Introduction: Turbulence accidents in aviation are common and can cause serious injuries, but injury patterns and relevant flight characteristics are often overlooked. This study aimed to analyze aviation accidents, classify turbulence-related injuries, and identify associated flight factors. Methods: This study was a retrospective database and chart review. The National Transportation Safety Board database was searched for air carrier accidents with serious injuries or fatalities from January 2014 to December 2023. Accident charts were hand-searched, and flight details with injury patterns were manually extracted and categorized by axial or extremity location and Anatomic Profile (AP) (Category A = head and spinal cord, Category B = thorax and anterior neck, Category C = remaining serious, Category D = remaining non-serious injuries). Injury types and severity are compared by flight phase and seatbelt status. Results: A total of 153 air carrier serious accidents resulted in 156 casualties with serious injuries and five deaths. Turbulence was the most common cause (107, 69.9%) and was responsible for 117 (75.0%) casualties with serious injuries and no deaths. Fractures were the most common injuries (112, 72.3%) and were more likely sustained in turbulence-related accidents (OR 4.79, 95% CI 1.63-14.07). Location of fractures was axial in 34 (22.8%) and extremity in 78 (52.3%). AP was Category A in 16 (10.7%), B in 11 (7.4%), and C in 102 (68.5%) injuries. Fractures were less likely during cruising (OR 0.09, 95% CI 0.01-0.80) and more likely during descending (OR 21.95, 95% CI 1.19-403.4) flight phases. There was no significant association between seatbelt sign presence and fractures (OR 2.22, 95% CI 0.09-52.1). Conclusion: Turbulence was the leading cause of aviation accidents and inflicted serious injuries like head and spine fractures, especially during flight descent. These findings can help airlines prioritize safety measures and healthcare responders prepare for relevant injuries.
Lim et al. (Sun,) studied this question.