Alcohol, bicycling, and head and brain injury: a study of impaired cyclists' riding patterns R1.

OBJECTIVE The aim of the study was to examine the interactions between alcohol, bicycle helmet use, experience level, riding environment, head and brain injury, insurance status, and hospital charges in a medium-sized city without an adult helmet law. METHODS A study of adult bicycle accident victims presenting to a regional trauma center over a 1-year period was undertaken. Data were collected at the bedside regarding helmet use, alcohol use, experience level, location and type of accident and prevailing vehicle speed (for road accidents), and presence and degree of head or brain injury. RESULTS Two hundred patients 18 years or older were enrolled from December 2006 through November 2007. Alcohol use showed a strong correlation with head injury (odds ratio, 3.23; 95% confidence interval, 1.57-6.63; P = .001). Impaired riders were less experienced, less likely to have medical insurance, rarely wore helmets, were more likely to ride at night and in slower speed zones such as city streets, and their hospital charges were double (all P values <.05). CONCLUSIONS Alcohol use leads to a host of unsafe bicycling practices, increased head and brain injuries, and costs to the cyclist and community. The interrelated characteristics of the riding patterns of the cyclists who use alcohol might help target interventions.