BICYCLIST AND ENVIRONMENTAL-FACTORS ASSOCIATED WITH FATAL BICYCLE RELATED TRAUMA IN ONTARIO

Objective: To identify bicyclist and environmental factors associated with fatal bicycle-related trauma in Ontario. Design: Retrospective st udy. Setting: Ontario. Participants: Information was extracted from th e provincial coroner's reports on 212 people who had died of bicycle-r elated injuries in Ontario between 1986 and 1991. Outcome measures: Ag e, sex and helmet use of the bicyclist, time and place of the event, t ype of bicyclist or motorist error(s) and use of alcohol by bicyclist or motorist. Results: Only 32% of the deaths involved bicyclists under 15 years of age. The male-female ratio was 3.5. Over 75% of the cases involved head injury; however, only 8 (4%) of the bicyclists had been wearing a helmet. In 91% of the cases death occurred as the result of a bicycle-motor vehicle collision, Most (65%) of the deaths for which the time was known occurred between 4 pm and 8 am. Bicyclist error wa s the main cause of crash for 26 (79%) of the children less than 10 ye ars old; it was also the main cause of crash among the bicyclists aged 10 to 19 years (43 [55%]) and those aged 45 years or more (15 [44%]). However, motorist error was the most common cause of collision in the group of cyclists 20 to 44 years of age (42 [63%]). Alcohol was detec ted in the blood of 7% of the bicyclists killed; alcohol had been cons umed by 30% of the motorists who claimed not to have seen the cyclist. Conclusions: Bicycle-related deaths result from factors that are gene rally avoidable. Identifiable risk Factors other than lack of helmet u se suggest that additional research is required to determine the benef its of preventive interventions aimed at reducing the number of such d eaths. Age-specific strategies appear warranted.