were included. Vehicle-involved physical component and occupant–vehicle contact maps were developed with the CIREN data set. Results and Conclusions:Of the 20 CIREN cases that met the inclusion criteria, 15 had one or more injuries attributed to contact with some part of the vehicle structure. The CIREN analyses revealed that the head was the most common seriously injured body region, primarily due to contact with the roof side rail and/or vehicle interior. This finding was true for both adolescents and younger pediatric passengers in outboard seating positions. Fifty percent of head injury causation scenarios involving the vehicle interior had component intrusion of 20+ cm at the point of contact. Further exploration of pediatric rollover injury mechanisms using computational modeling and real-world testing is recommended in order to improve upon current mitigation strategies. [ABSTRACT FROM PUBLISHER]