AIRBAG INDUCED
OCULAR INJURIES: A SHORT REPORT.
OCHIOGU
BC (FMCOph)1, UGHACHUKWU PO (PhD. Pharm.)2
1.
Department of Ophthalmology,
Chukwuemeka
Odumegwu Ojukwu University, Awka Campus.
2.
Department of Pharmacology and
Therapeutics, Chukwuemeka Odumegwu Ojukwu University, Awka Campus.
Correspondence
to: Dr. Ochiogu BC,
E-mail:
benardochiogu@yahoo.com
Citation: Ochiogu BC,
Ughachukwu PO. Airbag Induced Ocular Injuries: A Short Report. Orient
Journal of Surgical Sciences. March 2020; 1 (1): 25 - 28
ABSTRACT
Airbag is one of the new innovations in automotive safety.
It is being increasingly installed in motor vehicles by the car manufacturers
to cushion the vehicle occupants in the event of a car crash. However,
increased general morbidity and mortality have been recorded following auto
crash involving vehicles fitted this facility. Eye injuries, in particular,
have escalated leading to higher ocular morbidity. The mechanisms of ocular
damage by the airbag include mechanical, thermal and chemical.
Two cases of airbag related ocular injuries involving two
males aged 69 years and 55 years are presented. One was a driver while the
other was a passenger. The former sustained globe rupture while the latter
suffered thermal and chemical burns of the cornea.
In conclusion, airbag does not provide 100% safety but only
helps to mitigate injuries following a car crash. On some occasions, it could
be a source of injury especially when the victim is not wearing a seat belt. In
some cases, airbag related eye trauma could be very severe with resultant
significant ocular morbidity.
KEYWORDS:
Airbag, Ocular trauma, Auto crash.
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INTRODUCTION
Airbag is one of the new innovations in automotive safety.
It is increasingly becoming more common as standard safety equipment in new
cars.1 The aim of this device is to give cushioning effect to the
occupants and protect them from the rigid structures of the vehicle interior.
In fact, the airbag has significantly lowered morbidity and mortality from auto
crashes.2,3 However, this gadget, like the seat belt, produces its
own spectrum of injuries which has been on the increase.4,5
For the airbag, this ranges from relatively minor injuries
such as abrasions and superficial burns to unexpected fatalities.5
Appearance of articles documenting airbag-related eye trauma in the early
1990's prompted the United States Eye Injury Registry to editorialize, “Air
bag: friend or foe”.6 North American literature have reported
numerous fatalities from airbag injuries.7,8
The airbag is a coated thick nylon bag housed in strategic
locations within the body of the vehicle.9 Sensors located within
the vehicle structures are activated when a crash occurs at speed even as low
as 12mph and within a 600 frontal arc.1 An electrical
signal is usually sent to the airbag cartridge which contains a combustible
solid state powder, usually sodium azide (NaN3) and an oxidizing
agent.4 The combustion of sodium azide produces mostly inert
nitrogen gas. Other products from the reaction
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include
ammonia, carbon-dioxide, nitric oxide, carbon monoxide, an alkaline aerosol
containing sodium hydroxide and various metallic oxides.1 An inert
talc powder used in packaging is also discharged. Heat is an additional
by-product of the combustion process.1 Therefore, chemical and
thermal burns comprise mechanisms of airbag injuries.
Following
a car crash, the expanding airbag is propelled out of the storage compartment
at a speed of 100-200mph and the entire inflation sequence is completed with
0.05 seconds.1 Fully inflated airbag contains about 60 liters of gas
on the driver's side and 140 liters on the passenger's side.1 The
driver's airbag expands to a less depth than the passenger's airbag.1
Some airbags are tethered to limit the anterior-posterior expansion and the
airbag quickly begins to deflate through vents directed away from the
occupants.1
We
hereby present a short report of facial and unilateral ocular injuries in a 60
year old man who was involved in an auto crash while driving alone in a sports
utility vehicle in Awka, (Anambra State), Nigeria and another 55 year old man
who sustained right ocular and facial burns from an airbag following a car
crash while traveling as a front seat passenger in another sports utility
vehicle (SUV).
Authors
elsewhere have categorized ocular injuries which could arise from airbags into
two groups. The first group
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