Relative injury severity among vulnerable non-motorised road users: comparative analysis of injury arising from bicycle-motor vehicle and bicycle-pedestrian collisions

Accid Anal Prev. 2010 Jan;42(1):290-6. doi: 10.1016/j.aap.2009.08.006. Epub 2009 Sep 9.


With the expansion of bicycle usage and limited funding and/or space for segregated pedestrian and bicycle paths, there is a need for traffic, road design and local government engineers to decide if it is more appropriate for space to be shared between either cyclists and pedestrians, or between cars and cyclists, and what restrictions need to be applied in such circumstances. To provide knowledge to aid engineers and policy makers in making these decisions, this study explored death and morbidity data for the state of New South Wales, Australia to examine rates and severity of injury arising from collisions between pedestrians and cyclists, and between cyclists and motor vehicles (MVs). An analysis of the severity of hospitalised injuries was conducted using International Classification of Diseases, Version 10, Australian Modification (ICD-10-AM) diagnosis-based Injury Severity Score (ICISS) and the Disability Adjusted Life Year (DALY) was used to measure burden of injury arising from collisions resulting in death or hospitalisation. The greatest burden of injury in NSW, for the studied collision mechanisms, is for cyclists who are injured in collisions with motor vehicles. Collisions between cyclists and pedestrians also result in significant injuries. For all collision mechanisms, the odds of serious injury on admission are greater for the elderly than for those in other age groups. The significant burden of injury arising from collisions of cyclists and MVs needs to be addressed. However in the absence of appropriate controls, increasing the opportunity for conflict between cyclists and pedestrians (through an increase in shared spaces for these users) may shift the burden of injury from cyclists to pedestrians, in particular, older pedestrians.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accidents, Traffic / statistics & numerical data*
  • Adolescent
  • Adult
  • Aged
  • Bicycling / injuries*
  • Child
  • Female
  • Hospitalization / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • New South Wales / epidemiology
  • Odds Ratio
  • Quality of Life
  • Severity of Illness Index
  • Walking / injuries*
  • Wounds and Injuries / epidemiology*
  • Young Adult