BACKGROUND: The US Consumer Product Safety Commission is considering handlebar regulation regarding impact performance to address the risk of abdominal and pelvic organ injuries in bicyclists. OBJECTIVE: To provide national estimates of incidence and costs of handlebar-related abdominal and pelvic organ injuries. DESIGN AND SETTING: Censuses of hospital discharge data from 19 states were extrapolated to determine national estimates. The percentage of abdominal and pelvic injuries associated with handlebars was estimated based on a case series from a pediatric trauma center. Costs were estimated using standard methods. PARTICIPANTS: All subjects younger than 20 years treated as inpatients and discharged from acute care hospitals for non-motor vehicle bicycle-related injury in 19 states in 1997 and at a pediatric trauma center located in one of the states between January 1, 1996, and December 31, 2000. MAIN OUTCOME MEASURES: Incidence of bicycle-related handlebar abdominal and pelvic organ injury, total hospital charges, lifetime medical payments, lifetime productivity loss, and lifetime monetized quality-adjusted life-years. RESULTS: An estimated 1147 subjects (95% confidence interval, 1082-1215; 1.49 per 100 000 subjects 19 years and younger) in the United States had serious non-motor vehicle-involved bicycle-related abdominal or pelvic organ injury leading to hospitalization in 1997, and 886 (95% confidence interval, 828-944; 1.15 per 100 000 subjects 19 years and younger) of these injuries likely were associated with handlebars. The estimated national costs associated with handlebar-related abdominal and pelvic organ injuries were $9.6 million in total hospital charges, $10.0 million in lifetime medical costs (including claims processing), $11.5 million in lifetime productivity losses, and $503.9 million in lifetime monetized quality-adjusted life-years. CONCLUSIONS: Handlebar-related abdominal and pelvic organ injuries pose a serious health risk to children and result in substantial health care costs. Requirements for safer handlebar designs may provide one avenue to achieve a health and economic benefit.
BACKGROUND: The US Consumer Product Safety Commission is considering handlebar regulation regarding impact performance to address the risk of abdominal and pelvic organ injuries in bicyclists. OBJECTIVE: To provide national estimates of incidence and costs of handlebar-related abdominal and pelvic organ injuries. DESIGN AND SETTING: Censuses of hospital discharge data from 19 states were extrapolated to determine national estimates. The percentage of abdominal and pelvic injuries associated with handlebars was estimated based on a case series from a pediatric trauma center. Costs were estimated using standard methods. PARTICIPANTS: All subjects younger than 20 years treated as inpatients and discharged from acute care hospitals for non-motor vehicle bicycle-related injury in 19 states in 1997 and at a pediatric trauma center located in one of the states between January 1, 1996, and December 31, 2000. MAIN OUTCOME MEASURES: Incidence of bicycle-related handlebar abdominal and pelvic organ injury, total hospital charges, lifetime medical payments, lifetime productivity loss, and lifetime monetized quality-adjusted life-years. RESULTS: An estimated 1147 subjects (95% confidence interval, 1082-1215; 1.49 per 100 000 subjects 19 years and younger) in the United States had serious non-motor vehicle-involved bicycle-related abdominal or pelvic organ injury leading to hospitalization in 1997, and 886 (95% confidence interval, 828-944; 1.15 per 100 000 subjects 19 years and younger) of these injuries likely were associated with handlebars. The estimated national costs associated with handlebar-related abdominal and pelvic organ injuries were $9.6 million in total hospital charges, $10.0 million in lifetime medical costs (including claims processing), $11.5 million in lifetime productivity losses, and $503.9 million in lifetime monetized quality-adjusted life-years. CONCLUSIONS: Handlebar-related abdominal and pelvic organ injuries pose a serious health risk to children and result in substantial health care costs. Requirements for safer handlebar designs may provide one avenue to achieve a health and economic benefit.