Bicycling crash characteristics: An in-depth crash investigation 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.
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