The Pump Handle

Study uncovers occupational risks, injury trends among commercial bicyclists

Anyone who’s lived in a big, dense city is familiar with the sight of bicycle messengers weaving their way in between metro buses and taxi cabs, down side streets and around packed crosswalks, pedaling at impressive speeds and often with remarkable agility. Surprisingly, however, there’s little data on these workers, even though it seems they’d be particularly susceptible to injuries on the job.

To fill in that knowledge gap, a group of researchers from New York University School of Medicine and Bellevue Hospital Center decided to take a deeper look. Hypothesizing that those commercial bicyclists represented a distinct group of vulnerable roadway users with a high percentage of minority members, the researchers began analyzing data from a Level 1 trauma center in New York City between 2008 and 2014. Their findings were published in this month’s issue of the American Journal of Public Health (AJPH).

Noting that a comprehensive literature search found only three articles relevant to the topic, researchers Jessica Heyer, Monica Sethi, Stephen Wall, Patricia Ayoung-Chee, Dekeya Slaughter, Sally Jacko, Charles DiMaggio and Spiros Frangos write:

Furthermore, current New York state and city databases do not identify injured bicyclists as commercial or noncommercial. Previous work from our trauma center revealed that 43% of injured bicyclists involved in motor vehicle collisions were commercial. Although commercial bicyclists provide a convenient service in many urban centers, essential information regarding their safety practices, behaviors, and outcomes in the event of injury is lacking.

In examining data on bicyclists injured in motor vehicle-related incidents and who were treated at New York City’s Bellevue Hospital Center, researchers found that of the more than 800 patient bicyclists included in the study, 284 were working at the time of injury and were thus labeled “commercial bicyclists.” Among this group, the researchers uncovered a number of characteristics that could help safety advocates and officials more precisely target injury prevention education and training.

Among the findings, more than 98 percent of injured commercial bicyclists were men, compared with about 76 percent of injured noncommercial bicyclists. Injured commercial bicyclists were more likely to be minority patients, with significantly more Latinos, and were less likely to report English as their primary language. Over the entire study period, commercial bicyclists made up between 24.4 percent and 45.1 percent of injured bicyclists treated at the hospital every year.

According to the study, commercial bicyclists were more likely to sustain an injury from an open car door or in a crash with a taxi. They were less likely to be using an electronic device at the time of injury or have been drinking alcohol. In examining injury data recorded after implementation of a 2012 New York City Department of Transportation safety initiative targeting commercial bicyclists, researchers found that 46 percent of injured commercial bicyclists were wearing helmets, nearly 41 percent were carrying ID cards, and 51 percent were wearing vests showing their employers’ names. A particularly interesting finding — which could speak to the effectiveness of safety education — showed that helmet use among injured commercial bicyclists increased between 2009 and 2014, whereas helmet use did not increase among noncommercial bicyclists.

The study also found that compared to noncommercial bikers, commercial bicyclists were more likely to sustain an injury in the winter, on a wet road and while riding down an avenue. When it came to the injury, commercial bicyclists were less likely to be admitted to the hospital, experienced shorter hospital stays and were less likely to need surgery. In fact, injury severity was greater among noncommercial bicyclists. Also, the researchers found no deaths among commercial bicyclists within the data, while they identified five deaths among noncommercial bicyclists.

In discussing their findings, the researchers noted that in addition to the city’s safety initiatives, commercial bicyclists in New York City are required by law to review a safety course and wear helmets. Their employers are also required to post safety information and ensure bicycles have bells, reflectors, headlights, taillights and working brakes. They write: “Based on all of these initiatives, it is clear that the city views commercial bicyclists as a vulnerable population.”

Still, the AJPH study shines an informative light on which commercial bicyclists are at particular risk and where more enforcement is needed. For example, because the researchers found that 85 percent of the injured commercial bicyclists included in the study were Latino, black or East Asian, relevant and culturally competent safety education is important and should continue. And because nearly half of all crashes among commercial bicyclists involved a taxi, “education campaigns aimed at passengers exiting vehicles should continue, and further insight into this high-risk interaction is warranted,” the study stated.

To request a full copy of the commercial bicyclist study, visit AJPH.

Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for more than a decade.