Increase seen in bicycle-related injuries, hospital admissions

Between 1998 and 2013, there was a large increase in bicycle-related injuries and hospital admissions of adults in the United States, with the increase in injuries driven by more injuries among adults older than 45 years of age, according to a study in the September 1 issue of JAMA.

Cycling is associated with many health benefits, but also with the risk of injury. Trends in bicycle-related injuries are difficult to assess because the majority of nonfatal injuries sustained while cycling are not reported to police and thus are not included in traffic statistics. Benjamin N. Breyer, M.D., M.A.S., of the University of California, San Francisco, and colleagues analyzed data from the National Electronic Injury Surveillance System (NEISS), a national probability sample of approximately 100 emergency departments that gathers product-related injury data. The researchers queried the NEISS for injuries associated with bicycles from 1998 to 2013. The number of bicycle-related injuries in adults age 18 years or older was recorded in 2-year intervals.

During the study period, the 2-year age-adjusted incidence of injuries increased by 28 percent; the incidence of hospital admissions increased by 120 percent. The percentage of injured cyclists with head injuries increased from 10 percent to 16 percent. Overall, 35 percent of injuries occurred in women, with no significant change in sex ratio of injuries over time.

The proportion of injuries occurring in individuals older than 45 years increased 81 percent, from 23 percent to 42 percent, and the proportion of hospital admissions in individuals older than 45 years increased 66 percent, from 39 percent to 65 percent. "These injury trends likely reflect the trends in overall bicycle ridership in the United States in which multiple sources show an increase in ridership in adults older than 45 years," the authors write.

"Other possible factors contributing to the increase in overall injuries and hospital admissions include an increase in street accidents and an increase in sport cycling associated with faster speeds. As the population of cyclists in the United States shifts to an older demographic, further investments in infrastructure and promotion of safe riding practices are needed to protect bicyclists from injury."