title: Bicycle crashes in different riding environments in the Australian capital territory.
abstract: BACKGROUND
  Cyclists are increasingly overrepresented in traffic crash casualties in Australia. There is evidence that better cycling infrastructure increases participation, but whether it reduces the numbers of injured cyclists is less clear. This study examined injury outcomes of crashes in different cycling environments.
  
  
  METHODS
  Adult cyclists injured on- and off-road were recruited from emergency departments from November 2009 to May 2010 in the Australian Capital Territory. Eligible participants (n = 313/372, 84.1%) were interviewed and their injury self-reports were corroborated with medical records where available. Participants who had crashed in transport-related areas (n = 202, 64.5%) are the focus of this article.
  
  
  RESULTS
  Participants had crashed in traffic (39.1%), in cycle lanes (7.9%), on shared paths (36.1%), and on footpaths (16.8%). Based on average weekly traffic counts, the crash involvement rate per 1000 cyclists was 11.8 on shared paths compared to 5.8 on cycle lanes. Over half of the participants (52.0%) were injured in single-vehicle bicycle crashes. The remainder involved other road users, including motor vehicles (20.8%), other bicycles (18.8%), pedestrians (6.4%), and animals (2.0%). Pedestrians were involved in 16.4 percent of crashes on shared paths. Minor injuries (Abbreviated Injury Scale [AIS] 1) were sustained by 58.4 percent of cyclists, moderately severe injuries (AIS 2) were sustained by 36.1 percent of cyclists, and 5.4 percent of cyclists were seriously injured (AIS 3+). The average treatment required was 1.8 days with 7.5 days off work and cost to the cyclist of $869 excluding medical treatment. Cyclists who crashed on shared paths or in traffic had higher injury severity scores (ISS; 4.4, 4.0) compared to those in cycle lanes or on footpaths (3.3, 3.4) and required more treatment days (2.8, 1.7 versus 0.0, 0.2).
  
  
  CONCLUSIONS
  Fewer cyclists were injured in on-road cycle lanes than in other cycling environments, and a high proportion of injuries were incurred on shared paths. This study highlights an urgent need to determine appropriate criteria and management strategies for paths classified as suitable for shared or segregated usage. Supplemental materials are available for this article. Go to the publisher's online edition of Traffic Injury Prevention to view the supplemental files.
authors.affiliation: a The George Institute for Global Health, Injury Division , University of Sydney , Sydney , Australia.
authors.forename: Liz
authors.initials: L
authors.lastname: De Rome
authors.forename: Soufiane
authors.initials: S
authors.lastname: Boufous
authors.forename: Thomas
authors.initials: T
authors.lastname: Georgeson
authors.forename: Teresa
authors.initials: T
authors.lastname: Senserrick
authors.forename: Drew
authors.initials: D
authors.lastname: Richardson
authors.forename: Rebecca
authors.initials: R
authors.lastname: Ivers
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D020958:Australian Capital Territory / Q000453:epidemiology; D001642:Bicycling / Q000293:injuries*; D003430:Cross-Sectional Studies; D004779:Environment Design / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D036301:Qualitative Research; D015599:Trauma Severity Indices; D014947:Wounds and Injuries / Q000453:epidemiology; D055815:Young Adult