Analysis of bicycle crashes in Sweden involving injuries with high risk of health loss

Ohlin, Maria; Algurén, Beatrix; Lie, Anders · 2019 · Crossref

DOI: 10.1080/15389588.2019.1614567

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Summary

This study investigates the characteristics and health outcomes of bicycle crashes in Sweden involving injuries with a high risk of long-term health loss. While motor vehicle collisions are often associated with fatal bicyclist crashes, nonfatal injuries frequently result from single-vehicle incidents. The research aimed to describe crash circumstances, compare individuals reporting declined health against those reporting no health impact, and validate subjective health reports against predicted permanent medical impairments (PMI). The researchers utilized a cross-sectional design combining data from the Swedish Traffic Accident Data Acquisition (STRADA) database with a targeted survey. A sample of 2,678 individuals aged 15 and older, injured between 2013 and 2017, was selected based on specific diagnoses known to cause significant health-related quality of life problems or sickness absence, such as fractures to the hip, leg, shoulder, spine, and traumatic brain injuries. Participants were invited via postal questionnaire to report on crash dynamics, road environment, and post-crash health status. The study also calculated the predicted number of individuals with at least 1% permanent medical impairment using established risk matrices based on injury location and severity. Of the 947 respondents (36% response rate), 44% reported declined health after the crash. The majority of crashes (68%) were single-bicycle incidents, primarily caused by loss of control due to skidding on winter surfaces (14%) or braking (6%). Only 17% involved collisions with motor vehicles, and 11% involved other vulnerable road users. Statistical analysis revealed no significant difference in crash distribution between those with declined health and those without, indicating that the types of crashes leading to health loss do not substantially differ from those that do not. Notably, the predicted number of individuals with permanent medical impairment (427) closely matched the number of individuals self-reporting declined health (421). In crashes involving motor vehicles, the likelihood of declined health increased linearly with vehicle speed, ranging from 21% at speeds under 10 km/h to 67% at speeds over 40 km/h. The findings suggest that preventive strategies must extend beyond separating cyclists from motorized traffic, as two-thirds of injuries leading to health loss occur in single-bicycle crashes. The strong correlation between predicted impairment and self-reported health decline validates the use of PMI metrics for assessing long-term consequences. The authors conclude that effective countermeasures should address single-vehicle scenarios, including improved road maintenance for winter conditions, better infrastructure visibility, and potentially antilock braking systems for bicycles.

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Topics

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• cyclist safety
• vru crash typology
• incidence prevalence
• motorcycle crash typology
• demographic disparities
• helmet protective

Information type

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• Empirical Findings: crash risk outcomes