Despite being less frequent, road cycling accidents result in more serious injuries than mountain biking, according to a new study conducted in a hospital in Barcelona.
The study, which assessed 149 cycling-related emergency care visits, found “injuries from road cycling are less frequent but more severe than those from mountain biking accidents.”
Road cyclists also demonstrated a higher proportion of serious head injuries and severe lesions. One patient from the road cycling group died of a head injury.
The findings, published in Scientific Reports, show that road crashes accounted for 33% of all cases, but had a median Injury Severity Score (ISS) of 6. In comparison, the mountain bike crashes accounted for 67% of all cases and had a median ISS of 4.
The ISS is a scale that was derived from the Abbreviated Injury Scale (AIS) scores, which categorise injuries using a six-point scale based on affected body regions. These regions include the head, face, neck, chest, abdomen, spine, upper extremity, and lower extremity.
The ISS is the sum of the squares of the highest AIS code from each of the three most severely injured body regions.
Road cycling-related accidents recorded a higher percentage of the type of injuries in all places except the upper extremity. Prevalent injury locations were the upper extremity, followed by lower extremity, face, thorax, head, spine, neck and abdomen.
The study also revealed that “age appears to be a significant risk factor in cycling accidents, particularly among road cyclists.” The older the cyclist was, the more likely the injury was to be severe.
The study attributes this to “a longer reaction time, which makes it more difficult to avoid obstacles, bone fragility, acoustic or visual loss or higher presence of pathologies, which can determine the association between age and severe injuries.”
Also, most road and mountain biking injuries in this study resulted from a fall or loss of control, with a total of 71% of accidents.
However, this was higher for mountain bikers, with 79% of accidents being due to falls or loss of control. 30% of the road-cyclist accidents involved a motor vehicle drive
The study assessed patients who went to the Emergency Trauma Department in Parc Tauli Hospital from November 1, 2020, to October 31, 2021. This included a total of 149 cyclists, including 129 men and 18 women (12%), with an average age of 44.8 years.
17 thoughts on “Road cycling causes more serious injuries than mountain biking, new study finds”
‘Road cycling causes more
‘Road cycling causes more serious injuries than mountain biking……’
I’m not sure either cause injuries, perhaps that could be rephrased as ‘Road cycling is associated with more serious injuries…..’
‘Road cyclists also demonstrated a higher proportion of serious head injuries…..’
Yet Spain has a helmet law for riding on the road. The article doesn’t mention whether the higher injury rate for road cyclists was because of collisions with vehicles, and I’m not going to read the whole study to find out.
eburtthebike wrote:
Even that wouldn’t be justified by the study. A more accurate rewrite would be “More serious injuries presenting at hospital are associated with road cycling…”, since incidents that never reported to the hospital aren’t represented in the data. (In practical terms, that probably makes little difference when it comes to the serious injuries, since by nature they have a high likelihood of presenting. For lower severity injuries, though, it’s quite possible that one group is more likely to attend than the other.)
Even letting the reporting issue slide, though, the headline is still misleading, since the study just reports raw numbers of injuries, and doesn’t factor in the base rates of how much of each type of cycling is happening. The implication is that any specific bike ride is more likely to end up in a serious injury if it’s on the road, but if there’s more road cycling to start with, that’s not necessarily true.
Even that wouldn’t be
I’d go a step further because Barcelona isn’t necessarily representative of other places in the world for the amount of road and mountain biking that takes place, hence
“In a study conducted at a single hospital more road cyclists presented with serious injuries than mountain bikers during a single year from Nov 2020-Oct 2021.”
Not very catchy but doesn’t attempt to generalise beyond the scope of the study, which would be speculation and highlights that this was at a time when Covid was having a bearing on how people behaved.
Indeed. Metrics by population
Indeed. Metrics by population are wrong and should be by rider distance travelled, which is harder for the hospital to collect. Obviously not all riders are data lovers, even though cycle computers do that as standard.
Really difficult to get from the recently deceased. So study ethics review probably wouldn’t allow that.
I wonder how much of this is
I wonder how much of this is related to the fact that mountain biking takes place on a more unpredictable surface, so riders are used to lots of smaller stumbles and tumbles and develop the ability to “fall gracefully”?
Add to this that road cyclists are more likely to crash on tarmac, rather than mud, grass etc.
(Mind you, close up views of trees probably feature more in the life of mountain bikers.)
Solo vs multiple vehicle
Solo vs multiple vehicle incident data would be required to get better insight on harms, so crashing alone or with help from another person…
Motorcycle RTIs Alone are a significant proportion because it’s harder than people expect, for example.
I think this is pretty
I think this is pretty obvious to most people, but what might not be is we all have access to roads, we don’t all have access to MTB trails.
Road cycling is easier to work in to daily life, so if we want to encourage people to live a more active lifestyle and produce better health outcomes at a population level, it’s road, and specifically utility cycling that should be promoted over and above MTB. More people on bikes makes the world safer for everyone, including those that do not cycle at all.
If you have a MTB trail that gets you to the supermarket, the Dr’s, school dropoff, grand, but that’s going to be very unlikely for most people!
Indeed. It’s clear that
Indeed. It’s clear that metrics by population are wrong and by rider distance travelled is how to make a fair comparison.
… ideally separated by
… ideally separated by *type* of environment – eg. both “quality separated cycle infra” and “busy stroad” are found in urban environments – only one has a good safety record.
Yes. And distance travelled
Yes. And distance travelled is itself influenced by external factors, including how experienced the cyclist is, how comfortable they are on their regular route etc.
I managed to head-butt the tarmac recently*, in part because I deviated from a route I’m very familiar with to go somewhere I’d only ever travelled as a pedestrian and driver. Going from brilliant sunshine into shade, combined with dithering on the exact route (because I was trying to second guess how best to minimise contact with cars further on), I misjudged a dropped kerb.
Meanwhile, I know exactly where the pinch points, bad potholes, piles of gravel and dropped kerbs are on my regular commute, so I adjust my speed and direction in plenty of time.
Safety per mile travelled is often cited by the aviation industry (and I don’t blame them), but most issues happen at take-off and landing, and the distance between those actions is less relevant. Driving long distances along a motorway is usually safer than doing the same distance on country roads.
* I didn’t need to go to hospital, but it was as hard as I’d like to hit my head without getting properly checked out, and a more cautious person might have done. And without wanting to get into a debate on helmets, I’m certain I would have had to go to the hospital if I’d not been wearing one, or even if I’d been wearing the one I replaced a few months ago, which didn’t have such a good fit.
Well, I have never had a car
Well, I have never had a car or bus pull out onto a roundabout when I’m riding the trails.
I’ve never been left-hooked
I’ve never been left-hooked by a tree, and only once did I get close-passed by a rock. Nature is much more predictable than people
The national road traffic
The national road traffic data already tells us who harms who so a medical study can only provide insight into the harm mechanism that KSI data glosses over, at best.
Since that harm mechanism determines the cost to repair, yet is still not the full cost to those harmed, it might just inform the discussion on road danger.
#PACTS
Is there any indication of
Is there any indication of the background level of road vs MTB cycling? It’s all very well and good looking at cyclists admitted to a hospital and saying that 1/3 are roadies and 2/3 MTBers, but that doesn’t necessarily tell us very much about the frequency of injuries in both groups. For example, what if the hospital is near a major trail centre? Or in a city centre with little opportunity for mountain biking nearby?
AidanR wrote:
In fairness to the authors, they are quite open about the limitations of the study:
It was more a critique of the
It was more a critique of the reporting than the study itself…
On the age correlation, it
On the age correlation, it sounds plausible, but they spend more time discussing other studies results in this regard rather than their own. The only p-value reported is for the small difference between impact of age on MTB vs road. No indication how well the straight lines fit the data – for example there are three older roadies in there that could potentially skew the data on their own – without them, the slope might be flat or even the other way.
As they say, it is interesting, but demonstrates just how hard it is to get convincing results from a small dataset.