Good News from the Trauma Team

When I read about the OHSU Report , I was, of course, alarmed. The researchers’ conclusions:

“Approximately 20% of bicycle commuters experienced a traumatic event and 5% required medical attention during 1 year of commuting. Traumatic events were not related to rider demographics, safety practices, or experience levels.”

But then I actually read the report. And it turns out that the risk of serious injury being incurred while bicycle commuting is actually very small.

First issue: the terminology “traumatic event” actually should read “minor injury.” The author explained in an interview with Sarah Mirk of the Portland Mercury:

MERC: Your study shows that over 20 percent of cyclists experience a “traumatic or serious” injury. What qualified as traumatic?
DR. MAYBERRY: You had to actually be injured. It could just be skinning your knee or spraining your ankle, but it couldn’t just be a near miss.

So we’re talking about bumps and scrapes, like the ones I suffered the other day when I crashed on some railroad tracks. Emotionally, I was a bit shaken, but it passed. By the authors’ terminology, this is a traumatic event.

And herein lies a problem: the word ‘trauma’ has both an emotional and medical interpretation. The first definition of ‘traumatic’ that comes up on google is:

• of or relating to a physical injury or wound to the body
• psychologically painful;”few experiences are more traumatic than losing a child”;
  wordnetweb.princeton.edu/perl/webwn
• trauma – injury: any physical damage to the body caused by violence or accident or fracture etc.
• trauma – an emotional wound or shock often having long-lasting effects

Quite a wide range of trauma there, from a minor physical wound to the utterly devastating emotional loss of a child! So let’s be clear: the authors are using the medical term relating to injuries, and just about any bruise qualifies.

More good news, according to the authors: if we commute by bike to work approximately six miles a day, we’ll experience a minor mishap once every four years. That sounds perfectly reasonable and shouldn’t dissuade anyone from riding a bike for transportation. Shoot, I get injured every few months playing tennis. My son comes home from basketball practice with a scrape or bump pretty much daily. My daughter, who isn’t into sports, regularly manages to injure herself on the playground or in the house.

An average bike commuter that rides six miles a day will experience a minor mishap (bump, scrape, bruise) once every four years.

I wish the researchers had reported their results in comparison to other physical or accident-inducing activities, rather than in a vacuum. Quick research reveals common injury-inducing  activities include cooking (slicing a finger or burning a hand), swimming, getting bit by dogs, and participating in any and all sports.

I conducted a survey in my office of 21 regular bike commuters. The results:

• 69% suffered a minor injury in the last year NOT related to bike commuting;
• 19% had a minor injury related to bike commuting;
• 15% suffered a major injury (requiring medical attention) in the last year NOT related to bike commuting
• 5% had a major injury (requiring medical attention) related to bike commuting.

In other words, people living physically active lives suffer injuries, with bicycle commuting no worse an activity than anything else. And, as confirmed recently by a Dutch study, the benefits far outweigh the risks.

The use of the emotion-laden word ‘trauma’ and context-lacking statistics contribute to a culture of fear about bicycling as a dangerous activity. This fear then suppresses bike use, a real shame considering the extremely high level of individual and societal benefits and the fact that bicycling is actually getting safer. This we know from Portland’s extensive annual analysis of reported bike-motor crashes, which clearly show that the number of crashes is holding steady while the crash rate, due to the increase in cycling, is declining precipitously.

I wonder why the authors jumped to the conclusion that “these results imply that injury prevention should focus on improving the safety of the bicycle commuting environment.” They note that 20% of injuries involved road conditions like gravel, metal plates, and railroad tracks. Ok, I buy that. But what about the remaining 80%? Who/what caused these crashes? Were these all bike commute crashes or did some of the commuters also engage in racing or touring? Were the crashes correlated to speed? Were they at intersections? (I’ve left a message for the authors and hope to hear back soon.) Nevertheless, the City of Portland is indeed focused on improving the physical environment and continually looks for ways to improve safety for all of us. In recent years, this has meant everything from traffic calming to slow motorists, red light running and speeding enforcement, crosswalk violation stings, adding advance bike boxes at intersections, providing safety information truck drivers, distributing bike lights, and encouraging helmet use. Personally, I’d love to see a major crack-down on illegal motorist cell phone use, as statistics reveal this to be one of the most dangerous activities possible, on par with driving drunk.

In sum, the OHSU study helps confirm that the risk of injury is small and far outweighed by the individual and societal health and environmental benefits of bicycle commuting.