Comparison of physical and psychological health outcomes for motorcyclists and other road users after land transport crashes: an inception cohort study

Abstract Background: Serious injuries and fatalities among vulnerable road users on two wheeled motorised vehicles have increased across Australia and internationally in the past decade, yet fallen for motor vehicle occupants. Almost half of all reported motorcycle injury crashes cause serious injury or death, nearly double that of motor vehicle police-reported crashes. This study explores associations with sociodemographic and pre-injury health characteristics and health outcomes after a road traffic injury; aiming to compare motorcyclists with other road users and inform recovery care. Methods: An inception cohort study recruited 1854 individuals aged >17 years, injured following land-transport crashes in New South Wales, Australia (July 2013-November 2016). Interviews conducted at baseline, 6-and 12-months post-injury elicited demographic, socioeconomic, and self-reported health conditions. Results: 628 (33.9%) motorcyclists, 299 (16.1%) bicyclists and 927 (50%) vehicle occupants were recruited at baseline. Injury patterns differed significantly between groups; motorcyclist injuries were more likely lower extremity, more severe (p<0.001) and result in longer hospital stays (p<0.001). Injured motorcyclists were predominantly male (88.1%, p<0.001), were younger on average (38 years) than bicyclists (41.5 years), had lower income and education levels, and poorer pre-injury physical health than other road user groups. Despite these differences, at 12 months post-injury motorcyclists had better physical health and reported less pain than vehicle occupants. Motorcyclists displayed less evidence of psychological distress than vehicle occupants, but more than bicyclists across several measures used. Conclusions: Road user types differ in important characteristics, including pre-injury health status and recovery after injury, which influences health and recovery outcomes after land-transport crashes. This information could aid post-crash care, such as targeting early intervention strategies not only to injury types, but also to the type of road user, to improve long-term recovery.