4. Conclusion

The results of this analysis are similar to those identified in other studies around Australia. The rates of bicycle injury hospitalisations and deaths have remained fairly constant in Western Australia over the period 1981 to 1995, in comparison with a marked decrease in vehicle crash and overall injury rates. Bicycle injury rates are measured against the whole population, however, rather than against the cyclist population. If trends in the number of Western Australian cyclists over the study period do not parallel overall changes in the WA population, these results may be misleading. Unfortunately, accurate exposure data for bicycle-riding in Western Australia were not available for this analysis.

Despite a decrease in the number and proportion of head injuries (particularly intracranial injuries) since 1981, they remain the most important type of injury sustained in bicycle crashes. This decrease cannot be linked clearly with the introduction of helmet legislation. Nonetheless, the strong evidence from case-control and experimental studies that the use of bicycle helmets reduces head injury, and that helmet-wearing rose significantly following the introduction of helmet legislation, strongly supports continued mandatory use of bicycle helmets.

The decrease in bicycle-related head injury hospitalisations over the study period seems to have been counter-balanced by a substantial increase in the number of upper limb fractures. This may reflect a reduction in both the frequency and severity of head injuries over time, but not necessarily an increase in the number of upper limb fractures. This analysis has only examined the principal diagnosis associated with each hospital admission. It is possible that previously, cyclists who sustained multiple injuries would more frequently have had a head injury as their main diagnosis, whereas fractured limbs and other injuries would only have been recorded as secondary diagnoses. If the number and severity of head injuries has decreased, other injuries (eg. upper limb fractures) which were previously considered less severe than these head injuries may now be recorded as primary rather than secondary cause of hospital admission. More extensive analysis is required to verify this premise.

The study results suggest that future interventions to reduce serious bicycle injuries should target children aged 5-17 years (especially primary school children) and male cyclists. As the number of bicycle injuries in older cyclists is rising, they too may need to be targeted. Although most serious bicycle injuries involve people from the Perth metropolitan region, the bicycle injury rate in rural areas is increasing steadily, and even surpassed the corresponding metropolitan rate in 1993-95. Furthermore, the great majority of severe bicycle injuries, unless fatal, do not involve a motor vehicle.

Potential counter-measures for reducing bicycle injuries include:

The WA Police, Main Roads WA, Bikewest, RoadWise, the Office of Road Safety, the Education Department and other organisations in Western Australia have been involved with the implementation of bicycle injury prevention strategies in recent years, especially in the area of education and health promotion. An assessment of the effectiveness of these strategies and of other preventive measures should give some indication of how best to reduce the number of bicycle injuries in Western Australia in years to come.

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Last Updated: Wednesday, 21 October 1998 14:25