英国格拉斯哥大学Paul Welsh小组近日取得一项新成果。他们分析了英国受伤相关住院与骑自行车通勤的关系。2020年3月11日，《英国医学杂志》在线发表了这一成果。

为了确定骑自行车上下班是否与受伤风险相关，研究组进行了一项基于人群的前瞻性研究。在英国的22个地点招募了230390名通勤者，平均年龄为52.4岁，女性占52.1%，对他们每天上下班的交通方式进行分类，比较首次因伤住院的情况。

5704名（2.5％）参与者称骑自行车是他们的主要通勤方式。中位随访8.9年后，共有10241名（4.4％）参与者受伤。骑自行车的通勤者中有397人（7.0％）受伤，自驾或公交的通勤者中有7698人（4.3％）。

在对主要混杂社会人口统计学、健康和生活方式因素进行校正后，与自驾或公交通勤相比，骑车通勤的受伤风险更高，风险比为1.45。使用混合模式骑行的通勤者中也观察到了类似的趋势。步行通勤不会增加受伤风险。较长的通勤骑车距离与较高的受伤风险有关，但自驾或公交的通勤距离与受伤风险无关。

当外部原因是交通事故时，通勤还与更多的人受伤有关，事故发生率比为3.42。与不骑车的通勤者相比，骑自行车的通勤者患心血管疾病、癌症和死亡的风险更低。假设该相关性是因果关系，那么若1000名参与者将通勤方式改为骑自行车10年，因首次受伤而住院将增加26例，首次确诊癌症将减少15例，心血管事件减少4例，死亡减少3例。

总之，与自驾和公交通勤相比，骑自行车通勤者首次受伤住院的风险较高，尤其是交通事故的风险较高。

附：英文原文

Title: Association of injury related hospital admissions with commuting by bicycle in the UK: prospective population based study

Author: Claire Welsh, Carlos A Celis-Morales, Frederick Ho, Donald M Lyall, Daniel Mackay, Lyn Ferguson, Naveed Sattar, Stuart R Gray, Jason M R Gill, Jill P Pell, Paul Welsh

Issue&Volume: 2020/03/11

Abstract: AbstractObjective To determine whether bicycle commuting is associated with risk of injury.Design Prospective population based study.Setting UK Biobank.Participants 230390 commuters (52.1% women; mean age 52.4 years) recruited from 22 sites across the UK compared by mode of transport used (walking, cycling, mixed mode versus non-active (car or public transport)) to commute to and from work on a typical day.Main outcome measure First incident admission to hospital for injury.Results 5704 (2.5%) participants reported cycling as their main form of commuter transport. Median follow-up was 8.9 years (interquartile range 8.2-9.5 years), and overall 10241 (4.4%) participants experienced an injury. Injuries occurred in 397 (7.0%) of the commuters who cycled and 7698 (4.3%) of the commuters who used a non-active mode of transport. After adjustment for major confounding sociodemographic, health, and lifestyle factors, cycling to work was associated with a higher risk of injury compared with commuting by a non-active mode (hazard ratio 1.45, 95% confidence interval 1.30 to 1.61). Similar trends were observed for commuters who used mixed mode cycling. Walking to work was not associated with a higher risk of injury. Longer cycling distances during commuting were associated with a higher risk of injury, but commute distance was not associated with injury in non-active commuters. Cycle commuting was also associated with a higher number of injuries when the external cause was a transport related incident (incident rate ratio 3.42, 95% confidence interval 3.00 to 3.90). Commuters who cycled to work had a lower risk of cardiovascular disease, cancer, and death than those who did not. If the associations are causal, an estimated 1000 participants changing their mode of commuting to include cycling for 10 years would result in 26 additional admissions to hospital for a first injury (of which three would require a hospital stay of a week or longer), 15 fewer first cancer diagnoses, four fewer cardiovascular disease events, and three fewer deaths.Conclusion Compared with non-active commuting to work, commuting by cycling was associated with a higher risk of hospital admission for a first injury and higher risk of transport related incidents specifically. These risks should be viewed in context of the health benefits of active commuting and underscore the need for a safer infrastructure for cycling in the UK.

DOI: 10.1136/bmj.m336

Source: https://www.bmj.com/content/368/bmj.m336