Incidence and costs of bicycle-related traumatic brain injuries in the Netherlands |
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| Affiliation: | 1. Erasmus MC, Department of Public Health, Rotterdam, the Netherlands;2. Consumer and Safety Institute, Research Department, Amsterdam, the Netherlands;1. Department of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas Health Science Center at Houston, School of Public Health in Austin, Austin, Texas;2. Center for Nutrition and Health Science Research, National Institute of Public Health of Mexico, Cuernavaca, Mexico;3. Department of Kinesiology and Health Education, University of Texas at Austin, Austin, Texas;1. International Union of Railways (UIC), Security division, 16 rue Jean Rey, F-75015 Paris, France;2. IFSTTAR, AME, LPC, F-78000 Versailles, France;1. Departments of Paediatrics & Community Health Sciences, Alberta Children’s Hospital Research Institute for Child & Maternal Health, Cumming School of Medicine, University of Calgary, C4-434, Alberta Children’s Hospital, 2888 Shaganappi Trail NW, Calgary, Alberta T3B 6A8, Canada;2. Faculty of Kinesiology and Department of Paediatrics, Cumming School of Medicine, University of Calgary, KNB3300, 2500 University Dr. NW Calgary, Alberta T2N 1N4, Canada;3. Undergraduate Nursing Program, Faculty of Nursing, University of Calgary, 2800 University Way N.W., Calgary, Alberta T2N 1N4, Canada;4. Undergraduate Medical Education Program, Cumming School of Medicine, Health Sciences Centre Foothills Campus, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1, Canada;5. Department of Emergency Medicine & School of Public Health, University of Alberta, 1G1.50 Walter Mackenzie Centre, 8440 - 112 Street, Edmonton, Alberta T6G 2B7, Canada;1. Centre of Study and Research on Road Safety, Section of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy;2. Accident Research Unit, Hannover Medical University, Germany;1. Department of Human Physiology, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Belgium;2. Flemish Institute for Technological Research (VITO), Mol, Belgium;3. Transportation Research Institute (IMOB), Hasselt University, Diepenbeek, Belgium |
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| Abstract: | The main cause of death and serious disability in bicycle accidents is traumatic brain injury (TBI). The aim of this population-based study was to assess the incidence and costs of bicycle-related TBI across various age groups, and in comparison to all bicycle-related injuries, to identify main risk groups for the development of preventive strategies.Data from the National Injury Surveillance System and National Medical Registration were used for all patients with bicycle-related injuries and TBI who visited a Dutch emergency department (ED) between 1998 and 2012. Demographics and national, weighted estimates of injury mechanism, injury severity and costs were analysed per age group. Direct healthcare costs and indirect costs were determined using the incidence-based Dutch Burden of Injury Model.Between 1998 and 2012, the incidence of ED treatments due to bicycle-related TBI strongly increased with 54%, to 43 per 100,000 persons in 2012. However, the incidence of all bicycle-related injuries remained stable, from 444 in 1998 to 456/100,000 in 2012. Incidence of hospital admission increased in both TBI (92%) and all injuries from cycling (71%). Highest increase in incidence of both ED treatments and hospital admissions was seen in adults aged 55+. The injury rate of TBI per kilometre travelled increased (44%) except in children, but decreased (?4%) for all injuries, showing a strong decrease in children (?36%) but an increase in men aged 25+, and women aged 15+. Total costs of bicycle-related TBI were €74.5 million annually. Although bicycle-related TBI accounted for 9% of the incidence of all ED treatments due to cycling, it accounted for 18% of the total costs due to all bicycle-related injuries (€410.7 million). Children and adolescents (aged 0–24) had highest incidence of ED treatments due to bicycle-related injuries. Men in the working population (aged 15–64) had highest indirect costs following injuries from cycling, including TBI. Older cyclists (aged 55+) were identified as main risk group for TBI, as they had highest ED attendance, injury rate, injury severity, admission to hospital or intensive care unit, and costs.Incidence of ED treatments due to cycling are high and often involve TBI, imposing a high burden on individuals and society. Older cyclists aged 55+ were identified as main risk group for TBI to be targeted in preventive strategies, due to their high risk for (serious) injuries and ever-increasing share of ED visits and hospital admissions. |
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| Keywords: | Bicycle Bicycle-related injury Traumatic brain injury Risk groups Prevention |
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