Martin, A; Lloyd, M; Sargent, G; Feleke, R; Mindell, JS; (2018) Are head injuries to cyclists an important cause of death in road travel fatalities? Journal of Transport & Health , 10 pp. 178-185. 10.1016/j.jth.2018.06.002.

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Abstract

Background: Despite the well-recognised benefit for individuals and communities of increased active travel, cycling remains a minority travel mode in many high income countries. Fear of injury is often cited as a reason. Campaigns to promote cycle helmet wear are alleged to contribute to this. However, there is little information on whether head injuries to cyclists are an important cause of death in road travel fatalities, compared with other road users. // Methods: We examined secondary causes of death for road travel deaths in England 2007–2012, comparing travel modes and grouped causes of death (from national mortality statistics) as numbers and as rates, using distance travelled and time spent travelling by mode, age, and sex from National Travel Surveys for the same six years. // Results: Head injury was the main cause of death for 269 cyclists, 1324 pedestrians and 1046 drivers, accounting for 46%, 42% and 25% of road travel deaths at all ages in each mode respectively. Head injury was the commonest cause of death in cyclists, but most pedestrian and driver fatalities were from multiple injuries. Rates of fatal head injury per bnkm in males aged 17+ for cycling, walking, and driving were 11.2(95% CI 9.7–12.9), 23.4(21.8–25.0) and 0.7(0.6–0.7) respectively. Female fatality rates were 8.8(6.2–12.0), 9.6(8.7–10.7) and 0.4(0.4–0.5) per bnkm respectively. Using time as the denominator, rates were 0.16(0.14–0.19),0.10(0.10–0.11) and 0.03 (0.028–0.032) respectively in men and 0.10 (0.07–0.14), 0.04(0.037–0.045), and 0.01(0.012–0.016) respectively in women, per million hours travelled. // Conclusion: Answering the question ‘How important are head injuries in cyclists as a cause of road travel death?’ depends on the metric used for assessing importance. Pedestrians and drivers account for five and four times the number of fatal head injuries as cyclists. The fatal head injury rate is highest for cyclists by time travelled and for pedestrians using distance travelled.

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