Trauma to adult bicyclists: a growing problem in the urban environment.

The proportion of adults involved in serious bicycle accidents has increased in the last two decades. The majority of the bicycle injury prevention efforts, however, are directed toward child riders. The authors performed a retrospective review of injury statistics from the Massachusetts Hospital Discharge Data Set, 1994-1999, the Massachusetts Emergency Department Injury Surveillance System, 1999, and the trauma registry of an Urban Level I Trauma Centre, 1993-2000. Massachusetts's state-wide injury data reveals a 30% increase in hospital charges between 1994 and 1999 for adults following bicycle falls and collisions with concomitant stability in the charges for children. In the years 1993-2000, 60% of patients requiring inpatient care at the Study Centre for Bicycle Related Injuries were over 16 years of age. Fifty-one percent of patients were without a helmet. Positive blood alcohol tests were present in 35 (16%) of the 222 patients. Forty-six (75%) of patients suffering closed head injury were not helmeted. Adult bicycle trauma is a significant health and financial problem in the urban state of Massachusetts. Bicycle education and legislation emphasising safe bicycling practice, the protective effects of helmets, and the danger of cycling under the influence of alcohol may help alleviate this problem.