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they maintain, correctly, that these do ing radiation, mechanical energy, elec-
not account for all of the descriptive trical energy, and chemical energy, each
categories involved, or for all of the in a variety of forms. Since these have
problems associated with them. This been discussed in detail elsewhere,2'3 we
commonplace failure to understand this need not go into them further here, ex-
usual, and necessary, transition has, in- cept to note that in the highway safety
cidentally, especially been a problem in area the problem is almost exclusively
connection with research on descriptively one of mechanical energy reaching
based groupings such as "atheroscle- people at rates that involve forces in
rosis," "chronic bronchitis," "cancer," excess of their injury thresholds. None-
"diabetes," and many others of current theless, some chemical and thermal
concern. This failure in understanding hazards appear to be of increasing im-
has also delayed research and programs portance on the highway; for example,
concerned with what most still refer to in relation to the distribution of hazard-
as "accidents." ous amounts of propane, explosives, and
The notion of an accident is descrip- other hazardous materials, on our roads.
tive, not etiologic. It has a long his- The literature in the over-all field is
tory and close relationship-themselves increasingly divergent. Most of the be-
worthy of the most careful study by be- havioral science literature is highly in-
havioral scientists-to notions of per- bred and concerned almost exclusively
sonal vulnerability and invulnerability. with studies and programs centering on
This is illustrated, for example, by the the use of the descriptive notion of "acci-
themes of the stories of Job and Achilles. dent." Parallel to this literature is an-
Redolent of the extrarational and super- other-substantially based in physics
natural and prescientific, they remind and medicine-already very extensive
one of Malinowski's natives in their and growing much more rapidly, and
approach to the hazards outside the largely derived from De Haven's 1942
reef, which they did not understand, landmark paper entitled "Mechanical
in comparison with those inside which Analysis of Survival in Falls from
they approached in more rational Heights of Fifty to One Hundred and
terms.1 Fifty Feet."4 This second literature, in-
But the old, descriptive, concept of cidentally, is already producing major
an accident is largely giving way in payoffs in injury prevention and ame-
programs and research to an etiologic lioration. It is concerned with the forces
concept which, in turn-as is typical in that produce the injuries to animate
such transitions-is picking up a num- and inanimate structures, the ways these
ber of phenomena not normally included can be avoided, the susceptibilities of
under the term accident itself. As with the animate and inanimate structures in-
the examples I have briefly sketched, volved, and the amelioration of the vari-
neither set includes all of the ingredients ous forms of damage, once they occur.
of the other. An outstanding exception to the pre-
The etiologic basis is the various occupation of the behavioral literature
forms of energy exchange which must with "accidents" is James J. Gibson's
occur in excess of body injury thresh- 1961 paper. "The Contribution of Ex-
olds for the injuries which make the perimental Psychology to the Formula-
field of such current social concern to tion of the Problem of Safety-a Brief
occur. The forms of energy involved in for Basic Research."5 Gibson's subsec-
producing so-called "accidental injuries" tions delineate an ecological and etio-
of all types, and without which they can- logical approach: "a classification of
not occur. include thermal energy, ioniz- dangers" (wherein he discusses, for
elimination or reduction of the end re- nosology and its penumbra of folklore
sults of injury and death. In fact, as and traditional wisdom.
far as vehicle occupants are concerned,
the knowledge, both theoretical and ap- Technics in Use
plied, is already available. During the For simplicity, most of the prob-
next few years, this will make it en- lems of the field can be sorted out
tirely feasible to design vehicles whose with a two-dimensional matrix, within
occupants need not sustain either any the cells of which one can organ-
injuries at all or, at worst, no very seri- ize a great many more specific issues.
ous injuries at crash speeds under at Figure 3 shows this as done for the
least 60 miles an hour, a range in highway portion of the over-all chem-
which the overwhelming bulk of occu- ical and physical injury problem. Simi-
pant injuries and deaths now occur. (In lar matrices are used for other portions
illustration, Bohlin6 has recently shown of the over-all problem. Doing so is also
reductions in deaths in highway crashes, an important step in sorting out inter-
other factors being equal, of 80 per cent actions between the items covered in
as the result of the use of combination the individual cells and for purposes
lap-and-upper-torso safety belts. In addi- of mathematical modeling. Each of these
tion, no deaths occurred in his series be- cells contains a substantial number,
low 60 miles per hour, compared with breadth, and complexity of factors, cate-
12 miles per hour among the unbelted.6) gories of variables, and opportunities
Without going into further details, the for influencing the end results.
methods applied will, in essence, involve If fully developed here, two ana-
the far better "packaging" of human lagous matrices would be set up: the
cargo, accomplishing with people what first concerned with causal factors in
we long ago achieved with property.2'3 each cell; the second with counter-
A third phase of the sequences, which measures in each. We also use this
lead up to the end results of concern, matrix to identify resource requirements
involves maximizing salvage, once dam- and what is known scientifically.
age has been done to the susceptible It should be noted that this matrix
structures. Using polio again as an identifies the location of all, as far as
example, although there are many we know, that is done in the field to
others in the medical field, the problem reduce the end results of concern. It is
there was to reduce the likelihood of much broader than preoccupation with
death, once paralysis occurred, to lower the causation of accidents (i.e., crashes)
the extent and progression of paralysis, and their prevention. For example, in
to reverse it insofar as possible, and to the precrash phase, the research issues
provide the necessary emergency med- include those of alcoholism, blowouts,
ical, intermediate, and rehabilitative coefficients of friction of road surfaces.
care. Needless to say, the timing and In the crash phase, there are the injury
sequencing of salvage and a good deal thresholds of drivers and others, the
of its substance are identical to those dynamic integrity of vehicle "packages,"
appropriate for those injured on our and highway crash design. In the post-
highways. crash phase, the issues for research and
Clearly, the questions and opportuni- programs include emergency signal
ties, at each point in these etiological generation and other communications,
sequences, are different from those emergency transportation, emergency
likely to be recognized by merely talk- medical care, debris removal, and police
ing about injury control or about "acci- work.
dents," using the old and still traditional The most common and universal fal-
PRECRASH
TIME CRASH
POSTCRASH
DRIVER PASSENGER
INJURY INJURY & ____ ---
IPROPERTY DAMAGE --
& DEATH DEATH
Figure 3-A matrix for identifying major areas within the highway portion of the
over-all chemical and physical injury probl em
lacy in the field, whether viewed within pelling the use of appropriate helmets
a descriptive or etiologic framework, reduces deaths and injuries about 65
is one which is ingrained that it is
so per cent, it would have us concentrate,
seldom explicitly recognized. It in- despite our present lack of knowledge
volves the assumption that the prior- of ways to influence crashes, only on
ity rank of countermeasures, in terms the present far less productive manipula-
of their ability to influence the end re- tion of motorcycle drivers.2 In the case
sults of concern, must parallel the rank- of occupant protection, which we know
ing, in order of their relative contribu- has great potential,2 some of it already
tions, of causes influencing those end beginning to be realized, this fallacy
results. In its most common form, it has set back for many years the applica-
states that because drivers cause most tion of such information because of its
accidents, programs correspondingly insistence that the driver was the prob-
must be concerned with drivers. In the lem and, therefore, should be, in essence,
real world, there is no basis for making the only locus of countermeasure ac-
this assumption, especially since in nu- tivity.
merous areas of the field it leads to Earlier it was emphasized that transi-
demonstrably false conclusions. tions from descriptive to etiologic group-
Thus, if applied to the widespread ings of phenomena do not occur on a
thermal and electrical injuries associated one-to-one basis. It has been mentioned
with early house-wiring systems, this that the notion "accident" includes a
theory would have led to concentrating number of things not directly relevant
on attempts to influence human be- to highway or other injuries and deaths.
havior rather than the development of It includes the entire area of "mis-
the fuse. With respect to motorcycle haps," with all their extrarational and
accidents, where we know that com- other overlays, all of which should be