Bicyclists represent 11% of all on-road injuries in Missouri

In 2004, we compiled statistics from the Missouri Department of Health and Senior Services showing that bicyclists represent 12% of all on-road injuries and fatalities--far higher than the 1.3-1.5% percent injury rate usually quoted. (The 1.3% rate includes only injuries involving moving motor vehicles, missing over 94% of bicycle injuries--see below.)

Seven years later, it's time to take another look at that data.

Here is a summary of bicycle and pedestrian injuries from data collected by the Missouri Department of Health and Senior Services from hospitals across the state:

Missouri DHSS InjuryMICA figures, 1994-2008

                               Number   Percentage
                             ---------  ----------
          TOTAL INJURIES[1] : 1,123,899    100.0%   
     Bicycle injuries[2] :   123,846     11.0%
  Pedestrian injuries[3] :    36,085      3.2%

These results--which are far more comprehensive than the data usually collected by police departments across Missouri and summarized by the Missouri Highway Patrol--show that when ALL on-road bicycle injuries are considered, bicycle injuries comprise 11% of all roadway injuries.

That 11% is a significant percentage from a safety perspective.  It is more than the bicycling mode share (about 0.4% in Missouri), more than the usually quoted figure of 1.3-1.5% of motor vehicle injuries, far more than the 1.5% of our transportation budget spent on bicycle and pedestrian facilities, and it is far more than the percentage of highway safety funds spend on bicycle safety programs.

Nineteen out of twenty bicycle injuries don't involve a motor vehicle directly
One reason these bicycle-related injuries have been largely overlooked so far is that most of them do not involve direct contact with motor vehicles. 

In the years 1994-2008, 7460 bicycle-related injuries involved a motor vehicle.  But 116,386 were on a roadway but with no contact with a motor vehicle, and an additional 554 were off road.  That means 94.4% of bicycle-related injuries in Missouri don't involve contact with a motor vehicle.

Dr. Greg Luttrell has researched this area of bicycle injuries. Luttrell found that, nationwide, about 10% of bicycle crashes are with a motor vehicle and the other 90% are "bike only". 

Bicycle injuries--most easily preventable--cost Missourians $30 million annually
Luttrell also says that "the average out of pocket cost of a bike only crash (not involving a motor vehicle) was over $3,200. Taken nationwide, this results in almost $1.5 billion in annual bike crash costs (again, not including insurance payments)."

Assuming the figure of $3,200 per incident is true in Missouri, bicycle injuries have cost Missourians $396 million since 1994, an average of over $30 million each year.

The sad thing is that so many of these injuries are preventable--with good, safe infrastructure and teaching sensible, nationally established bicycle education skills.

What is being missed?
What type of injuries does the that 94.4% consist of--the injuries missed by Highway Patrol data?

This excludes a broad range of bicycle-related injuries that happen on the road, such as:

  • Bicyclist hits a parallel bar grate, a curb, roadway imperfections, etc., and falls
  • Dooring collisions--where a door of a parked car opens and the bicyclist strikes it
  • Motorist intentionally or unintentionally runs bicyclist off the road, however never physically contacts bicyclist
  • Bicyclist must take evasive action due to motorist, avoids colliding with motorist but still crashes
  • Simple falls, bicycle-bicycle collisions, bicycle-pedestrian collisions, bicycle-dog collisions, bicycle-road debris collisions, etc.
  • Many injuries where a motor vehicle is involved in some way, but which are never reported to police.

Lessons learned?
The conventional view of bicycle-related injuries is that they are small in number and mostly caused by collisions with automobiles.

How does it change our perspective to realize there are many times more injuries than normally considere and only a small minority are caused by collisions with automobiles?

What does the data tell bicyclists, safety advocates, government agencies concerned with roads and safety, and bicycle advocacy organizations?

  • Bicycle-only injuries are common and serious; they require serious and dedicated attention and funding
  • Specifically, a greater percentage of roadway safety funding should be dedicated to bicycle safety programs and education
  • Because many of these injuries involve the bicyclist alone, bicycle education is one key to reducing these injuries. We believe that good bicycle education programs should be universal in our K-12 education system. 
  • Poor facilities--roads and trails--also contribute to these injuries, many of which happen when bicyclists are riding along poorly maintained trails, along the crumbling edge of roads, when encountering drain grates, expansion joints, and debris.
  • Bicyclists are more sensitive to both poor construction and materials (i.e., dangerous drain grates and expansion joints in the road) and poor maintenance (potholes, deteriorated seams and slots in the road). Improving construction and maintenance can improve conditions dramatically.
  • For the bicyclist: Your safety is almost entirely in your own hands.  If you change the way you ride, you can dramatically improve your safety.

Improving the safety of bicyclists and pedestrians is one of the four major goals in MoBikeFed's Vision of Bicycling and Walking in Missouri.

Data source
Data source: Missouri Department of Health and Senior Services InjuryMICA, specifically: Trafficnon-traffic

[1]. Total injuries was calculated by adding the TOTAL from the "Traffic injury statistics" together with the total bicycle non-motor vehicle injuries and the total pedestrian non-motor vehicle injuries from "Bicycle/Ped non-motor vehicle injury statistics". The purpose of this was to include all on-road injuries, whether involving a motor vehicle or not, but to exclude off-road injuries not involving a motor vehicle.

[2] The total from the row labeled "Bicycle: Non-Motor Vehicle" in "Bicycle/Ped non-motor vehicle injury statistics".

[3] The total from the row labeled "Pedestrian: Non-Motor Vehicle" in "Bicycle/Ped non-motor vehicle injury statistics".

[4] Personal email communication with Dr. Greg Luttrell,