title: Cycling crashes in children, adolescents, and adults--a comparative analysis.
abstract: OBJECTIVE
  To compare rates, circumstances, and outcomes of cyclist crashes between children (aged 0-9 years), adolescents (aged 10-19 years), and adults (aged 20 years and over) in Victoria, Australia.
  
  
  METHODS
  A retrospective analysis of cyclist crashes in police records and the Victorian Admitted Episodes Dataset during the period 2004-2008.
  
  
  RESULTS
  Adolescent cyclists had the highest rates, per 100 000 people, of police-reported (32.6, 95% confidence interval [CI]: 30.7-34.5) and hospitalized cyclist crashes (71.6, 95% CI: 68.7-74.4). Police-reported helmet use at the time of the crash was lowest among children (57.1%, 95% CI: 49.5-64.8) compared to 60.2 percent (95% CI: 57.3-63.1) in adolescents and 77.7 percent (95% CI: 76.5-78.8) in adults. This was reflected in the hospital data, which indicated that more than one third of cyclist hospitalizations among children (37.4%) resulted in head injuries compared to around 1 in 4 hospitalized cyclist crashes in adolescents (26.8%) and adults (23.7%). Cyclists emerging off a footpath into the path of a vehicle as well as cyclists struck by vehicles emerging form a driveway were the most frequent types of police-reported crashes involving children (73.9%) and adolescents (48.1%). In contrast, most adult cyclist crashes occurred on the roadway, mainly at intersections.
  
  
  CONCLUSIONS
  Programs to improve the safety knowledge and behavior of children and adolescent cyclists, particularly focusing on helmet use, should be part of a comprehensive approach that encompasses legislative and environmental changes, including appropriate cyclist facilities and reduced speed limit in residential areas.
authors.affiliation: The George Institute for Global Health, The University of Sydney, Sydney, Australia. sboufous@george.org.au
authors.forename: Soufiane
authors.initials: S
authors.lastname: Boufous
authors.forename: Liz De
authors.initials: LD
authors.lastname: Rome
authors.forename: Teresa
authors.initials: T
authors.lastname: Senserrick
authors.forename: Rebecca
authors.initials: R
authors.lastname: Ivers
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001642:Bicycling / Q000293:injuries / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D006260:Head Protective Devices / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D016495:Police; D012189:Retrospective Studies; D014739:Victoria / Q000453:epidemiology; D055815:Young Adult