Fatal cyclist crashes in Australia.

OBJECTIVES: The number of casualty road crashes in Australia has steadily reduced over the past few decades; however, a concurrent reduction has not been achieved for crashes involving cyclists. This has resulted in a disproportionate overrepresentation of cyclists in fatal injury statistics. This article explores the contributing factors and injury mechanisms among coronial reported fatal cyclist crashes in Australia.
METHODS: The National Coronial Information System (NCIS) is a remote data entry and retrieval system containing detailed coronial information managed by the Victorian Department of Justice and Regulation. All coroner-reported closed cases involving a cyclist fatality in Australia from 2006 to 2015 were extracted from the database. In total, 336 cases in the NCIS database involving a cyclist fatality that occurred within the road reserve throughout Australia were identified and extracted for analysis. Variables in the analyses included age, gender, mechanism of injury, medical cause of death, time of incident, modes of transport involved, speed limit, road geometry, police narratives, and toxicology reports. The NCIS data were supplemented with spatial information using the geographic coordinates of the crash. Geographic information was utilized to gather information regarding various location characteristics such as speed limits and road geometry. Descriptive analysis techniques were performed on the data to examine key variables. Analyses also included cross-tabulation and Pearson's chi-squared tests (χ2) for comparison of variables collected. All analyses were undertaken at a level of significance (α) of .05. Effect size was assessed using Cramer's V statistic (φc).
RESULTS: The majority of fatal outcome crashes occurred in New South Wales (27.4%), followed by Victoria (25.9%) and Queensland (22.0%), and the majority involved male cyclists aged between 35 and 64 years. Those aged between 18 and 34 years were the next most frequent group of fatally injured cyclists. Helmet use was reported in 62.2% of cases. When reported, 19.6% of cyclists were not wearing a helmet at the time of the incident. The presence of alcohol was detected in 14.6% of postmortem examinations and illicit drugs including tetrahydrocannabinol, opioids, and methamphetamine were identified in 17.6% of cases. Analysis of the road characteristics identified a relatively even split between crashes that occurred in low speed environments (60 km/h and below; 51.2%) and higher speed environments (48.8%). Crash counterparts commonly involved light vehicles (31.3%) and heavy vehicles (38.4%), with approximately one quarter (23.8%) being single-vehicle crashes (i.e., bicycle only). Analyses of injury information identified that cyclists most commonly sustained multiple injuries (38.8%). Injuries to the head (31.3%), chest (4.8%), neck (3.4%), and brain (2.0%) were also commonly reported.
CONCLUSIONS: The findings provide insight into key contributing factors and injury characteristics of fatal cyclist crashes in Australia and can inform and guide the development of effective infrastructure designs and strategies to reduce cyclist trauma.