{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T22:56:35Z","timestamp":1781650595287,"version":"3.54.5"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T00:00:00Z","timestamp":1776643200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T00:00:00Z","timestamp":1776643200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004047","name":"Karolinska Institute","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004047","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Public Health"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Whiplash-associated disorders (WAD) are common injuries from car crashes, with a significant proportion leading to permanent medical impairment (PMI), especially among women and in rear-end impacts. While previous research has shown mixed results regarding work incapacity following WAD, severe cases may lead to long-term health and functional consequences. This study aimed to examine the occurrence of long-term WAD \u2013 based on insurance compensation, future PMI, and work incapacity (sickness absence (SA) and disability pension (DP)) among front seat occupants in rear-end crashes, and to assess how seat design with or without whiplash protection systems (WPS) relates to these outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The cohort (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200914,363) was selected from car crashes occurring 2001\u20132013, reported to the Folksam Insurance Group. Injury- and car-related information was linked with nationwide register data regarding sociodemographics, inpatient and specialized outpatient healthcare, SA, and DP. The SA\u2009+\u2009DP days\/year were calculated in relation to the crash date. Logistic regression analyses were performed with variables combining WPS and car model year of introduction (&lt;\u20091998 and \u2265\u20091998) for long-term WAD, PMI, and &gt;\u200990 days of all diagnoses and whiplash-specific SA\/DP in year two after the crash. Analyses were stratified by sex.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among women, 18% sustained long-term WAD and 12% resulted in PMI. Among men,13% and 9%, respectively. Among occupants with long-term WAD, there was a substantial increase in mean SA\/DP days\/year, WAD specific and all diagnoses, after the crash and remained high three years after. Compared to occupants in cars with WPS, occupants in older cars (&lt;\u20091998) without WPS were more likely to have long-term WAD (Women: OR:1.8, 95% confidence intervals (CI):1.5\u20132.2; Men: OR:2.2, 95% CI:1.7\u20132.8), and PMI (Women: OR:1.4, 95% CI:1.1\u20131.8; Men: OR:2.3, 95% CI:1.6\u20133.3). Among men, also occupants in newer cars without WPS were more likely to have long-term WAD (OR:1.6; 95% CI:1.2-2.0) and PMI (OR:1.9; 95% CI;1.3\u20132.7). Among men, but not women, those injured in older cars without WPS were more likely to have &gt;\u200990 days SA\/DP in year two following the crash (OR:1.8; 95% CI: 1.2\u20132.6).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>WPS were associated with a lower risk of long-term WAD, PMI, and prolonged SA\/DP, particularly among men, with substantial less benefit for women. These sex differences highlight the need to improve WPS performance, especially for women.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12889-026-27404-2","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T03:25:50Z","timestamp":1776655550000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long-term whiplash-associated disorders, sickness absence, and disability pension following rear-end car crashes and associations with whiplash protection systems: a longitudinal cohort study"],"prefix":"10.1186","volume":"26","author":[{"given":"Rasmus","family":"Elrud","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilie","family":"Friberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandra","family":"Machado","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina","family":"Alexanderson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena","family":"Stigson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,20]]},"reference":[{"key":"27404_CR1","doi-asserted-by":"publisher","first-page":"S52","DOI":"10.1097\/BRS.0b013e3181643ece","volume":"33","author":"LW Holm","year":"2008","unstructured":"Holm LW, Carroll LJ, Cassidy JD, et al. 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