Crash risk factors for novice motorcycle riders.

BACKGROUND: Motorcycle riders have the highest injury and fatality rates among all road users. This research sought in-depth understanding of crash risk factors to help in developing targeted measures to reduce motorcycle crash injuries and fatalities. METHODS: We used interview data from a study of 2,399 novice motorcycle riders in Victoria, Australia from 2010 to 2012 linked with their police-recorded crash and offence data. The outcome measure was self and/or police reported crash. The association between potential risk factors and crashes was explored in multivariable logistic regression models. RESULTS: In the multivariable analysis, riders who reported being involved in three or more near crashes had 1.74 times (95% CI 1.11-2.74) higher odds of crashing compared to riders who reported no near-crash events, and riders who participated in a pre-learner course had 1.41 times higher odds of crashing (95% CI 1.07-1.87) compared with riders who did not attend a pre-learner course. Riders who had been involved in a crash before the study had 1.58 times (95% CI 1.14-2.19) higher odds of crashing during the study period compared with riders who were not involved in a crash. Each additional month of having held a license and learner permit decreased the odds of crashing by 2%, and each additional 1,000 km of riding before the study increased the odds of crashing by 2%. CONCLUSION: Measures of pre-learner training and riding experience were the strongest predictors of crashing in this cohort of novice motorcycle riders. At the time of the study there was no compulsory rider training to obtain a learner permit in Victoria and no on-road courses were available. It may be plausible that riders who voluntarily participated in an unregulated pre-learner course became or remained at high risk of crash after obtaining a rider license. We suggest systematically reviewing the safety benefits of voluntary versus mandatory pre-learner and learner courses and the potential need to include on-road components.

Could wearing motorcycle protective clothing compromise rider safety in hot weather?

Motorcycle protective clothing (PPE) effectively reduces the risk of injury in crashes, however in hot conditions many motorcyclists ride unprotected. Recent work found available motorcycle PPE to be thermally inefficient in hot weather with potential to cause significant thermal strain under average Australian summer conditions. The current study investigated the potential for the cognitive and psychophysical concomitants of thermal strain to compromise reaction times, mood and fatigue with potential consequences for motorcyclists' safety. METHOD: Volunteers wearing motorcycle PPE participated in a 90 min trial (cycling 30 W) in 35 °C, 40%RH with overhead radiant heaters and a fan to simulate wind speed. Heart rate, core and skin temperature were recorded continuously. Reaction time and subjective ratings of thermal sensation and comfort, workload and mood were recorded at baseline, during rest breaks at 25 min intervals and on completion of the trail. Repeated measures analysis assessed each participant's performance against their own baseline. RESULTS: Core temperatures increased by 2 °C (p < .0001), skin temperatures (3 °C, (p < .0001) and heart rates (66bpm, p < .0001). Reaction times fluctuated 36 ms 8% (p < .0001) over the trial. Subjective workload increased 68% (p = 0.001) and mood deteriorated 33 points (p < .0001) including feeling less alert (p = <.0001), contented (p = 0.001) and calm (p = 0.0004). Multivariate repeated measures analysis found significant associations between core temperature and workload (p = 0.01), mood (p = 0.001) and reaction time (<.0001). Skin temperature and workload (p = 0.02), mood (p = 0.01) and reaction time (<.0001). Subjective ratings of temperature sensation and wetness discomfort were associated respectively with increased workload (p = 0.0001, p = 0.004), mood change (p < .0001, p = 0.04) and reaction time (p < .0001, p < .0001). CONCLUSIONS: The physiological impact of wearing thermally inefficient motorcycle PPE in hot conditions could impair motorcyclists cognitive and psychophysical functioning and, potentially, their riding performance and safety. These outcomes indicate an urgent need for manufacturers to develop motorcycle PPE that is effective and suitable for use, in hot conditions.

Near-miss crashes and other predictors of motorcycle crashes: Findings from a population-based survey.

OBJECTIVE: Crash and injury surveillance studies have identified a range of rider-related factors, including age, sex, licensure, training and experience, as being associated with motorcycle crash risk. The aim of this study was to establish whether these previously identified factors were associated with crash involvement in an Australian-based population. METHODS: Data obtained from motorcyclists recruited from road authority licensing offices in a population-based survey design were analyzed. In addition to descriptive analysis, survey logistic regression was used to examine predictors of self-reported motorcycle crashes. A statewide population prevalence study of motorcyclists in New South Wales, Australia, was conducted using a multistage stratified random sampling plan. Participants (n = 503) represented 47% of eligible riders invited to participate. The distribution of responses was weighted to represent the population based on motorcycle registrations as a proxy for active motorcyclists, adjusted for age, sex, and variations in sample size and population density between survey sites. RESULTS: This analysis investigated factors associated with having crashed in the past 12 months. The key predictors of increased crash risk included frequent near-crash experiences (6-10) in the past year (adjusted odds ratio [ORadj] = 5.3; 95% confidence interval [CI], 1.3-21.8), having 4 or more riding demerit points (ORadj = 4.1; 95% CI, 1.1-14.7), and motorcycle type and riding purpose. Sports (ORadj = 2.8; 95% CI, 1.1-7.3) and commuter motorcycles (ORadj = 4.0; 95% CI, 1.1-15.3) were associated with higher odds of crashes compared to cruiser/touring motorcycles. Those whose purpose for riding frequently involved commuting, high-speed roads, or motorcycle sports had higher odds of being involved in a crash compared to riders who rarely took part in such activities. Rider age, license type, and time holding a motorcycle license were not predictive of crash involvement when other factors were taken into account. CONCLUSIONS: These findings provide important population-level information and insights about risk exposure for motorcyclists. Taking a more tailored approach to data collection meant that factors associated with crash involvement were identified that are not commonly observed in studies relying on administrative data. In particular, the study highlights the importance of near-crash experiences as warnings to riders and the need to use such experiences as learning opportunities to improve their riding style and safety.

Validation of the abrasion resistance test protocols and performance criteria of EN13595: The probability of soft tissue injury to motorcycle riders by abrasion resistance of their clothing.

INTRODUCTION: Motorcyclists represent an increasing proportion of road users globally and are increasingly represented in crash statistics. Soft tissue injuries are the most common type of injuries to crashed motorcyclists. These injuries can be prevented through the use of protective clothing designed for motorcycle use. However, the quality of such clothing is not controlled in many countries around the world. A European Standard was developed to assess the performance of clothing but as this is not mandatory, clothing certified to this Standard is difficult to obtain. Given the importance of this Standard, and that it has been validated only once, further validation work is required. METHODS: In-depth crash investigation data were used to investigate the relationship between the abrasion resistance performance of clothing and real-world injury outcome. Clothing was collected from riders who crashed on public roads in Sydney and Newcastle, Australia. This clothing was tested according to the EU Standard and the time to hole was recorded. Hospital medical records were reviewed and the association between a rider suffering a soft tissue injury and the time-to-hole for the garment was examined. RESULTS: The probability of soft tissue injury for Level 1 Standard garments was between 40-60%, but more than 60% of garments tested failed to meet the minimum requirement. CONCLUSIONS: The findings of this study provide qualified support for the Standard, with a marginal association between time-to-hole and injury being found. PRACTICAL IMPLICATIONS: This work supports the need for improved safety performance and an increased number of high performing garments being available to motorcyclists.

Energy attenuation performance of impact protection worn by motorcyclists in real-world crashes.

OBJECTIVE: Laboratory studies have demonstrated that impact protectors (IP) used in motorcycle clothing can reduce fracture severities. While crash studies have reported IP are associated with reduced likelihood of soft tissue injury, there is little evidence of their effectiveness in reducing fracture likelihood. This discrepancy might be related to IP quality. There are mandatory requirements for IP supplied with protective clothing in Europe, but not elsewhere. This study examines the energy attenuation performance of IP used by Australian riders. METHODS: IP were harvested from clothing worn by crashed riders admitted to hospital. The IP were examined and energy attenuation properties were determined using EN 1621-1 test procedures. Impact injury was identified from medical records and defined as fractures, dislocations, and avulsions that occurred following impact to the rider's shoulders, elbows, hips, and/or knees. Fisher's exact test was used to examine the relationship between meeting the EN 1621-1 energy attenuation requirements and impact injury. The association between the average and maximum transmitted force, and impact injury was examined using generalized estimating equations. Motorcycle riders were recruited as part of an in-depth crash study through three hospitals in New South Wales, Australia, between 2012 and 2014. Riders were interviewed, and engineers conducted site, vehicle, and clothing inspections. Clothing was collected, or identical garments were purchased. RESULTS: Clothing was inspected for 62 riders. Of these, 19 wore clothing incorporating 76 IP. Twenty-six of these were impacted in the crash event. Almost all impacted IP (96%) were CE marked, and most (83%) met Level 1 energy attenuation requirements of EN 1621-1 when tested. Of the 26 impacted IP, four were associated with impact injuries, including midshaft and distal clavicle fractures and a scapula and olecranon fracture. No associations between meeting EN 1621-1 requirements and impact injury were found (p = 0.5). There was no association between average force transmitted and impact injury (95% CI: 0.91-1.24); however, as maximum force transmitted increased, the odds of impact injury increased (95% CI: 1.01-1.2). These results indicate a high probability of impact injury at 50 kN, the limit of maximum transmitted force specified in EN 1621-1. CONCLUSION: The allowable transmitted force of EN 1621-1 may be too high to effectively reduce the probability of impact injury. This is not surprising, given human tolerance levels that are reported in literature. Reducing the force limit below the reported fracture tolerance limits might be difficult with current technology. However, there is scope to reduce the EN 1621-1 maximum limit of 50 kN transmitted force. A reduction in the maximum force limit would improve rider protection and appears feasible, as 77% of tested IP recorded a maximum force <35 kN. This level of transmitted force is estimated to be associated with <20% probability of impact injury. While the performance of IP available to Australian riders is not regulated, most IP was CE marked. The results indicate a significant association between maximum transmitted force, tested according to EN 1621-1 procedures, and impact injury. Further investigation of the EN 1621-1 requirements may be warranted. This work will interest those targeting protective equipment for motorcyclists as a mechanism for reducing injury to these vulnerable road users.

The prevalence of crash risk factors in a population-based study of motorcycle riders.

INTRODUCTION: Motorcyclists represent an increasing proportion of road traffic casualties but, while factors associated with crashes are readily identifiable, little is known about the prevalence of those risk factors in the motorcycling population. METHOD: A stratified random-sampling frame was used to survey the population of registered motorcycles owners in New South Wales (NSW) when they attended motor registry offices. The postal codes in the State database of registered motorcycle were used to stratify the population into quartiles based on socioeconomic characteristics and to determine sample weights. RESULTS: Participants (n=506) represented 47% of eligible riders approached. On average participants were aged 43, rode 7h/week and had 17 years of riding experience. Estimates based on multiple ownership rates suggest motorcycle registration numbers exceed the active riding population by approximately 15%. Less than half rode under 101km/week, 25% rode over 300km/week and just 42% rode every day. More rode frequently for leisure (70%) than for commuting (53%) and over half rarely rode in dark (52%) or wet (67%) conditions. Most wore protective clothing - helmets (100%), jackets (82%), pants (56%), boots (57%) and gloves (73%). Those with traffic infringements (32%) were mostly for driving (25%), not riding (10%) offences. In the past year, 13% had one or more motorcycle crashes including minor spills and 76% one or more near-crash experiences. The youngest riders (15-19) reported the highest rates of exposure in kilometres, hours, frequency of riding and commuting. They also reported lower crash involvement (3%) but more near-crashes (80%). CONCLUSIONS: This study provides an account of the prevalence of key risk factors across age groups in a population of active motorcycle riders in NSW. Novice riders were represented in all age groups although most novices were under 40 years. These data can be used to guide the development of targeted countermeasures aimed at improving motorcycling safety for riders of different age groups.

Does an on-road motorcycle coaching program reduce crashes in novice riders? A randomised control trial.

OBJECTIVES: Motorcycle riding is increasing globally and confers a high risk of crash-related injury and death. There is community demand for investment in rider training programs but no high-quality evidence about its effectiveness in preventing crashes. This randomised trial of an on-road rider coaching program aimed to determine its effectiveness in reducing crashes in novice motorcycle riders. METHODS: Between May 2010 and October 2012, 2399 newly-licensed provisional riders were recruited in Victoria, Australia and completed a telephone interview before randomisation to intervention or control groups. Riders in the intervention group were offered an on-road motorcycle rider coaching program which involved pre-program activities, 4h riding and facilitated discussion in small groups with a riding coach. Outcome measures were collected for all participants via telephone interviews at 3 and 12 months after program delivery (or equivalent for controls), and via linkage to police-recorded crash and offence data. The primary outcome was a composite measure of police-recorded and self-reported crashes; secondary outcomes included traffic offences, near crashes, riding exposure, and riding behaviours and motivations. RESULTS: Follow-up was 89% at 3 months and 88% at 12 months; 60% of the intervention group completed the program. Intention-to-treat analyses conducted in 2014 indicated no effect on crash risk at 3 months (adjusted OR 0.90, 95% CI: 0.65-1.27) or 12 months (adjusted OR 1.00, 95% CI: 0.78-1.29). Riders in the intervention group reported increased riding exposure, speeding behaviours and rider confidence. CONCLUSIONS: There was no evidence that this on-road motorcycle rider coaching program reduced the risk of crash, and we found an increase in crash-related risk factors.

Thermal and cardiovascular strain imposed by motorcycle protective clothing under Australian summer conditions.

Motorcycle protective clothing can be uncomfortably hot during summer, and this experiment was designed to evaluate the physiological significance of that burden. Twelve males participated in four, 90-min trials (cycling 30 W) across three environments (25, 30, 35 °C [all 40% relative humidity]). Clothing was modified between full and minimal injury protection. Both ensembles were tested at 25 °C, with only the more protective ensemble investigated at 30 and 35 °C. At 35 °C, auditory canal temperature rose at 0.02 °C min(-1) (SD 0.005), deviating from all other trials (p < 0.05). The thresholds for moderate (>38.5 °C) and profound hyperthermia (>40.0 °C) were predicted to occur within 105 min (SD 20.6) and 180 min (SD 33.0), respectively. Profound hyperthermia might eventuate in ~10 h at 30 °C, but should not occur at 25 °C. These outcomes demonstrate a need to enhance the heat dissipation capabilities of motorcycle clothing designed for summer use in hot climates, but without compromising impact protection. Practitioner's Summary: Motorcycle protective clothing can be uncomfortably hot during summer. This experiment was designed to evaluate the physiological significance of this burden across climatic states. In the heat, moderate (>38.5 °C) and profound hyperthermia (>40.0 °C) were predicted to occur within 105 and 180 min, respectively.

Cyclists' clothing and reduced risk of injury in crashes.

INTRODUCTION: A majority of cyclists' hospital presentations involve relatively minor soft tissue injuries. This study investigated the role of clothing in reducing the risk of cyclists' injuries in crashes. METHODS: Adult cyclists were recruited and interviewed through hospital emergency departments in the Australian Capital Territory. This paper focuses on 202 who had crashed in transport related areas. Eligible participants were interviewed and their self-reported injuries corroborated with medical records. The association between clothing worn and injury was examined using logistic regression while controlling for potential confounders of injury. RESULTS: A high proportion of participants were wearing helmets (89%) and full cover footwear (93%). Fewer wore long sleeved tops (43%), long pants (33%), full cover gloves (14%) or conspicuity aids (34%). The primary cause of injury for the majority of participants (76%) was impact with the ground. Increased likelihood of arm injuries (Adj. OR=2.06, 95%CI: 1.02-4.18, p=0.05) and leg injuries (Adj. OR=3.37, 95%CI: 1.42-7.96, p=0.01) were associated with wearing short rather than long sleeves and pants. Open footwear was associated with increased risk of foot or ankle injuries (Adj. OR=6.21, 95%CI: 1.58-23.56, p=0.01) compared to enclosed shoes. Bare hands were associated with increased likelihood of cuts, lacerations or abrasion injuries (Adj. OR=4.62, 95%CI: 1.23-17.43, p=0.02) compared to wearing full cover gloves. There were no significant differences by fabric types such as Lycra/synthetic, natural fiber or leather. CONCLUSIONS: Clothing that fully covers a cyclist's body substantially reduced the risk of injuries in a crash. Coverage of skin was more important than fabric type. Further work is necessary to determine if targeted campaigns can improve cyclists' clothing choices and whether impact protection can further reduce injury risk.

Detailed analysis of pedestrian casualty collisions in Victoria, Australia.

OBJECTIVE: Pedestrian road trauma is significant in Australia and requires in-depth understanding to improve or inform new countermeasures. Analyses on single data sources can be limited. This study investigated demographic, behavioral, environmental, and collision characteristics of pedestrian injury in Victoria, Australia, over a 5-year period using multiple data sources. METHODS: Victorian state police, hospital presentation, hospital admission, and coronial data sets were analyzed and compared for the years 2004 to 2008. RESULTS: Analyses identified 3,702 police-recorded pedestrian casualties (deaths and injuries, of which 256 were deaths), 5,008 pedestrian traffic-related hospital presentations, and 2,802 pedestrian admissions. Trend analyses showed significant increases in police casualty and hospitalization rates per 100,000 population. Age groups most commonly involved were those aged 18-24 especially on weekends, 75+ especially on weekday days, and 13- to 17-year-olds especially at school commute times. Proportionally more cases were male in all data sets. One quarter of coroner-examined deaths involved alcohol and one third involved drugs. Two thirds of police-recorded casualties occurred on weekdays, and 45% of weekend casualties occurred at night. Most casualties occurred in urban areas (95%), in lower-speed zones (78%); however, 79% of rural casualties occurred in high-speed zones, of which more were fatal. Over half did not occur at intersections. The most common injuries were fractures as well as multiple injuries, which together with intracranial injuries, were most common among fatalities (50 and 34%, respectively). Serious injury was more likely in older pedestrians, in males, in rural areas, in 60-80 km/h zones, in areas with poor lighting, while crossing a carriageway, not at an intersection, and when struck by a heavy vehicle. CONCLUSIONS: Findings indicate pedestrian serious injury rates are increasing and identify targets for countermeasures. Inherent limitations present in each relevant data collection require mutliple data sets to be explored and results contrasted. Jurisdictions seeking to determine pedestrian injury risk factors should aim to link police and hospital data for a complete analysis.

Validation of the principles of injury risk zones for motorcycle protective clothing.

INTRODUCTION: The distributions of motorcycle crash impacts and injuries were compared to the four impact risk zones and protective performance specified in the European Standard for motorcycle clothing (EN 13595). METHODS: Crashed motorcyclists' (n=117) injuries and clothing damage were categorized by body area into the four risk zones. Three levels of protection were defined: protective clothing with impact protection, protective clothing only and non-protective clothing. RESULTS: The distribution of impact/injury sites corresponded to the predictions of EN 13595, with the proportion of all injuries decreasing from 43.9% in Zone 1, to 18.0%, 16.7%, and 11.5% in Zones 2 to 4, respectively. Protective clothing modified the distribution of injuries with substantially more injuries (OR=2.69, 95% CL: 20.1-3.59) at unprotected impact sites. PRACTICAL APPLICATION: These findings support an appropriate framework for determining performance specifications for the manufacture of motorcycle clothing that will effectively reduce the risk of injury in crashes.

Distribution and type of crash damage to motorcyclists' clothing: validation of the zone approach in the European Standard for motorcycle protective clothing, EN13595.

OBJECTIVE: Though the use of protective clothing reduces the risk of injury for motorcycle riders, not all protective clothing performs the same in crashes. A European Standard for motorcycle protective clothing (EN13595) was released in 2002 that specifies 4 zones in motorcycle clothing with different levels of protective qualities and 4 different test methods for assessing damage resistance. This project examined damage location and type in clothing worn by riders following a crash to establish the distribution of impact points and validate the zones described in EN13595. METHOD: Data from 117 crashed motorcycle riders collected during crash investigation were examined. These data included medical data and clothing inspections and contained 576 cases of clothing damage. To ensure that the impact point distribution included all possible contact locations, an additional 433 distinct injury locations were examined where injury had occurred but clothing was either undamaged or not present at that location. Descriptive techniques were used in the analysis. RESULTS: The majority of damage occurred in areas covering the extremities or pelvic girdle (93%), with most occurring on the wrists and hands (18%) and ankles and feet (18%). Clothing regions covering the shoulder (10%), forearm (10%), elbow (9%), thigh (7%), lower leg (6%), and pelvic-hip region (5%) were also frequently damaged. Other body regions contributed only 8 percent of damage seen. Analysis of distinct injury locations demonstrated a similar distribution of impact. The most common types of clothing damage were abrasion, accounting for 69 percent, and torn material, which accounted for 26 percent of all damage. Further, the majority of material abrasion and tearing occurred in regions corresponding to zone 1, followed by zones 2, 3, and then 4. There were very few instances (3%) of burst and cut damage. CONCLUSIONS: The results are in agreement with the general concept of the zones used in the EU Standard. However, these results indicate that minor adjustments may be warranted. In particular, the number of impacts to the forearm and lower leg suggest that these regions might be better protected by considering the whole regions as zone 1or 2 rather than the multiple regions as currently indicated in the EU Standard. However, the subjective nature of determining the zone in which damage (and/or injury) occurred limits these findings and any others that attempt to validate the zone principles using real-world data. Further validation requires consideration of the severity of impact at different zones.

The use of self-report exposure measures among novice motorcyclists: appropriateness and best practice recommendations.

OBJECTIVES: While self-report methods to collect exposure information have large practical advantages in many research contexts, little research has specifically investigated the reliability and validity of motorcyclists' self-reported exposure. The present study aimed to examine the reliability and validity of different self-report exposure measures and to provide recommendations on best practice self-report riding exposure questions. METHODS: The reliability and validity of different self-report exposure measures were examined amongst novice motorcyclists through t-tests, Bland Altman plots, coefficients of variation, and correlations. RESULTS: The most valid and reliable data was provided when riding exposure was asked for the current average week rather than earlier and longer periods, and in units of time rather than distance or number of trips. The greater reliability of riding exposure found amongst commuting and rural riders compared to recreational and metropolitan riders respectively and at the second interview compared to the first suggests that factors such as riding purposes, geographical locations, and riding experience can contribute to measurement error. CONCLUSIONS: If self-reported odometer readings are used, questions on whether the respondents share their own bike or ride more than one bike, and a built-in process to ensure respondents report the exact odometer reading on their bike are recommended. It is recommended that self-report riding exposure questions ask about the hours of riding for the current average week, and data on riding purposes, locations, and experience are also collected.

Bicycle crashes in different riding environments in the Australian capital territory.

INTRODUCTION: Cyclists are increasingly overrepresented in traffic crash casualties in Australia. There is evidence that better cycling infrastructure increases participation, but whether it reduces the numbers of injured cyclists is less clear. This study examined injury outcomes of crashes in different cycling environments. METHODS: Adult cyclists injured on- and off-road were recruited from emergency departments from November 2009 to May 2010 in the Australian Capital Territory. Eligible participants (n = 313/372, 84.1%) were interviewed and their injury self-reports were corroborated with medical records where available. Participants who had crashed in transport-related areas (n = 202, 64.5%) are the focus of this article. RESULTS: Participants had crashed in traffic (39.1%), in cycle lanes (7.9%), on shared paths (36.1%), and on footpaths (16.8%). Based on average weekly traffic counts, the crash involvement rate per 1000 cyclists was 11.8 on shared paths compared to 5.8 on cycle lanes. Over half of the participants (52.0%) were injured in single-vehicle bicycle crashes. The remainder involved other road users, including motor vehicles (20.8%), other bicycles (18.8%), pedestrians (6.4%), and animals (2.0%). Pedestrians were involved in 16.4 percent of crashes on shared paths. Minor injuries (Abbreviated Injury Scale [AIS] 1) were sustained by 58.4 percent of cyclists, moderately severe injuries (AIS 2) were sustained by 36.1 percent of cyclists, and 5.4 percent of cyclists were seriously injured (AIS 3+). The average treatment required was 1.8 days with 7.5 days off work and cost to the cyclist of $869 excluding medical treatment. Cyclists who crashed on shared paths or in traffic had higher injury severity scores (ISS; 4.4, 4.0) compared to those in cycle lanes or on footpaths (3.3, 3.4) and required more treatment days (2.8, 1.7 versus 0.0, 0.2). CONCLUSIONS: Fewer cyclists were injured in on-road cycle lanes than in other cycling environments, and a high proportion of injuries were incurred on shared paths. This study highlights an urgent need to determine appropriate criteria and management strategies for paths classified as suitable for shared or segregated usage. Supplemental materials are available for this article. Go to the publisher's online edition of Traffic Injury Prevention to view the supplemental files.

Single- versus multi-vehicle bicycle road crashes in Victoria, Australia.

The aim of the study is to compare trends, circumstances and outcomes of single- versus multi-vehicle bicycle on-road crashes in Victoria, Australia, through the analysis of police records and hospital admissions between January 2004 and December 2008. The results show that over 80% of on-road single-vehicle bicycle crashes occurred as a result of the cyclist losing control of the bicycle with the remainder involving collisions with objects. Compared with multi-vehicle crashes, single-vehicle crashes were more likely to occur in the dark, in wet conditions and in rural areas. Over half of the cyclists hospitalised as result of on-road crashes were injured in single-vehicle crashes and this proportion seems to be increasing over time. Single-vehicle crashes were associated with hospitalised injuries as severe as those resulting from multivehicle crashes. The findings highlight the significant burden of serious injury associated with single-vehicle bicycle road crashes. Further research is needed to investigate in greater detail the risk factors of these crashes and the effectiveness of countermeasures to reduce their burden.

Risk factors for severe injury in cyclists involved in traffic crashes in Victoria, Australia.

This study examines the impact of cyclist, road and crash characteristics on the injury severity of cyclists involved in traffic crashes reported to the police in Victoria, Australia between 2004 and 2008. Logistic regression analysis was carried out to identify predictors of severe injury (serious injury and fatality) in cyclist crashes reported to the police. There were 6432 cyclist crashes reported to the police in Victoria between 2004 and 2008 with 2181 (33.9%) resulting in severe injury of the cyclist involved. The multivariate analysis found that factors that increase the risk of severe injury in cyclists involved in traffic crashes were age (50 years and older), not wearing a helmet, riding in the dark on unlit roads, riding on roads zoned 70 km/h or above, on curved sections of the road, in rural locations and being involved in head-on collisions as well as off path crashes, which include losing control of vehicle, and on path crashes which include striking the door of a parked vehicle. While this study did not test effectiveness of preventative measures, policy makers should consider implementation of programs that address these risk factors including helmet programs and environmental modifications such as speed reduction on roads that are frequented by cyclists.

Motorcycle protective clothing: protection from injury or just the weather?

BACKGROUND: Apart from helmets, little is known about the effectiveness of motorcycle protective clothing in reducing injuries in crashes. The study aimed to quantify the association between usage of motorcycle clothing and injury in crashes. METHODS AND FINDINGS: Cross-sectional analytic study. Crashed motorcyclists (n=212, 71% of identified eligible cases) were recruited through hospitals and motorcycle repair services. Data was obtained through structured face-to-face interviews. The main outcome was hospitalization and motorcycle crash-related injury. Poisson regression was used to estimate relative risk (RR) and 95% confidence intervals for injury adjusting for potential confounders. RESULTS: Motorcyclists were significantly less likely to be admitted to hospital if they crashed wearing motorcycle jackets (RR=0.79, 95% CI: 0.69-0.91), pants (RR=0.49, 95% CI: 0.25-0.94), or gloves (RR=0.41, 95% CI: 0.26-0.66). When garments included fitted body armour there was a significantly reduced risk of injury to the upper body (RR=0.77, 95% CI: 0.66-0.89), hands and wrists (RR=0.55, 95% CI: 0.38-0.81), legs (RR=0.60, 95% CI: 0.40-0.90), feet and ankles (RR=0.54, 95% CI: 0.35-0.83). Non-motorcycle boots were also associated with a reduced risk of injury compared to shoes or joggers (RR=0.46, 95% CI: 0.28-0.75). No association between use of body armour and risk of fracture injuries was detected. A substantial proportion of motorcycle designed gloves (25.7%), jackets (29.7%) and pants (28.1%) were assessed to have failed due to material damage in the crash. CONCLUSIONS: Motorcycle protective clothing is associated with reduced risk and severity of crash related injury and hospitalization, particularly when fitted with body armour. The proportion of clothing items that failed under crash conditions indicates a need for improved quality control. While mandating usage of protective clothing is not recommended, consideration could be given to providing incentives for usage of protective clothing, such as tax exemptions for safety gear, health insurance premium reductions and rebates.

Novice riders and the predictors of riding without motorcycle protective clothing.

BACKGROUND: While helmet usage is often mandated, few motorcycle and scooter riders make full use of protection for the rest of the body. Little is known about the factors associated with riders' usage or non-usage of protective clothing. METHODS: Novice riders were surveyed prior to their provisional licence test in NSW, Australia. Questions related to usage and beliefs about protective clothing, riding experience and exposure, risk taking and demographic details. Multivariable Poisson regression models were used to identify factors associated with two measures of usage, comparing those who sometimes vs rarely/never rode unprotected and who usually wore non-motorcycle pants vs motorcycle pants. RESULTS: Ninety-four percent of eligible riders participated and usable data was obtained from 66% (n=776). Factors significantly associated with riding unprotected were: youth (17-25 years) (RR = 2.00, 95% CI: 1.50-2.65), not seeking protective clothing information (RR = 1.29, 95% CI = 1.07-1.56), non-usage in hot weather (RR = 3.01, 95% CI: 2.38-3.82), awareness of social pressure to wear more protection (RR = 1.48, 95% CI: 1.12-1.95), scepticism about protective benefits (RR = 2.00, 95% CI: 1.22-3.28) and riding a scooter vs any type of motorcycle. A similar cluster of factors including youth (RR = 1.17, 95% CI: 1.04-1.32), social pressure (RR = 1.32, 95% CI: 1.16-1.50), hot weather (RR = 1.30, 95% CI: 1.19-1.41) and scooter vs motorcycles were also associated with wearing non-motorcycle pants. There was no evidence of an association between use of protective clothing and other indicators of risk taking behaviour. CONCLUSIONS: Factors strongly associated with non-use of protective clothing include not having sought information about protective clothing and not believing in its injury reduction value. Interventions to increase use may therefore need to focus on development of credible information sources about crash risk and the benefits of protective clothing. Further work is required to develop motorcycle protective clothing suitable for hot climates.