Epidemiology of bicycle injuries and risk factors for serious injury.
OBJECTIVE
To determine the risk factors for serious injury to bicyclists, aside from helmet use.


METHODS
Prospective case-control study.


METHODS
Seven Seattle area hospital emergency departments and two county medical examiner's offices.


METHODS
Individuals treated in the emergency department or dying from bicycle related injuries.


METHODS
Information collected from injured bicyclists or their parents by questionnaire on circumstances of the crash; abstract of medical records for injury data. Serious injury defined as an injury severity score > 8.


METHODS
Odd ratios computed using the maximum likelihood method, and adjusted using unconditional logistic regression.


RESULTS
There were 3854 injured cyclists in the three year period; 3390 (88%) completed questionnaires were returned 51% wore helmets at the time of crash. Only 22.3% of patients had head injuries and 34% had facial injuries. Risk of serious injury was increased by collision with a motor vehicle (odds ratio (OR) = 4.6), self reported speed > 15 mph (OR = 1.2), young age (< 6 years), and age > 39 years (OR = 2.1 and 2.2 respectively, compared with adults 20-39 years). Risk for serious injury was not affected by helmet use (OR = 0.9). Risk of neck injury was increased in those struck by motor vehicles (OR = 4.0), hospitalized for any injury (OR = 2.0), and those who died (OR = 15.1), but neck injury was not affected by helmet use.


CONCLUSIONS
Prevention of serious bicycle injuries cannot be accomplished through helmet use alone, and may require separation of cyclists from motor vehicles, and delaying cycling until children are developmentally ready.
Rivara
F P
FP
Harborview Injury Prevention and Research Center, Department of Pediatrics and Epidemiology, University of Washington, Seattle USA.
Thompson
D C
DC
Thompson
R S
RS
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000704:Analysis of Variance; D001642:Bicycling / Q000293:injuries*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006260:Head Protective Devices; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D019838:Neck Injuries; D016017:Odds Ratio; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D011795:Surveys and Questionnaires; D015996:Survival Rate; D014861:Washington / Q000453:epidemiology