Analysis of fatal bicyclists in Shiga Prefecture

Abstract

We conducted retrospective analysis with the aim of helping decrease the number of bicycling fatalities. We reviewed bicycling fatalities recorded in accident records from Shiga Prefecture, Japan, in 2013–2014, broken down by sex, age, cause of death, type of accidents, and situation of death. Obtained results were compared with nationwide data to elucidate characteristics of the accidents in Shiga. Victims were 28 bicyclists（21 male, 7 female ; mean age, 66.9±18.4 years）. Older bicyclists, aged ≥60 years, accounted for 75.0％ of all victims in Shiga, which was similar to the nationwide figure of 72.4％. Head/neck injuries were the most common cause of death in both Shiga（60.6％）and nationwide（68.5％）. In Shiga, motor vehicle–bicycle collisions were the most common type of accident（57.1％）, followed by single-bicycle/individual collisions（39.3％）and train-bicycle collisions（3.6％）. The proportion of motor vehicle-bicycle collisions in Shiga was significantly lower, and of single-bicycle collisions, was considerably higher than in nationwide figures（57.1％ vs. 84.6％, 39.3％ vs. 14.3％, respectively p<0.001）. Deeper analysis of single-bicycle collisions in Shiga found three victims suffered acute health changes while driving. Furthermore, eight victims（72.8％）of such collisions had fallen into a ditch. Among these eight, five were inebriated, with mean blood alcohol concentration of 1.7 ± 0.5 mg/ml. The results led us to recommend the following effective preventive measures against such fatalities: bicyclists should be in sound health, use of helmets should be recommended to protect against severe head injuries, and drunk driving should be monitored and regulated for bicyclists. Furthermore, improving road conditions, such as installing guardrails, covering ditches, and installing streetlights or reflectors, is required. To our knowledge this is the first report to intensively analyze bicycling fatalities in a specific area of Japan, and to subsequently propose effective preventive measures from a medical standpoint.