Bicycling-Related Traumatic Brain Injury (TBI) Study

Bicycling provides an important opportunity for physical activity and is a popular mode for commuting that provides both health and environmental benefits.

There has been an increase in the number of sport- and recreation-related emergency room (ER) visits for traumatic brain injuries (TBIs) in the country as bicycling continues to grow in popularity among American adults.

While patients treated in a ERs for TBI have a good recovery rate of almost 83%, some patients might experience ongoing symptoms that can have emotional, cognitive, behavioral and academic consequences.

A study was conducted by the Centers for Diseases Control and Prevention (CDC) for a period ranging from 2009 to 2018. A case was classified as a TBI if the primary body part injured was the head and the principal diagnosis was concussion or internal organ injury. The study was conducted consistent with applicable federal and CDC policy. Some of its major findings and revelations were as follows:

  • There were an estimated 596,972 visits to the ER for bicycle-related TBIs in the country.
  • Rates of ER visits were highest among males (under age 18) and among children and adolescents (between the ages of 10 and 14).
  • The rate per 100,000 population of ER visits for bicycle-related TBIs decreased by 27.7%, from 18.6% in 2009 to 13.6% in 2018.
  • Over this period, rates of ER visits for bicycle-related TBIs decreased by 48.71% among children and by 5.5% among adults.
  • The decrease in bicycle-related TBIs among children compared to adults during the study period can be associated to more adults bicycling, fewer children bicycling and more adults using roadways to commute to work.
  • The decrease has been facilitated by the implementation of evidence-based policies and intervention by state and local communities, many of which focus on children.
  • The overall decline in rates of bicycle-related TBIs among children can be associated with increased awareness among parents about TBIs and their long-term consequences, too.
  • From 2009 to 2018, the rate of ER visits for bicycle-related TBIs among males of all ages was three times higher than among females.
  • However, bicycle-related deaths among adults increased. In 2018, 857 adult bicyclists died in traffic-related crashes in the United States, the highest figure in two decades.

Findings of the above report have their limitations. Many persons with TBIs seek care in primary care facilities or do not seek care at all. The analysis did not examine differences based on race/ethnicity or socioeconomic status, which can be associated with limited safety infrastructures.


Comprehensive strategies are needed to prevent cyclist deaths and most severe types of injuries. Policies that recommend the use of bicycle helmets have achieved a 20% to 50% reduction in bicycle-related head injuries, but bicycle helmets are not designed to prevent concussions.

To reduce injuries and deaths due to bicycle accidents, a multipronged approach that includes environmental, behavioral and policy intervention, combined with the implementation of helmet use, will be more effective. Building and improving roads with a focus on pedestrian and bicyclist safety by adding bicycle lanes and intersections, increasing compliance with traffic laws, and enhancing lighting on bicycles to improve the visibility of cyclists are other measures that need implementation.

Bicycle safety interventions have had only a small effect on reducing bicycle-related TBIs among adults, and more strategies and measures are needed to protect adult cyclists. Communities need to use social media platforms to run campaigns to enlighten and educate the general public about bicycle injuries, their consequences and bicycle injury prevention. Effective bicycle safety interventions can help ensure that children and adults can reap the benefits of cycling while staying safe from injuries, including TBIs.

Contact A Bicycle Accident Lawyer

If you or your loved one has suffered a TBI in a bicycle accident due to the carelessness or negligence of someone else, you deserve to be duly compensated for the injuries suffered and other damages. Call us, experienced bicycle accident lawyers at Kaire & Heffernan, PLLC, for a free case evaluation right away. Reach out to us by calling 305-376-7860 or contacting us online.