The Current Injury Situation of Bicyclists???A Medical and Technical Crash Analysis

Hannover Medical School, Hanover, Lower Saxony, Germany
The Journal of trauma (Impact Factor: 2.96). 05/2007; 62(5):1118-22. DOI: 10.1097/01.ta.0000221060.78894.cb
Source: PubMed


The purpose of the study was to analyze the actual injury situation of bicyclists in Germany to create a basis for effective preventive measures.
Technical and medical data were prospectively collected shortly after the crash at the crash scenes.
Included were 4,264 injured bicyclists from 1985 to 2003. Fifty-five percent of the bicyclists were male and 45% were women. The mean age of bicyclists was 52.0 years. The crashes took place in urban areas in 95.2% of the cases, and in rural areas in 4.8% of the cases. Collision opponents were cars in 65.8%, trucks in 7.2%, bicyclists in 7.4%, standing objects in 8.8%, multiple opponents or objects in 4.3%, and others in 6.5%. The mean collision speed was 21.3 km/h. The helmet use rate was 1.7%. Fifty-five percent of bicyclists used bicycle traffic lanes before the crash. The mean Maximum Abbreviated Injury Scale/Injury Severity Score (ISS) was 1.45 of 3.9. The incidence of multiple injuries (ISS>16)/death was 2.0%/1.5%. The ISS/Maximum Abbreviated Injury Scale score was higher in bicyclists without a helmet than in bicyclists with a helmet, and in bicyclists who had not used bicycle traffic lanes than in bicyclists who had used bicycle traffic lanes (t test, p<0.05).
In bicyclists, head and extremities are at high risk for injuries. The helmet use rate is unsatisfactorily low. Remarkably, two-thirds of the head injuries could have been prevented by helmets. More consequent helmet use and an extension of bicycle traffic lanes for a better separation of bicyclists and motorized vehicles would be simple but very effective preventive measures.

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    • "A report was written for each accident. The data were classified as demographic data, type of road user (car/truck occupant, motorcyclist, cyclist, pedestrian), delta-v (vehicle collision speed, kilometers per hour, kph), injury severity per anatomic region according to the abbreviated injury scale (AIS), maximum AIS (MAIS), and injury severity score (ISS) (American Association for Automotive Medicine, 1995; Baker et al., 1974; Haasper et al., 2008; Richter et al., 2007). 2.2. "
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    ABSTRACT: Spinal injuries pose a considerable risk to life and quality of life. In spite of improvements in active and passive safety of motor vehicles, car accidents are regarded as a major cause for vertebral fractures. The purpose of this study was to evaluate the current incidence of vertebral fractures among front-seat occupants in motor vehicle accidents, and to identify specific risk factors for sustaining vertebral fractures in motor vehicle accidents. Data from an accident research unit were accessed to collect collision details, preclinical data, and clinical data. We included all data on front-seat occupants. Hospital records were retrieved, and radiological images were evaluated. We analysed 33,015 front-seat occupants involved in motor vehicle accidents over a 24-year period. We identified 126 subjects (0.38%) with cervical spine fractures, 78 (0.24%) with thoracic fractures, and 99 (0.30%) with lumbar fractures. The mean relative collision speeds were 48, 39, and 40kph in subjects with cervical, thoracic, and lumbar spine fractures, respectively, while it was 17.3kph in the whole cohort. Contrary to the overall cohort, these patients typically sustained multiple hits rather than simple front collisions. Occupants with vertebral fractures frequently showed numerous concomitant injuries; for example, additional vertebral fractures. The incidence of vertebral fractures corresponded with collision speed. Safety belts were highly effective in the prevention of vertebral fractures. Apart from high speed, complex injury mechanisms as multiple collisions or rollovers were associated with vertebral fractures. Additional preventive measures should focus on these collision mechanisms.
    Full-text · Article · Jan 2014 · Accident; analysis and prevention
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    • "However, identifying the precise mechanism of knee injury in traffic accidents was not possible, as many components seemed to interact. Severe lower limb injuries of bicyclists or pedestrians are usually seen in collision with cars [13]. The most common injury is the proximal tibia fracture. "
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    ABSTRACT: Background Purpose of the presented study is to answer the following questions: Are knee injuries associated with trauma mechanisms or concomitant injuries? Do injuries of the knee region aggravate treatment costs or prolong hospital stay in polytraumatized patients? Methods A retrospective analysis including 29.779 severely injured patients (Injury Severity Score [greater than or equal to] 16) from the Trauma Registry of the German Society for Trauma Surgery database (1993-2008) was conducted. Patients were subdivided into two groups; the "Knee" group (n=3.458, 11.6% of all patients) including all multiple trauma patients with knee injuries, and the "Non Knee" group (n=26.321) including the remaining patients. Patients with knee injuries were slightly younger, less often male gender and had a significantly increased ISS. Results Patients in the Knee group suffered significantly more traffic accidents compared to the Non Knee group (82% vs. 52%, p<0.001). These injuries were more often caused by car or motorbike accidents. Severe thoracic and limb injuries (AIS[greater than or equal to]3) were more frequently found in the Knee group (p<0.001) while head injury was distributed equally. The overall hospital stay, ICU stay, and treatment costs were significantly higher for the Knee group (38.1 vs. 25.5 days, 15.2 vs. 11.4 days, 40,116 vs. 25,336 Euro, respectively; all p<0.001). Conclusions Traffic accidents are associated with an increased incidence of knee injuries than falls or attempted suicides. Furthermore, severe injuries of the limbs and chest are more common in polytraumatized patients with knee injuries. At last, treatment of these patients is prolonged and consequently more expensive.
    Full-text · Article · Aug 2012 · Journal of Trauma Management & Outcomes
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    • "The Prospective Questionnaire (PQ) is inspired by existing national official registration systems for traffic accidents (FPS Economy ), recent literature (e.g. Brooks and Fuller, 2007; Richter et al., 2007) and the BLITS ® online registration system for sports injuries (Cumps et al., 2007). The PQ is designed to collect detailed information on the (i) context and circumstances of the accident (e.g. "
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    ABSTRACT: The purpose of this study is to gain insight into bicycle accidents. Bicycle accident data and weekly exposure data were prospectively collected for one year to calculate the incidence rate (IR) of bicycle accidents. An accident was included if it occurred during utilitarian cycling, resulting in an acute injury with corporal damage. If an accident occurred, a detailed questionnaire was filled out to collect detailed information about its circumstances and consequences. A sample of 1087 regular (≥2 cycling trips to work a week) adult (40±10 years) cyclists was analyzed. Over the 1-year follow-up period, 20,107 weeks were covered, accumulating 1,474,978 cycled kilometers. Sixty-two participants were involved in 70 bicycle accidents, of which 68 were classified as 'minor'. The overall IR for the 70 accidents was 0.324 per 1000 trips (95% CI 0.248-0.400), 0.896 per 1000 h (95% CI 0.686-1.106) and 0.047 per 1000 km (95% CI 0.036-0.059) of exposure. Brussels-capital region is the region with the highest IR (0.086; 95% CI 0.054-0.118), with a significantly (P<0.05) higher IR compared to Flanders (0.037; 95% CI 0.025-0.050). Injuries were mainly caused by 'slipping' (35%) or 'collision with a car' (19%). The accidents caused abrasions (42%) and bruises (27%) to the lower (45%) and upper limbs (41%). Police, hospital emergency department or insurance companies were involved in only 7%, 10% and 30% of the cases, respectively. It is noteworthy that 37% of the participants indicated that they could have avoided the accident. In order to decrease the number of accidents, measures should be taken to keep cycling surfaces clean and decrease the number of obstacles on bicycle infrastructure. Roads and intersections need to be built so that the collisions between cars and bicycles are decreased to a minimum. Car drivers and cyclists should pay more attention towards each other. Underreporting of minor bicycle accidents in Belgium is confirmed, and is higher than expected. Reliable accident statistics, taking into account exposure, are needed to decide which road safety measures are the most effective. The 'safety in numbers' principle is also applicable for minor bicycle accidents.
    Full-text · Article · Mar 2012 · Accident; analysis and prevention
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