Serious Injuries Rise As Older Age Groups Takes Up Cycling

Benjamin N. Breyer MD, MAS, FACS Associate Professor in Residence Department of Urology University of California, San Francisco Chief of Urology, San Francisco General Hospital Director, UCSF Male Genitourinary Reconstruction and Trauma Surgery Fellowship Interview with:
Benjamin N. Breyer MD, MAS, FACS
Associate Professor in Residence
Department of Urology
University of California, San Francisco
Chief of Urology, San Francisco General Hospital
Director, UCSF Male Genitourinary Reconstruction and Trauma Surgery Fellowship


Medical Research: What is the background for this study? What are the main findings?

Dr. Breyer: Our group has studied genitourinary-specific injuries associated with bicycles using a national surveillance injury database called NEISS (National Electronic Injury Surveillance System), that monitors injuries associated with specific products.  In the current study, we examined trends in all bicycle-related injuries from  1997 to 2013.  We found an increase in bicycle-related injuries over the study period, even after adjusting for growth in the US population.  Even more concerning, we found the percentage of bicycle-related injuries resulting in admission increased 120%, suggesting the injuries sustained while cycling are becoming more severe.  These trends appear to be driven by a substantial rise in both injuries and admissions in individuals over 45 years of age, which likely reflects a change in the demographic of cyclists in the US – multiple studies have shown an increase in the cycling participation of adults over the age of 45.

Bicycles are no longer children’s toys – they are increasingly being used by adults as a means of transportation and physical activity. The rise in cycling in adults over the age 45 appears to be driving both the increase in injuries and admissions, suggesting that older individuals are at increased risk for sustaining severe injury while cycling.

Medical Research: What should clinicians and patients take away from your report?

Dr. Breyer: Bicycle riding provides a fantastic way to get exercise that is low impact; it is also can be a great way to commute. Previously, bicycle riding has been associated with reduced mortality and robust general health benefits. We are seeing more older riders get hurt and we’re seeing more head and torso injuries. I think clinicians should encourage bicycle riding but also promote helmet and safety gear usage, also well as safe riding practices.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Breyer: As cyclists in the US shift to an older demographic, greater attention is needed in injury prevention measures through improved infrastructure (e.g. bicyce lanes), personal protective equipment use (e.g. helmets) as well as improved rider/motorist education.

More research is needed to study the costs of bicycle injuries. More research is needed into how we can make bicycle riding more safe, all the way from the bicycle itself, the rider and on a policy level/infrastructure level.


Thomas Sanford, MD et al. Bicycle Trauma Injuries and Hospital Admissions in the United States, 1998-2013. JAMA, September 2015 DOI: 10.1001/jama.2015.8295 is not a forum for the exchange of personal medical information, advice or the promotion of self-destructive behavior (e.g., eating disorders, suicide). While you may freely discuss your troubles, you should not look to the Website for information or advice on such topics. Instead, we recommend that you talk in person with a trusted medical professional.

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