Risk and burden of bicycle crash injuries in Iowa and nationwide

Increases in bicycling in the United States result in increased exposure to crashes and injuries. This research focuses on the factors involved in bicycle crashes in the United States and the state of Iowa. Data from the U.S. Nationwide Inpatient Sample and the Iowa Department of Transportation were used to address three aims: 1) estimate the burden and examine the outcomes of bicycle crashes resulting in hospitalizations nationwide by motor vehicle involvement, 2) describe how bicycle motor vehicle (BMV) crashes vary by intersection and non-intersection in Iowa, and 3) identify the impact of on-road bicycle facilities on BMV crashes in Iowa. Using the U.S. Nationwide Inpatient Sample, years 2002-2009, the estimated annual burden of injury from bicycle-related hospitalizations equated to a billion dollars in hospital charges, over 100,000 days in the hospital, and over 34,000 non-routine discharges. We found that bicycling crashes involving motor vehicles had more hospital charges, longer stays, and greater odds of non-routine discharge. We also used the Iowa Department of Transportation crash database, 2001 to 2010, to examine risk factors for BMV crash locations. We found that BMV crashes involve risk factors at person-, crash-, environment-, and population-levels that vary by intersection and non-intersection. Compared to intersections, non-intersection crashes were more likely to involve young bicyclists (0-9 years), locations outside city limits, with driver vision obscured, reduced lighting on the roadway and less likely involve failure to yield