Epidemiology of bicycle injuries and risk factors for serious injury. 1997

Inj Prev. 2015 Feb;21(1):47-51. doi: 10.1136/injprev-00002-0038rep.


Objective: To determine the risk factors for serious injury to bicyclists, aside from helmet use.

Design: Prospective case-control study.

Setting: Seven Seattle area hospital emergency departments and two county medical examiner's offices.

Patients: Individuals treated in the emergency department or dying from bicycle related injuries.

Measurements: Information collected from injured bicyclists or their parents by questionnaire on circumstances of the crash; abstract of medical records for injury data. Serious injury defined as an injury severity score>8.

Analysis: Odd ratios computed using the maximum likelihood method, and adjusted using unconditional logistic regression.

Results: There were 3854 injured cyclists in the three year period; 3390 (88%) completed questionnaires were returned. 51% wore helmets at the time of crash. Only 22.3% of patients had head injuries and 34% had facial injuries. Risk of serious injury was increased by collision with a motor vehicle (odds ratio (OR)=4.6), self reported speed >15 mph (OR=1.2), young age (<6 years), and age >39 years (OR=2.1 and 2.2 respectively, compared with adults 20-39 years). Risk for serious injury was not affected by helmet use (OR=0.9). Risk of neck injury was increased in those struck by motor vehicles (OR=4.0), hospitalized for any injury (OR=2.0), and those who died (OR=15.1), but neck injury was not affected by helmet use.

Conclusions: Prevention of serious bicycle injuries cannot be accomplished through helmet use alone, and may require separation of cyclists from motor vehicles, and delaying cycling until children are developmentally ready.

Keywords: bicycles; motor vehicles; speed.

Publication types

  • Biography
  • Classical Article
  • Historical Article
  • Multicenter Study

MeSH terms

  • Accidents, Traffic / prevention & control*
  • Bicycling / injuries*
  • Bicycling / statistics & numerical data
  • Case-Control Studies
  • Craniocerebral Trauma / epidemiology
  • Craniocerebral Trauma / prevention & control*
  • Female
  • Head Protective Devices / statistics & numerical data*
  • History, 20th Century
  • Humans
  • Injury Severity Score
  • Likelihood Functions
  • Male
  • Odds Ratio
  • Prospective Studies
  • Risk Factors
  • Surveys and Questionnaires
  • United States / epidemiology

Personal name as subject

  • Frederick P Rivara
  • Diane C Thompson
  • Robert S Thompson