A COMPARATIVE-ANALYSIS OF ALCOHOL IN FATAL AND NONFATAL BICYCLING INJURIES

Bicycling is the leading cause of recreational injury, resulting in mo re than half a million emergency department visits and about 900 death s each year in the United States. Previous research on bicycling injur y was conducted predominantly in children and focused on the effective ness of safety helmets. Few studies have examined the role of alcohol in bicycling injuries. This study examined the magnitude of and factor s related to alcohol involvement in fatal and nonfatal bicycling injur ies, and tested the hypothesis that alcohol intoxication is associated with significantly increased likelihood of fatality given a serious b icycling injury. Medical examiner data on all fatally injured bicyclis ts aged 10 years or older from 1987 to 1994 in Maryland (fatal cases, n = 63) were compared with trauma registry data on all injured bicycli sts who were treated at a regional trauma center during the same time period (nonfatal cases, n = 253) on variables related to blood alcohol concentrations (BACs), demographic characteristics, and injury circum stances. The fatal cases were more likely than the nonfatal cases to h ave positive BACs (30% vs. 16%, p < 0.01) and to be legally intoxicate d (i.e., BACs greater than or equal to 0.10%) (22% vs. 13%, p < 0.01). For both fatal and nonfatal cases, intoxication was more prevalent am ong victims who were male, aged 20 to 39 years, or who were injured at nighttime (7:00 PM to 6:59 AM). Bicyclists who died at the scene were four times as likely as those who died at hospitals to be legally int oxicated (35% vs. 9%, p < 0.02). Given a serious bicycling injury, int oxication was associated with significantly increased likelihood of fa tality, with an adjusted odds ratio of 2.8 (95% confidence interval, 1 .3 to 6.3). This increased likelihood of fatality was probably due in part to the fact that the rate of helmet use at the time of injury amo ng the intoxicated was much lower than among the sober (6% vs. 31%, p < 0.05). Results indicate that alcohol plays an important role in fata l and serious bicycling injuries. Preventing intoxicated biking should be incorporated into helmet campaigns and other bicycle safety progra ms.