Bicycle crashes and sickness absence - a population-based Swedish register study of all individuals of working ages

BACKGROUND: In recent years, bicycle injuries have increased, yet little is known about the impact of such injures on sickness absence (SA) and disability pension (DP). The aim was to explore SA and DP among individuals of working ages injured in a bicycle crash. METHOD: A nationwide register-based study, including all individuals aged 16–64 years and living in Sweden, who in 2010 had in- or specialized out-patient healthcare (including emergency units) after a bicycle crash. Information on age, sex, sociodemographics, SA, DP, crash type, injury type, and injured body region was used. We analyzed individuals with no SA or DP, with ongoing SA or full-time DP already at the time of the crash, and with new SA > 14 days in connection to the crash. Crude and adjusted odds ratios (OR) with 95% confidence intervals for new SA were estimated by logistic regression. RESULTS: In total, 7643 individuals had healthcare due to a new bicycle crash (of which 85% were single-bicycle crashes). Among all, 10% were already on SA or full-time DP at the time of the crash, while 18% had a new SA spell. The most common types of injuries were external injuries (38%) and fractures (37%). The body region most frequently injured was the upper extremities (43%). Women had higher OR (1.40; 1.23–1.58) for new SA than men, as did older individuals compared with younger (OR 2.50; 2.02–3.09, for ages: 55–64 vs. 25–34). The injury types with the highest ORs for new SA, compared with the reference group external injuries was fractures (8.04; 6.62–9.77) and internal injuries (7.34; 3.67–14.66). Individuals with traumatic brain injury and injuries to the vertebral column and spinal cord had higher ORs for SA compared with other head, face, and neck injuries (2.72; 1.19–6.22 and 3.53; 2.24–5.55, respectively). CONCLUSIONS: In this explorative nationwide study of new bicycle crashes among individuals of working ages, 18% had a new SA spell in connection to the crash while 10% were already on SA or DP. The ORs for new SA were higher among women, older individuals, and among individuals with a fracture.