Alcohol in fatally injured bicyclists

Bicycling injury results in about 580,000 emergency room visits and 900 deaths each year in the United States. Alcohol involvement in bicycling injury has not been well documented in the literature. Using data from the Fatal Accident Reporting System, blood alcohol concentrations (BACs) among fatally injured bicyclists ages 15 years or older were examined for the years 1987-1991. Of 1,711 bicyclists who were killed at age 15 or older and tested for alcohol, 32% were positive and 23% legally intoxicated. Adjusted for age, time of crash, and other variables, male decedents were 3.3 times [95% confidence interval (CI) 2.1, 5.1] as likely as female decedents to be BAC positive, and 3.9 times (95% CI 2.2, 6.8) as likely to be legally intoxicated. Decedents ages 25 to 34 and those who died from nighttime crashes also had significantly increased likelihood of being BAC positive and being legally intoxicated. Even among decedents aged 15-19, who were legally prohibited from drinking, 14% had positive BACs. Further studies are needed to confirm the causal relationship between alcohol use and bicycling injury and to better understand the factors related to drinking and biking. The role of alcohol should be seriously considered in developing strategies of bicycling injury control and prevention.