The Chainlink

Riding a bike as an adult, it's just like ... well, riding a bike, right? But for all its fitness benefits and trendiness among commuters, older cyclists are part of a big increase in injuries while biking.

Injuries among adult bicyclists are up since 1998, according to a study published Tuesday in the Journal of the American Medical Association, with injuries to cyclists older than 45 fueling the increase.

The study's authors analyzed data collected from about 100 U.S. emergency rooms for the National Electronic Injury Surveillance System. From 1998 to 2013, bike injuries increased by 28%, from 96 to 123 per 100,000 U.S. adults, while hospitalizations from bike injuries increased 120%, from 5.1 to 11.2 per 100,000 adults. Cyclists' arms and legs were injured most often, but the percentage of injured cyclists with head injuries increased from 10% to 16% in that time period.

The largest increase in injuries was among cyclists older than 45, whose proportion of injuries increased from 23% to 42%, a jump of more than 80%. The proportion of hospitalizations among people older than 45 years grew from 39% to 65%, an increase of 66%.

The increase reflects a rise in the popularity of cycling, especially among older people, according to Benjamin Breyer, an associate professor of urology at University of California, San Francisco, and an author of the study. Since the late 1990s, there's been an uptick in bike commuting on urban streets and sport cycling that takes place at higher speeds, he said.

"A bicycle is no longer a kid's toy. It's enjoyed by adults, and it's great," Breyer said. "It's such a fantastic sport, it's great exercise, it's low-impact, it's been shown to have all these cardiovascular benefits and to improve your own general well-being."

But it has risks, especially for older riders. In May, U.S. Secretary of State John Kerry, 71, broke his right femur in a cycling accident in France. In 2014, U2 singer Bono underwent multiple surgeries after breaking an arm and fracturing his eye socket and shoulder blade in a bicycle accident in New York at age 54.

"If you take a 65 year old and a 20 year old, and they experience the same fall off a bike, or the same collision, the 65 year old is going to have more significant injuries," Breyer said.

The researchers noted that bicycle injury trends are hard to track. Traffic data is incomplete because so many bike accidents aren't reported to police, and emergency room data doesn't cover bumps, bruises and road rash deemed too minor for immediate medical care.

"The majority of minor bicycle injuries don't get reported, so we don't get to learn from them," Breyer said.

Breyer's advice for cyclists: "Take all the safety measures you can." Cyclists need to understand the rules of the road and wear safety gear such as helmets and reflective clothing, he said. Bike lanes and other infrastructure improvements require more research and investment from communities, as well, he said.

An increase in injuries is no surprise, given the increase in cyclists on the road, said Ken McLeod, the legal and policy specialist for the League of American Bicyclists, which was not involved in the study. He expects injury numbers will shrink as communities create networks of bike lanes and paths that minimize interactions between bikes and cars.

Local governments and bike advocacy groups often offer suggested bike routes and cycling classes for people who want to learn the safest ways to ride in their area, he said.

"People shouldn't get fixated on the big overall number. In many places, we are seeing it getting safer," McLeod said of injury increases while biking. "Even with our current risks that are hopefully diminishing, you're still better off in the long run.

"As you get more people bicycling, it contributes to more support for better infrastructure, and more awareness among motor vehicle drivers. (There's) safety in numbers."

LINKY

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This is a much smarter version compared to the condensed, dumbed down version NPR is running.

I usually expect more from NPR than from CNN, but clearly I have misplaced expectations.  This story from CNN is actually somewhat objective!

Thanks for sharing. I would agree that suggested bike routes and cycling classes are a good idea. I think also, riding in groups is also a great, supported way to get comfortable.

It'd be nice to know the "why" behind the injuries - self/operator error, hit by car/vehicle, due to road e.g. potholes, etc. 

Agreed. More detail would be useful here.

That's my question as well.  One interesting thing is that as cycling has increased in this City, many roads have unfortunately also seen decreases in quality, repairs, etc.  Though it's easy to just blame the increase on the increase in cycling in general, and these pieces can sometime read like scare tactics to anyone who doesn't ride on the regular, it would be nice to see if the state of infrastructure disrepair nationwide really is driving up injuries. 

We're also seeing an increase in distracted driving. How much does that factor in?

Good point. I think it'd be important to have a breakdown e.g. distracted driving (smart phones), driving under the influence, etc.

Yes!

Sometimes I wonder if they passed a law requiring drivers to be on a cell phone when they make a left turn.

Amen.  I count 1 in 4 drivers on the phone almost every day!!!

I ride all year round.  The only thing that stops me, is when the cars can no longer drive.

One odd thing abut this study is that the counts and percent increases are calculated on 100,000 total population.  With a doubling of bicycle use in the time period of the study, it is not surprising that crashes/100,000 population would increase. 

I wonder what the numbers would look like if the counts and percent increases were based on bicycle usage, such as the total number of cyclists, total number of bike trips  or total number of miles ridden.

It'd be nice to know the "why" behind the injuries - self/operator error, hit by car/vehicle, due to road e.g. potholes, etc.

That is a glaring omission.  Multiple studies of cyclists admitted to the ER because of crashes show that only something on the order of 13% involve motor vehicles.  Most injuries (77%) are because of things like single rider falls.  Reasons range from poor infrastructure, like pot holes, bike malfunction, or poor handling skills.

Two sources ( Oz and Sweden) that cite sources of those or related studies are:

http://www.monash.edu.au/miri/research/reports/muarc311.pdf

http://www.ircobi.org/downloads/irc13/pdf_files/46.pdf

There are Canadian and older US sources as well.

An increase in riders leads to an increase in injuries. It doesn't matter if you're a 'newb' or a veteran cyclist.  Experienced riders probably have just as many injuries. This page crash stories has scores of crashes by experienced cyclists. (Safety hint: Don't do what they do).

Most of the accident studies are useless. They don't focus on WHY a crash happened, and instead report such things as x% happened at night (Why? Did they have lights or not? It doesn't say) or that x% of the victims were men and x% were women (totally irrelevant, non-helpful information). They should focus on causes, and ways to prevent crashes.

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