A new report out today from the Australian Institute of Health and Welfare (read it here) records trends in serious injuries from what they call land transport accidents. It records serious injuries requiring hospitalisation – including life-threatening injuries, but not deaths from road traffic accidents (either at the time or in hospital).
The report contains worrying statistics for male middle-aged cyclists (45-64) – life threatening serious injury for this group of cyclists has tripled between 2001 and 2008, from 83 (around 4 per every 100,000 people in the population) up to 265 (around 10 per 100,000 population). The percentage of all serious injuries that happen to cyclists and motorcyclists in this age group has gone from 30% in 2001 to 50% in 2008 (of that 50%, 17% is cyclist injuries and 33% are motorcyclists injuries). Males aged 25-44 also recorded a significant (though smaller) increase in serious injury – nearly doubling the number of injuries over the same period. Rates for males of all ages are between 4 and 10 times higher than for females.
What can we make of these numbers?
Far fewer females have been involved in a serious road cycling accident requiring hospitalisation than males.
But there is something really important missing from these data (and it’s not the fault of the AIHW...). We have no way of adjusting these numbers to take account of how many people are actually cycling. These are all figures compared to the size of the Australian population. However, if more people are cycling you would expect there would be an increase in the total number of serious injuries. We know (from other surveys, our own eyes & experiences, the interest of the mainstream media and advertisers in cycling, increasing bike sales etc. etc.) that there has been an increase in cycling, especially in the middle-aged male age group. And we know there are many more male cyclists than females. We just don’t know how big any of these numbers actually are.
By comparison, the same report was able to show the injury rates for occupants of cars by the number of car registrations and the motorcycle injury rates by number of motorcycle registrations. When they did this, the trend in motorcycle injuries pretty much disappeared. Motorcyclist injuries were still 8 to 10 times (!!) as common as serious injuries to occupants of cars but over time there hadn’t been any increase in the rates, there were just more motorcycles registered (the report noted registrations had increased faster than population so when they measured the number of km travelled the rates did increase as you would expect, more bikes are going to travel further overall).
I reckon this is problem on a number of levels.
These data highlight a service delivery problem for hospitals and rehabilitation services – they need to treat and manage more middle aged men in particular who are seriously injured. There are obviously knock on effects as these men (on average) are likely to have financial responsibilities and dependents and are likely to be off work for some time as a result of the accident (this is setting aside all of the other results of being injured while riding including the effect on short and long term mental health).
But can they tell us anything about whether the likelihood of being seriously injured has increased or decreased? Well, obviously, you’re more likely to be involved in a cycling accident if you cycle than if you don’t...but we can’t really tell whether cyclists are like motorcyclists, and are much more vulnerable than occupants of cars (though on the face of it this does seem likely).
Without proper numbers it’s very difficult to determine whether there is safety in numbers, or whether improving cycling infrastructure does result in a downward trend in injuries. If we have no count of who is cycling, then if increasing numbers and/or improvements in cycling infrastructure increase the numbers of cyclists on the road we would probably expect to see rates of injuries increase as a percentage of the population.
So could there be an argument for registering bicycles to get some indication of how many people are actually riding? (of course this wouldn’t solve the problem of how often or how far people ride).
And of course, this report doesn’t give us any ideas about the overall cost-benefit of cycling – more people are being serious injured but is this balanced out by improved fitness, cardiovascular health, mental health and wellbeing etc. etc? (by the way this wasn’t the intention of the report)