RT Journal Article SR Electronic T1 Epidemiology of bicycle injuries and risk factors for serious injury. JF Injury Prevention JO Inj Prev FD BMJ Publishing Group Ltd SP 110 OP 114 DO 10.1136/ip.3.2.110 VO 3 IS 2 A1 F. P. Rivara A1 D. C. Thompson A1 R. S. Thompson YR 1997 UL http://injuryprevention.bmj.com/content/3/2/110.abstract AB OBJECTIVE: To determine the risk factors for serious injury to bicyclists, aside from helmet use. DESIGN: Prospective case-control study. SETTING: Seven Seattle area hospital emergency departments and two county medical examiner's offices. PATIENTS: Individuals treated in the emergency department or dying from bicycle related injuries. MEASUREMENTS: Information collected from injured bicyclists or their parents by questionnaire on circumstances of the crash; abstract of medical records for injury data. Serious injury defined as an injury severity score > 8. ANALYSIS: Odd ratios computed using the maximum likelihood method, and adjusted using unconditional logistic regression. RESULTS: There were 3854 injured cyclists in the three year period; 3390 (88%) completed questionnaires were returned 51% wore helmets at the time of crash. Only 22.3% of patients had head injuries and 34% had facial injuries. Risk of serious injury was increased by collision with a motor vehicle (odds ratio (OR) = 4.6), self reported speed > 15 mph (OR = 1.2), young age (< 6 years), and age > 39 years (OR = 2.1 and 2.2 respectively, compared with adults 20-39 years). Risk for serious injury was not affected by helmet use (OR = 0.9). Risk of neck injury was increased in those struck by motor vehicles (OR = 4.0), hospitalized for any injury (OR = 2.0), and those who died (OR = 15.1), but neck injury was not affected by helmet use. CONCLUSIONS: Prevention of serious bicycle injuries cannot be accomplished through helmet use alone, and may require separation of cyclists from motor vehicles, and delaying cycling until children are developmentally ready.