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As More Adults Pedal, Their Biking Injuries And Deaths Spike, Too

The uptick in serious bike injuries occurred for both male and female cyclists, although more men get in accidents each year.
Justin Sullivan
Getty Images
The uptick in serious bike injuries occurred for both male and female cyclists, although more men get in accidents each year.

More adults across the country are strapping on helmets and hopping on bikes to get to work. That's good news for people's hearts and waistlines, but it also means more visits to the emergency room.

Hospital admissions because of bike injuries more than doubled between 1998 and 2013, doctors reported Tuesday in JAMA, the journal of the American Medical Association. And the rise was the biggest with bikers ages 45 and over.

"There are just more people riding and getting injured in that age group. It's definitely striking," says Dr. Benjamin Breyer, who led the study at the University of California, San Francisco.

Another study, published last month in the Morbidity and Mortality Weekly Report, found a similar trend with bicycle deaths: While the death rate among child cyclists has plummeted in the past four decades, the mortality rate among cyclists ages 35 to 54 has tripled.

Breyer isn't sure what's driving the surge in accidents among Generation Xers and baby boomers, but one reason could be what's known as the "Lance Armstrong effect."

"After Lance Armstrong had all of his success at the Tour de France, a lot more people were riding, and there were a lot more older riders that took up the bicycle for sport," he says.

The most recent National Household Travel Survey showed that the vast majority of the increase in bicycling between 1995 and 2009 came from Americans older than 25, with the biggest increases coming in the oldest groups. That has meant more men in their 50s and 60s on road bikes, riding at high speeds, Breyer says — a recipe for serious injuries.

"If you consider a 65-year-old who falls off their bike exactly the same way a 25-year-old does, the 65-year-old is going to sustain more injuries even if they're in great shape," he says.

So what can be done to keep riders in this age group safe?

Basic safety precautions are absolutely essential, Breyer says: Wear a helmet and reflective gear, have lights for night riding, and drive defensively.

But even that might not be enough, says Jason Vargo, who studies urban planning at the University of Wisconsin, Madison and led the recent study on bicycle deaths. He says society also needs to change the definition of what a road is to implicitly include bikers.

Some cities — like Madison, Wis., San Francisco and Portland, Ore. — are starting to do a better job at this.

"They're slowing down speeds on biking routes, adding protective places for cyclists and using different-colored paint," Vargo says.

But at the end of the day, reducing cycling accidents may boil down to something simpler: Making sure that bikers know the rules of the road — and that drivers know how to deal with bikers.

Copyright 2021 NPR. To see more, visit

Corrected: September 3, 2015 at 12:00 AM EDT
An earlier Web version of this story incorrectly stated that Dr. Benjamin Breyer is affiliated with University of San Francisco. He is an associate professor of urology at University of California, San Francisco.
Michaeleen Doucleff, PhD, is a correspondent for NPR's Science Desk. For nearly a decade, she has been reporting for the radio and the web for NPR's global health outlet, Goats and Soda. Doucleff focuses on disease outbreaks, cross-cultural parenting, and women and children's health.
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