In our crowded urban environments, cyclists inevitably face significantly higher risks of crash-related deaths than would be faced by the occupant of a motor vehicle. How significant is the risk? Consider these statistics: despite the fact that only 1% of all trips in the United States are reportedly taken by bicycle, data from the CDC reveal that, in 2013 alone, over 900 bicyclists were killed, and an estimated 494,000 visits to the E.R. due to bicycle-related injuries. And data from the Federal Highway Administration (FHWA) indicates that 33% of bicycle crashes with motor vehicles resulted in serious injury or death.

While we often refer to them as “accidents”, a collision between a car and a bicyclist is usually anything but an “accident.” That is, they don’t “just happen”. To the contrary, most collisions occur because of poor decisions or careless actions, such as when a motorist fails to yield. As such, the term “crash” is generally a better word because it doesn’t remove the concept of accountability for what occurred. Unfortunately, in a car vs. bike crash, the solid object into which the cyclist “crashes” is either a 3500 lb. car or the unforgiving pavement. The result of a crash can be VERY severe and, all too often, the result is even life-altering.

Research from the International Research Council on Biomechanics of Injury (IRCBI) indicates that severe injuries happen in about 20% of car-bike crashes, including:

• Head and neck injuries from impact with the car or pavement

• Brain damage

• Deep facial lacerations and bone damage

• Debilitating leg injuries including shattered bones, compound fractures, and severed arteries

• Torso injuries to the chest or abdomen

• Spinal injuries and paralysis

Each crash is unique, and the injuries produced will differ depending on a variety of factors, including the accident location, the speeds at the time of the crash, and the direction that the car and the bike are traveling relative to one another on approach to the accident scene. What type of impact causes the most severe injuries? Frankly, it’s not possible to accurately answer this from the data available, as serious injuries can arise from virtually any crash; even low-speed collisions. However, what is clear is that a cyclist’s injuries frequently give rise to lifelong medical problems including:

• Chronic pain

• Traumatic Arthritis

• Loss of one’s range of motion, and smooth motor function

• Secondary dysfunction caused by altered body mechanics on adjacent structures

• Cognitive disability due to brain injury

• Nerve damage and paralysis

• Long term medical treatment

• Psychological trauma

• Permanent or long term disability

Injuries of this magnitude have dramatic effects on the lives of cyclists and their families. As was discussed in Part 1: How to Reduce the Risk of Bike Accidents, it is very important for cyclists to pay attention to their insurance coverage. When there is a crash, the people involved must generally turn to insurance to cover medical bills and other damages. Depending on state law, one may need to look to a variety of insurance coverage. In a state like New Jersey, one’s primary medical coverage may come from their own auto insurance policy (rather than the “at fault” party’s coverage). The scope of involvement of a motor vehicle and whether or not the other party is insured may call one’s uninsured or “underinsured” motorist coverage into play. Crashes caused by negligent conduct which is not related to the use of a motor vehicle may implicate homeowners/renters insurance. The point is, the scope of coverage or types of coverage available may not always be clear cut. It’s a good idea to consult your insurance agent or an attorney who knows the risks for bicyclists and drivers to ensure adequate protection BEFORE getting on the road. Even if you elect not to follow this advice, bear in mind that low medical limits or high deductibles could make a car vs. bike accident even more costly.

For anyone who may be thinking: “a serious injury won’t happen to me”, consider this: Long term medical issues can also arise from common injuries. The most common injuries in bike crashes include:

• Hand and wrist fractures

• Ligament damage

• Broken collar bones

• Broken ribs & thoracic vertebrae

Each and every one of these “common” injuries can have long term implications. Consider the cyclist who, 10 years after breaking a collar bone in a crash, begins to suffer serious shoulder problems from the altered body mechanics caused by the fracture. Or the cyclist who develops traumatic arthritis years after sustaining what was represented to be a “simple” wrist fracture. The point being: Serious injuries can happen to anyone, and any injury can be serious.

Bicycle crash test studies are being conducted in Europe and the U.S. to help predict injuries and develop new safety equipment. But meaningful safety advances are likely a long way out. Right now the best bet is to act proactively and to do everything to avoid car-bike crashes. Wear a helmet, check bike equipment, be visible, and watch for vehicles that don’t respect the right-of-way rules—especially at intersections.

Part 1: How to Avoid Bike Accidents

Part 2: Types of Injuries from Bike Accidents

Part 3: Bike Crashes and Insurance