Skull/brain injuries to car occupants are still a major problem in road accidents, as they are a dominating cause of death, and for survivors, as they often lead to permanent problems. Many of the preventive actions in passive safety have therefore been directed towards injuries to the head.

In Sweden, it is since 1997 possible to link medical data coded according to ICD (International Classification of Diseases), and police reported accident data, for all cases where an injured person has been admitted to hospital. This provides an opportunity to study the influence of the car design on injuries.

In this study, a material from the police and the hospitals on the national basis has been used to study the influence of new car design. The method used was predominantly paired comparisons, which can control the influence of accident severity and other problems associated with exposure.

It was found, that there has been a dramatic reduction of skull/brain as well as facial injuries in the last years that can be related to the design of the cars. The reduction was in the order of 50-60% when comparing cars from 1984 with cars from 1995, involved in car to car impacts.