Background Bicycle riding is a popular leisure activity worldwide. Compared to other traffic participants such as drivers or motorcycles, bicycle riders are least protected. Even a minor collision or fall can cause serious injuries for bike riders if fall on road. Well-designed bike lanes improve safety for people riding bikes from collision with other vehicles and protect pedestrians.

The object of this study is to evaluate the effect of bike lane on hospitalization from bike accident injuries.

Method Data from Emergency department based In-depth Injury Surveillance Data collected by Korean CDC was analyzed for patients hospitalized following bike accident. Data from 2013 to 2016 was used in analysis with excluding those without hospital outcome or information on injury incident time. Main exposure was injury place which was categorized in to 3 groups, traffic road, sidewalk and bike lane. Main outcome was hospitalization including hospital death.

Result Total 26 983 patients visited ED by bike accident. Among them, 10 120 accidents happened at traffic road, 3496 at sidewalk, 4924 at bike lane and 8443 at other places. Among the bike accidents, 19.1% of traffic road accidents, 12.6% of sidewalk accidents and 11.6% of bike lane accidents were admitted. The odds ratio of traffic road accidents for hospitalization in bike drivers were 1.39 (95% CI 1.24–1.55), whereas odds ratio of bike lane accidents for hospitalization was 0.81 (95% CI 0.71–0.93) compared to sidewalk accidents.

Conclusion Bike lane is safer for bike drivers compared to drive at traffic road or sidewalks. Community based preventions as well as individual preventive strategy to prevent bike accident injuries can be established by constructing bike lanes. Further research including cost-effectiveness study is needed.