Bicycle commuter injury prevention: it is time to focus on the environment.
BACKGROUND
Few data exist on the risk of injury while commuting to work or school by bicycle. The proportion of commuters choosing to travel by bike is increasing in the United States, and information on injury incidence and the influences of rider characteristics and environmental factors may suggest opportunities for prevention actions.


METHODS
Bicycle commuters in the Portland, OR, metropolitan area were recruited via the websites and community advertising to participate in a 1-year study. Riders completed an initial online survey along with 12 monthly surveys describing their commutes and injury events from September 2007 to August 2008. A traumatic event was considered a serious traumatic event if medical attention was sought.


RESULTS
Nine hundred sixty-two adult bicyclists (52% men and 48% women) with a mean age of 36.7 ± 0.4 years (range, 22-70 years) commuted an average of 135 miles (range, 7-617) per month. There were 225 (23%) beginner, 256 (27%) intermediate, and 481 (50%) advanced riders. Four hundred twenty (44%) had a prior traumatic event. Over the 1-year period, 164 (18%) riders reported 192 traumatic events and 49 (5%) reported 50 serious traumatic events. The incidence rates of traumatic events and serious traumatic events were 15.0 (95% CI, 13.2-17.5) and 3.9 (95% CI, 2.9-5.1) per 100,000 miles commuted. There were no differences in age, gender, safety practices, and experience levels between commuters who experienced a traumatic event and those who did not.


CONCLUSIONS
Approximately 20% of bicycle commuters experienced a traumatic event and 5% required medical attention during 1 year of commuting. Traumatic events were not related to rider demographics, safety practices, or experience levels. These results imply that injury prevention should focus on improving the safety of the bicycle commuting environment.
Division of Trauma, Critical Care and Acute Care Surgery, Department of Surgery, Oregon Health & Science University, Portland, Oregon 97239, USA.
Melissa R
MR
Hoffman
William E
WE
Lambert
Ellen G
EG
Peck
John C
JC
Mayberry
D000063:Accidents, Traffic / Q000517:prevention & control* / Q000706:statistics & numerical data; D000328:Adult; D000368:Aged; D001642:Bicycling / Q000293:injuries*; D004777:Environment; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009922:Oregon / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D014947:Wounds and Injuries / Q000453:epidemiology / Q000517:prevention & control*; D055815:Young Adult