Objective:​ To evaluate the maximum potential for side underride guards (SUGs) to reduce passenger vehicle occupant fatalities and injuries in crashes with large trucks in the United States.

Methods:​ Examination of the Large Truck Crash Causation Study (LTCCS) identified 206 crash events involving a passenger vehicle impact with the side of a large truck. Each case was evaluated to determine whether the most severe injury sustained by a passenger vehicle occupant was a result of the impact with the side of the truck and whether an SUG could have reduced the injury severity. Data from the 2006–2008 Fatality Analysis Reporting System (FARS) and Trucks Involved in Fatal Accidents (TIFA) survey were used to compare the types of trucks involved in all fatal side impacts with passenger vehicles with the truck types in the LTCCS cases that were studied. FARS and TIFA data also were used to estimate the total annual number of passenger vehicle occupants killed in truck side impacts.

Results:​ In 143 of the 206 cases, the truck side impact produced the most severe injury sustained by a passenger vehicle occupant. In the other cases, no passenger vehicle occupant was injured or the most severe injury was due to an event preceding or following the truck side impact. Forty-nine of these occupants sustained injuries coded as level 3 or higher on the abbreviated injury scale (AIS) or were killed. SUGs could have reduced injury severity in 76 of the 143 cases, including 38 of the 49 cases with an AIS ≥ 3 coded injury or fatality. Semi-trailers were the most common type of impacted truck unit, both overall and when considering only cases where an SUG could have mitigated injury severity. Crashes where the front of the passenger vehicle struck the side of the semi-trailer perpendicularly or obliquely from the oncoming direction were less common overall than side-to-side and oblique/same direction crashes but more often produced an AIS ≥ 3 injury or fatality. The distribution of truck types in the LTCCS sample was similar to that in the FARS and TIFA data. Overall, around 1600 passenger vehicle occupants were killed in 2-vehicle truck side impact crashes during 2006–2008, or 22 percent of all passenger vehicle occupants who died in 2-vehicle crashes with large trucks.

Conclusions:​ Structural incompatibility was a common factor in LTCCS crashes between passenger vehicles and the sides of large trucks. SUGs could have reduced injury risk in around three fourths of the crashes that produced an AIS ≥ 3 injury or fatality. Most of these crashes involved semi-trailers. However, the necessary strength and location of these SUGs present technical challenges that need to be addressed.