An exposure based study of crash and injury rates in a cohort of transport and recreational cyclists in New South Wales, Australia

• Exposure-based crash and injury rates were estimated for a large cohort of transport and recreational cyclists.
• Statistical models adjusted for different cyclist characteristics, and for time travelled or infrastructure used.
• Adjusted models found females, less experienced cyclists and transport cyclists at increased risk.

This paper examines self-reported prospectively collected data from 2038 adult transport and recreational cyclists from New South Wales (Australia) to determine exposure-based incident crash and injury rates. During 25,971 days of cycling, 198 crashes were reported, comprising approximately equal numbers of falls and collisions. The overall crash rate was 0.290 (95% CI, 0.264–0.319) per 1000 km or 6.06 (95% CI, 5.52–6.65) per 1000 h of travel. The rate of crashes causing any injury (self-treated, or medically attended without overnight hospital stay) was 0.148 (95% CI, 0.133–0.164) per 1000 km or 3.09 (95% CI, 2.79-3.43) per 1000 h of travel. The rate of crashes causing a medically attended injury (without overnight hospital stay) was 0.023 (95% CI, 0.020–0.027) per 1000 km or 0.49 (95% CI, 0.43-0.56) per 1000 h of travel. No injuries requiring an overnight stay in hospital were reported on days meeting the inclusion criteria. After adjustment for exposure in hours, or for the risks associated with different infrastructure utilisation, the rates of crashes and medically attended injuries were found to be greater for females than males, less experienced than more experienced cyclists, and for those who rode mainly for transport rather than mainly for recreation. Comparison of estimated crash and injury rates on different infrastructure types were limited by the small number of events, however findings suggest that the separation of cyclists from motorised traffic is by itself not sufficient to ensure safe cycling.