Emergency Department Visits for Bicycle-Related Traumatic Brain Injuries Among Children and Adults — United States, 2009–2018
Weekly / May 14, 2021 / 70(19);693–697
What is already known about this topic?
Although most persons treated in an emergency department (ED) for a traumatic brain injury (TBI) have a good recovery, some might experience ongoing symptoms that have emotional, cognitive, behavioral, and academic sequelae.
What is added by this report?
During 2009–2018, an estimated 596,972 ED visits for bicycle-related TBIs occurred in the United States. The rate of ED visits for bicycle-related TBIs decreased by approximately one half among children and adolescents aged ≤17 years and by 5.5% among adults during this time. Rates were highest among adult males and children and adolescents aged 10–14 years.
What are the implications for public health practice?
Expanded implementation of comprehensive bicycling safety interventions (e.g., improving compliance with traffic laws, helmet use, and bicycling infrastructure) and targeted interventions might be beneficial.
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Bicycling leads to the highest number of sport and recreation–related emergency department (ED) visits for traumatic brain injuries (TBIs) in the United States (1). Because bicycling continues to grow in popularity,* primarily among U.S. adults, examining the strategies that mitigate the risk for TBI is important. CDC analyzed data from the National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP) to determine the incidence of EDs for bicycle-related TBIs during 2009–2018. An estimated 596,972 ED visits for bicycle-related TBIs occurred in the United States during the study period. Rates of ED visits were highest among adult males (aged ≥18 years) and among children and adolescents aged 10–14 years during 2009–2018. Overall, the rate of ED visits for bicycle-related TBIs decreased by approximately one half (48.7%) among children and by 5.5% among adults. As the number of persons riding bicycles increases, expansion of comprehensive bicycling safety interventions for bicyclists and drivers by states and local communities, such as interventions to increase driver compliance with traffic laws and helmet use among riders, improvements in bicycling infrastructure, and customized interventions for males and other groups at high risk might help reduce bicycle-related injuries.
NEISS-AIP, operated by the U.S. Consumer Product Safety Commission, contains annual data on patients treated in hospital EDs drawn from a nationally representative, stratified probability sample of hospitals,† and weighted by the inverse probability of selection to provide national estimates. This analysis included data on bicycling-related TBIs that occurred among adults aged ≥18 years and children and adolescents (children) aged ≤17 years during 2009–2018. 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. Rates of bicycle-related TBIs per 100,000 population per year were calculated by using U.S. Census Bureau population estimates as the denominator, stratified by sex and age group. Rates and 95% confidence intervals were calculated by using SAS (version 9.4; SAS Institute), accounting for sample weights and the complex survey design. Temporal trends were evaluated by applying the Joinpoint Regression Program (version 126.96.36.199; National Cancer Institute) to the annual rates. Annual percentage change was estimated for each trend segment and considered significantly different from zero for p-values