A comprehensive analysis of factors influencing the injury severity of large-truck crashes

Given the importance of trucking to the economic well being of a country and the safety concerns posed by the trucks, a study of large-truck crashes is critical. This paper contributes by undertaking an extensive analysis of the empirical factors affecting injury severity of large-truck crashes. Data from a recent, nationally representative sample of large-truck crashes are examined to determine the factors affecting the overall injury severity of these crashes. The explanatory factors include the characteristics of the crash, vehicle(s), and the driver(s). The injury severity was modeled using two measures. Several similarities and some differences were observed across the two models which underscore the need for improved accuracy in the assessment of injury severity of crashes. The estimated models capture the marginal effects of a variety of explanatory factors simultaneously. In particular, the models indicate the impacts of several driver behavior variables on the severity of the crashes, after controlling for a variety of other factors. For example, driver distraction (truck drivers), alcohol use (car drivers), and emotional factors (car drivers) are found to be associated with higher severity crashes. A further interesting finding is the strong statistical significance of several dummy variables that indicate missing data – these reflect how the nature of the crash itself could affect the completeness of the data. Future efforts should seek to collect such data more comprehensively so that the true effects of these aspects on the crash severity can be determined.     

Driver injury severity outcome analysis in rural interstate highway crashes: a two-level Bayesian logistic regression interpretation

There is a high potential of severe injury outcomes in traffic crashes on rural interstate highways due to the significant amount of high speed traffic on these corridors. Hierarchical Bayesian models are capable of incorporating between-crash variance and within-crash correlations into traffic crash data analysis and are increasingly utilized in traffic crash severity analysis. This paper applies a hierarchical Bayesian logistic model to examine the significant factors at crash and vehicle/driver levels and their heterogeneous impacts on driver injury severity in rural interstate highway crashes. Analysis results indicate that the majority of the total variance is induced by the between-crash variance, showing the appropriateness of the utilized hierarchical modeling approach. Three crash-level variables and six vehicle/driver-level variables are found significant in predicting driver injury severities: road curve, maximum vehicle damage in a crash, number of vehicles in a crash, wet road surface, vehicle type, driver age, driver gender, driver seatbelt use and driver alcohol or drug involvement. Among these variables, road curve, functional and disabled vehicle damage in crash, single-vehicle crashes, female drivers, senior drivers, motorcycles and driver alcohol or drug involvement tend to increase the odds of drivers being incapably injured or killed in rural interstate crashes, while wet road surface, male drivers and driver seatbelt use are more likely to decrease the probability of severe driver injuries. The developed methodology and estimation results provide insightful understanding of the internal mechanism of rural interstate crashes and beneficial references for developing effective countermeasures for rural interstate crash prevention.     

Heterogeneous impacts of gender-interpreted contributing factors on driver injury severities in single-vehicle rollover crashes

In this study, a mixed logit model is developed to identify the heterogeneous impacts of gender-interpreted contributing factors on driver injury severities in single-vehicle rollover crashes. The random parameter of the variables in the mixed logit model, the heterogeneous mean, is elaborated by driver gender-based linear regression models. The model is estimated using crash data in New Mexico from 2010 to 2012. The percentage changes of factors’ predicted probabilities are calculated in order to better understand the model specifications. Female drivers are found more likely to experience severe or fatal injuries in rollover crashes than male drivers. However, the probability of male drivers being severely injured is higher than female drivers when the road surface is unpaved. Two other factors with fixed parameters are also found to significantly increase driver injury severities, including Wet and Alcohol Influenced. This study provides a better understanding of contributing factors influencing driver injury severities in rollover crashes as well as their heterogeneous impacts in terms of driver gender. Those results are also helpful to develop appropriate countermeasures and policies to reduce driver injury severities in single-vehicle rollover crashes.     

Hierarchical Bayesian random intercept model-based cross-level interaction decomposition for truck driver injury severity investigations

Traffic crashes occurring on rural roadways induce more severe injuries and fatalities than those in urban areas, especially when there are trucks involved. Truck drivers are found to suffer higher potential of crash injuries compared with other occupational labors. Besides, unobserved heterogeneity in crash data analysis is a critical issue that needs to be carefully addressed. In this study, a hierarchical Bayesian random intercept model decomposing cross-level interaction effects as unobserved heterogeneity is developed to examine the posterior probabilities of truck driver injuries in rural truck-involved crashes. The interaction effects contributing to truck driver injury outcomes are investigated based on two-year rural truck-involved crashes in New Mexico from 2010 to 2011. The analysis results indicate that the cross-level interaction effects play an important role in predicting truck driver injury severities, and the proposed model produces comparable performance with the traditional random intercept model and the mixed logit model even after penalization by high model complexity. It is revealed that factors including road grade, number of vehicles involved in a crash, maximum vehicle damage in a crash, vehicle actions, driver age, seatbelt use, and driver under alcohol or drug influence, as well as a portion of their cross-level interaction effects with other variables are significantly associated with truck driver incapacitating injuries and fatalities. These findings are helpful to understand the respective or joint impacts of these attributes on truck driver injury patterns in rural truck-involved crashes.     

Mixed logit analysis of bicyclist injury severity resulting from motor vehicle crashes at intersection and non-intersection locations

Standard multinomial logit (MNL) and mixed logit (MXL) models are developed to estimate the degree of influence that bicyclist, driver, motor vehicle, geometric, environmental, and crash type characteristics have on bicyclist injury severity, classified as property damage only, possible, nonincapacitating or severe (i.e., incapacitating or fatal) injury. This study is based on 10,029 bicycleinvolved crashes that occurred in the State of Ohio from 2002 to 2008. Results of likelihood ratio tests reveal that some of the factors affecting bicyclist injury severity at intersection and non-intersection locations are substantively different and using a common model to jointly estimate impacts on severity at both types of locations may result in biased or inconsistent estimates. Consequently, separate models are developed to independently assess the impacts of various factors on the degree of bicyclist injury severity resulting from crashes at intersection and non-intersection locations.Several covariates are found to have similar impacts on injury severity at both intersection and non-intersection locations. Conversely, six variables were found to significantly influence injury severity at intersection locations but not non-intersection locations while four variables influenced bicyclist injury severity only at non-intersection locations. In crashes occurring at intersection locations, the likelihood of severe bicyclist injury increases by 14.8 percent if the bicyclist is not wearing a helmet, 82.2 percent if the motorist is under the influence of alcohol, 141.3 percent if the crash-involved motor vehicle is a van, 40.6 percent if the motor vehicle strikes the side of the bicycle, and 182.6 percent if the crash occurs on a horizontal curve with a grade. Results from non-intersection locations show the likelihood of severe injuries increases by 374.5 percent if the bicyclist is under the influence of drugs, 150.1 percent if the motorist is under the influence of alcohol, 53.5 percent if the motor vehicle strikes the side of the bicycle and 99.9 percent if the crash-involved motor vehicle is a heavy-duty truck.     

Examining driver injury severity outcomes in rural non-interstate roadway crashes using a hierarchical ordered logit model

Rural non-interstate crashes induce a significant amount of severe injuries and fatalities. Examination of such injury patterns and the associated contributing factors is of practical importance. Taking into account the ordinal nature of injury severity levels and the hierarchical feature of crash data, this study employs a hierarchical ordered logit model to examine the significant factors in predicting driver injury severities in rural non-interstate crashes based on two-year New Mexico crash records. Bayesian inference is utilized in model estimation procedure and 95% Bayesian Credible Interval (BCI) is applied to testing variable significance. An ordinary ordered logit model omitting the between-crash variance effect is evaluated as well for model performance comparison. Results indicate that the model employed in this study outperforms ordinary ordered logit model in model fit and parameter estimation. Variables regarding crash features, environment conditions, and driver and vehicle characteristics are found to have significant influence on the predictions of driver injury severities in rural non-interstate crashes. Factors such as road segments far from intersection, wet road surface condition, collision with animals, heavy vehicle drivers, male drivers and driver seatbelt used tend to induce less severe driver injury outcomes than the factors such as multiple-vehicle crashes, severe vehicle damage in a crash, motorcyclists, females, senior drivers, driver with alcohol or drug impairment, and other major collision types. Research limitations regarding crash data and model assumptions are also discussed. Overall, this research provides reasonable results and insight in developing effective road safety measures for crash injury severity reduction and prevention.     

Analysis of left-turn crash injury severity by conflicting pattern using partial proportional odds models

The purpose of this study is to examine left-turn crash injury severity. Left-turning traffic colliding with opposing through traffic and with near-side through traffic are the two most frequently occurring conflicting patterns among left-turn crashes (Patterns 5 and 8 in the paper, respectively), and they are prone to be severe. Ordered probability models with either logit or probit function is commonly applied in crash injury severity analyses; however, its critical assumption that the slope coefficients do not vary over different alternatives except the cut-off points is usually too restrictive. Partial proportional odds models are generalizations of ordered probability models, for which some of the beta coefficients can differ across alternatives, were applied to investigate Patterns 5 and 8, and the total left-turn crash injuries. The results show that partial proportional odds models consistently perform better than ordered probability models. By focusing on specific conflicting patterns, locating crashes to the exact crash sites and relating approach variables to crash injury in the analysis, researchers are able to investigate how these variables affect left-turn crash injuries. For example, opposing through traffic and near-side crossing through traffic in the hour of collision were identified significant for Patterns 5 and 8 crash injuries, respectively. Protected left-turn phasing is significantly correlated with Pattern 5 crash injury. Many other variables in driver attributes, vehicular characteristics, roadway geometry design, environmental factors, and crash characteristics were identified. Specifically, the use of the partial proportional formulation allows a much better identification of the increasing effect of alcohol and/or drug use on crash injury severity, which previously was masked using the conventional ordered probability models.     

Mixed logit model-based driver injury severity investigations in single- and multi-vehicle crashes on rural two-lane highways

Crashes occurring on rural two-lane highways are more likely to result in severe driver incapacitating injuries and fatalities. In this study, mixed logit models are developed to analyze driver injury severities in single-vehicle (SV) and multi-vehicle (MV) crashes on rural two-lane highways in New Mexico from 2010 to 2011. A series of significant contributing factors in terms of driver behavior, weather conditions, environmental characteristics, roadway geometric features and traffic compositions, are identified and their impacts on injury severities are quantified for these two types of crashes, respectively. Elasticity analyses and transferability tests were conducted to better understand the models’ specification and generality. The research findings indicate that there are significant differences in causal attributes determining driver injury severities between SV and MV crashes. For example, more severe driver injuries and fatalities can be observed in MV crashes when motorcycles or trucks are involved. Dark lighting conditions and dusty weather conditions are found to significantly increase MV crash injury severities. However, SV crashes demonstrate different characteristics influencing driver injury severities. For example, the probability of having severe injury outcomes is higher when vans are identified in SV crashes. Drivers’ overtaking actions will significantly increase SV crash injury severities. Although some common attributes, such as alcohol impaired driving, are significant in both SV and MV crash severity models, their effects on different injury outcomes vary substantially. This study provides a better understanding of similarities and differences in significant contributing factors and their impacts on driver injury severities between SV and MV crashes on rural two-lane highways. It is also helpful to develop cost-effective solutions or appropriate injury prevention strategies for rural SV and MV crashes.     

Rollover crashes: predicting serious injury based on occupant, vehicle, and crash characteristics

The purpose of this research was to determine occupant, vehicle, and crash characteristics predicting serious injury during rollover crashes. We compared 27 case occupants with serious or greater severity injuries with 606 control occupants without injury or with only minor or moderate injury. Odds ratios (OR) for individual variables and logistic regression were used to identify predictive variables for serious injury associated with rollovers. Cases more often had thorax, spine, or head injury compared to controls that more often had extremity injuries. Intrusion (especially roof rail or B-pillar intrusion) at the occupant's position, the vehicle interior side and roof as sources of injury, and improper safety belt use were significantly associated with serious injury. Even when safety belt use or proper use was controlled for, occupants with greater magnitude of intrusion at their seat position were about 10 times more likely to receive serious injury. Although prevention of rollover crashes is the ultimate goal, it is important to develop safer vehicles and safety systems to better protect occupants who are involved in rollover crashes. This also requires improvement in data collection systems documenting these types of crashes.     

Analysis of injury severity of drivers involved in single- and two-vehicle crashes on highways in Ontario

This study analyzes driver's injury severity in single- and two-vehicle crashes and compares the effects of explanatory variables among various types of crashes. The study identified factors affecting injury severity and their effects on severity levels using 5-year crash records for provincial highways in Ontario, Canada. Considering heteroscedasticity in the effects of explanatory variables on injury severity, the heteroscedastic ordered logit (HOL) models were developed for single- and two-vehicle crashes separately. The results of the models show that there exists heteroscedasticity for young drivers (≤30), safety equipment and ejection in the single-vehicle crash model, and female drivers, safety equipment and head-on collision in the two-vehicle crash models. The results also show that young car drivers have opposite effects between single-car and car–car crashes, and sideswipe crashes have opposite effects between car–car and truck–truck crashes. The study demonstrates that separate HOL models for single-vehicle and different types of two-vehicle crashes can identify differential effects of factors on driver's injury severity.     

Factors influential in making an injury severity difference to older drivers involved in fixed object-passenger car crashes

To identify factors influencing severity of injury to older drivers in fixed object-passenger car crashes, two sets of sequential binary logistic regression models were developed. The dependent variable in one set of models was driver injury severity, whereas for the other it was the crash severity (most severe injury in the crash). For each set of models, crash or injury severity was varied from the least severity level (no injury) to the highest severity level (fatality) and vice versa. The source of data was police crash reports from the state of Florida. The model with the best fitting and highest predictive capability was used to identify the influence of roadway, environmental, vehicle, and driver related factors on severity. Travel speed, restraint device usage, point of impact, use of alcohol and drugs, personal condition, gender, whether the driver is at fault, urban/rural nature and grade/curve existence at the crash location were identified as the important factors for making an injury severity difference to older drivers involved in single vehicle crashes.     

A multinomial logit model-Bayesian network hybrid approach for driver injury severity analyses in rear-end crashes

Rear-end crash is one of the most common types of traffic crashes in the U.S. A good understanding of its characteristics and contributing factors is of practical importance. Previously, both multinomial Logit models and Bayesian network methods have been used in crash modeling and analysis, respectively, although each of them has its own application restrictions and limitations. In this study, a hybrid approach is developed to combine multinomial logit models and Bayesian network methods for comprehensively analyzing driver injury severities in rear-end crashes based on state-wide crash data collected in New Mexico from 2010 to 2011. A multinomial logit model is developed to investigate and identify significant contributing factors for rear-end crash driver injury severities classified into three categories: no injury, injury, and fatality. Then, the identified significant factors are utilized to establish a Bayesian network to explicitly formulate statistical associations between injury severity outcomes and explanatory attributes, including driver behavior, demographic features, vehicle factors, geometric and environmental characteristics, etc. The test results demonstrate that the proposed hybrid approach performs reasonably well. The Bayesian network reference analyses indicate that the factors including truck-involvement, inferior lighting conditions, windy weather conditions, the number of vehicles involved, etc. could significantly increase driver injury severities in rear-end crashes. The developed methodology and estimation results provide insights for developing effective countermeasures to reduce rear-end crash injury severities and improve traffic system safety performance.     

Overall injury risk to different drivers: combining exposure,frequency, and severity models

Traffic crash risk assessments should incorporate appropriate exposure data. However, existing US nationwide crash data sets, the NASS General Estimates System (GES) and the Fatality Analysis Reporting System (FARS), do not contain information on driver or vehicle exposure. In order to obtain appropriate exposure data, this work estimates vehicle miles driven (VMD) by different drivers using the Nationwide Personal Transportation Survey (NPTS). These results are combined with annual crash rates and injury severity information from the GES for a comprehensive assessment of overall risk to different drivers across vehicle classes.Data are distinguished by driver age, gender, vehicle type, crash type (rollover versus non-rollover), and injury severity. After correcting for drivers' crash exposure, results indicate that young drivers are far more crash prone than other drivers (per VMD) and that drivers of sports utility vehicles (SUVs) and pickups (PUs) are more likely to be involved in rollover crashes than those driving passenger cars. Although, the results suggest that drivers of SUVs are generally much less crash prone than drivers of passenger cars, the rollover propensity of SUVs and the severity of that crash type offset many of the incident benefits for SUV drivers.     

Thoracic injuries to contained and restrained occupants in single-vehicle pure rollover crashes

Around one in three contained and restrained seriously injured occupants in single-vehicle pure rollover crashes receive a serious injury to the thorax. With dynamic rollover test protocols currently under development, there is a need to understand the nature and cause of serious thoracic injuries incurred in rollover events. This will allow decisions to be made with regards to adoption of a suitable crash test dummy and appropriate thoracic injury criteria in such protocols. Valid rollover occupant protection test protocols will lead to vehicle improvements that will reduce the high trauma burden of vehicle rollover crashes. This paper presents an analysis of contained and restrained occupants involved in single-vehicle pure rollover crashes that occurred in the United States between 2000 and 2009 (inclusive). Serious thoracic injury typology and causality are determined. A logistic regression model is developed to determine associations between the incidence of serious thoracic injury and the human, vehicle and environmental characteristics of the crashes. Recommendations are made with regards to the appropriate assessment of potential thoracic injury in dynamic rollover occupant protection crash test protocols.     

Occupant injury in rollover crashes – Contribution of planar impacts with objects and other vehicles

Planar impacts with objects and other vehicles may increase the risk and severity of injury in rollover crashes. The current study compares the frequency of injury measures (MAIS 2+, 3+, and 4+; fatal; AIS 2+ head and cervical spine; and AIS 3+ head and thorax) as well as vehicle type distribution (passenger car, SUV, van, and light truck), crash kinematics, and occupant demographics between single vehicle single event rollovers (SV Pure) and multiple event rollovers to determine which types of multiple event rollovers can be pooled with SV Pure to study rollover induced occupant injury. Four different types of multiple event rollovers were defined: single and multi-vehicle crashes for which the rollover is the most severe event (SV Prim and MV Prim) and single and multi-vehicle crashes for which the rollover is not the most severe event (SV Non-Prim and MV Non-Prim). Information from real world crashes was obtained from the National Automotive Sampling System – Crashworthiness Data System (NASS-CDS) for the period from 1995 through 2011. Belted, contained or partially ejected, adult occupants in vehicles that completed 1–16 lateral quarter turns were assigned to one of the five rollover categories. The results showed that the frequency of injury in non-primary rollovers (SV Non-Prim and MV Non-Prim) involving no more than one roof inversion is substantially greater than in SV Pure, but that this disparity diminishes for crashes involving multiple inversions. It can further be concluded that for a given number of roof inversions, the distribution of injuries and crash characteristics in SV Pure and SV Prim crashes are sufficiently similar for these categories to be considered collectively for purposes of understanding etiologies and developing strategies for prevention.     

Modeling occupant-level injury severity: An application to large-truck crashes

Most of the injury-severity analyses to date have focused primarily on modeling the most-severe injury of any crash, although a substantial fraction of crashes involve multiple vehicles and multiple persons. In this study, we present an extensive exploratory analysis that highlights that the highest injury severity is not necessarily the comprehensive indicator of the overall severity of any crash. Subsequently, we present a panel, hetroskedastic ordered-probit model to simultaneously analyze the injury severities of all persons involved in a crash. The models are estimated in the context of large-truck crashes. The results indicate strong effects of person-, driver-, vehicle-, and crash-characteristics on the injury severities of persons involved in large-truck crashes. For example, several driver behavior characteristics (such as use of illegal drugs, DUI, and inattention) were found to be statistically significant predictors of injury severity. The availability of airbags and the use of seat-belts are also found to be associated with less-severe injuries to car-drivers and car-passengers in the event of crashes with large trucks. Car drivers’ familiarity with the vehicle and the roadway are also important for both the car drivers and passengers. Finally, the models also indicate the strong presence of intra-vehicle correlations (effect of common vehicle-specific unobserved factors) among the injury propensities of all persons within a vehicle.     

Analysis of factors associated with injury severity in crashes involving young New Zealand drivers

Young people are a risk to themselves and other road users, as motor vehicle crashes are the leading cause of their death. A thorough understanding of the most important factors associated with injury severity in crashes involving young drivers is important for designing well-targeted restrictive measures within youth-oriented road safety programs. The current study estimates discrete choice models of injury severity of crashes involving young drivers conditional on these crashes having occurred. The analysis examined a comprehensive set of single-vehicle and two-vehicle crashes involving at least one 15–24 year-old driver in New Zealand between 2002 and 2011 that resulted in minor, serious or fatal injuries. A mixed logit model accounting for heterogeneity and heteroscedasticity in the propensity to injury severity outcomes and for correlation between serious and fatal injuries proved a better fit than a binary and a generalized ordered logit. Results show that the young drivers’ behavior, the presence of passengers and the involvement of vulnerable road users were the most relevant factors associated with higher injury severity in both single-vehicle and two-vehicle crashes. Seatbelt non-use, inexperience and alcohol use were the deadliest behavioral factors in single-vehicle crashes, while fatigue, reckless driving and seatbelt non-use were the deadliest factors in two-vehicle crashes. The presence of passengers in the young drivers’ vehicle, and in particular a combination of males and females, dramatically increased the probability of serious and fatal injuries. The involvement of vulnerable road users, in particular on rural highways and open roads, considerably amplified the probability of higher crash injury severity.     

Analysis of driver injury severity in single-vehicle crashes on rural and urban roadways

This study analyzes driver injury severities for single-vehicle crashes occurring in rural and urban areas using data collected in New Mexico from 2010 to 2011. Nested logit models and mixed logit models are developed in order to account for the correlation between severity categories (No injury, Possible injury, Visible injury, Incapacitating injury and fatality) and individual heterogeneity among drivers. Various factors, such as crash and environment characteristics, geometric features, and driver behavior are examined in this study. Nested logit model and mixed logit model reveal similar results in terms of identifying contributing factors for driver injury severities. In the analysis of urban crashes, only the nested logit model is presented since no random parameter is found in the mixed logit model. The results indicate that significant differences exist between factors contributing to driver injury severity in single-vehicle crashes in rural and urban areas. There are 5 variables found only significant in the rural model and six significant variables identified only in the urban crash model. These findings can help transportation agencies develop effective policies or appropriate strategies to reduce injury severity resulting from single-vehicle crashes.     

Cervical and thoracic spine injury from interactions with vehicle roofs in pure rollover crashes

Around one third of serious injuries sustained by belted, non-ejected occupants in pure rollover crashes occur to the spine. Dynamic rollover crash test methodologies have been established in Australia and the United States, with the aims of understanding injury potential in rollovers and establishing the basis of an occupant rollover protection crashworthiness test protocol that could be adopted by consumer new car assessment programmes and government regulators internationally. However, for any proposed test protocol to be effective in reducing the high trauma burden resulting from rollover crashes, appropriate anthropomorphic devices that replicate real-world injury mechanisms and biomechanical loads are required. To date, consensus regarding the combination of anthropomorphic device and neck injury criteria for rollover crash tests has not been reached. The aim of the present study is to provide new information pertaining to the nature and mechanisms of spine injury in pure rollover crashes, and to assist in the assessment of spine injury potential in rollover crash tests. Real-world spine injury cases that resulted from pure rollover crashes in the United States between 2000 and 2009 are identified, and compared with cadaver experiments under vertical load by other authors. The analysis is restricted to contained, restrained occupants that were injured from contact with the vehicle roof structure during a pure rollover, and the role of roof intrusion in creating potential for spine injury is assessed. Recommendations for assessing the potential for spine injury in rollover occupant protection crash test protocols are made.     

Exploring factors contributing to injury severity at freeway merging and diverging locations in Ohio

Identifying factors that affect crash injury severity and understanding how these factors affect injury severity is critical in planning and implementing highway safety improvement programs. Factors such as driver-related, traffic-related, environment-related and geometric design-related were considered when developing statistical models to predict the effects of these factors on the severity of injuries sustained from motor vehicle crashes at merging and diverging locations. Police-reported crash data at selected freeway merging and diverging areas in the state of Ohio were used for the development of the models. A generalized ordinal logit model also known as partial proportional odds model was applied to identify significant factors increasing the likelihood of one of the five KABCO scale of injury severity: no injuries, possible/invisible injuries, non-incapacitating injuries, incapacitating injuries, or fatal injuries. The results of this study show that semi-truck related crashes, higher number of lanes on freeways, higher number of lanes on ramps, speeding related crashes, and alcohol related crashes tend to increase the likelihood of sustaining severe injuries at freeway merging locations. In addition, females and older persons are more likely to sustain severe injuries especially at freeway merge locations. Alcohol related crashes, speeding related crashes, angle-type collisions, and lane-ramp configuration type D significantly increase the likelihood of severe injury crashes at diverging areas. Poor lighting condition tends to increase non-incapacitating injuries at diverging areas only. Moreover, adverse weather condition increases the likelihood of no-injury and fatal injuries at merging areas only and adverse road conditions tend to increase a range of injury severity levels from possible/invisible injuries to incapacitating injuries at merging areas only.