Impact of Rising Gasoline Prices on Bicycle Injuries in the United States, 1997-2009

Background: The trend towards higher gasoline prices over the past decade in the U.S. has been associated with higher rates of bicycle use for utilitarian trips. This shift towards non-motorized transportation should be encouraged from a physical activity promotion and sustainability perspective. However, gas-price induced changes in travel behavior may be associated with higher rates of bicycle-related injury. Data are needed to anticipate necessary injury prevention strategies. Methods: Bicycle injury data for adults (16-65 years) were obtained from the National Electronic Injury Surveillance System (NEISS) database for emergency department visits between 1997-2009. The relationship between national seasonally adjusted monthly rates of bicycle injuries, obtained by a seasonal decomposition of time series, and average national gasoline prices, reported by the Energy Information Administration, was examined using a linear regression analysis. Results: Monthly rates of bicycle injuries requiring emergency care among adults increase significantly as gas prices rise (p<0.0001, see Figure). An additional 1,149 adult injuries (95% CI, 963-1,336) can be predicted to occur each month in the U.S. (>13,700 injuries annually) for each $1 rise in average gasoline price. Injury severity also increases during periods of high gas prices, with a higher percentage of injuries requiring admission. Conclusions: Increases in adult bicycle use in response to higher gas prices are accompanied by higher rates of significant bicycle-related injuries. Supporting the use of non-motorized transportation will be imperative to address public health concerns such as obesity and climate change; however, resources must also be dedicated to improve bicycle-related injury care and prevention.