Alcohol, bicycling, and head and brain injury: a study of impaired cyclists' riding patterns R1

Dell Children's Medical Center of Central Texas, Austin, TX 78723, USA.
The American journal of emergency medicine (Impact Factor: 1.27). 01/2010; 28(1):68-72. DOI: 10.1016/j.ajem.2008.09.011
Source: PubMed


The aim of the study was to examine the interactions between alcohol, bicycle helmet use, experience level, riding environment, head and brain injury, insurance status, and hospital charges in a medium-sized city without an adult helmet law.
A study of adult bicycle accident victims presenting to a regional trauma center over a 1-year period was undertaken. Data were collected at the bedside regarding helmet use, alcohol use, experience level, location and type of accident and prevailing vehicle speed (for road accidents), and presence and degree of head or brain injury.
Two hundred patients 18 years or older were enrolled from December 2006 through November 2007. Alcohol use showed a strong correlation with head injury (odds ratio, 3.23; 95% confidence interval, 1.57-6.63; P = .001). Impaired riders were less experienced, less likely to have medical insurance, rarely wore helmets, were more likely to ride at night and in slower speed zones such as city streets, and their hospital charges were double (all P values <.05).
Alcohol use leads to a host of unsafe bicycling practices, increased head and brain injuries, and costs to the cyclist and community. The interrelated characteristics of the riding patterns of the cyclists who use alcohol might help target interventions.

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Available from: Truman Milling, Apr 07, 2014
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    • "In particular, alcohol and cannabis impair the cognitive and psychomotor skills necessary for safe cycling behavior (Crocker et al., 2010; Li et al., 2001). Alcohol has been detected in a high percentage of cyclists involved in crashes leading to injury or death (Crocker et al., 2010; Li et al., 1996, 2001). Moreover, although evidence is limited, alcohol consumption among cyclists has been shown to increase the risk of an injury or fatal crash (Li et al., 2001; Martínez-Ruiz et al., 2013; Olkkonen and Honkanen, 1990) with a clear dose–response relationship starting at blood alcohol concentrations (BACs) of 0.02 g/dL, lower than the legal limit for driving a motor vehicle in most jurisdictions worldwide. "
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    ABSTRACT: Objective: To examine whether alcohol and cannabis consumption increase crash risk among non-fatally injured bicyclists (N=393) seen in three Canadian emergency departments, between April 2009 and July 2011. Method: Employing a case-crossover design, cannabis and alcohol were identified through blood sample or by self-report. All cyclists involved in a crash and exposure status (cannabis and alcohol) were compared between case period (current crash) and two control periods: prior to the last time the victim cycled around the same time of day; and the typical use prior to bicycling. Crash risk was assessed through conditional fixed effects logistic regression models. Results: Approximately 15% of cyclists reported using cannabis just prior to the crash, and 14.5% reported using alcohol. Cannabis use identified by blood testing or self-report in the case period and by self-report in the control period yielded a crash risk of 2.38 (1.04-5.43); however, when self-report was used for both the case and control periods the estimate was 0.40 (0.12-1.27). Alcohol use, as measure either in blood or self-report, was associated with an odds ratio of 4.00 (95% CI: 1.64-9.78); results were similar when alcohol was measured by self-report only. Conclusion: Cannabis and alcohol use each appear to increase the risk of a non-fatal injury-related crash among bicyclists, and point to the need for improved efforts to deter substance use prior to cycling, with the help of regulation, increased education, and greater public awareness. However, cannabis results should be interpreted with caution, as the observed association with crash risk was contingent on how consumption was measured.
    Full-text · Article · Jun 2014 · Preventive Medicine
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    • "A UK study reported 27% of observed cyclists wore helmets [20]. Factors associated with not wearing a helmet are similar to many of those found in our study: alcohol use [10-12]; younger ages [14,16,25]; lower education and income [14,16]; and less distance or duration of cycling [14,15,25]. Studies examining sex have not found consistent relationships [14-16,22], though in North America (as in our study) women appear to be more likely to use helmets [15,16]. "
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    ABSTRACT: Background The aim of this study was to estimate use of helmets, lights, and visible clothing among cyclists and to examine trip and personal characteristics associated with their use. Methods Using data from a study of transportation infrastructure and injuries to 690 adult cyclists in Toronto and Vancouver, Canada, we examined the proportion who used bike lights, conspicuous clothing on the torso, and helmets on their injury trip. Multiple logistic regression was used to examine associations between personal and trip characteristics and each type of safety equipment. Results Bike lights were the least frequently used (20% of all trips) although they were used on 77% of trips at night. Conspicuous clothing (white, yellow, orange, red) was worn on 33% of trips. Helmets were used on 69% of trips, 76% in Vancouver where adult helmet use is required by law and 59% in Toronto where it is not. Factors positively associated with bike light use included night, dawn and dusk trips, poor weather conditions, weekday trips, male sex, and helmet use. Factors positively associated with conspicuous clothing use included good weather conditions, older age, and more frequent cycling. Factors positively associated with helmet use included bike light use, longer trip distances, hybrid bike type, not using alcohol in the 6 hours prior to the trip, female sex, older age, higher income, and higher education. Conclusions In two of Canada’s largest cities, helmets were the most widely used safety equipment. Measures to increase use of visibility aids on both daytime and night-time cycling trips may help prevent crashes.
    Full-text · Article · Sep 2012 · BMC Public Health
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    • "The research of Crocker et. al. drawed the conclusions, that alcohol use causes accidents, increasing amounts of head and brain injuries via unsafe bicycling practices and is expensive for the cyclist and community.[7] "
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    ABSTRACT: Bicycle traumata are very common and especially neurologic complications lead to disability and death in all stages of the life. This review assembles the most recent findings concerning research in the field of bicycle traumata combined with the factor of bicycle helmet use. The area of bicycle trauma research is by nature multidisciplinary and relevant not only for physicians but also for experts with educational, engineering, judicial, rehabilitative or public health functions. Due to this plurality of global publications and special subjects, short time reviews help to detect recent research directions and provide also information from neighbour disciplines for researchers. It can be stated that to date, that although a huge amount of research has been conducted in this area more studies are needed to evaluate and improve special conditions and needs in different regions, ages, nationalities and to create successful prevention programs of severe head and face injuries while cycling. Focus was explicit the bicycle helmet use, wherefore sledding, ski and snowboard studies were excluded and only one study concerning electric bicycles remained due to similar motion structures within this review. The considered studies were all published between January 2010 and August 2011 and were identified via the online databases Medline PubMed and ISI Web of Science.
    Full-text · Article · May 2012 · Journal of Occupational Medicine and Toxicology
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