Citation

Molina-Soberanes D, Martínez-Ruiz V, Lardelli-Claret P, Pulido-Manzanero J, Martín-delosReyes LM, Moreno-Roldán E, Jiménez-Mejías E. BMJ Open 2019; 9(8): e028039.

Affiliation

Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain.

Copyright

(Copyright © 2019, BMJ Publishing Group)

DOI

10.1136/bmjopen-2018-028039

PMID

31444182

Abstract

OBJECTIVE: To quantify the magnitude of associations between cyclist fatalities and both cyclist and environment related characteristics in Spain during the first 24 hours after a crash.

DESIGN: Cohort study. SETTING: Spain. PARTICIPANTS: 65 977 cyclists injured in road crashes recorded between 1993 and 2013 in the Spanish Register of Road Crashes with Victims. MAIN OUTCOME: Death within the first 24 hours after the crash.

METHODS: A multiple imputation procedure was used to mitigate the effect of missing values. Differences between regions were assumed and managed with multilevel analysis at the cyclist and province levels. Incidence density ratios (IDR) with 95% CI were calculated with a multivariate Poisson model.

RESULTS: Non-use of a helmet was directly associated with death (IDR 1.43, 95% CI 1.25 to 1.64). Among other cyclist characteristics, age after the third decade of life was also directly associated with death, especially in older cyclists ('over 74' category, IDR 4.61, 95% CI 3.49 to 6.08). The association with death did not differ between work-related cycling and other reasons for cycling.There was an inverse association with death for crashes in urban areas and on community roads. Any adverse meteorological condition also showed a direct association with death, whereas altered road surfaces showed an inverse association. Crashes during nighttime were directly associated with death, with a peak between 3:00 and 5:59 am (IDR 1.58, 95% CI 1.03 to 2.41).

CONCLUSIONS: We found strong direct and inverse associations between several cyclist and environment related variables and death. These variables should be considered in efforts to prioritise public health measures aimed at reducing the number of cycling-related fatalities.

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Language: en

Keywords

bicycling; cyclist; fatality; injuries; risk factor; road crash