Despite dramatic safety improvements in cars, drivers and passengers continue to be injured because the laws of physics and biology cannot always be overcome. Rapid deceleration while being restrained by the seatbelts puts a huge strain on the human body.
Wrist and finger injuries
These are usually caused by the driver not letting go of the wheel. The impact fractures the wrists. If the wheels are wrenched sideways, this can turn the steering wheel with such force that thumbs are dislocated or broken.
Long terms issues can be caused with loss of fine motor control in the fingers, or weakness in the wrists and arms.
Whiplash
This is caused when a driver is hit from behind and their head and neck snap backwards. Virtually all new vehicles have anti-whiplash head restraints in for front passengers to help reduce this. Tall rear passengers, though, can be vulnerable as headrests are shorter. It’s important to set your headrest so that the top of it aligns with the top of your head.
The symptoms of whiplash include a sore or stiff neck, headaches, numbness in the upper torso or neck, trapped nerves in the neck, and loss of range of motion.
Burns
Minor burns are frequently caused by the explosives in airbags. More serious burns can occur if the car catches fire, but this is rare.
Burns can result in scarring if they are deep enough.
Head injuries
While airbags will cushion the driver’s head when it is thrown forwards, a side-on impact is much more dangerous as the airbags are less effective. In a side-on impact, the head can easily hit the side window and B-pillar.
Airbags are not effective in a second impact as they will have deflated.
This can result in facial injuries, bruising and skull fractures
Brain injuries
Large g-forces due to impacts and deceleration cause the brain to move around in the skull. It can cause concussion at best and permanent brain damage or death at worse. A brain injury can cause temporary or permanent changes in mood or personality, impaired speech, impaired vision, nausea, migraines, foggy thinking, difficulty in communicating (speaking, writing and reading) and loss of fine motor coordination.
Rib and sternum injuries
The force of the seatbelt against the rib cage can crack or break ribs and the sternum. Items hitting the seat from behind (e.g. another passenger or items carried in the car) can also damage the seat occupant’s ribs and back. Carry items in the boot where possible, or low behind the front seats.
Front-seat passengers carrying things on their lap will find that thing between them and the airbag approaching at 300km/h
Rib and sternum injuries can take months to heal and can come with chronic pain (i.e. every time you breath or move).
Back and neck injuries
In a frontal or side-on impact, the neck can be hyperextended, as can the spine, causing serious damage to it such as spinal cord damage leading to paralysis or long-term weakness and disability.
Lumbar strains and muscle sprains can occur, as can a herniated disc.
These types of injuries can also be caused by just using a lap belt rather than a three-point seat belt.
Bruising and contusions
Bruising can occur due to impact with various parts of the vehicle or things being thrown around in the vehicle. All soft tissues can be damaged by impacts.
Eye injuries
A detached retina is possible if the deceleration force is strong enough. A detached retina can cause a curtain-like shadow over your visual field, a reduced peripheral vision, blurred vision with many tiny specks (floaters) that appear, and flashes of light in one or both eyes.
An eye injury may mean that your eyesight doesn’t meet the requirements for driving.
Internal organs damage
During deceleration, the internal organs hit the rib cage. If the rib cage is broken at the same time, the sharp edges of bones can lacerate internal organs and even damage major arteries and veins causing massive internal bleeding.
Blood vessel damage, clots and stroke: accidents have cause fatty deposits within arteries to dislodge, then become lodged in another part of the body. This has lead to strokes or loss of limbs as it’s difficult to diagnose quickly.
If an artery is torn, internal blood loss can result in death in minutes. Bruising of or damage to the internal organs can cause a variety of problems, depending on the organ involved.
Cuts
Broken glass from the windscreen and side windows can cause a cut hazard, as can sharp bits of metal.
Foot and lower leg injuries
These are usually caused by the engine being pushed back into the cabin, or the steering column being pushed into the knees. Some cars have knee airbags to mitigate this.
Feet can get caught in the pedals, especially if the driver or passenger ‘submarines’ (slides under the seatbelt). Most vehicles have anti-submarining seats.
These injuries can cause ongoing issues with mobility and pain.
Passengers who put their feet on the dashboard can suffer horrific injuries if the air bag is deployed. The knees will be propelled into the face, crushing facial bones and the knee caps. The femurs could be hyperextended and dislocated from the hip. Or, it can simply snap your shins and femurs and crush bones in your feet, depending on the angle you have your legs at.
This also is a risk if a front-seat passenger has a large bag in front of them.
Recovery
While recovery from some of these can be rapid, that’s not always the case particularly as it’s difficult in an emergency situation to diagnose all of the issues if the driver is unconscious. As well as the physical ailments, psychological trauma can occur resulting in ongoing anxiety or phobias about driving. Counselling may be required to overcome this.