• Chih-Wei Pai, Yi-Chu Chen, Hsiao-Yu Lin, and Ping-Ling Chen.
• Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan.
• BMJ Open. 2017 Nov 8; 7 (11): e018574.

IntroductionAccording to official statistics in Taiwan, the main body region of injury causing bicyclist deaths is the head, and bicyclists are 2.6 times more likely to be fatally injured than motorcyclists. There is currently a national helmet law for motorcyclists but not for bicyclists.ObjectivesThe primary aim of this study was to determine whether bicyclist casualties have higher odds of head-related hospitalisation than motorcyclists. This study also aims to investigate the determinants of head injury-related hospitalisation among bicyclists and motorcyclists.MethodsUsing linked data from the National Traffic Accident Dataset and the National Health Insurance Research Database for the period 2003-2012, this study investigates the crash characteristics of bicyclist and motorcyclist casualties presenting to hospitals due to motor vehicle crashes. Head injury-related hospitalisation was used as the study outcome for both road users to evaluate whether various factors (eg, human attributes, road and weather conditions, vehicle characteristics) are related to hospital admission of those who sustained serious injuries.ResultsAmong 1 239 474 bicyclist and motorcyclist casualties, the proportion of bicyclists hospitalised for head injuries was higher than that of motorcyclists (10.0% vs 6.5%). However, the multiple logistic regression model shows that, after adjustment of this result for other factors such as helmet use, bicyclists were 18% significantly less likely to be hospitalised for head injuries than motorcyclists (AOR 0.82, 95% CI 0.79 to 0.85). Other important determinants of head injury-related hospitalisation for bicyclists and motorcyclists include female riders, elderly riders, crashes occurring in rural areas, moped riders, riding unhelmeted, intoxicated bicyclists and motorcyclists, unlicensed motorcyclists, dusk and dawn conditions and single-vehicle crashes.ConclusionsOur finding underscores the importance of helmet use in reducing hospitalisation due to head injuries among bicyclists while current helmet use is relatively low.© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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