Factors Influencing Injury Severity of Bicyclists Involved in Crashes with Motor Vehicles: Bike Lanes, Alcohol, Lighting, Speed, and Helmet Use

OBJECTIVES: In 2014, 726 bicyclists were killed and an additional 50,000 were injured in crashes with motor vehicles. The number of cyclists in the United States is increasing, and as a result there has been a call for more bike lanes. We examined the difference in the severity of injury of bicyclists involved in motor vehicle crashes when riding in the traffic lane compared with riding in a bike lane or on a paved shoulder. We also controlled for other safety factors, including alcohol use, travel speed, posted speed, helmet usage, and lighting conditions to determine their impact on bicyclist safety. METHODS: Single-year National Automotive Sampling System-General Estimates System files were used to analyze data regarding the bike lanes, and multiyear data were used to analyze the additional factors. Univariate and multiple regression analyses controlling for confounders were performed on the data. RESULTS: < 0.0001). CONCLUSIONS: Our findings suggest that simply having a dedicated space for bicyclists, such as a bike lane or a paved shoulder, does not reduce the severity of injuries sustained when a crash with a motor vehicle takes place. Cyclist safety could be improved by implementing changes that affect vehicle speed, alcohol use by drivers, and lighting conditions. Moreover, emergency physicians should be aware that when they receive a report of a cyclist being struck by a car in a bike lane, they should prepare to treat injuries of severity similar to those received by a bicyclist hit by a vehicle in traffic.