Self-reported Alcohol Use Is an Independent Risk Factor for Head and Brain Injury among Cyclists but Does Not Confound Helmets’ Protective Effect

Crocker, P.; King, Ben; Cooper, Hassie; Milling, Truman J.

doi:10.1016/j.jemermed.2011.05.029

Cited by 21 publications

(9 citation statements)

References 9 publications

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“…Similar findings were reported by a 2010 study by Crocker et al, which demonstrated a strong correlation between alcohol use and head injury (OR 3.23, 95% CI 1.57–6.63) [19]. In 2012, the same group focused their regression analysis on whether increased risks of head and brain injury among intoxicated bicyclists were caused by their lower rates of helmet use and concluded that alcohol use is independently associated with head and brain injury regardless of helmet use [20]. …”

Section: Discussionmentioning

confidence: 99%

Alcohol use by urban bicyclists is associated with more severe injury, greater hospital resource use, and higher mortality

Sethi

Heyer

Wall

et al. 2016

Alcohol

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Alcohol use is a risk factor for severe injury in pedestrians struck by motor vehicles. Our objective was to investigate alcohol use by bicyclists and its effects on riding behaviors, medical management, injury severity, and mortality within a congested urban setting. A hospital-based, observational study of injured bicyclists presenting to a Level I regional trauma center in New York City was conducted. Data were collected prospectively from 2012 to 2014 by interviewing all bicyclists presenting within 24 h of injury and supplemented with medical record review. Variables included demographic characteristics, scene-related data, Glasgow Coma Scale (GCS), computed tomography (CT) scans, and clinical outcomes. Alcohol use at the time of injury was determined by history or blood alcohol level (BAL) >0.01 g/dL. Of 689 bicyclists, 585 (84.9%) were male with a mean age of 35.2. One hundred four (15.1%) bicyclists had consumed alcohol prior to injury. Alcohol use was inversely associated with helmet use (16.5% [9.9–25.1] vs. 43.2% [39.1–47.3]). Alcohol-consuming bicyclists were more likely to fall from their bicycles (42.0% [32.2–52.3] vs. 24.2% [20.8–27.9]) and less likely to be injured by collision with a motor vehicle (52.0% [41.7–62.1] vs. 67.5% [63.5–71.3]). 80% of alcohol-consuming bicyclists underwent CT imaging at presentation compared with 51.5% of non-users. Mortality was higher among injured bicyclists who had used alcohol (2.9% [0.6–8.2] vs. 0.0% [0.0–0.6]). Adjusted multivariable analysis revealed that alcohol use was independently associated with more severe injury (Adjusted Odds Ratio 2.27, p = 0.001, 95% Confidence Interval 1.40–3.68). Within a dense urban environment, alcohol use by bicyclists was associated with more severe injury, greater hospital resource use, and higher mortality. As bicycling continues to increase in popularity internationally, it is important to heighten awareness about the risks and consequences of bicycling while under the influence of alcohol.

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Section: Discussionmentioning

confidence: 99%

Alcohol use by urban bicyclists is associated with more severe injury, greater hospital resource use, and higher mortality

Sethi

Heyer

Wall

et al. 2016

Alcohol

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“…The second and more ample stream concentrates on bicycle crash and injury rates and can be crudely divided into 4 main research lines. The first line explores the effect of cyclists' behaviors on crash and injury rates, with particular attention devoted to helmet use (e.g., Elvik 2011; Kopjar and Wickizer 2000;Robinson 2007; J. T. Wang et al 2009), intoxication (e.g., Andersson and Bunketorp 2002;Crocker et al 2012;Olkkonen and Honkanen 1990), and cell phone use (de Waard et al 2011). The second line examines the effect of infrastructure characteristics on crash and injury rates, in particular bicycle paths (e.g., Gårder et al 1994), intersections (e.g., Phillips et al 2011;Schepers et al 2011;Y.…”

Section: Introductionmentioning

confidence: 99%

Cyclist–Motorist Crash Patterns in Denmark: A Latent Class Clustering Approach

Kaplan

Prato

2013

Traffic Injury Prevention

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“…The majority of those severely injured were injured at night, and on major roads. 1,4–7 In cycling-related trauma, the spectrum of injury is wide with a small but significant chance of mortality, related to patient demographics, behavioral risk factors, safety strategy adoption, and severity of the injury mechanism.…”

Section: Epidemiologymentioning

confidence: 99%

“…Unsafe riding practices, particularly riding while under the influence of alcohol, are independent risk factors for head injury while bicycling. 5,8,9…”

Section: Patterns Of Injurymentioning

confidence: 99%

Injuries sustained by bicyclists

Melo

Berg

Inaba

2014

Trauma

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Although generally a safe activity with considerable health benefit, the wide social prevalence of cycling, its performance by both young and elderly riders, and the increasing operation of bicycles in complex urban environments results in a significant incidence of trauma. Orthopedic injuries, followed by head and facial trauma, are most frequent but all anatomic regions can be affected and the spectrum of injury ranges from minor to severe and potentially fatal. Clinicians need to be aware of the range of injuries and causative mechanisms as many patients may present with relatively minor signs and symptoms despite significant underlying pathology. Non-commuter, recreational cyclists are also at risk for injury due to: variable terrain and environmental conditions; increased competitive and risk-taking behavior; technical equipment failure; and poor compliance with protective equipment. Numerous injury preventative strategies have been advocated including: increased rider training; creation of dedicated traffic lanes for commuting cyclists; bike-awareness education for motorists and interventions to improve cyclist visibility; increased utilization of protective equipment and programs to reduce concomitant drug or alcohol use. Of all preventative strategies, bicycle helmets have received the most study, leading to legislated use in some jurisdictions. As urban environments become more congested for commuter cyclists, and interest in recreational and competitive cycling grows, bicycle injury is likely to become more prevalent.

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Self-reported Alcohol Use Is an Independent Risk Factor for Head and Brain Injury among Cyclists but Does Not Confound Helmets’ Protective Effect

Cited by 21 publications

References 9 publications

Alcohol use by urban bicyclists is associated with more severe injury, greater hospital resource use, and higher mortality

Alcohol use by urban bicyclists is associated with more severe injury, greater hospital resource use, and higher mortality

Cyclist–Motorist Crash Patterns in Denmark: A Latent Class Clustering Approach

Injuries sustained by bicyclists

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