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Whiplash risk estimation based on linked hospital–police road crash data from France and Spain
  1. J-L Martin1,
  2. K Pérez2,3,
  3. M Marí-Dell’Olmo4,
  4. M Chiron1
  1. 1
    UMRESTTE, INRETS, Bron, France
  2. 2
    Agència de Salut Pública de Barcelona, Barcelona, Spain
  3. 3
    CIBER en Epidemiología y Salud Pública (CIBERESP), Spain
  4. 4
    Institut d’Investigació en Atenció Primèria Jordi Gol, Barcelona, Spain
  1. J-L Martin, UMRESTTE, INRETS, 25 avenue François Mitterrand, 69675 Bron cedex, France; Jean-louis.martin{at}


Objectives: To investigate potential risk factors for whiplash injury as a function of crash configuration and driver’s characteristics, and to provide information on over-reporting and under-reporting of whiplash.

Design: A case–control study of drivers involved in two-car injury collisions. Cases were drivers who had a diagnosis of whiplash injury, with or without another injury. Controls were drivers without diagnosed whiplash injury.

Setting: Hospital registries linked to police crash databases for Barcelona (Spain) and the “Département du Rhône” (France).

Main outcome measures: Relative risks of whiplash and 95% confidence intervals were estimated using a modified Poisson regression.

Results: Of the 8720 drivers involved in car-to-car crashes recorded in the French database, 12.2% were diagnosed with whiplash; the corresponding figure in the Spanish database was 12.0% of 7558 drivers. Female drivers and drivers in rear-impact collisions were most likely to have a whiplash diagnosis, although the absolute number of whiplash cases was greater in front and side impacts. Wearing a seatbelt, being in a heavier car, and age greater than 65 years were associated with a lower risk of whiplash injury. Drivers with other injuries were also more often diagnosed as having a whiplash injury, except the most severely injured.

Conclusions: Devices aimed at reducing the occurrence of whiplash injuries, such as dynamic headrest systems, should be adapted to the characteristics of at-risk occupants, especially women, and should address the mechanics of front and side impacts in addition to rear impacts.

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  • Competing interests: None.