The association between exposure to a rear-end collision and future healthcomplaints

Different symptoms, together with neck pain, have been attributed to person s with persistent complaints after a previous motor vehicle crash (MVC) and are sometimes referred to as the "late whiplash syndrome." A cohort study was conducted to determine whether exposure to a rear-end collision, with o r without whiplash injury, is associated with future health complaints. The results regarding future neck or shoulder pain have previously been descri bed, and the objective of the present report was to focus on outcomes other than neck pain. Included in the study were persons 18 to 65 years of age a nd covered by traffic insurance at one of the largest insurance companies i n Sweden. Claim reports were collected from the period November 1987 to Apr il 1988. Drivers exposed to a rear-end collision were divided into two subg roups: those with reported whiplash injury (n = 232) and those without repo rted whiplash injury (n = 204). For comparison, 3688 subjects who were unex posed to MVCs were selected, with consideration taken to the age and gender distribution in the exposed subgroups. The prevalence of different health complaints among the study subjects was estimated according to a mailed que stionnaire at follow-up in 1994, 7 years after the rear-end collision. When exposed subjects with whiplash injury were compared to unexposed subjects, increased relative risks in the range of 1.6-3.7 were seen for headache, t horacic and low back pain, as well as for fatigue, sleep disturbances and i ll health. No corresponding increased risks were found among the exposed su bjects without reported whiplash injury. We conclude that rear-end collisio ns resulting in reported whiplash injuries seem to have a substantial impac t on health complaints, even a long time after the collision. There is a ne ed to identify factors that predict a non-favorable outcome in order to imp rove clinical management. (C) 2001 Elsevier Science Inc. All rights reserve d.