Monash University researcher Dr Christina Ekegren is a cyclist who rides to work across Melbourne – around 20 kilometres – every day. She’s never had an accident or collided with a car or suffered major trauma (or death) during her commute. Not yet, anyway. But the alarming new data that she's analysed shows she's one of the lucky ones.
Dr Ekegren, of Monash’s Department of Epidemiology and Preventative Medicine, researched trauma and death in sport and recreation in Victoria with her team from Victorian State Trauma Registry, using data from 2005-2015. They cross-referenced it with changes in participation using Australian Bureau of Statistics numbers.
They found out a lot – but the headline finding was that even taking into account increased participation (that is, more cyclists on the road), death or trauma from cycling has almost doubled in 10 years. In raw numbers there was a 2.3-fold increase of cycling-related major trauma or death, but with increased participation in cycling taken into account it had almost doubled. For a case to be considered major trauma, a patient needs to have been admitted to an intensive care unit or need immediate life-saving surgery.
“This was a very surprising finding,” she said. “However, it's corroborated by national hospital admissions data. The number of cases doubled over time, and as a proportion of all major trauma due to sport it went from 30 per cent of all injuries to 42 per cent of all injuries.”
Dr Ekegren, whose team’s findings were published in The Orthopaedic Journal of Sports Medicine, said most serious injuries in cyclists were after collisions with cars. But she said all types of cyclists – not just commuters – were included in the study because the research wanted to capture all forms of biking. She also said the numbers may have been inflated slightly by participation data “deficiencies” – for example, that participation in an activity isn't separated from the frequency of that participation. So a cyclist who rode a bike once in the 12-month survey period would be considered equal to a five-day-a-week bicycle commuter.
"The increase in traffic and the increase in cyclists has leapt ahead of the infrastructure to protect cyclists, such as properly separated cycle lanes.”
But even accounting for those factors, the numbers are high.
“Normally, increases like this are explained by more people doing the activity,” Dr Ekegren said, “but that wasn’t the whole case here because we took participation into account. So what’s going on?
"The strongest hypothesis in cycling and especially commuter cycling is that there's more traffic on the roads. The increase in traffic and the increase in cyclists has leapt ahead of the infrastructure to protect cyclists, such as properly separated cycle lanes.”
Trauma injuries also rose in motorsports and equestrian sports.
Dr Ekegren said the category of motorsports causing the increase was trail bike (motorbikes) riding, because it's usually done in rural areas and anecdotally with the added factor of alcohol.
Death rates stabilised in cycling, equestrian and motorsports – probably due to improvements in hospital and ambulance trauma care – while the injuries rose.
Trauma and deaths in swimming and diving, power boating, snow and ice sports, aerosports and fishing showed fluctuating results. Football has stayed roughly the same over the 10 years.
Just over half of those studied were women, yet men died or suffered major trauma more often, with males aged 15-24 most at risk over all sports.
In terms of trauma injuries, the thoracic region (ribs) was the most injured, followed by the head and spine. In equestrian, swimming and diving, power boating, snow and ice sports and aerosports, spine injuries were most common.
“Thoracic injuries include rib fractures,” said Dr Ekegren. “They're more common overall, but head injuries can be more serious. Cyclists can also tend to break their collarbones and legs. With fractured ribs, fragments of bone can puncture the lung, which is life-threatening.”
The results of the Monash study go to stakeholders including the Transport Accident Commission and Victorian state government agencies. In the study’s conclusion, the researchers write that further research to understanding “injury mechanisms” is essential.
“Efforts to increase overall physical activity levels [in the community] must be accompanied by investment in making participation safer,” she said.