ArticleBMJ open2019
Individual and environmental factors associated with death of cyclists involved in road crashes in Spain: a cohort study.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
4 citing papers in PubMed.
- Hospitalizations After Bicycle Accidents: Injury Patterns, Severity and Costs.International journal of environmental research and public health · 2026Observational
- The impact of slow mobility and built environment characteristics on 12.5-year all-cause mortality among older women and men: A prospective cohort study from Poland.SSM - population health · 2025Article
- Severe and Fatal Cycling Crash Injury in Britain: Time to Make Urban Cycling Safer.Journal of urban health : bulletin of the New York Academy of Medicine · 2022Article
- Cycling area can be a confounder and effect modifier of the association between helmet use and cyclists' risk of death after a crash.Scientific reports · 2022Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo quantify the magnitude of associations between cyclist fatalities and both cyclist and environment related characteristics in Spain during the first 24 hours after a crash.
designCohort study.
settingSpain.
participants65 977 cyclists injured in road crashes recorded between 1993 and 2013 in the Spanish Register of Road Crashes with Victims. MAIN OUTCOME: Death within the first 24 hours after the crash.
methodsA multiple imputation procedure was used to mitigate the effect of missing values. Differences between regions were assumed and managed with multilevel analysis at the cyclist and province levels. Incidence density ratios (IDR) with 95% CI were calculated with a multivariate Poisson model.
resultsNon-use of a helmet was directly associated with death (IDR 1.43, 95% CI 1.25 to 1.64). Among other cyclist characteristics, age after the third decade of life was also directly associated with death, especially in older cyclists ('over 74' category, IDR 4.61, 95% CI 3.49 to 6.08). The association with death did not differ between work-related cycling and other reasons for cycling.There was an inverse association with death for crashes in urban areas and on community roads. Any adverse meteorological condition also showed a direct association with death, whereas altered road surfaces showed an inverse association. Crashes during nighttime were directly associated with death, with a peak between 3:00 and 5:59 am (IDR 1.58, 95% CI 1.03 to 2.41).
conclusionsWe found strong direct and inverse associations between several cyclist and environment related variables and death. These variables should be considered in efforts to prioritise public health measures aimed at reducing the number of cycling-related fatalities.
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