title: Cyclists' clothing and reduced risk of injury in crashes.
abstract: BACKGROUND
  A majority of cyclists' hospital presentations involve relatively minor soft tissue injuries. This study investigated the role of clothing in reducing the risk of cyclists' injuries in crashes.
  
  
  METHODS
  Adult cyclists were recruited and interviewed through hospital emergency departments in the Australian Capital Territory. This paper focuses on 202 who had crashed in transport related areas. Eligible participants were interviewed and their self-reported injuries corroborated with medical records. The association between clothing worn and injury was examined using logistic regression while controlling for potential confounders of injury.
  
  
  RESULTS
  A high proportion of participants were wearing helmets (89%) and full cover footwear (93%). Fewer wore long sleeved tops (43%), long pants (33%), full cover gloves (14%) or conspicuity aids (34%). The primary cause of injury for the majority of participants (76%) was impact with the ground. Increased likelihood of arm injuries (Adj. OR=2.06, 95%CI: 1.02-4.18, p=0.05) and leg injuries (Adj. OR=3.37, 95%CI: 1.42-7.96, p=0.01) were associated with wearing short rather than long sleeves and pants. Open footwear was associated with increased risk of foot or ankle injuries (Adj. OR=6.21, 95%CI: 1.58-23.56, p=0.01) compared to enclosed shoes. Bare hands were associated with increased likelihood of cuts, lacerations or abrasion injuries (Adj. OR=4.62, 95%CI: 1.23-17.43, p=0.02) compared to wearing full cover gloves. There were no significant differences by fabric types such as Lycra/synthetic, natural fiber or leather.
  
  
  CONCLUSIONS
  Clothing that fully covers a cyclist's body substantially reduced the risk of injuries in a crash. Coverage of skin was more important than fabric type. Further work is necessary to determine if targeted campaigns can improve cyclists' clothing choices and whether impact protection can further reduce injury risk.
authors.affiliation: Neuroscience Research Australia; The George Institute for Global Health, The University of Sydney. Electronic address: liz@lderconsulting.com.au.
authors.forename: Liz
authors.initials: L
authors.lastname: de Rome
authors.affiliation: Transport and Road Safety Research, The University of New South Wales.
authors.forename: Soufiane
authors.initials: S
authors.lastname: Boufous
authors.affiliation: The George Institute for Global Health, The University of Sydney.
authors.forename: Thomas
authors.initials: T
authors.lastname: Georgeson
authors.affiliation: Transport and Road Safety Research, The University of New South Wales.
authors.forename: Teresa
authors.initials: T
authors.lastname: Senserrick
authors.affiliation: The George Institute for Global Health, The University of Sydney.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Ivers
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000368:Aged; D001315:Australia; D020958:Australian Capital Territory; D003020:Clothing / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D017575:Gloves, Protective / Q000706:statistics & numerical data*; D006260:Head Protective Devices / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011336:Probability; D011481:Protective Clothing / Q000706:statistics & numerical data; D040242:Risk Reduction Behavior; D012775:Shoes / Q000706:statistics & numerical data*; D012867:Skin / Q000293:injuries*; D014947:Wounds and Injuries / Q000517:prevention & control*; D055815:Young Adult
keywords: Bicycle; Clothing; Crashes; Injury; Injury reduction; Protective clothing