OBJECTIVE To determine whether bicycle commuting is associated with risk of injury. DESIGN Prospective population based study. SETTING UK Biobank. PARTICIPANTS 230 390 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 10 241 (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.

中文翻译：

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英国与伤害相关的医院住院与自行车通勤的关联：基于前瞻性人群的研究。

目的确定自行车上下班是否与受伤风险相关。设计基于人群的前瞻性研究。设置英国生物库。参与者从英国22个地点招募的230 390名通勤者（女性占52.1％；平均年龄52.4岁），按往返交通方式（步行，骑自行车，混合方式与非活动方式（汽车或公共交通工具）比较）在典型的一天工作。主要观察指标首次因伤害入院。结果5704名（2.5％）参与者报告骑自行车是他们通勤运输的主要形式。中位随访时间为8.9年（四分位间距为8.2-9.5年），共有10 241名参与者（4.4％）受伤。骑自行车的通勤者中有397人（7.0％），使用非主动运输方式的通勤中有7698人（4.3％）受伤。在对主要的混杂社会人口统计学，健康和生活方式因素进行调整之后，与非主动方式通勤相比，骑车上班与受伤风险更高（危险比1.45，95％置信区间1.30至1.61）。对于使用混合模式骑行的通勤者，观察到了类似的趋势。走路上班与更高的受伤风险无关。通勤期间较长的骑车距离与较高的受伤风险有关，但非活动通勤者的通勤距离与伤害无关。当外部原因是交通运输相关事故时，通勤通勤还与更多的人受伤有关（事故发生率比为3.42，95％置信区间为3.00至3.90）。骑自行车上下班的通勤者患心血管疾病，癌症，比那些没有的人和死亡。如果是因果关系，则估计有1000名参与者将通勤方式更改为包括骑自行车10年，将导致26人因首次受伤而再次入院（其中三人需要住院一周或更长时间），15更少的首次癌症诊断，更少的四次心血管疾病事件和更少的三例死亡。结论与非主动上下班相比，骑自行车上下班与首次受伤住院的风险较高，特别是与交通运输相关的事故的风险较高。应从积极通勤对健康有益的角度考虑这些风险，并强调需要在英国建立更安全的自行车基础设施。估计有1000名参与者将通勤方式更改为包括骑自行车10年，将导致26例因首次受伤住院（其中3例需要住院一周或更长时间），减少15例首次癌症诊断，4例更少的心血管疾病事件和更少的三例死亡。结论与非主动上下班相比，骑自行车上下班与首次受伤住院的风险较高，特别是与交通运输相关的事故的风险较高。应从积极通勤对健康有益的角度考虑这些风险，并强调需要在英国建立更安全的自行车基础设施。估计有1000名参与者将通勤方式更改为包括骑自行车10年，将导致26例因首次受伤住院（其中3例需要住院一周或更长时间），减少15例首次癌症诊断，4例更少的心血管疾病事件和更少的三例死亡。结论与非主动上下班相比，骑自行车上下班与首次受伤住院的风险较高，特别是与交通运输相关的事故的风险较高。应从积极通勤对健康有益的角度考虑这些风险，并强调需要在英国建立更安全的自行车基础设施。