Elsevier

Accident Analysis & Prevention

Volume 96, November 2016, Pages 219-227
Accident Analysis & Prevention

Bicycling crash characteristics: An in-depth crash investigation study

https://doi.org/10.1016/j.aap.2016.08.012Get rights and content

Highlights

  • Two-thirds of crashes occurred on-road and 16% occurred on bicycle paths.

  • One quarter of on-road crashes occurred when the cyclist was in a bicycle lane.

  • Distinct pre-crash directional interactions were observed in crashes with motor vehicles.

  • Most cyclists had returned to work at 6 months post-injury.

  • However, only a third of participants reported a complete functional recovery.

Abstract

The aim of this study was to describe the crash characteristics and patient outcomes of a sample of patients admitted to hospital following bicycle crashes. Injured cyclists were recruited from the two major trauma services for the state of Victoria, Australia. Enrolled cyclists completed a structured interview, and injury details and patient outcomes were extracted from the Victorian State Trauma Registry (VSTR) and the Victorian Orthopaedic Trauma Outcomes Registry (VOTOR). 186 cyclists consented to participate in the study. Crashes commonly occurred during daylight hours and in clear weather conditions. Two-thirds of crashes occurred on-road (69%) and were a combination of single cyclist-only events (56%) and multi-vehicle crashes (44%). Of the multi-vehicle crashes, a motor vehicle was the most common impact partner (72%) and distinct pre-crash directional interactions were observed between the cyclist and motor vehicle. Nearly a quarter of on-road crashes occurred when the cyclist was in a marked bicycle lane. Of the 31% of crashes that were not on-road, 28 (15%) occurred on bicycle paths and 29 (16%) occurred in other locations. Crashes on bicycle paths commonly occurred on shared bicycle and pedestrian paths (83%) and did not involve another person or vehicle. Other crash locations included mountain bike trails (39%), BMX parks (21%) and footpaths (18%). While differences in impact partners and crash characteristics were observed between crashes occurring on-road, on bicycle paths and in other locations, injury patterns and severity were similar. Most cyclists had returned to work at 6 months post-injury, however only a third of participants reported a complete functional recovery. Further research is required to develop targeted countermeasures to address the risk factors identified in this study.

Introduction

Cycling is an alternative mode of transport to motor vehicles that has numerous health and economic benefits (Oja et al., 2011, Grabow et al., 2012). In line with this, cycling-specific strategies have been developed by government agencies and cycling committees with the aim of increasing cycling participation both in Australia (Australian Bicycle Council, 2010, Victorian Government, 2012) and internationally (German Federal Ministry of Transport Building and Urban Development, 2012, United Kingdom Department of Transport, 2014). Specifically, the Australian National Cycling Strategy aimed to double cycling participation between 2011 and 2016 (Australian Bicycle Council, 2010). Whilst acknowledging the health, environmental and economic benefits of cycling, cyclists are considered vulnerable road users and safety concerns remain a barrier to increased participation (Winters et al., 2011).

Previous studies have shown that serious injury rates among cyclists have increased (Sikic et al., 2009, Henley and Harrison, 2012), highlighting the need to identify cyclist, route and crash factors associated with crashes in order to inform targeted interventions to reduce the likelihood of injury. For on-road cycling crashes, cycling on streets where cars are parked has been associated with increased crash risk, while on-road bicycle infrastructure, such as marked bicycle lanes, and lower motor vehicle speeds have been associated with reduced crash risk (Reynolds et al., 2009, Teschke et al., 2012, Cripton et al., 2015). When compared to on-road cycling crashes, those occurring on bicycle paths that are separated from traffic more commonly result from a fall than a collision, and are more likely to involve a pedestrian or cyclist, or be single bicycle-only events (De Rome et al., 2014, Teschke et al., 2014). Given the differences in infrastructure and crash characteristics between crash locations, it is likely that interventions targeting risk factors specific to each locale will be most effective. In order to inform the design of such interventions, this study aimed to describe the crash characteristics and injury outcomes of a sample of cyclists admitted to hospital following bicycle crashes with a specific focus of crashes occurring on-road, on bicycle paths and in other locations.

Section snippets

Study design

Cycling-related trauma patients were prospectively recruited from two hospitals in Melbourne, Australia. The hospitals, The Alfred Hospital and the Royal Melbourne Hospital, are the two adult major trauma services (Level 1 trauma centre equivalent) for the state of Victoria. These trauma centres definitively manage more than 80% of cycling-related major trauma each year. Recruitment occurred between 1 January 2013 and 31 December 2013. This study forms a component of a wider study investigating

Results

During the study period, there were 345 cycling related injured patients admitted at the participating hospitals. Of these, 308 cyclists were invited to participate in the study, and 186 consented to participate. These 186 cyclists represented 54% of all cycling related injured patients admitted at participating hospitals. The median (IQR) age of participants was 44 (34–54) years and 81% were male. Most cyclists had more than 10 years of cycling experience and cycled more than three times per

Discussion

Our study investigated demographic, crash and injury characteristics, as well as patient outcomes, in a sample of patients admitted to hospital following bicycle crashes. Events commonly occurred during daylight hours and in clear weather conditions. There were a greater number of on-road crashes compared to crashes occurring on bicycle paths and other crash locations in our sample. On-road events more commonly involved another impact partner, of which collisions with motor vehicles were most

Conclusions

In this sample of hospitalised injured cyclists, distinct differences were noted in the crash characteristics between crashes occurring on-road, on bicycle paths and in other locations. These results suggest that targeted interventions specific to these three crash locales may be most effective in injury prevention. Our finding that a fifth of on-road cycling crashes occurred while the cyclist was riding in a marked bicycle lane suggests that further measures are required to reduce the risk to

Funding

This study was specifically supported by a Monash University, Faculty of Medicine, Nursing and Health Sciences Strategic Grant. The Safer Cycling in the Urban Environment Study (Stevenson et al., 2014) is supported by an Australian Research Council Grant (Number: LP130100380). The Victorian Orthopaedic Trauma Outcomes Registry (VOTOR) is funded by the Transport Accident Commission via the Institute for Safety Compensation and Recovery Research (ISCRR). Ben Beck received salary support from the

Acknowledgements

The authors would like to acknowledge the contributions of Mandy Brown, Melissa Hart, Carol Roberts and Jasmine Fischer.

References (45)

  • S.P. Baker et al.

    The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care

    J. Trauma Acute Care Surg.

    (1974)
  • P. Biegler et al.

    Maccs Monash Alfred Cyclist Crash Study

    (2012)
  • S. Boufous et al.

    Single-versus multi-vehicle bicycle road crashes in Victoria, Australia

    Inj. Prev.

    (2013)
  • P.A. Cameron et al.

    Developing Australia’s first statewide trauma registry: what are the lessons?

    ANZ J. Surg.

    (2004)
  • W.G. Cochran

    The χ2 test of goodness of fit

    Ann. Math. Stat.

    (1952)
  • P.A. Cripton et al.

    Severity of urban cycling injuries and the relationship with personal, trip, route and crash characteristics: analyses using four severity metrics

    BMJ Open

    (2015)
  • L. De Rome et al.

    Bicycle crashes in different riding environments in the Australian capital territory

    Traffic Inj. Prev.

    (2014)
  • B.J. Gabbe et al.

    Population-based capture of long-term functional and quality of life outcomes after major trauma: the experiences of the Victorian state trauma registry

    J. Trauma Acute Care Surg.

    (2010)
  • B.J. Gabbe et al.

    Return to work and functional outcomes after major trauma: who recovers, when and how well?

    Ann. Surg.

    (2016)
  • German Federal Ministry of Transport Building and Urban Development

    National Cycling Plan 2020

    (2012)
  • M.L. Grabow et al.

    Air quality and exercise-related health benefits from reduced car travel in the midwestern united states

    Environ. Health Perspect.

    (2012)
  • C. Hamann et al.

    Burden of hospitalizations for bicycling injuries by motor vehicle involvement: United States, 2002–2009

    J. Trauma Acute Care Surg.

    (2013)
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