Cyclist road deaths in London 1985-1992: drivers, vehicles, manoeuvres and injuries

Naturalistic driving study on the impact of an aftermarket blind spot monitoring system on the driver's behaviour of heavy goods vehicles and buses on reducing conflicts with pedestrians and cyclists

The risk being severely or fatally injured in crashes with heavy goods vehicle and buses is much higher compared to other vehicles. Especially vulnerable road users such as pedestrian and cyclists are at high risk. In the European Union 4600 pedestrian and more than 2000 cyclists were killed in 2019. 18% of the fatalities were counted in crashes with heavy goods vehicles or buses. Blind spot situations and driver inattention or distraction are causing and contributing crash factors. Driver assistance systems are intended to support drivers and might have a positive effect on the crash avoidance. The objective of the study is the analysis of the change of driver behaviour in heavy goods vehicles and buses due to a aftermarket blind spot monitoring system. In a naturalistic driving study 15 heavy goods vehicles and five buses were equipped with a blind spot monitoring system and data were collected over a period of two years. The results revealed that the system would reduce the number of warnings with vulnerable road users by one third for heavy goods vehicles and 10% for buses. Up to 200 lives annually could potentially be saved with the analysed system, on the assumption that the collision warnings correlate directly with crashes.

Caught in the blind spot of a truck: A choice model on driver glance behavior towards cyclists at intersections

Vulnerable road users (VRUs) constitute an increasing proportion of the annual road fatalities across Europe. One of the crash types involved in these fatalities are blind spot crashes between trucks and bicyclists. Despite the presence of mandatory blind spot mirrors, truck drivers are often reported to have overlooked the presence of a bicyclist. This raises the question if and when truck drivers check their blind spot mirrors for the presence of bicyclists, and which factors contribute to such glance behavior. The current study presents the results of an analysis of naturalistic glance behavior by 39 truck drivers in 1,903 right-turning maneuvers at urban intersections, where in each maneuver there was a chance of crossing the path of a bicyclist. The descriptive analysis revealed that most often truck drivers did not cast a glance upon their blind spot mirrors as recommended by the examination guidelines. Furthermore, a choice model was developed with the main factors that have an impact on glance behavior. Drivers were more likely to glance with a priority regulation that allowed conflicts, with lower speed limits, with zebra crossings, without cyclist facilities, without a lead vehicle making the same maneuver, in presence of VRUs, without adverse sight conditions, in lower age groups, without certain non-driving related activities, when driving a truck with more direct vision on VRUs, and without a camera providing a view on the blind spot, and with less time between a standstill and starting the maneuver. Three factors did not significantly improve the choice model and were therefore left out, despite showing significant effects in bivariate tests: intersection layout (e.g., three vs. four legs), presence of advanced stopping lanes, and visual obstruction. Implications of the choice model are discussed for driver education (in terms of timely glances, reducing inattention, and hazard anticipation) and vehicle design (in terms of direct vision).

Bicyclists injury severities: An empirical assessment of temporal stability

Cyclists are among the most vulnerable participants in road traffic, making their safety a top priority. Riding behavior of bicyclists could shift over time, affecting the level of injuries sustained in bicyclist-involved crashes. Many studies have been done to identify the factors influencing bicyclist injury severity, but the temporal stability of these variables over time needs further study. The temporal instability of components that affect the cyclist injury levels in bicycle collisions is explored in this paper. To obtain potential unobserved heterogeneity, yearly models of cyclist-injury levels (including potential consequences of no, minor, and severe injury) were measured separately applying a random parameters logit model that allows for potential heterogeneity in estimated parameters' means and variances. Employing a data source on bicycle collisions in Los Angeles, California, over the course of six years (January 1, 2012 to December 31, 2017), several variables which may impact the injury level of cyclists were explored. This paper has also employed a set of likelihood ratio tests assessing the temporal instability of the models. The temporal instability of the explanatory parameters has been evaluated with marginal effects. The results of the model assessment indicate that several factors may raise the chances of severe bicyclist injuries in collisions, including cyclists older than 55 years old, cyclists who were identified to be at-fault in crashes, rear-end collisions, cyclists who crossed into opposing lane before the collision, crashes occurring early mornings (i.e., 00:00 to 06:00) and so on. The results also showed that the details and estimated parameters of the model do not remain stable over the years, however the source of this instability is unclear. In addition, the findings of model estimation demonstrate that considering the heterogeneity in the random parameter means and variances will enhance the overall model fit. This study also emphasizes the significance of accounting for the transferability of estimated models and the temporal instability of parameters influencing the injury severity outcomes in order to dynamically examine the collected data and adjust safety regulations according to new observations.

Factors impacting bicyclist lateral position and velocity in proximity to commercial vehicle loading zones: Application of a bicycling simulator

There is little research on the behavioral interaction between bicycle lanes and commercial vehicle loading zones (CVLZ) in the United States. These interactions are important to understand, to preempt increasing conflicts between truckers and bicyclists. In this study, a bicycling simulator experiment examined bicycle and truck interactions. The experiment was successfully completed by 48 participants. The bicycling simulator collected data regarding a participant's velocity and lateral position. Three independent variables reflecting common engineering approaches were included in this experiment: pavement marking (L1: white lane markings with no supplemental pavement color, termed white lane markings, L2: white lane markings with solid green pavement applied on the conflict area, termed solid green, and L3: white lane markings with dashed green pavement applied on the conflict area, termed dashed green), signage (L1: No sign and L2: a truck warning sign), and truck maneuver (L1: no truck in CVLZ, L2: truck parked in CVLZ, and L3: truck pulling out of CVLZ). The results showed that truck presence does have an effect on bicyclist's performance, and this effect varies based on the engineering and design treatments employed. Of the three independent variables, truck maneuvering had the greatest impact by decreasing mean bicyclist velocity and increasing mean lateral position. It was also observed that when a truck was present in a CVLZ, bicyclists had a lower velocity and lower divergence from right-edge of bike lane on solid green pavement, and a higher divergence from the right-edge of bike lane was observed when a warning sign was present.

Using data mining techniques to predict the severity of bicycle crashes

To investigate the factors predicting severity of bicycle crashes in Italy, we used an observational study of official statistics. We applied two of the most widely used data mining techniques, CHAID decision tree technique and Bayesian network analysis. We used data provided by the Italian National Institute of Statistics on road crashes that occurred on the Italian road network during the period ranging from 2011 to 2013. In the present study, the dataset contains information about road crashes occurred on the Italian road network during the period ranging from 2011 to 2013. We extracted 49,621 road accidents where at least one cyclist was injured or killed from the original database that comprised a total of 575,093 road accidents. CHAID decision tree technique was employed to establish the relationship between severity of bicycle crashes and factors related to crash characteristics (type of collision and opponent vehicle), infrastructure characteristics (type of carriageway, road type, road signage, pavement type, and type of road segment), cyclists (gender and age), and environmental factors (time of the day, day of the week, month, pavement condition, and weather). CHAID analysis revealed that the most important predictors were, in decreasing order of importance, road type (0.30), crash type (0.24), age of cyclist (0.19), road signage (0.08), gender of cyclist (0.07), type of opponent vehicle (0.05), month (0.04), and type of road segment (0.02). These eight most important predictors of the severity of bicycle crashes were included as predictors of the target (i.e., severity of bicycle crashes) in Bayesian network analysis. Bayesian network analysis identified crash type (0.31), road type (0.19), and type of opponent vehicle (0.18) as the most important predictors of severity of bicycle crashes.

Characteristics of cyclist crashes in Italy using latent class analysis and association rule mining

The factors associated with severity of the bicycle crashes may differ across different bicycle crash patterns. Therefore, it is important to identify distinct bicycle crash patterns with homogeneous attributes. The current study aimed at identifying subgroups of bicycle crashes in Italy and analyzing separately the different bicycle crash types. The present study focused on bicycle crashes that occurred in Italy during the period between 2011 and 2013. We analyzed categorical indicators corresponding to the characteristics of infrastructure (road type, road signage, and location type), road user (i.e., opponent vehicle and cyclist's maneuver, type of collision, age and gender of the cyclist), vehicle (type of opponent vehicle), and the environmental and time period variables (time of the day, day of the week, season, pavement condition, and weather). To identify homogenous subgroups of bicycle crashes, we used latent class analysis. Using latent class analysis, the bicycle crash data set was segmented into 19 classes, which represents 19 different bicycle crash types. Logistic regression analysis was used to identify the association between class membership and severity of the bicycle crashes. Finally, association rules were conducted for each of the latent classes to uncover the factors associated with an increased likelihood of severity. Association rules highlighted different crash characteristics associated with an increased likelihood of severity for each of the 19 bicycle crash types.

Cyclists fatalities: Forensic remarks regarding 335 cases

A retrospective study was carried out on post-mortem examination data regarding 335 cyclists involved in fatal accidents along the period 1983-2012. The following variables were considered: temporal data (year, month, day of the week and hour of the day), circumstances of the accident, vehicles involved, victims' features (sex, age), pathological and toxicological findings, cause of death. Most victims were male (77.62%), with a mean age of 58 years. In most cases vehicles other than only bicycles were involved, more frequently cars, followed by heavy motor vehicles. Head was the most frequently body region involved in lethal injuries (65.37%); low extremities were the body district most frequently involved in non-lethal injuries (63.9%). This study confirmed the importance of using helmet; head protection should be a priority for bikers.

Societal cost of traumatic brain injury: A comparison of cost-of-injuries related to biking with and without helmet use

OBJECTIVE

The goal of this study is to determine if a difference in societal costs exists from traumatic brain injuries (TBI) in patients who wear helmets compared to non-wearers.

METHODS

This is a retrospective cost-of-injury study of 128 patients admitted to the Montreal General Hospital (MGH) following a TBI that occurred while cycling between 2007-2011. Information was collected from Quebec Trauma Registry. The independent variables collected were socio-demographic, helmet status, clinical and neurological patient information. The dependent variables evaluated societal costs.

RESULTS

The median costs of hospitalization were significantly higher (p = 0.037) in the no helmet group ($7246.67 vs. $4328.17). No differences in costs were found for inpatient rehabilitation (p = 0.525), outpatient rehabilitation (p = 0.192), loss of productivity (p = 0.108) or death (p = 1.000). Overall, the differences in total societal costs between the helmet and no helmet group were not significantly different (p = 0.065). However, the median total costs for patients with isolated TBI in the non-helmet group ($22, 232.82) was significantly higher (p = 0.045) compared to the helmet group ($13, 920.15).

CONCLUSION

Cyclists sustaining TBIs who did not wear helmets in this study were found to cost society nearly double that of helmeted cyclists.

Safety in numbers? Investigating Australian driver behaviour, knowledge and attitudes towards cyclists

A key tenet of the safety in numbers theory is that as the number of people cycling increases, more drivers will also be cyclists and therefore will give greater consideration to cyclists when driving. We tested this theory in relation to self-reported behaviour, attitudes and knowledge in relation to cycling. An online survey was conducted of Australian drivers (n=1984) who were also cyclists (cyclist-drivers) and drivers who did not cycle (drivers). Cyclist-drivers were 1.5 times more likely than drivers to report safe driving behaviours related to sharing the roads with cyclists (95% CI: 1.1-1.9, p<0.01). Cyclist-drivers had better knowledge of the road rules related to cycling infrastructure than drivers; however knowledge of road rules related to bike lanes was low for both groups. Drivers were more likely than cyclist-drivers to have negative attitudes (e.g. cyclists are unpredictable and repeatedly overtaking cyclists is frustrating). Findings from this study highlight the need for increased education and awareness in relation to safe driving behaviour, road rules and attitudes towards cyclists. Specific recommendations are made for approaches to improve safety for cyclists.

The influence of a bicycle commuter's appearance on drivers' overtaking proximities: an on-road test of bicyclist stereotypes, high-visibility clothing and safety aids in the United Kingdom

This study looked at whether drivers overtaking a bicyclist changed the proximities of their passes in response to the level of experience and skill signalled by the bicyclist's appearance. Seven outfits were tested, ranging from a stereotypical sport rider's outfit, portraying high experience and skill, to a vest with 'novice cyclist' printed on the back, portraying low experience. A high-visibility bicycling jacket was also used, as were two commercially available safety vests, one featuring a prominent mention of the word 'police' and a warning that the rider was video-recording their journey, and one modelled after a police officer's jacket but with a letter changed so it read 'POLITE'. An ultrasonic distance sensor recorded the space left by vehicles passing the bicyclist on a regular commuting route. 5690 data points fulfilled the criteria for the study and were included in the analyses. The only outfit associated with a significant change in mean passing proximities was the police/video-recording jacket. Contrary to predictions, drivers treated the sports outfit and the 'novice cyclist' outfit equivalently, suggesting they do not adjust overtaking proximity as a function of a rider's perceived experience. Notably, whilst some outfits seemed to discourage motorists from passing within 1m of the rider, approximately 1-2% of overtakes came within 50 cm no matter what outfit was worn. This suggests there is little riders can do, by altering their appearance, to prevent the very closest overtakes; it is suggested that infrastructural, educational or legal measures are more promising for preventing drivers from passing extremely close to bicyclists.

Predicting cycling accident risk in Brussels: a spatial case-control approach

This paper aims at predicting cycling accident risk for an entire network and identifying how road infrastructure influences cycling safety in the Brussels-Capital Region (Belgium). A spatial Bayesian modelling approach is proposed using a binary dependent variable (accident, no accident at location i) constructed from a case-control strategy. Control sites are sampled along the 'bikeable' road network in function of the potential bicycle traffic transiting in each ward. Risk factors are limited to infrastructure, traffic and environmental characteristics. Results suggest that a high risk is statistically associated with the presence of on-road tram tracks, bridges without cycling facility, complex intersections, proximity to shopping centres or garages, and busy van and truck traffic. Cycle facilities built at intersections and parked vehicles located next to separated cycle facilities are also associated with an increased risk, whereas contraflow cycling is associated with a reduced risk. The cycling accident risk is far from being negligible in points where there is actually no reported cycling accident but where they are yet expected to occur. Hence, mapping predicted accident risks provides planners and policy makers with a useful tool for accurately locating places with a high potential risk even before accidents actually happen. This also provides comprehensible information for orienting cyclists to the safest routes in Brussels.

The safety of urban cycle tracks: a review of the literature

Cycling has to be a safe activity, and perceived as such, if bicycle trips by all populations are to increase and the public health benefits are to be realized. A key characteristic of developed countries with a high cycling mode share is their provision of cycle tracks--separated bikeways along city streets--on major routes. This literature review therefore sought to examine studies of cycle tracks from different countries in order elucidate the safety of these facilities relative to cycling in the street and to point to areas where further research is needed. The review indicates that one-way cycle tracks are generally safer at intersections than two-way and that, when effective intersection treatments are employed, constructing cycle tracks on busy streets reduces collisions and injuries. The evidence also suggests that, when controlling for exposure and including all collision types, building one-way cycle tracks reduces injury severity even when such intersection treatments are not employed. However, the extent of this effect has not been well examined, as very few studies both look at severity and control for exposure. Future studies of the safety of cycle tracks and associated intersection treatments should focus foremost on examining injury severity, while controlling for exposure. In the U.S., where the obesity epidemic and its health consequences and costs are well documented, the benefits of increased cycling should be a focus of research and policy development in order to provide the infrastructure needed to attract people to cycling while minimizing injuries.

Bicyclist fatalities involving heavy goods vehicles: gender differences in risk perception, behavioral choices, and training

OBJECTIVES

Females are typically involved in fewer collisions when pedal cycling than males. However, female cyclists appear to be overrepresented in the number of fatal collisions involving heavy goods vehicles (HGVs). These collisions often involve cyclists passing HGVs on the side furthest from the HGV driver (nearside). It is hypothesized that this pattern of fatalities may be partly due to differences in how males and females perceive the risk associated with various cycling maneuvers. It is also hypothesized that this difference may be overcome with advanced training.

METHODS

4,596 UK cyclists completed an online questionnaire in which they reported their level of cycle training and rated the risk they perceived to be associated with various cycling maneuvers, the likelihood that they would engage in them, and history of collision involvement.

RESULTS

Females perceived a slightly greater level of risk to be associated with cycling. However, males differentiated between the risks involved in nearside and offside overtaking to a greater extent than females. Risk perception was significantly correlated with the reported likelihood that participants would engage in risky maneuvers such as overtaking on the nearside and also with past collision prevalence. Advanced cycling training was correlated with higher levels of perceived risk associated with overtaking on the nearside; however, basic cycle training was not.

CONCLUSIONS

Cyclists who do not correctly differentiate between the risks associated with nearside and offside overtaking may be more at risk of being involved in HGV-related collisions. Advanced cycling training is linked to more accurate risk perception. To reduce fatalities, public awareness campaigns should focus on the increased risk of nearside overtaking and encourage cyclists to take advanced training.

Motor vehicle-bicycle crashes in Beijing: irregular maneuvers, crash patterns, and injury severity

This research presents a comprehensive analysis of motor vehicle-bicycle crashes using 4 years of reported crash data (2004-2007) in Beijing. The interrelationship of irregular maneuvers, crash patterns and bicyclist injury severity are investigated by controlling for a variety of risk factors related to bicyclist demographics, roadway geometric design, road environment, etc. Results show that different irregular maneuvers are correlated with a number of risk factors at different roadway locations such as the bicyclist age and gender, weather and traffic condition. Furthermore, angle collisions are the leading pattern of motor vehicle-bicycle crashes, and different irregular maneuvers may lead to some specific crash patterns such as head-on or rear-end crashes. Orthokinetic scrape is more likely to result in running over bicyclists, which may lead to more severe injury. Moreover, bicyclist injury severity level could be elevated by specific crash patterns and risk factors including head-on and angle collisions, occurrence of running over bicyclists, night without streetlight, roads without median/division, higher speed limit, heavy vehicle involvement and older bicyclists. This study suggests installation of median, division between roadway and bikeway, and improvement of illumination on road segments. Reduced speed limit is also recommended at roadway locations with high bicycle traffic volume. Furthermore, it may be necessary to develop safety campaigns aimed at male, teenage and older bicyclists.

Overtaking, rear-end, and door crashes involving bicycles: an empirical investigation

Recent emphasis on bicycling as an alternative to automobile transportation has underscored the need for research efforts directed at bicycle safety when sharing roadways with motorised vehicles. Much of the research attention is focused on junction accidents where motorists tend to infringe upon bicycles' right of way. Non-junction accidents where a motorist strikes a bicycle while overtaking it, or crashes into the rear of the bicycle, have been less frequently researched. Another common crash type is a door crash that involves a bicycle striking an open door of an automobile. Using British Stats19 accident data, the present study estimates a mixed multinomial model to predict the likelihood of a non-junction crash being of a certain crash type (out of three possible types). The methodological approach adopted allows for the individuals within the observations to have different parameter estimates (as opposed to a single parameter representing all observations). Main findings include that buses/coaches as collision partners were associated with overtaking crashes; and bicycles' traversing manoeuvres were associated with overtaking and rear-end collisions. Given a crash where a bicycle collides with a motorcycle/taxi, it is more likely a rear-end crash and a door crash, respectively. Implications of the research findings, the concluding remarks, and recommendations for future research are finally provided.

Risk of injury for bicycling on cycle tracks versus in the street

Most individuals prefer bicycling separated from motor traffic. However, cycle tracks (physically separated bicycle-exclusive paths along roads, as found in The Netherlands) are discouraged in the USA by engineering guidance that suggests that facilities such as cycle tracks are more dangerous than the street. The objective of this study conducted in Montreal (with a longstanding network of cycle tracks) was to compare bicyclist injury rates on cycle tracks versus in the street. For six cycle tracks and comparable reference streets, vehicle/bicycle crashes and health record injury counts were obtained and use counts conducted. The relative risk (RR) of injury on cycle tracks, compared with reference streets, was determined. Overall, 2.5 times as many cyclists rode on cycle tracks compared with reference streets and there were 8.5 injuries and 10.5 crashes per million bicycle-kilometres. The RR of injury on cycle tracks was 0.72 (95% CI 0.60 to 0.85) compared with bicycling in reference streets. These data suggest that the injury risk of bicycling on cycle tracks is less than bicycling in streets. The construction of cycle tracks should not be discouraged.

Bicycle crash casualties in a highly motorized city

The characteristics of bicycle crashes in cities where bicycles are a minor transport mode have received little attention in road safety research. However, the characteristics of these injury-inflicting bicycle crashes are expected to be very different from those happening in cities where cycling is generally considered as one of the major transport modes. Specifically, this study has the following three objectives: (1) to conduct the first scientific spatial analysis of bicycle crashes in Hong Kong; (2) to analyze the circumstances leading to bicycle crashes; and (3) to conduct an epidemiological study on injury patterns of cyclist casualties. Various spatial and statistical tools, including buffer analysis, chi-square tests, analysis-of-variance and binary logistic regression, are used to analyze the bicycle crashes in Hong Kong from 2005-2007. An important finding of this paper is that the bicycle safety problem has a clear spatial dimension. The crash circumstances in different parts of the city differed systematically. Furthermore, the findings suggest that initiatives to develop new cycle tracks and to encourage bicycles as a transport mode must be planned carefully with new infrastructure and policies to ensure the safety of cyclists.

Critical factors in fatal collisions of adult cyclists with automobiles

This article evaluates, by means of multivariate regression, critical factors influencing the collisions of motor vehicles with adult (over 17 years) cyclists that result in fatal injury of cyclists. The analysis is based on the database of the Traffic Police of Czech Republic from the time period 1995-2007. The results suggest that the most consequential categories of factors under study are: inappropriate driving speed of automobile; the head-on crash; and night-time traffic in places without streetlights. The cyclists' faults are of most serious consequence on crossroads when cyclists deny the right of way. Males are more likely to suffer a fatal injury due to a collision with a car than females. The most vulnerable age group are cyclists above 65 years. A fatal injury of a cyclist is more often driver's fault than cyclist's (598 vs. 370). In order to reduce the fatal risk, it is recommended to separate the road traffic of motor vehicles from bicyclists in critical road-sections; or, at least, to reduce speed limits there.

Road Traffic Collisions—Case Fatality Rate, Crash Injury Rate, and Number of Motor Vehicles: Time Trends between a Developed and Developing Country

Road traffic collisions (RTCs) are one of the most common preventable causes of death and disability worldwide. We investigated changes in numbers of motor vehicles, case fatality rate, and crash injury rate for the most present recorded year (2002) 5 and 10 years before that in the United Kingdom (UK) and Sri Lanka (SL). We also investigated environmental and individual factors impacting patients at South Birmingham Trauma Unit, UK and Colombo General Hospital, SL. We conducted a descriptive cross-sectional study (both quantitative and qualitative). Over the 10-year period, numbers of motor vehicles have risen in both countries; the crash injury remained stable in both countries. Case fatality rate (far higher) in SL has decreased, as in the UK. Three hundred and twenty-five patients took part in the survey in SL, with 83 in the UK. In the categories investigated, including patient demographics, RTC environment, visual impairment, pedestrian and driver factors, the majority of results were significantly different between the two countries. Target factors such as inadequate street lighting, visual impairment, speeding, and not wearing seatbelts at time of accident were identified, and recommendations developed as a result.

The use of conspicuity aids by cyclists and risk of crashes involving other road users: a protocol for a population based case-control study

Background

Regular cycling has been shown to improve health and has a role in tackling the threats posed by obesity and inactivity. Cycle collisions, particularly those involving motorised vehicles, can lead to significant mortality and morbidity and are currently a barrier to wider uptake of cycling. There is evidence that the conspicuity of cyclists is a factor in many injury collisions. Low-cost, easy to use retro-reflective and fluorescent clothing and accessories ('conspicuity aids') are available. Their effectiveness in reducing cycling collisions is unknown. The study is designed to investigate the relationship between the use of conspicuity aids and risk of collision or evasion crashes for utility and commuter cyclists in the UK.

Methods/Design

A matched case-control study is proposed. Cases are adult commuter and utility cyclists involved in a crash resulting from a collision or attempted evasion of a collision with another road user recruited at a UK emergency department. Controls are commuter and utility cyclists matched by journey purpose, time and day of travel and geographical area recruited at public and private cycle parking sites. Data on the use of conspicuity aids, crash circumstances, demographics, cycling experience, safety equipment use, journey characteristics and route will be collected using self-completed questionnaires and maps. Conditional logistic regression will be used to calculate adjusted odds ratios and 95% confidence intervals of the risk of a crash when using any item of fluorescent or reflective clothing or equipment.

Discussion

This study will provide information on the effectiveness of conspicuity aids in reducing the risk of injury to cyclists resulting from crashes involving other road users.

Epidemiology of bicycle injuries in 13 health divisions, Islamic Republic of Iran 2003

Bicyclists are vulnerable road users for severe injury all over the world. The nature and extent of such injuries are less well known in Iran. Using data from a comprehensive survey conducted by the Ministry of Health and Medical Education in 13 health divisions of Iran, in 2003, we examined circumstances around bicyclist injury and death. Trained health workers completed the survey instruments by interviewing patients who stayed more than 24h in hospitals and/or relatives, hospital personnel and by reviewing patient charts. Data were cross-matched with medico-legal documents to prevent missing deaths. The information that was collected from 64 cities/towns' emergency departments (EDs), over the study period, showed that 440 injured cyclists were hospitalized and/or died due to traffic collisions. Most injuries occurred in males (94.8%) and in the young (median age: 14 years with 75% </=18 years). Head injury occurred in 14% of all hospitalized and in 90% of fatally injured bicyclists. Striking a moving vehicle increased the odds of death (OR: 32.3; 95% CI 3.5-291.0) as well as the odds of severe injury (OR: 1.9; 95% CI 1.2-3.2) compared with other mechanisms of injury. As a conclusion, bicyclists in Iran, particularly males and young children, are vulnerable to severe injury and death when struck by moving vehicles on highways.

Bicyclist injury severities in bicycle-motor vehicle accidents

This research explores the factors contributing to the injury severity of bicyclists in bicycle-motor vehicle accidents using a multinomial logit model. The model predicts the probability of four injury severity outcomes: fatal, incapacitating, non-incapacitating, and possible or no injury. The analysis is based on police-reported accident data between 1997 and 2002 from North Carolina, USA. The results show several factors which more than double the probability of a bicyclist suffering a fatal injury in an accident, all other things being kept constant. Notably, inclement weather, darkness with no streetlights, a.m. peak (06:00 a.m. to 09:59 a.m.), head-on collision, speeding-involved, vehicle speeds above 48.3 km/h (30 mph), truck involved, intoxicated driver, bicyclist age 55 or over, and intoxicated bicyclist. The largest effect is caused when estimated vehicle speed prior to impact is greater than 80.5 km/h (50 mph), where the probability of fatal injury increases more than 16-fold. Speed also shows a threshold effect at 32.2 km/h (20 mph), which supports the commonly used 30km/h speed limit in residential neighborhoods. The results also imply that bicyclist fault is more closely correlated with greater bicyclist injury severity than driver fault.

Individual cyclists' probability distributions of severe/fatal crashes in large French urban areas

The present article deals with individual cyclists' probabilities of severe injury or death from a bicycle accident. We use an empirical Bayesian method to conduct an analysis of the fatal/severe probability distribution of a bicycle accident, at the level of individuals, in dense French urban areas. Among intuitive results, it is found that wearing a helmet lowers the average probability of such a crash; it is also shown that young bicyclists are, on average, more exposed to severe and/or fatal crashes. Finally, the results highlight a decrease of attention paid by all types of road users following road infrastructure improvements in favor of cyclists.

A Review of Serious Injuries and Deaths from Bicycle Accidents in Sweden from 1987 to 1994

BACKGROUND

Injured cyclists are often seen in emergency departments. The aims of this study were to determine the long-term incidence of injuries, age and gender distributions, mortality rates, and geographic differences among all patients admitted to hospitals because of bicycle accidents in Sweden.

METHODS

Between 1987 and 1994, 34,606 persons (39,183 admissions) were injured in bicycle accidents in Sweden (19,978 men and 14,628 women).

RESULTS

The annual frequency of hospital admissions ranged from 4,585 to 5,212. Fifty-seven patients were admitted with bicycle-related injuries per 100,000 population each year. Children between 5 and 14 years of age, especially boys, and men older than 70 were more commonly involved. Injuries to the head and brain were very frequent (46%). The survival rate was poorest in persons of older age, male gender, and cyclists involved in collisions with motor vehicles.

CONCLUSION

About 4,900 cyclists have been hospitalized each year after bicycle accidents in Sweden. Young children were affected very often, with injuries of the brain and various types of fractures of the extremities being common. Significant factors for a poor survival outcome included old age, male gender, and collisions with motor vehicles.

Differential profile of facial injuries among mountainbikers compared with bicyclists

BACKGROUND

Bicyclists and mountainbikers are prone to facial trauma. In the current study, we present a large series of cycling-related sports trauma to the face in an effort to identify the injury pattern among mountainbikers compared with bicyclists.

METHODS

The medical records of a single pediatric and adult Level I trauma center were evaluated from January 1, 1991, through October 31, 1996. All admissions with injuries caused by cycling-related sports were reviewed, analyzed, and compared according to age and sex distributions, causes of accidents, injury types, frequency, and localization of fractures and associated injuries. The injury types were divided into three categories: fractures, dentoalveolar trauma, and soft-tissue injuries.

RESULTS

Five hundred sixty-two injured bicyclists (10.3% of all trauma patients) were registered at the Department of Oral and Maxillofacial Surgery, University of Innsbruck, Austria, during the study period, accounting for 31% of all sports-related or 48.4% of all traffic collisions, respectively. The review of the patient records revealed especially more severe injury profiles in 60 mountainbikers, with 55% facial bone fractures, 22% dentoalveolar trauma, and 23% soft-tissue injuries, compared with 502 street cyclists showing 50.8% dentoalveolar trauma, 34.5% facial bone fractures, and 14% soft-tissue lesions. The dominant fracture site in bicyclists was the zygoma (30.8%), whereas mountainbikers sustained an impressive 15.2% Le Fort I, II, and III fractures. Condyle fractures were more common in bicyclists, with 18.8% opposing 10.8% in mountainbikers.

CONCLUSION

Appropriate design of helmets with faceguards will reduce the incidence of facial injuries caused by cycling-related accidents and incentives are needed for making helmet use compulsory for all cyclists, particularly for mountainbikers.