Teschke K,
Koehoorn M, Shen H, et al.
Bicycling injury
hospitalisation rates
in Canadian jurisdictions:
analyses examining
associations with helmet
legislation and mode share.
BMJ Open 2015; 5:e008052.
doi:10.1136/bmjopen-2015-
008052
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ABSTRACT
Objectives: The purpose of this study was to
calculate exposure-based bicycling hospitalisation rates
in Canadian jurisdictions with different helmet
legislation and bicycling mode shares, and to examine
whether the rates were related to these differences.
Methods: Administrative data on hospital stays for
bicycling injuries to 10 body region groups and
national survey data on bicycling trips were used to
calculate hospitalisation rates. Rates were calculated for
44 sex, age and jurisdiction strata for all injury causes
and 22 age and jurisdiction strata for traffic-related
injury causes. Inferential analyses examined
associations between hospitalisation rates and sex, age
group, helmet legislation and bicycling mode share.
Results: In Canada, over the study period 2006–2011,
there was an average of 3690 hospitalisations per year
and an estimated 593 million annual trips by bicycle
among people 12 years of age and older, for a cycling
hospitalisation rate of 622 per 100 million trips (95%
CI 611 to 633). Hospitalisation rates varied
substantially across the jurisdiction, age and sex strata,
but only two characteristics explained this variability.
For all injury causes, sex was associated with
hospitalisation rates; females had rates consistently
lower than males. For traffic-related injury causes,
higher cycling mode share was consistently associated
with lower hospitalisation rates. Helmet legislation was
not associated with hospitalisation rates for brain,
head, scalp, skull, face or neck injuries.
Conclusions: These results suggest that
transportation and health policymakers who aim to
reduce bicycling injury rates in the population should
focus on factors related to increased cycling mode
share and female cycling choices. Bicycling routes
designed to be physically separated from traffic or
along quiet streets fit both these criteria and are
associated with lower relative risks of injury.