{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T07:59:42Z","timestamp":1791273582059,"version":"4.1.0"},"reference-count":36,"publisher":"BMJ","issue":"11","funder":[{"name":"Health Promotion Administration, Ministry of Health and Welfare, Executive Yuan, Taiwan"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,10,13]]},"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>According to official statistics in Taiwan, the main body region of injury causing bicyclist deaths is the head, and bicyclists are 2.6 times more likely to be fatally injured than motorcyclists. There is currently a national helmet law for motorcyclists but not for bicyclists.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The primary aim of this study was to determine whether bicyclist casualties have higher odds of head-related hospitalisation than motorcyclists. This study also aims to investigate the determinants of head injury-related hospitalisation among bicyclists and motorcyclists.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using linked data from the National Traffic Accident Dataset and the National Health Insurance Research Database for the period 2003\u20132012, this study investigates the crash characteristics of bicyclist and motorcyclist casualties presenting to hospitals due to motor vehicle crashes. Head injury-related hospitalisation was used as the study outcome for both road users to evaluate whether various factors (eg, human attributes, road and weather conditions, vehicle characteristics) are related to hospital admission of those who sustained serious injuries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 1 239 474 bicyclist and motorcyclist casualties, the proportion of bicyclists hospitalised for head injuries was higher than that of motorcyclists (10.0% vs 6.5%). However, the multiple logistic regression model shows that, after adjustment of this result for other factors such as helmet use, bicyclists were 18% significantly less likely to be hospitalised for head injuries than motorcyclists (AOR 0.82, 95% CI 0.79 to 0.85). Other important determinants of head injury-related hospitalisation for bicyclists and motorcyclists include female riders, elderly riders, crashes occurring in rural areas, moped riders, riding unhelmeted, intoxicated bicyclists and motorcyclists, unlicensed motorcyclists, dusk and dawn conditions and single-vehicle crashes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our finding underscores the importance of helmet use in reducing hospitalisation due to head injuries among bicyclists while current helmet use is relatively low.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-018574","type":"journal-article","created":{"date-parts":[[2017,11,9]],"date-time":"2017-11-09T01:05:32Z","timestamp":1510189532000},"page":"e018574","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["A population-based case-control study of hospitalisation due to head injuries among bicyclists and motorcyclists in Taiwan"],"prefix":"10.1136","volume":"7","author":[{"given":"Chih-Wei","family":"Pai","sequence":"first","affiliation":[{"name":"Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Chu","family":"Chen","sequence":"additional","affiliation":[{"name":"Graduate Institute of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsiao-Yu","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Urology, Taipei Medical University Hospital, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping-Ling","family":"Chen","sequence":"additional","affiliation":[{"name":"Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,11,8]]},"reference":[{"key":"2025121223122660000_7.11.e018574.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0001-4575(03)00062-9"},{"key":"2025121223122660000_7.11.e018574.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsr.2008.07.001"},{"key":"2025121223122660000_7.11.e018574.3","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1016\/j.amepre.2016.11.030","article-title":"Universal motorcycle helmet laws to reduce injuries: a community guide systematic review","volume":"52","author":"Peng","year":"2017","journal-title":"Am J Prev Med"},{"key":"2025121223122660000_7.11.e018574.4","unstructured":"Chen PL . Statistics for injury surveillance\u00a0Health Promotion Administration: Ministry of Health and Welfare, 2015."},{"key":"2025121223122660000_7.11.e018574.5","unstructured":"Ministry of Transportation and Communications. Traffic statistics of year 2014. Republic of China, 2015."},{"key":"2025121223122660000_7.11.e018574.6","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.987"},{"key":"2025121223122660000_7.11.e018574.7","doi-asserted-by":"publisher","DOI":"10.1016\/S0001-4575(01)00102-6"},{"key":"2025121223122660000_7.11.e018574.8","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/0001-4575(84)90009-5","article-title":"Fatal motorcycle accidents and helmet laws in Peninsular Malaysia","volume":"16","author":"Supramaniam","year":"1984","journal-title":"Accid Anal Prev"},{"key":"2025121223122660000_7.11.e018574.9","doi-asserted-by":"publisher","DOI":"10.1080\/15389580903497121"},{"key":"2025121223122660000_7.11.e018574.10","doi-asserted-by":"publisher","DOI":"10.1136\/ip.9.3.257"},{"key":"2025121223122660000_7.11.e018574.11","doi-asserted-by":"publisher","DOI":"10.1136\/ip.2011.031815"},{"key":"2025121223122660000_7.11.e018574.12","doi-asserted-by":"publisher","DOI":"10.1016\/S0001-4575(00)00048-8"},{"key":"2025121223122660000_7.11.e018574.13","first-page":"60-9","article-title":"Evaluation of New Zealand\u2019s bicycle helmet law","volume":"125","author":"Clarke","year":"2012","journal-title":"N Z Med J"},{"key":"2025121223122660000_7.11.e018574.14","first-page":"CD005401","article-title":"Bicycle helmet legislation for the uptake of helmet use and prevention of head injuries","volume":"2","author":"Macpherson","year":"2007","journal-title":"Cochrane Database Syst Rev"},{"key":"2025121223122660000_7.11.e018574.15","doi-asserted-by":"publisher","DOI":"10.1136\/ip.2009.025353"},{"key":"2025121223122660000_7.11.e018574.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.aap.2011.05.029"},{"key":"2025121223122660000_7.11.e018574.17","doi-asserted-by":"publisher","DOI":"10.1016\/j.aap.2013.01.005"},{"key":"2025121223122660000_7.11.e018574.18","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1016\/j.ssci.2015.11.024","article-title":"Helmet use and injuries in children\u2019s bicycle crashes in the Gothenburg region","volume":"92","author":"Olofsson","year":"2017","journal-title":"Saf Sci"},{"key":"2025121223122660000_7.11.e018574.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsr.2014.07.001"},{"key":"2025121223122660000_7.11.e018574.20","doi-asserted-by":"publisher","DOI":"10.1016\/S0001-4575(99)00033-0"},{"key":"2025121223122660000_7.11.e018574.21","doi-asserted-by":"publisher","DOI":"10.1016\/S0001-4575(99)00081-0"},{"key":"2025121223122660000_7.11.e018574.22","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1002\/atr.1372","article-title":"Accidents involving pedestrians with their backs to traffic or facing traffic: an evaluation of crash characteristics and injuries","volume":"50","author":"Chen","year":"2016","journal-title":"J Advan Transportation"},{"key":"2025121223122660000_7.11.e018574.23","doi-asserted-by":"publisher","DOI":"10.2337\/dc11-1511"},{"key":"2025121223122660000_7.11.e018574.24","unstructured":"National Health Interview Survey. Health Promotion Administration. Ministry of Health and Welfare, 2013."},{"key":"2025121223122660000_7.11.e018574.25","doi-asserted-by":"publisher","DOI":"10.1016\/j.aap.2010.11.024"},{"key":"2025121223122660000_7.11.e018574.26","doi-asserted-by":"publisher","DOI":"10.1016\/j.aap.2013.02.033"},{"key":"2025121223122660000_7.11.e018574.27","doi-asserted-by":"publisher","DOI":"10.1016\/S0033-3506(01)00411-5"},{"key":"2025121223122660000_7.11.e018574.28","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1016\/S0196-0644(00)70032-1","article-title":"Motor vehicle crash characteristics and medical outcomes among older drivers in Utah, 1992-1995","volume":"35","author":"Cook","year":"2000","journal-title":"Ann Emerg Med"},{"key":"2025121223122660000_7.11.e018574.29","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1016\/j.aap.2012.02.016","article-title":"Older drivers' crashes in Queensland, Australia","volume":"48","author":"Rakotonirainy","year":"2012","journal-title":"Accid Anal Prev"},{"key":"2025121223122660000_7.11.e018574.30","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/j.aap.2011.07.013","article-title":"Motorcyclists' speed and \"looked-but-failed-to-see\" accidents","volume":"49","author":"Clabaux","year":"2012","journal-title":"Accid Anal Prev"},{"key":"2025121223122660000_7.11.e018574.31","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1080\/15389588.2016.1168925","article-title":"Examination of factors associated with use rates after transition from a universal to partial motorcycle helmet use law","volume":"18","author":"Russo","year":"2017","journal-title":"Traffic Inj Prev"},{"key":"2025121223122660000_7.11.e018574.32","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1016\/j.aap.2015.05.016","article-title":"Risky riding: naturalistic methods comparing safety behavior from conventional bicycle riders and electric bike riders","volume":"82","author":"Langford","year":"2015","journal-title":"Accid Anal Prev"},{"key":"2025121223122660000_7.11.e018574.33","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1016\/j.aap.2007.08.003","article-title":"Exploring motorcyclist injury severity in approach-turn collisions at T-junctions: focusing on the effects of driver\u2019s failure to yield and junction control measures","volume":"40","author":"Pai","year":"2008","journal-title":"Accid Anal Prev"},{"key":"2025121223122660000_7.11.e018574.34","unstructured":"Broughton J . Car occupant and motorcyclist deaths, 1994-2002. England: Transport Research Laboratory, Crowthorne, 2005."},{"key":"2025121223122660000_7.11.e018574.35","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.aap.2013.11.008","article-title":"A cross-sectional observational study of helmet use among motorcyclists in Wa, Ghana","volume":"64","author":"Akaateba","year":"2014","journal-title":"Accid Anal Prev"},{"key":"2025121223122660000_7.11.e018574.36","doi-asserted-by":"crossref","first-page":"28","DOI":"10.3141\/1897-04","article-title":"Analysis of pedestrian and bicycle casualties with regional panel data","volume":"1897","author":"Noland","year":"2004","journal-title":"Transp Res Rec"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2017-018574","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T07:12:34Z","timestamp":1765609954000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2017-018574"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,11]]},"references-count":36,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2017,11,8]]},"published-print":{"date-parts":[[2017,11]]}},"alternative-id":["10.1136\/bmjopen-2017-018574"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2017-018574","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,11]]}}}