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Bicycle injuries: road trauma is not the only concern

Jacobson GA, Blizzard L, Dwyer T. Austr NZ J Public Health 1998 Jun;22(4):451-5.

Summary of original paper

The study examined bicycle injury presentations at a Tasmanian hospital from 1991 to 1995. Legislation was introduced in Tasmania from 1st January 1991 making cycle helmet use compulsory while riding on a public road. 79.3% of presentations were rider-only injuries, 5.2% involved collisions with moving traffic. Cyclists injured on-road with traffic had a higher proportion of hospital admissions (40.0%) than those injured on-road by other mechanisms (7.6%). Children under 10 years of age who had been riding without a helmet had a much higher proportion of injuries to the head (53.2% of all injuries) than older cyclists riding without a helmet (19.4%). 83.1% of head injuries in children under 10 years occurred off-road and helmet use was lowest in this group (28.6%). The authors conclude that promoting helmet use off-road should be given a high priority.

BHRF Commentary

The paper yields evidence for the low risk of injury through cycling. Only 2% of hospital presentations were cycling-related. Of those just 1 in 20 involved a collision with a motor vehicle, the principal cause of serious injury.

The following shortcomings affect the validity of this paper's conclusions:

 

On-road Off-road

 

Helmeted No helmet Helmeted No helmet
Age Number Head injury Other injury Number Head injury Other injury Number Head injury Other injury Number Head injury Other injury
0 - 9 years 20 4 (25%) 16 (80%) 7 4 (57%) 3 (43%) 16 3 (19%) 13 (81%) 40 21 (53%) 19 (48%)
10 - 14 years 24 2 (8%) 22 (92%) 8 2 (25%) 6 (75%) 20 4 (20%) 16 (80%) 20 3 (15%) 17 (85%)
15 years + 25 5 (20%) 20 (80%) 24 5 (21%) 19 (79%) 10 0 (0%) 10 (100%) 15 3 (20%) 12 (80%)

Peer criticism

By Towner et al, 2002:

Conclusion

In summary the paper proves little, except that cycling injuries are usually not serious, and helmets not obviously effective, even when slight injuries are captured as well as those more serious.

References

Towner et al, 2002

Towner E, Dowswell T, Burkes M, Dickinson H, Towner J, Hayes M, 2002. Bicycle helmets - a review of their effectiveness: a critical review of the literature. Department for Transport Road Safety Research Report 30.

See also