Here is a follow-up email I received from Dr. Baker:
"John,
I appreciate the feedback. Please thank your group.
I’ve looked at the comments you referenced. I agree with most of them.
Here’s some information that may prove helpful to your group. Feel free to pass this along.
The riders in Cyclo-Vets are more safety conscious than any other racing-club group I’ve ridden with; I’ve ridden with about 100 clubs and groups.
The median age of the respondents is over 50 years of age. Many in the club are long-time friends. The club is composed of working or retired folks who are aware that they are mortal and are not eager to take chances and crash.
Riders stop at stop signs and traffic lights scrupulously on almost every ride. The exception is the Saturday ride where riders may occasionally roll right-hand turns or T-intersections. Rides regroup frequently so that riders don’t feel that have to run signs or lights to keep up.
Most of the Cyclo-Vet group rides are relatively small. Almost all rides are split into groups immediately, generally of 15 or fewer riders. Again the exception is the Saturday club ride, the club’s most dangerous ride.. The Saturday ride may attract up to 50 people. After about an hour, this group splits into smaller groups, generally 15 or fewer.
This study is of a defined group and the response rate was high. The final report, to be published in a few weeks, will have at least a 95% response rate. This is an important strength of the study. Unlike studies of emergency-room visits or police reports, there is no ascertainment bias in this group—the numerators and denominators are known.
That is one reason why I did not publish a report of riders who were not in this defined group, such as yourself—there would be no way to know if responders had more or fewer injuries than non-responders.
The injury rates reported reflect only on this group, and as some of your list members have noted, may not be applicable to cycling groups or individuals in general, or to similar riders in other parts of the country or in other countries.
Addressing this issue of applicability informally, rather than on a scientific basis:
There is a racing adage that the cat 4/5s (beginning racers) crash by accident and that the Cat 1/2s (top-level racers) crash on purpose. Finger-pointing, perhaps. I don’t have a study to show this, but my impression is that all levels of racers crash about in equal numbers.
1. One of your list-members referred to http://www.massbikeboston.org/resources/stats.htm. This review of bicycle-crash statistics indicates that club riders may be safer or less prone to crashes than general recreational riders. (Racing is more dangerous per mile for club riders than general riding). The Massachusetts Bicycle Coalition quotes figures of one crash per 10,000 miles for the safest group—club riders.
The Cyclo-Vet crash rate is higher than disabling rate, though still lower than the one crash per 10,000 miles quoted in the Mass Bike Coalition report. There were about 2.5 ER or MD visits per rider vs. 1.8 disabling injuries per rider. Most riders take care of road rash on their own; there were almost three times as many crashes resulting in road rash as in disability.
2. As some of your list members have noted, almost 75% of the injuries were riders riding alone.
3. I don’t have a study to show this, but my impression is that the disabling injury rate for recreation riders in Team in Training is about the same, namely very roughly about 1 in 50,000 miles. (Team in Training is the world’s largest endurance training program. The cycling program trains riders to complete a century. There are about 5,000 riders a year in the cycling program. I am the National Coach for this program.)
<< The survey asked the opinions of these cyclists. Is that really science? >>
Opinions aren’t science. But polls or surveys of opinions are. The subjective responses of riders to their perception of cycling risk does not provide a basis for establishing that risk. Rather it allows the reader to assess the congruence of riders’ perception, the readers’ perception, and the results of the study.
<<Could not get past the "20 riders surveyed. >>
The survey was of 76 riders, out of a possible 84. The final report will include at least 80 riders. These 80 riders ride about 500,000 miles a year, and have ridden about 8 million miles. The referred to 20 riders were a smaller sample. I discussed the study with these riders before publication. They were astonished at the degree of risk. I apologize if that was confusing. Those 20 were not part of any formal study. Their surprise was meant to grab interest. Their opinions have no place in the study. I have removed that paragraph.
Perhaps what makes the numbers appear high to some readers is that the average rider in the group has ridden over 100,000 miles over 14 years. The odds catch up.
Here are some ways the risks add up for me:
1. The average rider going to a century rider doesn’t think they are going to crash. More than 99% will have no problem. Team in Training brings 1,000 out of the 2,500 riders who ride the 112 mile El Tour de Tucson. I have attended this event the last 8 years.
For those 2,500 riders I figure: About 300,000 miles. Based on my experience, I am not going to be surprised if there are 8 crashes needed an ER visit, and that 4 riders will miss a day or more of work or riding. If there are only 1 or 2 disabling injuries, it might be called a good day.
2. I conduct a 3-day coaching camp at a ski resort to prepare riders for the Markleeville Death Ride, a popular ACE (altitude-climbing-endurance) event. We ride 200 miles over 3 days. I have 75 riders. 15,000 miles collectively. I talk about safety every ride. I have riders wear helmets, instruct them to obey the rules of the road, ask them to avoid riding in large groups. I figure: Every few year someone will crash and have a disabling injury.
The odds add up.
<<I know that I've never had a disabling injury or major concussion in over 100,000km of riding. >>
The reason for some studies is to learn about the collective, rather than individual, experience.
<<It isn't exactly revealing about bicycling collectively, since it appears he only surveyed a select group of cyclists. >>
That’s right. On the other hand almost every one in the group responded. There is no ascertainment bias, a common problem of almost every other study.
<<Are these racing cyclists more prone to accidents than others? Were they more focused on going fast than on traffic safety? >>
Perhaps. As discussed above, the group may be less prone to injuries.
<<The hefty percentage of club members that are avid racers probably skew the results a little. >>
If you define an avid racer as racing more than 15 races a year, about 10% qualify. I don’t consider that a hefty percentage.
<<Does this survey really indicate that cycling, in general, is dangerous? >>
Depends, in part, how you define danger.
<<We cyclists seem to have a knee-jerk reaction whenever somebody suggests that cycling is dangerous. >>
This quote reflects on the five above it.
In some ways I think the message of many of responses above is similar to what I have often observed as a physician in myself, my patients, and my friends. Something that happens when a family member or friend has cancer or other disease. We try to find a reason for the problem.
We try to find some reason to say “It won’t happen to me.”
“Oh, they smoked. I don’t.” “They had diabetes, I don’t.” “They had a family history of problems, I don’t.” “I smoke, but I’m fine, and George Bernard Shaw lived to be 90 years old.”
The study showed greater than 40% of respondents had concussions; the majority had one or more disabling injuries.
“Well, they were racers.” “They must be a dangerous group.” “They take unnecessary risks, I don’t, and I’m safe.”
Whatever works to help us cope; hope; say nope that it won’t happen to me.
I myself enjoy riding, racing, and coaching. I’ve also taken care of hundreds, if not thousands, of injured cyclists over many years in a medical practice devoted to cyclists.
The risks are there. Like the first step of an alcoholic who must first acknowledge that there is a problem in order to quit, I’m trying to elucidate those risks for all of us to see, so we can work to reduce those risks.
Of course, your list members are all about bicycle safety and advocacy. For many of your list members, I’m addressing the choir.
Thank you again for your comments,
Best wishes,
Arnie
arniebaker@arniebakercycling.com (Arnie Baker, MD)
Bicycle Racing, Coaching, Sports Science, Medicine & Writing
The Argo Clinic
1820 Washington Place, San Diego, CA 92103
619 295-3024 (voice) 619 295-7632 (fax)
website:arniebakercycling.com
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