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Individual and environmental factors associated with death of cyclists involved in road crashes in Spain: a cohort study.

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Date

2019-07-31

Authors

Molina-Soberanes, Daniel
Martinez-Ruiz, Virginia
Lardelli-Claret, Pablo
Pulido-Manzanero, Jose
Martín-delosReyes, Luis Miguel
Moreno-Roldan, Elena
Jimenez-Mejias, Eladio

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BMJ Group
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Abstract

To quantify the magnitude of associations between cyclist fatalities and both cyclist and environment related characteristics in Spain during the first 24 hours after a crash. Cohort study. Spain. 65 977 cyclists injured in road crashes recorded between 1993 and 2013 in the Spanish Register of Road Crashes with Victims. Death within the first 24 hours after the crash. A multiple imputation procedure was used to mitigate the effect of missing values. Differences between regions were assumed and managed with multilevel analysis at the cyclist and province levels. Incidence density ratios (IDR) with 95% CI were calculated with a multivariate Poisson model. Non-use of a helmet was directly associated with death (IDR 1.43, 95% CI 1.25 to 1.64). Among other cyclist characteristics, age after the third decade of life was also directly associated with death, especially in older cyclists ('over 74' category, IDR 4.61, 95% CI 3.49 to 6.08). The association with death did not differ between work-related cycling and other reasons for cycling.There was an inverse association with death for crashes in urban areas and on community roads. Any adverse meteorological condition also showed a direct association with death, whereas altered road surfaces showed an inverse association. Crashes during nighttime were directly associated with death, with a peak between 3:00 and 5:59 am (IDR 1.58, 95% CI 1.03 to 2.41). We found strong direct and inverse associations between several cyclist and environment related variables and death. These variables should be considered in efforts to prioritise public health measures aimed at reducing the number of cycling-related fatalities.

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MeSH Terms

Accidents, Traffic
Adolescent
Adult
Aged
Bicycling
Child
Cohort Studies
Female
Head Protective Devices
Humans
Incidence
Male
Middle Aged
Multivariate Analysis
Registries
Regression Analysis
Risk Factors
Spain
Young Adult

DeCS Terms

Accidentes de tránsito
Análisis multivariante
Análisis de regresión
Ciclismo
Dispositivos de protección de la cabeza
España
Estudios de cohortes
Factores de riesgo
Incidencia
Sistema de registros

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Keywords

bicycling, cyclist, fatality, injuries, risk factor, road crash

Citation

Molina-Soberanes D, Martínez-Ruiz V, Lardelli-Claret P, Pulido-Manzanero J, Martín-delosReyes LM, Moreno-Roldán E, et al. Individual and environmental factors associated with death of cyclists involved in road crashes in Spain: a cohort study. BMJ Open. 2019 Aug 22;9(8):e028039.