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      Describing and comparing the characteristics of injured bicyclists and other injured road users: a prospective cohort study

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          Abstract

          Background

          We aimed to establish the frequency and characteristics (e.g. socioeconomic, pre-injury, and crash-related parameters) of injured bicyclists and other injured road users.

          Methods

          748 participants aged ≥17 years who had sustained a minor or non-catastrophic injury in a land-transport crash, were interviewed after presenting to a metro hospital emergency department in New South Wales, Australia. A telephone-administered questionnaire obtained information on socio-economic, pre-injury health, and crash-related characteristics. These factors were then compared between injured bicyclists and other road users (car driver/passengers, motorcyclists/pillion and pedestrians/skateboarders). Cycling injury severity was characterized by three metrics (sustaining multiple injuries; hospital admission for ≥12 h; and sustaining a head/neck and/or facial injury).

          Results

          In this cohort of people with injuries, 238 (32 %) were bicyclists. Frequency of cycling injuries were significantly different between age-groups among men ( p = 0.0002), and were more common in men aged 45–59. Bicyclists were more likely to be aged 45–59, married, have university/tertiary qualifications and have a professional occupation compared to other road users (all p <0.0001). Bicyclists compared to participants involved in other types of land transport crashes were more likely to self-report excellent general health ( p = 0.01), and were less likely to report a great/overwhelming perceived danger of death or 15.0 % versus 23–41 %; p <0.0001). Frequency of upper extremity and lower extremity injuries in bicyclists were 81.9 % and 60.5 %, respectively. Explanatory variables significantly associated with injury severity metrics were age, education level, paid work status and perceived danger of death/disability in the crash.

          Conclusions

          Minor cycling injuries were a relatively common cause of mild-moderate injury presentations to metro emergency departments. A wide spectrum of socio-demographic-, pre-injury-, and crash-related characteristics were related to cycling injuries.

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          Most cited references21

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          Bicyclist injury severities in bicycle-motor vehicle accidents.

          This research explores the factors contributing to the injury severity of bicyclists in bicycle-motor vehicle accidents using a multinomial logit model. The model predicts the probability of four injury severity outcomes: fatal, incapacitating, non-incapacitating, and possible or no injury. The analysis is based on police-reported accident data between 1997 and 2002 from North Carolina, USA. The results show several factors which more than double the probability of a bicyclist suffering a fatal injury in an accident, all other things being kept constant. Notably, inclement weather, darkness with no streetlights, a.m. peak (06:00 a.m. to 09:59 a.m.), head-on collision, speeding-involved, vehicle speeds above 48.3 km/h (30 mph), truck involved, intoxicated driver, bicyclist age 55 or over, and intoxicated bicyclist. The largest effect is caused when estimated vehicle speed prior to impact is greater than 80.5 km/h (50 mph), where the probability of fatal injury increases more than 16-fold. Speed also shows a threshold effect at 32.2 km/h (20 mph), which supports the commonly used 30km/h speed limit in residential neighborhoods. The results also imply that bicyclist fault is more closely correlated with greater bicyclist injury severity than driver fault.
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            Epidemiology of bicycle injuries and risk factors for serious injury.

            To determine the risk factors for serious injury to bicyclists, aside from helmet use. Prospective case-control study. Seven Seattle area hospital emergency departments and two county medical examiner's offices. Individuals treated in the emergency department or dying from bicycle related injuries. 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. Odd ratios computed using the maximum likelihood method, and adjusted using unconditional logistic regression. 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 ( 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. 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.
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              Telephone reliability of the Frenchay Activity Index and EQ-5D amongst older adults

              Background Older adults may find it problematic to attend hospital appointments due to the difficulty associated with travelling to, within and from a hospital facility for the purpose of a face-to-face assessment. This study aims to investigate equivalence between telephone and face-to-face administration for the Frenchay Activities Index (FAI) and the Euroqol-5D (EQ-5D) generic health-related quality of life instrument amongst an older adult population. Methods Patients aged >65 (n = 53) who had been discharged to the community following an acute hospital admission underwent telephone administration of the FAI and EQ-5D instruments seven days prior to attending a hospital outpatient appointment where they completed a face-to-face administration of these instruments. Results Overall, 40 subjects' datasets were complete for both assessments and included in analysis. The FAI items had high levels of agreement between the two modes of administration (item kappa's ranged 0.73 to 1.00) as did the EQ-5D (item kappa's ranged 0.67–0.83). For the FAI, EQ-5D VAS and EQ-5D utility score, intraclass correlation coefficients were 0.94, 0.58 and 0.82 respectively with paired t-tests indicating no significant systematic difference (p = 0.100, p = 0.690 and p = 0.290 respectively). Conclusion Telephone administration of the FAI and EQ-5D instruments provides comparable results to face-to-face administration amongst older adults deemed to have cognitive functioning intact at a basic level, indicating that this is a suitable alternate approach for collection of this information.
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                Author and article information

                Contributors
                61 2 9926 4995 , bamini.gopinath@sydney.edu.au
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                14 April 2016
                14 April 2016
                2016
                : 16
                : 324
                Affiliations
                [ ]John Walsh Centre for Rehabilitation Research, Sydney Medical School, Kolling Medical Research Institute, University of Sydney, Sydney, Australia
                [ ]The George Institute for Global Health, Sydney Medical School, University of Sydney, Sydney, Australia
                [ ]Department of Trauma Services, Royal Prince Alfred Hospital, Sydney, Australia
                [ ]Transport and Road Safety Research, The University of NSW, Sydney, Australia
                Article
                2988
                10.1186/s12889-016-2988-y
                4831149
                27074801
                dd1a4e9e-de63-458d-9463-ba2e07b8faf7
                © Gopinath et al. 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 12 November 2015
                : 28 March 2016
                Funding
                Funded by: State Insurance Regulatory Authority of New South Wales
                Funded by: Australian National Health and Medical Research Council
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2016

                Public health
                bicyclist,non-catastrophic injury,socio-demographic,cohort,pre-injury
                Public health
                bicyclist, non-catastrophic injury, socio-demographic, cohort, pre-injury

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