Bicycle-related accidents in Rome: Investigating clinical patterns, demographics, injury contexts, and health outcomes for enhanced public safety

INTRODUCTION

This study aims to analyze the clinical characteristics, demographic features, and injury circumstances of patients admitted to the Emergency Department (ED) at Fondazione Policlinico Universitario A. Gemelli (IRCCS) in Rome, Italy, due to bicycle accidents.

METHODS

Data on clinical characteristics, accident timing, injury circumstances, and helmet use were collected for ED patients involved in bicycle accidents from January 2019 to December 2022. Subsequently, Abbreviated Injury Scale codes of all diagnoses were recorded and the Injury Severity Score was calculated.

RESULTS

Over the study period, 763 patients were admitted to the ED following bicycle accidents, with a 0.3 % fatality rate and a 30.4 % frequency of multitrauma. Multivariate analysis revealed that collisions with other vehicles increased trauma severity and the risk of ICU admission. Conversely, helmet use was associated with reduced severity of head trauma and a lower likelihood of ICU admission. Notably, toxicological investigations were not conducted for any ED-admitted patients.

CONCLUSIONS

Although a low mortality rate and a low incidence of multi-trauma have been shown in comparison to other nations, it is necessary to adopt prevention strategies like safety devices, more cycle paths, and better infrastructures on the one hand, and stricter laws on the other. It is essential to require toxicological testing in Italy for all accidents involving this means of transport, and to make helmet use compulsory for all ages.

The combination of e-bike-sharing and demand-responsive transport systems in rural areas: A case study of Velenje

An analysis of the operational characteristics of the transit system serving the town of Velenje (Slovenia) revealed poor performance and the need for improvements. This paper describes the potential integration of an electric bike-sharing system and a semi-flexible demand-responsive transport system to effectively solve this issue. Additionally, general guidance is provided for transit systems with low travel demand. Appropriate transport system schedules are proposed to facilitate customers' use and thus to move demand shares away from private motorized transport. Focus group interviews, implemented to directly involve local stakeholders, revealed an overall positive perception of the proposed transport system. Furthermore, the cost analysis demonstrated that the costs of the new system would not be much higher for the municipality than those currently incurred, making it an important performance improvement achieved at low cost.

Incidence and Profile of Severe Cycling Injuries After Bikeway Infrastructure Changes

The objective of this study was to evaluate whether bicycling infrastructure changes in the city of Minneapolis effectively reduced the incidence or severity of traumatic bicycling related injuries sustained by patients admitted to our Level 1 Trauma Center. Data for this retrospective cohort study was obtained from the trauma database at our institution and retrospective chart review. The total number of miles of bikeway in the city on a yearly basis was used to demonstrate the change in cycling infrastructure. Adjusted regression analysis demonstrated a significant reduction in ISS when total bike lane miles increased (Coef. − 0.04, P < 0.001). Increasing bike lane miles was also associated with a significant reduction in severe head injury (OR 0.99, P < 0.001) and ICU LOS (Coef. − 0.17, P = 0.013). The miles of bike lanes were not associated with any significant changes in mortality or mechanical ventilation days when adjusted for other factors. We were able to demonstrate a reduction in the severity of injuries incurred by cyclists in the setting of a significant increase in the total number of bicycle lane miles. Our data lends credence to the existing evidence that the addition of bicycle lane miles increases cyclist safety.

The long-term impact of restricting cycling and walking during high air pollution days on all-cause mortality: Health impact Assessment study

Regular active commuting, such as cycling and walking to and from the workplace, is associated with lower all-cause mortality through increased physical activity (PA). However, active commuting may increase intake of fine particles (PM_2.5), causing negative health effects. The purpose of this study is to estimate the combined risk of PA and air pollution for all-cause mortality among active commuters who, on days with high PM_2.5 levels, switch to commuting by public transportation or work from home. Towards this purpose, we developed a Health Impact Assessment model for six cities (Helsinki, London, Sao Paulo, Warsaw, Beijing, New Delhi) using daily, city-specific PM_2.5 concentrations. For each city we estimated combined Relative Risk (RR) due to all-cause mortality for the PA benefits and PM_2.5 risks with different thresholds concentrations. Everyday cycling to work resulted in annual all-cause mortality risk reductions ranging from 28 averted deaths per 1000 cyclists (95% confidence interval (CI): 20-38) in Sao Paolo to 12 averted deaths per 1000 cyclists (95% CI: 5-19) in Beijing. Similarly, for everyday walking, the reductions in annual all-cause mortality ranged from 23 averted deaths per 1000 pedestrians (95 CI: 16-31) in Sao Paolo to 10 averted deaths per 1000 pedestrians (95%CI: 5-16) in Beijing. Restricting active commuting during days with PM_2.5 levels above specific air quality thresholds would not decrease all-cause mortality risk in any examined city. On the contrary, all-cause mortality risk would increase if walking and cycling are restricted in days with PM_2.5 concentrations below 150 μg/m³ in highly polluted cities (Beijing, New Delhi). In all six cities, everyday active commuting reduced all-cause mortality when benefits of PA and risk or air pollution were combined. Switching to working from home or using public transport on days with high air pollution is not expected to lead to improved all-cause mortality risks.

Injuries related to bicycle accidents: an epidemiological study in The Netherlands

Background

This study aims to analyze the incidence and outcomes of bicycle-related injuries in hospitalized patients in The Netherlands.

Methods

Bicycle accidents resulting in hospitalization in a level-I trauma center in The Netherlands between 2007 and 2017 were retrospectively identified. We subcategorized data of patients involved in a regular bicycle, race bike, off-road bike or e-bike accident. The primary outcomes were mortality rate and incidence of multitrauma. Secondary outcomes were differences between bicycle subcategories. Independent risk factors were identified using multivariable logistic regression. All variables with a p value < 0.20 in univariable analysis were entered in multivariable analysis.

Results

We identified 1986 patients. The mortality rate after emergency room admission was 5.7%, and 41.0% were multitraumas. A higher age, multitrauma and cerebral haemorrhages were independent risk factors for in hospital mortality. Independent risk factors found for multitrauma were a higher age, two-sided trauma, e-bike accidents and cerebral haemorrhage.

Conclusion

Bicycle accidents resulting in hospitalization have a high mortality rate. Furthermore, a high incidence of multitrauma, fractures and cerebral haemorrhages were found. Considering the increasing incidence of bicycle accident victims needing hospital admission, new and more efficient prevention strategies are essential.

Determinants of pedestrian and bicyclist crash severity by party at fault in San Francisco, CA

Pedestrian and bicyclist safety is of growing concern, especially given the increasing numbers of urban residents choosing to walk and bike. Sharing the roads with automobiles, these road users are particularly vulnerable. An intuitive conceptual model is proposed of the determinants of injury severity in crashes between vehicles and nonmotorized road users. Using 10 years of crash data from San Francisco, CA, we estimate logistic regression models to illuminate key determinants of crash severity for both pedestrian and bicyclist collisions. The analyses are separated by party at fault to test the novel hypothesis that environmental factors affecting driver speed and reaction time may be especially important when the driver is not at fault. Pedestrian results are broadly consistent with prior research, and offer considerable support for this hypothesis. The strongest predictors of injury severity include pedestrian advanced age, driver sobriety, vehicle type, and a set of variables that help determine driver speed and reaction time. Bicyclist results were weaker overall, and the distinction by party at fault was less important.