Bicycle riding is one of the most popular recreational activities in the United States. The National Sporting Goods Association (1992) estimates that bicycle riding was the third leading U.S. recreational activity in 1991, after exercise walking and swimming. In addition, bicycle riding is an important means of transportation. The Bicycle Institute of America (1993) estimates that there were about 4.3 million Americans who regularly commuted to work in 1992.
Bicycle riding is also a risky activity, as indicated by the large numbers of injuries and deaths involving bicycles every year. According to the U.S. Consumer Product Safety Commission’s (CPSC) National Electronic Injury Surveillance System (NEISS), an injury reporting system that consists of a statistical sample of the nation’s hospital emergency rooms, there have been about one-half million nonfatal bicycle-related injuries treated in hospital emergency rooms every year since the early 1970s, when NEISS became operational. When other medically-attended injuries are counted, such as injuries treated in physicians’ offices, there may be on the order of one million medically-attended injuries involving bicycles every year. In addition, there are as many as 1,000 bicycle-related fatalities annually. The estimated costs of these injuries and deaths to society are high — approximately $8 billion annually — and suggest that injury reduction strategies with even modest levels of effectiveness could prove to be cost-effective.
The CPSC has long had an interest in bicycle-related hazards and in promoting bicycle safety. The agency began development of a mandatory standard for bicycles as one of its first orders of business in 1973. The bicycle standard, which became effective in 1976,1 set safety requirements for reflectors, wheels and tires, chains, pedals, braking and steering systems, and for structural components such as frames and forks. More recently, the Commission has provided a substantial amount of information on bicycle safety to the public and encourages all riders to use helmets.
Bicycle safety is also promoted by many other governmental and non-governmental organizations, and is of considerable interest to the health and safety research community. In 1991, Congress passed the Intermodal Surface Transportation Efficiency Act (ISTEA), an act that required all states and metropolitan planning organizations incorporate programs and facilities for bicyclists in their transportation plans. Also in 1991, the Department of Transportation’s (DOT) Appropriations Act instructed DOT to develop a plan to promote bicycling and walking, and to enhance the safety of these transportation modes.
The interest of the health and safety community in bicycle safety is evidenced by the large number of professional publications in the safety and medical literature. For the most part, however, the published literature on bicycle hazards consists of injury analyses carried out at the level of the individual hospital or in limited geographical areas. While these studies provide valuable information about injury characteristics in various localities, there has never been a comprehensive national study of bicycle use and hazard patterns designed to quantify riding patterns and the rider and environmental factors associated with risk. Moreover, while injuries resulting from bicycle-motor vehicle collisions have been evaluated extensively (Cross and Fisher, 1977; Roland et al., 1979), little attention has been given to the analysis of bicyclerelated hazard patterns which do not involve motor vehicles, but which do account for the great majority of injuries.
The CPSC bicycle project was intended to remedy some of these data deficiencies by evaluating bicycle use and hazard patterns on a national basis. The remainder of this report provides an overview of the methodology of the bicycle study, and the study findings.