Original quantitative research – Lockdowns and cycling injuries: temporal analysis of rates in Quebec during the first year of the pandemic
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Published by: The Public Health Agency of Canada
Date published: July 2023
ISSN: 2368-738X
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Nathalie Auger, Author reference footnote 1 Author reference footnote 2 Author reference footnote 3 Author reference footnote 4; Antoine Lewin, PhDAuthor reference footnote 5; Émilie Brousseau, MScAuthor reference footnote 1 Author reference footnote 2; Aimina Ayoub, MScAuthor reference footnote 1 Author reference footnote 2; Christine Blaser, PhDAuthor reference footnote 3; Thuy Mai Luu, MDAuthor reference footnote 6
https://doi.org/10.24095/hpcdp.43.7.03
This article has been peer reviewed.
Author references
Correspondence
Nathalie Auger, 190 Cremazie Blvd. E., Montréal, QC H2P 1E2; Tel: 514-864-1600; Fax: 514-864-1616; Email: nathalie.auger@inspq.qc.ca
Suggested citation
Auger N, Lewin A, Brousseau É, Ayoub A, Blaser C, Luu TM. Lockdowns and cycling injuries: temporal analysis of rates in Quebec during the first year of the pandemic. Health Promot Chronic Dis Prev Can. 2023;43(7):330-7. https://doi.org/10.24095/hpcdp.43.7.03
Abstract
Introduction: Cycling increased in popularity during the COVID-19 pandemic, but the impact on cycling injuries is not known. We examined the effect of lockdowns on cycling injury hospitalizations.
Methods: We identified hospitalizations for cycling injuries in Quebec, Canada, between April 2006 and March 2021. We used rate ratios (RR) and 95% confidence intervals (CI) to compare hospitalization rates by type of cycling injury and anatomical site during two waves of the pandemic. We performed interrupted time series regression to assess the effect of lockdowns on monthly cycling injury hospitalization rates, according to age, sex and other characteristics.
Results: There were 2020 hospitalizations for cycling injuries between March 2020 and March 2021, including 617 during the first lockdown and 67 during the second lockdown. Compared with the period before the pandemic, risk of cycling-related injuries during the first lockdown increased the most for fractures (RR = 1.44; 95% CI: 1.26–1.64) and head and neck injuries (RR = 1.59; 95% CI: 1.19–2.12). Cycling injury hospitalization rates increased significantly among adults, adolescents and individuals from socioeconomically advantaged neighbourhoods or those with low concentrations of racialized people every month of the first lockdown. The second lockdown was not associated with cycling injuries.
Conclusion: The first lockdown triggered a sharp increase in cycling injury hospitalizations, especially among adults, adolescents and individuals from socioeconomically advantaged and less racialized neighbourhoods.
Keywords: bicycling, COVID-19, exercise, transportation, wounds, injuries, fracture, socioeconomic factors
Highlights
- Cycling injuries in Quebec increased among adults and adolescents during the COVID-19 pandemic.
- Fractures and head and neck injuries increased the most.
- Most injuries were due to falls from a bicycle rather than due to collisions.
- People living in socioeconomically advantaged and less racialized neighbourhoods experienced the greatest increase in number of cycling injuries.
Introduction
Although cycling became more popular in cities around the world during the COVID-19 pandemic,Footnote 1 Footnote 2 Footnote 3 Footnote 4 the impact of lockdowns on cycling injuries is unclear. This growth in popularity came about when lockdowns triggered a reduction in public transport and made people consider other means of transportation.Footnote 5 The closures of gyms and community centres led people to try other forms of physical activity, including cycling.1 Many people went cycling with friends as a way to socialize while socially distancing.Footnote 4
Cycling has numerous physical and mental health benefits,Footnote 6 but it is also associated with an estimated 3.1 injuries per 1000 hours travelled, with the greatest risk of injury occurring among less experienced cyclists.Footnote 7 Although many adults took up cycling during the pandemic, the relationship with cycling injuries has received little attention as injury research has been largely limited to children and adolescents.Footnote 8 Footnote 9 A study of 1215 pediatric emergency department visits found that bicycle injuries among children and adolescents less than 18 years old increased significantly in Canada during the first eight months of the pandemic.Footnote 8 An Australian study reported a 43% increase in emergency department visits and a 49% increase in hospital admissions for bike-related injuries among children and adolescents 15 years old or younger during the first lockdown, compared with 2019.Footnote 9 The only study that examined adults' trauma-related injuries found an increase in emergency orthopaedic referrals during the first lockdown in the United Kingdom among those between 19 and 65 years old, but cycling and scooter injury data were combined.Footnote 10
Owing to the paucity of data, we assessed the effect of pandemic lockdowns on cycling injury hospitalizations in a population of children, adolescents and adults in the province of Quebec, Canada.
Methods
Study population
We carried out a natural experimental study of hospitalization rates for cycling injuries between 1 April 2006 and 31 March 2021 in Quebec. We extracted hospitalization records from the Maintenance et exploitation des données pour l'étude de la clientèle hospitalière (MED-ÉCHO) dataset, a registry of discharge abstracts for admissions throughout Quebec.Footnote 11
We received a waiver for a full ethical review from the institutional review board of the Centre hospitalier de l'Université de Montréal. Data used in the analysis were de-identified.
Measures
We considered three exposure periods in the analysis: two lockdown periods and a reopening period between them. In Quebec, the government declared COVID-19 a public health emergency on 13 March 2020.Footnote 12 The province was marked by two major lockdowns over the course of one year.Footnote 12 The first lockdown lasted from 13 March 2020 to 23 June 2020, and was followed by a period of partial reopening between 24 June 2020 and 14 December 2020. The second lockdown began on 15 December 2020 and continued past the end of the study on 31 March 2021. The lockdowns were characterized by stay-at-home orders, curfews and widespread closures of nonessential businesses and schools.Footnote 12 Restrictions eased during reopening.Footnote 12
We used three periods from before the pandemic as comparison groups. The comparison period for the first lockdown extended from 13 March 2019 to 23 June 2019, for the reopening from 24 June 2019 to 14 December 2019, and for the second lockdown from 15 December 2019 to 12 March 2020. These comparison periods match the calendar dates of the pandemic, to take into account, in part, effects of seasonality.
The outcome measure was cycling injury hospitalization. We used accident codes from the International Classification of Diseases, 10th Revision (ICD-10), to capture cycling injuries. We assessed the type (fracture, superficial wound, open wound, other), anatomical site (head and neck, spine/thorax/pelvis, upper limb, lower limb), place (roadway, other location, unspecified) and mechanism of injury (collision, fall, unspecified).
We accounted for patient characteristics that were potential determinants of cycling injury: age (<10, 10–19, 20–39, 40–59, ≥60 years), sex (male, female), neighbourhood socioeconomic disadvantage (very high, high, moderate, low, or very low) and racialized group concentration within neighbourhoods (very high, high, moderate, low, or very low). Both socioeconomic disadvantage and racialized group concentration were measured as composite indices, with socioeconomic disadvantage accounting for median income, education and unemployment, and racialized group concentration accounting for the proportion of racialized people, recent immigrants and refugees within local neighbourhoods.Footnote 13
The indices are representative of the population, as they were developed from census data13 and mapped to postal codes covering small areas with an average of 500 residents. Very high socioeconomic disadvantage and racialized group concentration represented the most deprived quintile of each index.
Statistical analysis
We examined the characteristics of patients hospitalized for cycling injuries before and during the pandemic. Sex-specific hospitalization rates for cycling injuries were computed using population estimates from the Institut de la statistique du Québec.Footnote 14 We estimated rate ratios (RR) and 95% confidence intervals (CI) for the first lockdown, reopening and second lockdown compared with their respective pre-pandemic periods.
We assessed trends over time using an interrupted time series analysis of monthly cycling injury hospitalization rates. Interrupted time series analysis is a quasi-experimental method designed to estimate the effect of a sudden intervention, such as a lockdown, on an outcome.Footnote 15 This method relies on the regression of a time series, while including an interaction term between time and the onset of each interruption (first lockdown, reopening, second lockdown).Footnote 15
For this analysis, we used an autoregressive time series model to remove the effect of seasonal patterns in bike injuries, and to account for rates that may be correlated from month to month.Footnote 15 We stratified the time series by age, sex, socioeconomic disadvantage and racialized group concentration. In sensitivity analyses, weekly hospitalization rates were used in the time series to ensure that monthly rates did not mask week-to-week trends during the pandemic.
We carried out data analyses using statistical package SAS version 9.4 (SAS Institute Inc., Cary, NC, US). We assessed statistical significance through p values and 95% CIs.
Results
There were 2020 cycling injury hospitalizations between 13 March 2020 and 31 March 2021. Of these injury hospitalizations, 617 occurred during the first lockdown, 1336 during reopening and 67 during the second lockdown (see Table 1). The majority of patients hospitalized for cycling injuries before and during the pandemic were male, aged 40 to 59 years, and resided in neighbourhoods with low socioeconomic disadvantage and with low racialized group concentration. The proportion of patients aged 10 to 19 years who were hospitalized for cycling injuries increased during each phase of the pandemic compared with the corresponding pre-pandemic period.
Characteristic | Number of hospitalizations, n (%) | |||||
---|---|---|---|---|---|---|
First lockdownFootnote a | ReopeningFootnote b | Second lockdownFootnote c | ||||
Before | During | Before | During | Before | During | |
Age, years | ||||||
<10 | 31 (7.0) | 49 (7.9) | 57 (5.1) | 46 (3.4) | 0 | <5 |
10–19 | 61 (13.8) | 101 (16.4) | 117 (10.4) | 166 (12.4) | <5 | 7 (10.5) |
20–39 | 86 (19.5) | 126 (20.4) | 275 (24.4) | 363 (27.2) | 13 (23.6) | 9 (13.4) |
40–59 | 135 (30.6) | 175 (28.4) | 399 (35.3) | 430 (32.2) | 26 (47.3) | 34 (50.8) |
≥60 | 128 (29.0) | 166 (26.9) | 281 (24.9) | 331 (24.8) | 15 (27.3) | 13 (19.4) |
Sex | ||||||
Male | 309 (70.1) | 421 (68.2) | 783 (69.4) | 913 (68.3) | 41 (74.6) | 53 (79.1) |
Female | 132 (29.9) | 196 (31.8) | 346 (30.7) | 423 (31.7) | 14 (25.5) | 14 (20.9) |
Socioeconomic disadvantage | ||||||
Very low | 84 (19.1) | 137 (22.2) | 199 (17.6) | 245 (18.3) | 6 (10.9) | 16 (23.9) |
Low | 112 (25.4) | 192 (31.1) | 356 (31.5) | 402 (30.1) | 15 (27.3) | 16 (23.9) |
Moderate | 124 (28.1) | 137 (22.2) | 261 (23.1) | 332 (24.9) | 17 (30.9) | 16 (23.9) |
High | 74 (16.8) | 99 (16.1) | 185 (16.4) | 211 (15.8) | 13 (23.6) | 9 (13.4) |
Very high | 34 (7.7) | 37 (6.0) | 93 (8.2) | 107 (8.0) | <5 | 9 (13.4) |
Racialized group concentrationFootnote d | ||||||
Very low | 164 (37.2) | 265 (43.0) | 412 (36.5) | 498 (37.3) | 20 (36.4) | 25 (37.3) |
Low | 137 (31.1) | 160 (25.9) | 346 (30.7) | 379 (28.4) | 18 (32.7) | 21 (31.3) |
Moderate | 71 (16.1) | 99 (16.1) | 193 (17.1) | 209 (15.6) | 10 (18.2) | 12 (17.9) |
High | 37 (8.4) | 54 (8.8) | 107 (9.5) | 153 (11.5) | <5 | <5 |
Very high | 19 (4.3) | 24 (3.9) | 36 (3.2) | 58 (4.3) | <5 | <5 |
Total | 441 (100) | 617 (100) | 1129 (100) | 1336 (100) | 55 (100) | 67 (100) |
|
Hospitalization rates for cycling-related fractures increased considerably during the first lockdown (RR = 1.44; 95% CI: 1.26–1.64) and in the reopening period (RR = 1.16; 95% CI: 1.06–1.26), compared with their respective pre-pandemic comparison periods (see Table 2). The rates for head and neck injuries increased the most, followed by spine/thorax/pelvis, lower limb and upper limb injuries. Both upper limb and spine/thorax/pelvis injuries remained elevated during reopening. The first lockdown and reopening were marked by a rise in cycling-related falls and injuries on roadways. There was no difference in the type, site, place or mechanism of cycling injuries in the second lockdown compared with the previous calendar year.
Cycling injury characteristic | First lockdownFootnote a | ReopeningFootnote b | Second lockdownFootnote c | ||||||
---|---|---|---|---|---|---|---|---|---|
Hospitalization rate per 100 000 | RR (95% CI)Footnote d |
Hospitalization rate per 100 000 | RR (95% CI)Footnote d |
Hospitalization rate per 100 000 | RR (95% CI)Footnote d |
||||
Before | During | Before | During | Before | During | ||||
Type of injury | |||||||||
Any | 18.4 | 25.6 | 1.39 (1.23–1.57) | 27.9 | 32.8 | 1.18 (1.09–1.27) | 2.6 | 2.7 | 1.01 (0.71–1.44) |
Fracture | 15.3 | 22.1 | 1.44 (1.26–1.64) | 23.9 | 27.7 | 1.16 (1.06–1.26) | 2.1 | 1.5 | 0.73 (0.47–1.13) |
Superficial wound | 1.6 | 2.3 | 1.43 (0.95–2.15) | 2.3 | 2.7 | 1.17 (0.89–1.54) | 0.0 | 0.1 | 1.65 (0.15–18.24) |
Open wound | 1.3 | 1.3 | 1.06 (0.64–1.74) | 1.8 | 1.8 | 0.98 (0.71–1.36) | 0.0 | 0.2 | 4.13 (0.48–35.39) |
Other | 5.6 | 7.5 | 1.33 (1.07–1.67) | 8.2 | 9.8 | 1.20 (1.04–1.39) | 0.8 | 1.1 | 1.45 (0.78–2.67) |
Anatomical site | |||||||||
Head and neck | 3.1 | 4.9 | 1.59 (1.19–2.12) | 5.2 | 5.7 | 1.09 (0.90–1.31) | 0.2 | 0.4 | 1.49 (0.50–4.44) |
Spine, thorax, pelvis | 3.5 | 4.9 | 1.39 (1.05–1.84) | 4.9 | 6.0 | 1.23 (1.02–1.48) | 0.2 | 0.2 | 0.99 (0.30–3.25) |
Upper limb | 11.1 | 14.7 | 1.33 (1.13–1.55) | 17.8 | 20.5 | 1.16 (1.05–1.28) | 1.0 | 1.4 | 1.42 (0.83–2.43) |
Lower limb | 5.0 | 6.8 | 1.35 (1.07–1.71) | 6.6 | 7.6 | 1.16 (0.98–1.36) | 1.2 | 0.9 | 0.73 (0.41–1.29) |
Place of injury | |||||||||
Roadway | 11.8 | 16.1 | 1.37 (1.17–1.59) | 17.0 | 19.0 | 1.12 (1.01–1.24) | 1.6 | 1.7 | 1.05 (0.67–1.64) |
Other location | 1.8 | 3.4 | 1.85 (1.28–2.67) | 4.4 | 5.6 | 1.27 (1.05–1.55) | 0.7 | 0.3 | 0.41 (0.17–1.02) |
Unspecified | 4.5 | 5.8 | 1.29 (1.00–1.65) | 5.9 | 7.9 | 1.32 (1.12–1.56) | 0.3 | 0.6 | 2.20 (0.86–5.63) |
Mechanism | |||||||||
Collision | 3.0 | 3.5 | 1.16 (0.85–1.59) | 4.4 | 5.3 | 1.21 (0.99–1.48) | 0.4 | 0.5 | 1.34 (0.56–3.24) |
Fall | 14.2 | 20.8 | 1.47 (1.28–1.68) | 21.9 | 25.5 | 1.16 (1.06–1.27) | 2.1 | 2.1 | 1.00 (0.67–1.50) |
Unspecified | 1.2 | 1.2 | 1.06 (0.64–1.78) | 1.6 | 2.0 | 1.26 (0.91–1.76) | 0.2 | 0.1 | 0.41 (0.08–2.26) |
Abbreviations: CI, confidence interval; RR, rate ratio. |
Interrupted time series analysis indicated that there was a sharp decline in cycling injuries the first month of the pandemic, with 11.4 fewer hospitalizations per 100 000 individuals in March 2020 (see Figure 1). During the remainder of the first lockdown, however, cycling injury hospitalization rates rose by 6.5 per 100 000 individuals each month. These trends were the same for both males and females.
Figure 1 - Text description
Bike injury (both sexes) | Bike injury (males) | Bike injury (females) | |||
---|---|---|---|---|---|
Date | Rate per 100 000 | Date | Rate per 100 000 | Date | Rate per 100 000 |
2006-04-01 | 18.1552124 | 2006-04-01 | 25.6570588 | 2006-04-01 | 10.1398801 |
2006-05-01 | 18.165268 | 2006-05-01 | 25.672715 | 2006-05-01 | 10.1515401 |
2006-06-01 | 18.1753236 | 2006-06-01 | 25.6883712 | 2006-06-01 | 10.1632002 |
2006-07-01 | 18.1853791 | 2006-07-01 | 25.7040275 | 2006-07-01 | 10.1748602 |
2006-08-01 | 18.1954347 | 2006-08-01 | 25.7196837 | 2006-08-01 | 10.1865203 |
2006-09-01 | 18.2054903 | 2006-09-01 | 25.73534 | 2006-09-01 | 10.1981803 |
2006-10-01 | 18.2155459 | 2006-10-01 | 25.7509962 | 2006-10-01 | 10.2098403 |
2006-11-01 | 18.2256015 | 2006-11-01 | 25.7666525 | 2006-11-01 | 10.2215004 |
2006-12-01 | 18.2356571 | 2006-12-01 | 25.7823087 | 2006-12-01 | 10.2331604 |
2007-01-01 | 18.2457127 | 2007-01-01 | 25.7979649 | 2007-01-01 | 10.2448205 |
2007-02-01 | 18.2557683 | 2007-02-01 | 25.8136212 | 2007-02-01 | 10.2564805 |
2007-03-01 | 18.2658239 | 2007-03-01 | 25.8292774 | 2007-03-01 | 10.2681406 |
2007-04-01 | 18.2758795 | 2007-04-01 | 25.8449337 | 2007-04-01 | 10.2798006 |
2007-05-01 | 18.2859351 | 2007-05-01 | 25.8605899 | 2007-05-01 | 10.2914607 |
2007-06-01 | 18.2959907 | 2007-06-01 | 25.8762462 | 2007-06-01 | 10.3031207 |
2007-07-01 | 18.3060463 | 2007-07-01 | 25.8919024 | 2007-07-01 | 10.3147808 |
2007-08-01 | 18.3161019 | 2007-08-01 | 25.9075586 | 2007-08-01 | 10.3264408 |
2007-09-01 | 18.3261575 | 2007-09-01 | 25.9232149 | 2007-09-01 | 10.3381009 |
2007-10-01 | 18.3362131 | 2007-10-01 | 25.9388711 | 2007-10-01 | 10.3497609 |
2007-11-01 | 18.3462687 | 2007-11-01 | 25.9545274 | 2007-11-01 | 10.361421 |
2007-12-01 | 18.3563243 | 2007-12-01 | 25.9701836 | 2007-12-01 | 10.373081 |
2008-01-01 | 18.3663799 | 2008-01-01 | 25.9858399 | 2008-01-01 | 10.3847411 |
2008-02-01 | 18.3764355 | 2008-02-01 | 26.0014961 | 2008-02-01 | 10.3964011 |
2008-03-01 | 18.3864911 | 2008-03-01 | 26.0171523 | 2008-03-01 | 10.4080612 |
2008-04-01 | 18.3965467 | 2008-04-01 | 26.0328086 | 2008-04-01 | 10.4197212 |
2008-05-01 | 18.4066023 | 2008-05-01 | 26.0484648 | 2008-05-01 | 10.4313813 |
2008-06-01 | 18.4166579 | 2008-06-01 | 26.0641211 | 2008-06-01 | 10.4430413 |
2008-07-01 | 18.4267135 | 2008-07-01 | 26.0797773 | 2008-07-01 | 10.4547014 |
2008-08-01 | 18.4367691 | 2008-08-01 | 26.0954336 | 2008-08-01 | 10.4663614 |
2008-09-01 | 18.4468247 | 2008-09-01 | 26.1110898 | 2008-09-01 | 10.4780215 |
2008-10-01 | 18.4568803 | 2008-10-01 | 26.1267461 | 2008-10-01 | 10.4896815 |
2008-11-01 | 18.4669359 | 2008-11-01 | 26.1424023 | 2008-11-01 | 10.5013416 |
2008-12-01 | 18.4769915 | 2008-12-01 | 26.1580585 | 2008-12-01 | 10.5130016 |
2009-01-01 | 18.487047 | 2009-01-01 | 26.1737148 | 2009-01-01 | 10.5246617 |
2009-02-01 | 18.4971026 | 2009-02-01 | 26.189371 | 2009-02-01 | 10.5363217 |
2009-03-01 | 18.5071582 | 2009-03-01 | 26.2050273 | 2009-03-01 | 10.5479818 |
2009-04-01 | 18.5172138 | 2009-04-01 | 26.2206835 | 2009-04-01 | 10.5596418 |
2009-05-01 | 18.5272694 | 2009-05-01 | 26.2363398 | 2009-05-01 | 10.5713019 |
2009-06-01 | 18.537325 | 2009-06-01 | 26.251996 | 2009-06-01 | 10.5829619 |
2009-07-01 | 18.5473806 | 2009-07-01 | 26.2676522 | 2009-07-01 | 10.594622 |
2009-08-01 | 18.5574362 | 2009-08-01 | 26.2833085 | 2009-08-01 | 10.606282 |
2009-09-01 | 18.5674918 | 2009-09-01 | 26.2989647 | 2009-09-01 | 10.6179421 |
2009-10-01 | 18.5775474 | 2009-10-01 | 26.314621 | 2009-10-01 | 10.6296021 |
2009-11-01 | 18.587603 | 2009-11-01 | 26.3302772 | 2009-11-01 | 10.6412622 |
2009-12-01 | 18.5976586 | 2009-12-01 | 26.3459335 | 2009-12-01 | 10.6529222 |
2010-01-01 | 18.6077142 | 2010-01-01 | 26.3615897 | 2010-01-01 | 10.6645823 |
2010-02-01 | 18.6177698 | 2010-02-01 | 26.3772459 | 2010-02-01 | 10.6762423 |
2010-03-01 | 18.6278254 | 2010-03-01 | 26.3929022 | 2010-03-01 | 10.6879024 |
2010-04-01 | 18.637881 | 2010-04-01 | 26.4085584 | 2010-04-01 | 10.6995624 |
2010-05-01 | 18.6479366 | 2010-05-01 | 26.4242147 | 2010-05-01 | 10.7112224 |
2010-06-01 | 18.6579922 | 2010-06-01 | 26.4398709 | 2010-06-01 | 10.7228825 |
2010-07-01 | 18.6680478 | 2010-07-01 | 26.4555272 | 2010-07-01 | 10.7345425 |
2010-08-01 | 18.6781034 | 2010-08-01 | 26.4711834 | 2010-08-01 | 10.7462026 |
2010-09-01 | 18.688159 | 2010-09-01 | 26.4868397 | 2010-09-01 | 10.7578626 |
2010-10-01 | 18.6982146 | 2010-10-01 | 26.5024959 | 2010-10-01 | 10.7695227 |
2010-11-01 | 18.7082702 | 2010-11-01 | 26.5181521 | 2010-11-01 | 10.7811827 |
2010-12-01 | 18.7183258 | 2010-12-01 | 26.5338084 | 2010-12-01 | 10.7928428 |
2011-01-01 | 18.7283814 | 2011-01-01 | 26.5494646 | 2011-01-01 | 10.8045028 |
2011-02-01 | 18.738437 | 2011-02-01 | 26.5651209 | 2011-02-01 | 10.8161629 |
2011-03-01 | 18.7484926 | 2011-03-01 | 26.5807771 | 2011-03-01 | 10.8278229 |
2011-04-01 | 18.7585482 | 2011-04-01 | 26.5964334 | 2011-04-01 | 10.839483 |
2011-05-01 | 18.7686038 | 2011-05-01 | 26.6120896 | 2011-05-01 | 10.851143 |
2011-06-01 | 18.7786594 | 2011-06-01 | 26.6277458 | 2011-06-01 | 10.8628031 |
2011-07-01 | 18.7887149 | 2011-07-01 | 26.6434021 | 2011-07-01 | 10.8744631 |
2011-08-01 | 18.7987705 | 2011-08-01 | 26.6590583 | 2011-08-01 | 10.8861232 |
2011-09-01 | 18.8088261 | 2011-09-01 | 26.6747146 | 2011-09-01 | 10.8977832 |
2011-10-01 | 18.8188817 | 2011-10-01 | 26.6903708 | 2011-10-01 | 10.9094433 |
2011-11-01 | 18.8289373 | 2011-11-01 | 26.7060271 | 2011-11-01 | 10.9211033 |
2011-12-01 | 18.8389929 | 2011-12-01 | 26.7216833 | 2011-12-01 | 10.9327634 |
2012-01-01 | 18.8490485 | 2012-01-01 | 26.7373395 | 2012-01-01 | 10.9444234 |
2012-02-01 | 18.8591041 | 2012-02-01 | 26.7529958 | 2012-02-01 | 10.9560835 |
2012-03-01 | 18.8691597 | 2012-03-01 | 26.768652 | 2012-03-01 | 10.9677435 |
2012-04-01 | 18.8792153 | 2012-04-01 | 26.7843083 | 2012-04-01 | 10.9794036 |
2012-05-01 | 18.8892709 | 2012-05-01 | 26.7999645 | 2012-05-01 | 10.9910636 |
2012-06-01 | 18.8993265 | 2012-06-01 | 26.8156208 | 2012-06-01 | 11.0027237 |
2012-07-01 | 18.9093821 | 2012-07-01 | 26.831277 | 2012-07-01 | 11.0143837 |
2012-08-01 | 18.9194377 | 2012-08-01 | 26.8469332 | 2012-08-01 | 11.0260438 |
2012-09-01 | 18.9294933 | 2012-09-01 | 26.8625895 | 2012-09-01 | 11.0377038 |
2012-10-01 | 18.9395489 | 2012-10-01 | 26.8782457 | 2012-10-01 | 11.0493639 |
2012-11-01 | 18.9496045 | 2012-11-01 | 26.893902 | 2012-11-01 | 11.0610239 |
2012-12-01 | 18.9596601 | 2012-12-01 | 26.9095582 | 2012-12-01 | 11.072684 |
2013-01-01 | 18.9697157 | 2013-01-01 | 26.9252145 | 2013-01-01 | 11.084344 |
2013-02-01 | 18.9797713 | 2013-02-01 | 26.9408707 | 2013-02-01 | 11.0960041 |
2013-03-01 | 18.9898269 | 2013-03-01 | 26.956527 | 2013-03-01 | 11.1076641 |
2013-04-01 | 18.9998825 | 2013-04-01 | 26.9721832 | 2013-04-01 | 11.1193242 |
2013-05-01 | 19.0099381 | 2013-05-01 | 26.9878394 | 2013-05-01 | 11.1309842 |
2013-06-01 | 19.0199937 | 2013-06-01 | 27.0034957 | 2013-06-01 | 11.1426443 |
2013-07-01 | 19.0300493 | 2013-07-01 | 27.0191519 | 2013-07-01 | 11.1543043 |
2013-08-01 | 19.0401049 | 2013-08-01 | 27.0348082 | 2013-08-01 | 11.1659644 |
2013-09-01 | 19.0501605 | 2013-09-01 | 27.0504644 | 2013-09-01 | 11.1776244 |
2013-10-01 | 19.0602161 | 2013-10-01 | 27.0661207 | 2013-10-01 | 11.1892845 |
2013-11-01 | 19.0702717 | 2013-11-01 | 27.0817769 | 2013-11-01 | 11.2009445 |
2013-12-01 | 19.0803273 | 2013-12-01 | 27.0974331 | 2013-12-01 | 11.2126045 |
2014-01-01 | 19.0903828 | 2014-01-01 | 27.1130894 | 2014-01-01 | 11.2242646 |
2014-02-01 | 19.1004384 | 2014-02-01 | 27.1287456 | 2014-02-01 | 11.2359246 |
2014-03-01 | 19.110494 | 2014-03-01 | 27.1444019 | 2014-03-01 | 11.2475847 |
2014-04-01 | 19.1205496 | 2014-04-01 | 27.1600581 | 2014-04-01 | 11.2592447 |
2014-05-01 | 19.1306052 | 2014-05-01 | 27.1757144 | 2014-05-01 | 11.2709048 |
2014-06-01 | 19.1406608 | 2014-06-01 | 27.1913706 | 2014-06-01 | 11.2825648 |
2014-07-01 | 19.1507164 | 2014-07-01 | 27.2070268 | 2014-07-01 | 11.2942249 |
2014-08-01 | 19.160772 | 2014-08-01 | 27.2226831 | 2014-08-01 | 11.3058849 |
2014-09-01 | 19.1708276 | 2014-09-01 | 27.2383393 | 2014-09-01 | 11.317545 |
2014-10-01 | 19.1808832 | 2014-10-01 | 27.2539956 | 2014-10-01 | 11.329205 |
2014-11-01 | 19.1909388 | 2014-11-01 | 27.2696518 | 2014-11-01 | 11.3408651 |
2014-12-01 | 19.2009944 | 2014-12-01 | 27.2853081 | 2014-12-01 | 11.3525251 |
2015-01-01 | 19.21105 | 2015-01-01 | 27.3009643 | 2015-01-01 | 11.3641852 |
2015-02-01 | 19.2211056 | 2015-02-01 | 27.3166206 | 2015-02-01 | 11.3758452 |
2015-03-01 | 19.2311612 | 2015-03-01 | 27.3322768 | 2015-03-01 | 11.3875053 |
2015-04-01 | 19.2412168 | 2015-04-01 | 27.347933 | 2015-04-01 | 11.3991653 |
2015-05-01 | 19.2512724 | 2015-05-01 | 27.3635893 | 2015-05-01 | 11.4108254 |
2015-06-01 | 19.261328 | 2015-06-01 | 27.3792455 | 2015-06-01 | 11.4224854 |
2015-07-01 | 19.2713836 | 2015-07-01 | 27.3949018 | 2015-07-01 | 11.4341455 |
2015-08-01 | 19.2814392 | 2015-08-01 | 27.410558 | 2015-08-01 | 11.4458055 |
2015-09-01 | 19.2914948 | 2015-09-01 | 27.4262143 | 2015-09-01 | 11.4574656 |
2015-10-01 | 19.3015504 | 2015-10-01 | 27.4418705 | 2015-10-01 | 11.4691256 |
2015-11-01 | 19.311606 | 2015-11-01 | 27.4575267 | 2015-11-01 | 11.4807857 |
2015-12-01 | 19.3216616 | 2015-12-01 | 27.473183 | 2015-12-01 | 11.4924457 |
2016-01-01 | 19.3317172 | 2016-01-01 | 27.4888392 | 2016-01-01 | 11.5041058 |
2016-02-01 | 19.3417728 | 2016-02-01 | 27.5044955 | 2016-02-01 | 11.5157658 |
2016-03-01 | 19.3518284 | 2016-03-01 | 27.5201517 | 2016-03-01 | 11.5274259 |
2016-04-01 | 19.361884 | 2016-04-01 | 27.535808 | 2016-04-01 | 11.5390859 |
2016-05-01 | 19.3719396 | 2016-05-01 | 27.5514642 | 2016-05-01 | 11.550746 |
2016-06-01 | 19.3819952 | 2016-06-01 | 27.5671204 | 2016-06-01 | 11.562406 |
2016-07-01 | 19.3920507 | 2016-07-01 | 27.5827767 | 2016-07-01 | 11.5740661 |
2016-08-01 | 19.4021063 | 2016-08-01 | 27.5984329 | 2016-08-01 | 11.5857261 |
2016-09-01 | 19.4121619 | 2016-09-01 | 27.6140892 | 2016-09-01 | 11.5973862 |
2016-10-01 | 19.4222175 | 2016-10-01 | 27.6297454 | 2016-10-01 | 11.6090462 |
2016-11-01 | 19.4322731 | 2016-11-01 | 27.6454017 | 2016-11-01 | 11.6207063 |
2016-12-01 | 19.4423287 | 2016-12-01 | 27.6610579 | 2016-12-01 | 11.6323663 |
2017-01-01 | 19.4523843 | 2017-01-01 | 27.6767141 | 2017-01-01 | 11.6440264 |
2017-02-01 | 19.4624399 | 2017-02-01 | 27.6923704 | 2017-02-01 | 11.6556864 |
2017-03-01 | 19.4724955 | 2017-03-01 | 27.7080266 | 2017-03-01 | 11.6673465 |
2017-04-01 | 19.4825511 | 2017-04-01 | 27.7236829 | 2017-04-01 | 11.6790065 |
2017-05-01 | 19.4926067 | 2017-05-01 | 27.7393391 | 2017-05-01 | 11.6906666 |
2017-06-01 | 19.5026623 | 2017-06-01 | 27.7549954 | 2017-06-01 | 11.7023266 |
2017-07-01 | 19.5127179 | 2017-07-01 | 27.7706516 | 2017-07-01 | 11.7139866 |
2017-08-01 | 19.5227735 | 2017-08-01 | 27.7863079 | 2017-08-01 | 11.7256467 |
2017-09-01 | 19.5328291 | 2017-09-01 | 27.8019641 | 2017-09-01 | 11.7373067 |
2017-10-01 | 19.5428847 | 2017-10-01 | 27.8176203 | 2017-10-01 | 11.7489668 |
2017-11-01 | 19.5529403 | 2017-11-01 | 27.8332766 | 2017-11-01 | 11.7606268 |
2017-12-01 | 19.5629959 | 2017-12-01 | 27.8489328 | 2017-12-01 | 11.7722869 |
2018-01-01 | 19.5730515 | 2018-01-01 | 27.8645891 | 2018-01-01 | 11.7839469 |
2018-02-01 | 19.5831071 | 2018-02-01 | 27.8802453 | 2018-02-01 | 11.795607 |
2018-03-01 | 19.5931627 | 2018-03-01 | 27.8959016 | 2018-03-01 | 11.807267 |
2018-04-01 | 19.6032183 | 2018-04-01 | 27.9115578 | 2018-04-01 | 11.8189271 |
2018-05-01 | 19.6132739 | 2018-05-01 | 27.927214 | 2018-05-01 | 11.8305871 |
2018-06-01 | 19.6233295 | 2018-06-01 | 27.9428703 | 2018-06-01 | 11.8422472 |
2018-07-01 | 19.6333851 | 2018-07-01 | 27.9585265 | 2018-07-01 | 11.8539072 |
2018-08-01 | 19.6434407 | 2018-08-01 | 27.9741828 | 2018-08-01 | 11.8655673 |
2018-09-01 | 19.6534963 | 2018-09-01 | 27.989839 | 2018-09-01 | 11.8772273 |
2018-10-01 | 19.6635519 | 2018-10-01 | 28.0054953 | 2018-10-01 | 11.8888874 |
2018-11-01 | 19.6736075 | 2018-11-01 | 28.0211515 | 2018-11-01 | 11.9005474 |
2018-12-01 | 19.6836631 | 2018-12-01 | 28.0368077 | 2018-12-01 | 11.9122075 |
2019-01-01 | 19.6937186 | 2019-01-01 | 28.052464 | 2019-01-01 | 11.9238675 |
2019-02-01 | 19.7037742 | 2019-02-01 | 28.0681202 | 2019-02-01 | 11.9355276 |
2019-03-01 | 19.7138298 | 2019-03-01 | 28.0837765 | 2019-03-01 | 11.9471876 |
2019-04-01 | 19.7238854 | 2019-04-01 | 28.0994327 | 2019-04-01 | 11.9588477 |
2019-05-01 | 19.733941 | 2019-05-01 | 28.115089 | 2019-05-01 | 11.9705077 |
2019-06-01 | 19.7439966 | 2019-06-01 | 28.1307452 | 2019-06-01 | 11.9821678 |
2019-07-01 | 19.7540522 | 2019-07-01 | 28.1464014 | 2019-07-01 | 11.9938278 |
2019-08-01 | 19.7641078 | 2019-08-01 | 28.1620577 | 2019-08-01 | 12.0054879 |
2019-09-01 | 19.7741634 | 2019-09-01 | 28.1777139 | 2019-09-01 | 12.0171479 |
2019-10-01 | 19.784219 | 2019-10-01 | 28.1933702 | 2019-10-01 | 12.028808 |
2019-11-01 | 19.7942746 | 2019-11-01 | 28.2090264 | 2019-11-01 | 12.040468 |
2019-12-01 | 19.8043302 | 2019-12-01 | 28.2246827 | 2019-12-01 | 12.0521281 |
2020-01-01 | 19.8143858 | 2020-01-01 | 28.2403389 | 2020-01-01 | 12.0637881 |
2020-02-01 | 19.8244414 | 2020-02-01 | 28.2559952 | 2020-02-01 | 12.0754482 |
2020-03-01 | 14.9555634 | 2020-03-01 | 22.0256111 | 2020-03-01 | 7.7813891 |
2020-04-01 | 21.4454834 | 2020-04-01 | 29.7230327 | 2020-04-01 | 12.9347292 |
2020-05-01 | 27.9354034 | 2020-05-01 | 37.4204544 | 2020-05-01 | 18.0880693 |
2020-06-01 | 34.4253234 | 2020-06-01 | 45.1178761 | 2020-06-01 | 23.2414094 |
2020-07-01 | 27.1016554 | 2020-07-01 | 35.5481986 | 2020-07-01 | 18.2424352 |
2020-08-01 | 25.9846329 | 2020-08-01 | 34.5711149 | 2020-08-01 | 17.1655988 |
2020-09-01 | 24.8676104 | 2020-09-01 | 33.5940311 | 2020-09-01 | 16.0887624 |
2020-10-01 | 23.7505878 | 2020-10-01 | 32.6169473 | 2020-10-01 | 15.011926 |
2020-11-01 | 22.6335653 | 2020-11-01 | 31.6398636 | 2020-11-01 | 13.9350895 |
2020-12-01 | 21.5165428 | 2020-12-01 | 30.6627798 | 2020-12-01 | 12.8582531 |
2021-01-01 | 20.3995203 | 2021-01-01 | 29.685696 | 2021-01-01 | 11.7814167 |
2021-02-01 | 19.2824978 | 2021-02-01 | 28.7086123 | 2021-02-01 | 10.7045803 |
2021-03-01 | 18.1654753 | 2021-03-01 | 27.7315285 | 2021-03-01 | 9.6277439 |
The trends were also superimposed onto a general pattern of increasing cycling injury rates over time that began well before the start of the pandemic. Cycling injury hospitalization rates declined and gradually returned to pre-pandemic levels during the reopening period. There were too few cycling injuries to estimate trends during the second lockdown.
Trends in cycling injury hospitalizations depended on patient age (see Figure 2). Before the pandemic, the 20 to 39, 40 to 59, and 60 years and older age groups all had steady increases in hospitalization rates for cycling injuries over time. In contrast, children aged 0 to 9 and adolescents aged 10 to 19 years had a steady decrease in hospitalization rates. In March 2020, rates fell significantly for all age groups except children less than 10 years old and adolescents 10 to 19 years old. The remainder of the first lockdown was marked by a sharp rise in cycling injury hospitalization rates among individuals 10 years and over, and particularly those aged between 10 and 19 years and between 40 and 59 years. Hospitalization rates declined for most age groups during reopening.
Figure 2 - Text description
Bike injury (<10 years) | Bike injury (10-19 years) | Bike injury (20-39 years) | Bike injury (40-59 years) | Bike injury (60 years and over) | |||||
---|---|---|---|---|---|---|---|---|---|
Date | Rate per 100 000 | Date | Rate per 100 000 | Date | Rate per 100 000 | Date | Rate per 100 000 | Date | Rate per 100 000 |
2006-04-01 | 19.7818548 | 2006-04-01 | 38.9970778 | 2006-04-01 | 13.7085896 | 2006-04-01 | 17.0969383 | 2006-04-01 | 12.6714603 |
2006-05-01 | 19.7127406 | 2006-05-01 | 38.8891165 | 2006-05-01 | 13.7401745 | 2006-05-01 | 17.149158 | 2006-05-01 | 12.7160689 |
2006-06-01 | 19.6436264 | 2006-06-01 | 38.7811552 | 2006-06-01 | 13.7717594 | 2006-06-01 | 17.2013777 | 2006-06-01 | 12.7606775 |
2006-07-01 | 19.5745122 | 2006-07-01 | 38.6731938 | 2006-07-01 | 13.8033442 | 2006-07-01 | 17.2535975 | 2006-07-01 | 12.8052862 |
2006-08-01 | 19.5053979 | 2006-08-01 | 38.5652325 | 2006-08-01 | 13.8349291 | 2006-08-01 | 17.3058172 | 2006-08-01 | 12.8498948 |
2006-09-01 | 19.4362837 | 2006-09-01 | 38.4572712 | 2006-09-01 | 13.866514 | 2006-09-01 | 17.3580369 | 2006-09-01 | 12.8945034 |
2006-10-01 | 19.3671695 | 2006-10-01 | 38.3493099 | 2006-10-01 | 13.8980988 | 2006-10-01 | 17.4102567 | 2006-10-01 | 12.939112 |
2006-11-01 | 19.2980553 | 2006-11-01 | 38.2413486 | 2006-11-01 | 13.9296837 | 2006-11-01 | 17.4624764 | 2006-11-01 | 12.9837206 |
2006-12-01 | 19.228941 | 2006-12-01 | 38.1333873 | 2006-12-01 | 13.9612686 | 2006-12-01 | 17.5146962 | 2006-12-01 | 13.0283292 |
2007-01-01 | 19.1598268 | 2007-01-01 | 38.025426 | 2007-01-01 | 13.9928534 | 2007-01-01 | 17.5669159 | 2007-01-01 | 13.0729378 |
2007-02-01 | 19.0907126 | 2007-02-01 | 37.9174647 | 2007-02-01 | 14.0244383 | 2007-02-01 | 17.6191356 | 2007-02-01 | 13.1175464 |
2007-03-01 | 19.0215984 | 2007-03-01 | 37.8095034 | 2007-03-01 | 14.0560231 | 2007-03-01 | 17.6713554 | 2007-03-01 | 13.162155 |
2007-04-01 | 18.9524841 | 2007-04-01 | 37.7015421 | 2007-04-01 | 14.087608 | 2007-04-01 | 17.7235751 | 2007-04-01 | 13.2067636 |
2007-05-01 | 18.8833699 | 2007-05-01 | 37.5935807 | 2007-05-01 | 14.1191929 | 2007-05-01 | 17.7757949 | 2007-05-01 | 13.2513722 |
2007-06-01 | 18.8142557 | 2007-06-01 | 37.4856194 | 2007-06-01 | 14.1507777 | 2007-06-01 | 17.8280146 | 2007-06-01 | 13.2959809 |
2007-07-01 | 18.7451415 | 2007-07-01 | 37.3776581 | 2007-07-01 | 14.1823626 | 2007-07-01 | 17.8802343 | 2007-07-01 | 13.3405895 |
2007-08-01 | 18.6760273 | 2007-08-01 | 37.2696968 | 2007-08-01 | 14.2139475 | 2007-08-01 | 17.9324541 | 2007-08-01 | 13.3851981 |
2007-09-01 | 18.606913 | 2007-09-01 | 37.1617355 | 2007-09-01 | 14.2455323 | 2007-09-01 | 17.9846738 | 2007-09-01 | 13.4298067 |
2007-10-01 | 18.5377988 | 2007-10-01 | 37.0537742 | 2007-10-01 | 14.2771172 | 2007-10-01 | 18.0368936 | 2007-10-01 | 13.4744153 |
2007-11-01 | 18.4686846 | 2007-11-01 | 36.9458129 | 2007-11-01 | 14.3087021 | 2007-11-01 | 18.0891133 | 2007-11-01 | 13.5190239 |
2007-12-01 | 18.3995704 | 2007-12-01 | 36.8378516 | 2007-12-01 | 14.3402869 | 2007-12-01 | 18.141333 | 2007-12-01 | 13.5636325 |
2008-01-01 | 18.3304561 | 2008-01-01 | 36.7298903 | 2008-01-01 | 14.3718718 | 2008-01-01 | 18.1935528 | 2008-01-01 | 13.6082411 |
2008-02-01 | 18.2613419 | 2008-02-01 | 36.621929 | 2008-02-01 | 14.4034567 | 2008-02-01 | 18.2457725 | 2008-02-01 | 13.6528497 |
2008-03-01 | 18.1922277 | 2008-03-01 | 36.5139676 | 2008-03-01 | 14.4350415 | 2008-03-01 | 18.2979922 | 2008-03-01 | 13.6974583 |
2008-04-01 | 18.1231135 | 2008-04-01 | 36.4060063 | 2008-04-01 | 14.4666264 | 2008-04-01 | 18.350212 | 2008-04-01 | 13.7420669 |
2008-05-01 | 18.0539992 | 2008-05-01 | 36.298045 | 2008-05-01 | 14.4982113 | 2008-05-01 | 18.4024317 | 2008-05-01 | 13.7866756 |
2008-06-01 | 17.984885 | 2008-06-01 | 36.1900837 | 2008-06-01 | 14.5297961 | 2008-06-01 | 18.4546515 | 2008-06-01 | 13.8312842 |
2008-07-01 | 17.9157708 | 2008-07-01 | 36.0821224 | 2008-07-01 | 14.561381 | 2008-07-01 | 18.5068712 | 2008-07-01 | 13.8758928 |
2008-08-01 | 17.8466566 | 2008-08-01 | 35.9741611 | 2008-08-01 | 14.5929658 | 2008-08-01 | 18.5590909 | 2008-08-01 | 13.9205014 |
2008-09-01 | 17.7775423 | 2008-09-01 | 35.8661998 | 2008-09-01 | 14.6245507 | 2008-09-01 | 18.6113107 | 2008-09-01 | 13.96511 |
2008-10-01 | 17.7084281 | 2008-10-01 | 35.7582385 | 2008-10-01 | 14.6561356 | 2008-10-01 | 18.6635304 | 2008-10-01 | 14.0097186 |
2008-11-01 | 17.6393139 | 2008-11-01 | 35.6502772 | 2008-11-01 | 14.6877204 | 2008-11-01 | 18.7157502 | 2008-11-01 | 14.0543272 |
2008-12-01 | 17.5701997 | 2008-12-01 | 35.5423159 | 2008-12-01 | 14.7193053 | 2008-12-01 | 18.7679699 | 2008-12-01 | 14.0989358 |
2009-01-01 | 17.5010854 | 2009-01-01 | 35.4343545 | 2009-01-01 | 14.7508902 | 2009-01-01 | 18.8201896 | 2009-01-01 | 14.1435444 |
2009-02-01 | 17.4319712 | 2009-02-01 | 35.3263932 | 2009-02-01 | 14.782475 | 2009-02-01 | 18.8724094 | 2009-02-01 | 14.188153 |
2009-03-01 | 17.362857 | 2009-03-01 | 35.2184319 | 2009-03-01 | 14.8140599 | 2009-03-01 | 18.9246291 | 2009-03-01 | 14.2327616 |
2009-04-01 | 17.2937428 | 2009-04-01 | 35.1104706 | 2009-04-01 | 14.8456448 | 2009-04-01 | 18.9768488 | 2009-04-01 | 14.2773703 |
2009-05-01 | 17.2246285 | 2009-05-01 | 35.0025093 | 2009-05-01 | 14.8772296 | 2009-05-01 | 19.0290686 | 2009-05-01 | 14.3219789 |
2009-06-01 | 17.1555143 | 2009-06-01 | 34.894548 | 2009-06-01 | 14.9088145 | 2009-06-01 | 19.0812883 | 2009-06-01 | 14.3665875 |
2009-07-01 | 17.0864001 | 2009-07-01 | 34.7865867 | 2009-07-01 | 14.9403994 | 2009-07-01 | 19.1335081 | 2009-07-01 | 14.4111961 |
2009-08-01 | 17.0172859 | 2009-08-01 | 34.6786254 | 2009-08-01 | 14.9719842 | 2009-08-01 | 19.1857278 | 2009-08-01 | 14.4558047 |
2009-09-01 | 16.9481716 | 2009-09-01 | 34.5706641 | 2009-09-01 | 15.0035691 | 2009-09-01 | 19.2379475 | 2009-09-01 | 14.5004133 |
2009-10-01 | 16.8790574 | 2009-10-01 | 34.4627027 | 2009-10-01 | 15.035154 | 2009-10-01 | 19.2901673 | 2009-10-01 | 14.5450219 |
2009-11-01 | 16.8099432 | 2009-11-01 | 34.3547414 | 2009-11-01 | 15.0667388 | 2009-11-01 | 19.342387 | 2009-11-01 | 14.5896305 |
2009-12-01 | 16.740829 | 2009-12-01 | 34.2467801 | 2009-12-01 | 15.0983237 | 2009-12-01 | 19.3946068 | 2009-12-01 | 14.6342391 |
2010-01-01 | 16.6717147 | 2010-01-01 | 34.1388188 | 2010-01-01 | 15.1299086 | 2010-01-01 | 19.4468265 | 2010-01-01 | 14.6788477 |
2010-02-01 | 16.6026005 | 2010-02-01 | 34.0308575 | 2010-02-01 | 15.1614934 | 2010-02-01 | 19.4990462 | 2010-02-01 | 14.7234564 |
2010-03-01 | 16.5334863 | 2010-03-01 | 33.9228962 | 2010-03-01 | 15.1930783 | 2010-03-01 | 19.551266 | 2010-03-01 | 14.768065 |
2010-04-01 | 16.4643721 | 2010-04-01 | 33.8149349 | 2010-04-01 | 15.2246631 | 2010-04-01 | 19.6034857 | 2010-04-01 | 14.8126736 |
2010-05-01 | 16.3952578 | 2010-05-01 | 33.7069736 | 2010-05-01 | 15.256248 | 2010-05-01 | 19.6557054 | 2010-05-01 | 14.8572822 |
2010-06-01 | 16.3261436 | 2010-06-01 | 33.5990123 | 2010-06-01 | 15.2878329 | 2010-06-01 | 19.7079252 | 2010-06-01 | 14.9018908 |
2010-07-01 | 16.2570294 | 2010-07-01 | 33.491051 | 2010-07-01 | 15.3194177 | 2010-07-01 | 19.7601449 | 2010-07-01 | 14.9464994 |
2010-08-01 | 16.1879152 | 2010-08-01 | 33.3830896 | 2010-08-01 | 15.3510026 | 2010-08-01 | 19.8123647 | 2010-08-01 | 14.991108 |
2010-09-01 | 16.1188009 | 2010-09-01 | 33.2751283 | 2010-09-01 | 15.3825875 | 2010-09-01 | 19.8645844 | 2010-09-01 | 15.0357166 |
2010-10-01 | 16.0496867 | 2010-10-01 | 33.167167 | 2010-10-01 | 15.4141723 | 2010-10-01 | 19.9168041 | 2010-10-01 | 15.0803252 |
2010-11-01 | 15.9805725 | 2010-11-01 | 33.0592057 | 2010-11-01 | 15.4457572 | 2010-11-01 | 19.9690239 | 2010-11-01 | 15.1249338 |
2010-12-01 | 15.9114583 | 2010-12-01 | 32.9512444 | 2010-12-01 | 15.4773421 | 2010-12-01 | 20.0212436 | 2010-12-01 | 15.1695424 |
2011-01-01 | 15.842344 | 2011-01-01 | 32.8432831 | 2011-01-01 | 15.5089269 | 2011-01-01 | 20.0734634 | 2011-01-01 | 15.2141511 |
2011-02-01 | 15.7732298 | 2011-02-01 | 32.7353218 | 2011-02-01 | 15.5405118 | 2011-02-01 | 20.1256831 | 2011-02-01 | 15.2587597 |
2011-03-01 | 15.7041156 | 2011-03-01 | 32.6273605 | 2011-03-01 | 15.5720967 | 2011-03-01 | 20.1779028 | 2011-03-01 | 15.3033683 |
2011-04-01 | 15.6350014 | 2011-04-01 | 32.5193992 | 2011-04-01 | 15.6036815 | 2011-04-01 | 20.2301226 | 2011-04-01 | 15.3479769 |
2011-05-01 | 15.5658872 | 2011-05-01 | 32.4114379 | 2011-05-01 | 15.6352664 | 2011-05-01 | 20.2823423 | 2011-05-01 | 15.3925855 |
2011-06-01 | 15.4967729 | 2011-06-01 | 32.3034765 | 2011-06-01 | 15.6668513 | 2011-06-01 | 20.334562 | 2011-06-01 | 15.4371941 |
2011-07-01 | 15.4276587 | 2011-07-01 | 32.1955152 | 2011-07-01 | 15.6984361 | 2011-07-01 | 20.3867818 | 2011-07-01 | 15.4818027 |
2011-08-01 | 15.3585445 | 2011-08-01 | 32.0875539 | 2011-08-01 | 15.730021 | 2011-08-01 | 20.4390015 | 2011-08-01 | 15.5264113 |
2011-09-01 | 15.2894303 | 2011-09-01 | 31.9795926 | 2011-09-01 | 15.7616058 | 2011-09-01 | 20.4912213 | 2011-09-01 | 15.5710199 |
2011-10-01 | 15.220316 | 2011-10-01 | 31.8716313 | 2011-10-01 | 15.7931907 | 2011-10-01 | 20.543441 | 2011-10-01 | 15.6156285 |
2011-11-01 | 15.1512018 | 2011-11-01 | 31.76367 | 2011-11-01 | 15.8247756 | 2011-11-01 | 20.5956607 | 2011-11-01 | 15.6602371 |
2011-12-01 | 15.0820876 | 2011-12-01 | 31.6557087 | 2011-12-01 | 15.8563604 | 2011-12-01 | 20.6478805 | 2011-12-01 | 15.7048458 |
2012-01-01 | 15.0129734 | 2012-01-01 | 31.5477474 | 2012-01-01 | 15.8879453 | 2012-01-01 | 20.7001002 | 2012-01-01 | 15.7494544 |
2012-02-01 | 14.9438591 | 2012-02-01 | 31.4397861 | 2012-02-01 | 15.9195302 | 2012-02-01 | 20.75232 | 2012-02-01 | 15.794063 |
2012-03-01 | 14.8747449 | 2012-03-01 | 31.3318248 | 2012-03-01 | 15.951115 | 2012-03-01 | 20.8045397 | 2012-03-01 | 15.8386716 |
2012-04-01 | 14.8056307 | 2012-04-01 | 31.2238634 | 2012-04-01 | 15.9826999 | 2012-04-01 | 20.8567594 | 2012-04-01 | 15.8832802 |
2012-05-01 | 14.7365165 | 2012-05-01 | 31.1159021 | 2012-05-01 | 16.0142848 | 2012-05-01 | 20.9089792 | 2012-05-01 | 15.9278888 |
2012-06-01 | 14.6674022 | 2012-06-01 | 31.0079408 | 2012-06-01 | 16.0458696 | 2012-06-01 | 20.9611989 | 2012-06-01 | 15.9724974 |
2012-07-01 | 14.598288 | 2012-07-01 | 30.8999795 | 2012-07-01 | 16.0774545 | 2012-07-01 | 21.0134187 | 2012-07-01 | 16.017106 |
2012-08-01 | 14.5291738 | 2012-08-01 | 30.7920182 | 2012-08-01 | 16.1090394 | 2012-08-01 | 21.0656384 | 2012-08-01 | 16.0617146 |
2012-09-01 | 14.4600596 | 2012-09-01 | 30.6840569 | 2012-09-01 | 16.1406242 | 2012-09-01 | 21.1178581 | 2012-09-01 | 16.1063232 |
2012-10-01 | 14.3909453 | 2012-10-01 | 30.5760956 | 2012-10-01 | 16.1722091 | 2012-10-01 | 21.1700779 | 2012-10-01 | 16.1509318 |
2012-11-01 | 14.3218311 | 2012-11-01 | 30.4681343 | 2012-11-01 | 16.203794 | 2012-11-01 | 21.2222976 | 2012-11-01 | 16.1955405 |
2012-12-01 | 14.2527169 | 2012-12-01 | 30.360173 | 2012-12-01 | 16.2353788 | 2012-12-01 | 21.2745173 | 2012-12-01 | 16.2401491 |
2013-01-01 | 14.1836027 | 2013-01-01 | 30.2522117 | 2013-01-01 | 16.2669637 | 2013-01-01 | 21.3267371 | 2013-01-01 | 16.2847577 |
2013-02-01 | 14.1144884 | 2013-02-01 | 30.1442503 | 2013-02-01 | 16.2985486 | 2013-02-01 | 21.3789568 | 2013-02-01 | 16.3293663 |
2013-03-01 | 14.0453742 | 2013-03-01 | 30.036289 | 2013-03-01 | 16.3301334 | 2013-03-01 | 21.4311766 | 2013-03-01 | 16.3739749 |
2013-04-01 | 13.97626 | 2013-04-01 | 29.9283277 | 2013-04-01 | 16.3617183 | 2013-04-01 | 21.4833963 | 2013-04-01 | 16.4185835 |
2013-05-01 | 13.9071458 | 2013-05-01 | 29.8203664 | 2013-05-01 | 16.3933031 | 2013-05-01 | 21.535616 | 2013-05-01 | 16.4631921 |
2013-06-01 | 13.8380315 | 2013-06-01 | 29.7124051 | 2013-06-01 | 16.424888 | 2013-06-01 | 21.5878358 | 2013-06-01 | 16.5078007 |
2013-07-01 | 13.7689173 | 2013-07-01 | 29.6044438 | 2013-07-01 | 16.4564729 | 2013-07-01 | 21.6400555 | 2013-07-01 | 16.5524093 |
2013-08-01 | 13.6998031 | 2013-08-01 | 29.4964825 | 2013-08-01 | 16.4880577 | 2013-08-01 | 21.6922753 | 2013-08-01 | 16.5970179 |
2013-09-01 | 13.6306889 | 2013-09-01 | 29.3885212 | 2013-09-01 | 16.5196426 | 2013-09-01 | 21.744495 | 2013-09-01 | 16.6416265 |
2013-10-01 | 13.5615746 | 2013-10-01 | 29.2805599 | 2013-10-01 | 16.5512275 | 2013-10-01 | 21.7967147 | 2013-10-01 | 16.6862352 |
2013-11-01 | 13.4924604 | 2013-11-01 | 29.1725986 | 2013-11-01 | 16.5828123 | 2013-11-01 | 21.8489345 | 2013-11-01 | 16.7308438 |
2013-12-01 | 13.4233462 | 2013-12-01 | 29.0646372 | 2013-12-01 | 16.6143972 | 2013-12-01 | 21.9011542 | 2013-12-01 | 16.7754524 |
2014-01-01 | 13.354232 | 2014-01-01 | 28.9566759 | 2014-01-01 | 16.6459821 | 2014-01-01 | 21.9533739 | 2014-01-01 | 16.820061 |
2014-02-01 | 13.2851177 | 2014-02-01 | 28.8487146 | 2014-02-01 | 16.6775669 | 2014-02-01 | 22.0055937 | 2014-02-01 | 16.8646696 |
2014-03-01 | 13.2160035 | 2014-03-01 | 28.7407533 | 2014-03-01 | 16.7091518 | 2014-03-01 | 22.0578134 | 2014-03-01 | 16.9092782 |
2014-04-01 | 13.1468893 | 2014-04-01 | 28.632792 | 2014-04-01 | 16.7407367 | 2014-04-01 | 22.1100332 | 2014-04-01 | 16.9538868 |
2014-05-01 | 13.0777751 | 2014-05-01 | 28.5248307 | 2014-05-01 | 16.7723215 | 2014-05-01 | 22.1622529 | 2014-05-01 | 16.9984954 |
2014-06-01 | 13.0086608 | 2014-06-01 | 28.4168694 | 2014-06-01 | 16.8039064 | 2014-06-01 | 22.2144726 | 2014-06-01 | 17.043104 |
2014-07-01 | 12.9395466 | 2014-07-01 | 28.3089081 | 2014-07-01 | 16.8354913 | 2014-07-01 | 22.2666924 | 2014-07-01 | 17.0877126 |
2014-08-01 | 12.8704324 | 2014-08-01 | 28.2009468 | 2014-08-01 | 16.8670761 | 2014-08-01 | 22.3189121 | 2014-08-01 | 17.1323212 |
2014-09-01 | 12.8013182 | 2014-09-01 | 28.0929855 | 2014-09-01 | 16.898661 | 2014-09-01 | 22.3711319 | 2014-09-01 | 17.1769299 |
2014-10-01 | 12.7322039 | 2014-10-01 | 27.9850241 | 2014-10-01 | 16.9302458 | 2014-10-01 | 22.4233516 | 2014-10-01 | 17.2215385 |
2014-11-01 | 12.6630897 | 2014-11-01 | 27.8770628 | 2014-11-01 | 16.9618307 | 2014-11-01 | 22.4755713 | 2014-11-01 | 17.2661471 |
2014-12-01 | 12.5939755 | 2014-12-01 | 27.7691015 | 2014-12-01 | 16.9934156 | 2014-12-01 | 22.5277911 | 2014-12-01 | 17.3107557 |
2015-01-01 | 12.5248613 | 2015-01-01 | 27.6611402 | 2015-01-01 | 17.0250004 | 2015-01-01 | 22.5800108 | 2015-01-01 | 17.3553643 |
2015-02-01 | 12.4557471 | 2015-02-01 | 27.5531789 | 2015-02-01 | 17.0565853 | 2015-02-01 | 22.6322305 | 2015-02-01 | 17.3999729 |
2015-03-01 | 12.3866328 | 2015-03-01 | 27.4452176 | 2015-03-01 | 17.0881702 | 2015-03-01 | 22.6844503 | 2015-03-01 | 17.4445815 |
2015-04-01 | 12.3175186 | 2015-04-01 | 27.3372563 | 2015-04-01 | 17.119755 | 2015-04-01 | 22.73667 | 2015-04-01 | 17.4891901 |
2015-05-01 | 12.2484044 | 2015-05-01 | 27.229295 | 2015-05-01 | 17.1513399 | 2015-05-01 | 22.7888898 | 2015-05-01 | 17.5337987 |
2015-06-01 | 12.1792902 | 2015-06-01 | 27.1213337 | 2015-06-01 | 17.1829248 | 2015-06-01 | 22.8411095 | 2015-06-01 | 17.5784073 |
2015-07-01 | 12.1101759 | 2015-07-01 | 27.0133724 | 2015-07-01 | 17.2145096 | 2015-07-01 | 22.8933292 | 2015-07-01 | 17.6230159 |
2015-08-01 | 12.0410617 | 2015-08-01 | 26.905411 | 2015-08-01 | 17.2460945 | 2015-08-01 | 22.945549 | 2015-08-01 | 17.6676246 |
2015-09-01 | 11.9719475 | 2015-09-01 | 26.7974497 | 2015-09-01 | 17.2776794 | 2015-09-01 | 22.9977687 | 2015-09-01 | 17.7122332 |
2015-10-01 | 11.9028333 | 2015-10-01 | 26.6894884 | 2015-10-01 | 17.3092642 | 2015-10-01 | 23.0499885 | 2015-10-01 | 17.7568418 |
2015-11-01 | 11.833719 | 2015-11-01 | 26.5815271 | 2015-11-01 | 17.3408491 | 2015-11-01 | 23.1022082 | 2015-11-01 | 17.8014504 |
2015-12-01 | 11.7646048 | 2015-12-01 | 26.4735658 | 2015-12-01 | 17.372434 | 2015-12-01 | 23.1544279 | 2015-12-01 | 17.846059 |
2016-01-01 | 11.6954906 | 2016-01-01 | 26.3656045 | 2016-01-01 | 17.4040188 | 2016-01-01 | 23.2066477 | 2016-01-01 | 17.8906676 |
2016-02-01 | 11.6263764 | 2016-02-01 | 26.2576432 | 2016-02-01 | 17.4356037 | 2016-02-01 | 23.2588674 | 2016-02-01 | 17.9352762 |
2016-03-01 | 11.5572621 | 2016-03-01 | 26.1496819 | 2016-03-01 | 17.4671886 | 2016-03-01 | 23.3110871 | 2016-03-01 | 17.9798848 |
2016-04-01 | 11.4881479 | 2016-04-01 | 26.0417206 | 2016-04-01 | 17.4987734 | 2016-04-01 | 23.3633069 | 2016-04-01 | 18.0244934 |
2016-05-01 | 11.4190337 | 2016-05-01 | 25.9337592 | 2016-05-01 | 17.5303583 | 2016-05-01 | 23.4155266 | 2016-05-01 | 18.069102 |
2016-06-01 | 11.3499195 | 2016-06-01 | 25.8257979 | 2016-06-01 | 17.5619431 | 2016-06-01 | 23.4677464 | 2016-06-01 | 18.1137106 |
2016-07-01 | 11.2808052 | 2016-07-01 | 25.7178366 | 2016-07-01 | 17.593528 | 2016-07-01 | 23.5199661 | 2016-07-01 | 18.1583193 |
2016-08-01 | 11.211691 | 2016-08-01 | 25.6098753 | 2016-08-01 | 17.6251129 | 2016-08-01 | 23.5721858 | 2016-08-01 | 18.2029279 |
2016-09-01 | 11.1425768 | 2016-09-01 | 25.501914 | 2016-09-01 | 17.6566977 | 2016-09-01 | 23.6244056 | 2016-09-01 | 18.2475365 |
2016-10-01 | 11.0734626 | 2016-10-01 | 25.3939527 | 2016-10-01 | 17.6882826 | 2016-10-01 | 23.6766253 | 2016-10-01 | 18.2921451 |
2016-11-01 | 11.0043483 | 2016-11-01 | 25.2859914 | 2016-11-01 | 17.7198675 | 2016-11-01 | 23.7288451 | 2016-11-01 | 18.3367537 |
2016-12-01 | 10.9352341 | 2016-12-01 | 25.1780301 | 2016-12-01 | 17.7514523 | 2016-12-01 | 23.7810648 | 2016-12-01 | 18.3813623 |
2017-01-01 | 10.8661199 | 2017-01-01 | 25.0700688 | 2017-01-01 | 17.7830372 | 2017-01-01 | 23.8332845 | 2017-01-01 | 18.4259709 |
2017-02-01 | 10.7970057 | 2017-02-01 | 24.9621075 | 2017-02-01 | 17.8146221 | 2017-02-01 | 23.8855043 | 2017-02-01 | 18.4705795 |
2017-03-01 | 10.7278914 | 2017-03-01 | 24.8541461 | 2017-03-01 | 17.8462069 | 2017-03-01 | 23.937724 | 2017-03-01 | 18.5151881 |
2017-04-01 | 10.6587772 | 2017-04-01 | 24.7461848 | 2017-04-01 | 17.8777918 | 2017-04-01 | 23.9899438 | 2017-04-01 | 18.5597967 |
2017-05-01 | 10.589663 | 2017-05-01 | 24.6382235 | 2017-05-01 | 17.9093767 | 2017-05-01 | 24.0421635 | 2017-05-01 | 18.6044053 |
2017-06-01 | 10.5205488 | 2017-06-01 | 24.5302622 | 2017-06-01 | 17.9409615 | 2017-06-01 | 24.0943832 | 2017-06-01 | 18.649014 |
2017-07-01 | 10.4514345 | 2017-07-01 | 24.4223009 | 2017-07-01 | 17.9725464 | 2017-07-01 | 24.146603 | 2017-07-01 | 18.6936226 |
2017-08-01 | 10.3823203 | 2017-08-01 | 24.3143396 | 2017-08-01 | 18.0041313 | 2017-08-01 | 24.1988227 | 2017-08-01 | 18.7382312 |
2017-09-01 | 10.3132061 | 2017-09-01 | 24.2063783 | 2017-09-01 | 18.0357161 | 2017-09-01 | 24.2510424 | 2017-09-01 | 18.7828398 |
2017-10-01 | 10.2440919 | 2017-10-01 | 24.098417 | 2017-10-01 | 18.067301 | 2017-10-01 | 24.3032622 | 2017-10-01 | 18.8274484 |
2017-11-01 | 10.1749776 | 2017-11-01 | 23.9904557 | 2017-11-01 | 18.0988858 | 2017-11-01 | 24.3554819 | 2017-11-01 | 18.872057 |
2017-12-01 | 10.1058634 | 2017-12-01 | 23.8824944 | 2017-12-01 | 18.1304707 | 2017-12-01 | 24.4077017 | 2017-12-01 | 18.9166656 |
2018-01-01 | 10.0367492 | 2018-01-01 | 23.774533 | 2018-01-01 | 18.1620556 | 2018-01-01 | 24.4599214 | 2018-01-01 | 18.9612742 |
2018-02-01 | 9.96763497 | 2018-02-01 | 23.6665717 | 2018-02-01 | 18.1936404 | 2018-02-01 | 24.5121411 | 2018-02-01 | 19.0058828 |
2018-03-01 | 9.89852075 | 2018-03-01 | 23.5586104 | 2018-03-01 | 18.2252253 | 2018-03-01 | 24.5643609 | 2018-03-01 | 19.0504914 |
2018-04-01 | 9.82940652 | 2018-04-01 | 23.4506491 | 2018-04-01 | 18.2568102 | 2018-04-01 | 24.6165806 | 2018-04-01 | 19.0951 |
2018-05-01 | 9.7602923 | 2018-05-01 | 23.3426878 | 2018-05-01 | 18.288395 | 2018-05-01 | 24.6688004 | 2018-05-01 | 19.1397087 |
2018-06-01 | 9.69117807 | 2018-06-01 | 23.2347265 | 2018-06-01 | 18.3199799 | 2018-06-01 | 24.7210201 | 2018-06-01 | 19.1843173 |
2018-07-01 | 9.62206385 | 2018-07-01 | 23.1267652 | 2018-07-01 | 18.3515648 | 2018-07-01 | 24.7732398 | 2018-07-01 | 19.2289259 |
2018-08-01 | 9.55294963 | 2018-08-01 | 23.0188039 | 2018-08-01 | 18.3831496 | 2018-08-01 | 24.8254596 | 2018-08-01 | 19.2735345 |
2018-09-01 | 9.4838354 | 2018-09-01 | 22.9108426 | 2018-09-01 | 18.4147345 | 2018-09-01 | 24.8776793 | 2018-09-01 | 19.3181431 |
2018-10-01 | 9.41472118 | 2018-10-01 | 22.8028813 | 2018-10-01 | 18.4463194 | 2018-10-01 | 24.929899 | 2018-10-01 | 19.3627517 |
2018-11-01 | 9.34560695 | 2018-11-01 | 22.6949199 | 2018-11-01 | 18.4779042 | 2018-11-01 | 24.9821188 | 2018-11-01 | 19.4073603 |
2018-12-01 | 9.27649273 | 2018-12-01 | 22.5869586 | 2018-12-01 | 18.5094891 | 2018-12-01 | 25.0343385 | 2018-12-01 | 19.4519689 |
2019-01-01 | 9.2073785 | 2019-01-01 | 22.4789973 | 2019-01-01 | 18.541074 | 2019-01-01 | 25.0865583 | 2019-01-01 | 19.4965775 |
2019-02-01 | 9.13826428 | 2019-02-01 | 22.371036 | 2019-02-01 | 18.5726588 | 2019-02-01 | 25.138778 | 2019-02-01 | 19.5411861 |
2019-03-01 | 9.06915005 | 2019-03-01 | 22.2630747 | 2019-03-01 | 18.6042437 | 2019-03-01 | 25.1909977 | 2019-03-01 | 19.5857947 |
2019-04-01 | 9.00003583 | 2019-04-01 | 22.1551134 | 2019-04-01 | 18.6358285 | 2019-04-01 | 25.2432175 | 2019-04-01 | 19.6304034 |
2019-05-01 | 8.93092161 | 2019-05-01 | 22.0471521 | 2019-05-01 | 18.6674134 | 2019-05-01 | 25.2954372 | 2019-05-01 | 19.675012 |
2019-06-01 | 8.86180738 | 2019-06-01 | 21.9391908 | 2019-06-01 | 18.6989983 | 2019-06-01 | 25.347657 | 2019-06-01 | 19.7196206 |
2019-07-01 | 8.79269316 | 2019-07-01 | 21.8312295 | 2019-07-01 | 18.7305831 | 2019-07-01 | 25.3998767 | 2019-07-01 | 19.7642292 |
2019-08-01 | 8.72357893 | 2019-08-01 | 21.7232682 | 2019-08-01 | 18.762168 | 2019-08-01 | 25.4520964 | 2019-08-01 | 19.8088378 |
2019-09-01 | 8.65446471 | 2019-09-01 | 21.6153068 | 2019-09-01 | 18.7937529 | 2019-09-01 | 25.5043162 | 2019-09-01 | 19.8534464 |
2019-10-01 | 8.58535048 | 2019-10-01 | 21.5073455 | 2019-10-01 | 18.8253377 | 2019-10-01 | 25.5565359 | 2019-10-01 | 19.898055 |
2019-11-01 | 8.51623626 | 2019-11-01 | 21.3993842 | 2019-11-01 | 18.8569226 | 2019-11-01 | 25.6087556 | 2019-11-01 | 19.9426636 |
2019-12-01 | 8.44712204 | 2019-12-01 | 21.2914229 | 2019-12-01 | 18.8885075 | 2019-12-01 | 25.6609754 | 2019-12-01 | 19.9872722 |
2020-01-01 | 8.37800781 | 2020-01-01 | 21.1834616 | 2020-01-01 | 18.9200923 | 2020-01-01 | 25.7131951 | 2020-01-01 | 20.0318808 |
2020-02-01 | 8.30889359 | 2020-02-01 | 21.0755003 | 2020-02-01 | 18.9516772 | 2020-02-01 | 25.7654149 | 2020-02-01 | 20.0764894 |
2020-03-01 | 12.726065 | 2020-03-01 | 14.9115794 | 2020-03-01 | 13.0606157 | 2020-03-01 | 17.8148833 | 2020-03-01 | 11.5331499 |
2020-04-01 | 12.8093758 | 2020-04-01 | 28.2066552 | 2020-04-01 | 18.1262381 | 2020-04-01 | 26.759843 | 2020-04-01 | 17.4266651 |
2020-05-01 | 12.8926867 | 2020-05-01 | 41.5017311 | 2020-05-01 | 23.1918605 | 2020-05-01 | 35.7048027 | 2020-05-01 | 23.3201803 |
2020-06-01 | 12.9759975 | 2020-06-01 | 54.7968069 | 2020-06-01 | 28.2574828 | 2020-06-01 | 44.6497624 | 2020-06-01 | 29.2136955 |
2020-07-01 | 4.96792103 | 2020-07-01 | 36.2765503 | 2020-07-01 | 34.6476931 | 2020-07-01 | 25.2236849 | 2020-07-01 | 30.5534746 |
2020-08-01 | 5.78604877 | 2020-08-01 | 34.3243962 | 2020-08-01 | 31.9227663 | 2020-08-01 | 25.4983678 | 2020-08-01 | 28.461176 |
2020-09-01 | 6.60417651 | 2020-09-01 | 32.3722422 | 2020-09-01 | 29.1978395 | 2020-09-01 | 25.7730508 | 2020-09-01 | 26.3688773 |
2020-10-01 | 7.42230425 | 2020-10-01 | 30.4200882 | 2020-10-01 | 26.4729127 | 2020-10-01 | 26.0477337 | 2020-10-01 | 24.2765787 |
2020-11-01 | 8.24043199 | 2020-11-01 | 28.4679342 | 2020-11-01 | 23.7479859 | 2020-11-01 | 26.3224166 | 2020-11-01 | 22.1842801 |
2020-12-01 | 9.05855973 | 2020-12-01 | 26.5157802 | 2020-12-01 | 21.0230591 | 2020-12-01 | 26.5970995 | 2020-12-01 | 20.0919814 |
2021-01-01 | 9.87668747 | 2021-01-01 | 24.5636262 | 2021-01-01 | 18.2981323 | 2021-01-01 | 26.8717825 | 2021-01-01 | 17.9996828 |
2021-02-01 | 10.6948152 | 2021-02-01 | 22.6114722 | 2021-02-01 | 15.5732056 | 2021-02-01 | 27.1464654 | 2021-02-01 | 15.9073841 |
2021-03-01 | 11.512943 | 2021-03-01 | 20.6593182 | 2021-03-01 | 12.8482788 | 2021-03-01 | 27.4211483 | 2021-03-01 | 13.8150855 |
Period | <10 years | 10-19 years | 20-39 years | 40-59 years | ≥60 years | |||||
---|---|---|---|---|---|---|---|---|---|---|
Monthly change | p value | Monthly change | p value | Monthly change | p value | Monthly change | p value | Monthly change | p value | |
Pre-pandemic | -0.069 | 0.04 | -0.108 | <0.01 | 0.032 | 0.04 | 0.052 | <0.01 | 0.045 | <0.01 |
First month of lockdown | 4.33 | 0.51 | -19.46 | 0.06 | -10.96 | 0.04 | -16.90 | <0.01 | -14.44 | 0.02 |
Remainder of first lockdown | 0.08 | 0.97 | 13.30 | <0.01 | 5.07 | 0.01 | 8.94 | <0.01 | 5.89 | 0.01 |
First month of reopening | -8.83 | 0.16 | -16.57 | 0.10 | 9.12 | 0.08 | -19.70 | <0.01 | 3.43 | 0.58 |
Remainder of follow-up | 0.82 | 0.36 | -1.95 | 0.19 | -2.72 | <0.01 | 0.27 | 0.76 | -2.09 | 0.06 |
The impact of the pandemic on cycling injury hospitalizations depended on socioeconomic status and neighbourhood racialized group concentration (see Figure 3). Hospitalization rates for cycling injuries decreased in March 2020, but increased during the remainder of the first lockdown for individuals from neighbourhoods with very low socioeconomic disadvantage and racialized group concentration. Individuals from neighbourhoods with very low socioeconomic disadvantage had 9.6 additional hospitalizations per 100 000 each month, and individuals living in neighbourhoods with very low racialized group concentration had 19.2 additional hospitalizations per 100 000 each month. In contrast, rates increased only slightly for patients from socioeconomically disadvantaged neighbourhoods and those with very high racialized group concentration. During reopening, rates returned to pre-pandemic levels in all groups. In sensitivity analyses of weekly rates, trends resembled monthly rates.
Figure 3 - Text description
Bike injury (socioeconomic disadvantage - low) | Bike injury (socioeconomic disadvantage - high) | Bike injury (ethnic concentration - low) | Bike injury (ethnic concentration - high) | ||||
---|---|---|---|---|---|---|---|
Date | Rate per 100 000 | Date | Rate per 100 000 | Date | Rate per 100 000 | Date | Rate per 100 000 |
2006-04-01 | 12.1060827 | 2006-04-01 | 7.94199474 | 2006-04-01 | 32.495474 | 2006-04-01 | 4.15830115 |
2006-05-01 | 12.1406012 | 2006-05-01 | 7.94213117 | 2006-05-01 | 32.5183952 | 2006-05-01 | 4.1554557 |
2006-06-01 | 12.1751197 | 2006-06-01 | 7.9422676 | 2006-06-01 | 32.5413164 | 2006-06-01 | 4.15261025 |
2006-07-01 | 12.2096382 | 2006-07-01 | 7.94240403 | 2006-07-01 | 32.5642376 | 2006-07-01 | 4.1497648 |
2006-08-01 | 12.2441566 | 2006-08-01 | 7.94254046 | 2006-08-01 | 32.5871588 | 2006-08-01 | 4.14691935 |
2006-09-01 | 12.2786751 | 2006-09-01 | 7.94267689 | 2006-09-01 | 32.6100799 | 2006-09-01 | 4.14407391 |
2006-10-01 | 12.3131936 | 2006-10-01 | 7.94281332 | 2006-10-01 | 32.6330011 | 2006-10-01 | 4.14122846 |
2006-11-01 | 12.3477121 | 2006-11-01 | 7.94294975 | 2006-11-01 | 32.6559223 | 2006-11-01 | 4.13838301 |
2006-12-01 | 12.3822306 | 2006-12-01 | 7.94308618 | 2006-12-01 | 32.6788435 | 2006-12-01 | 4.13553756 |
2007-01-01 | 12.4167491 | 2007-01-01 | 7.94322261 | 2007-01-01 | 32.7017646 | 2007-01-01 | 4.13269211 |
2007-02-01 | 12.4512676 | 2007-02-01 | 7.94335904 | 2007-02-01 | 32.7246858 | 2007-02-01 | 4.12984666 |
2007-03-01 | 12.485786 | 2007-03-01 | 7.94349547 | 2007-03-01 | 32.747607 | 2007-03-01 | 4.12700121 |
2007-04-01 | 12.5203045 | 2007-04-01 | 7.9436319 | 2007-04-01 | 32.7705282 | 2007-04-01 | 4.12415577 |
2007-05-01 | 12.554823 | 2007-05-01 | 7.94376833 | 2007-05-01 | 32.7934494 | 2007-05-01 | 4.12131032 |
2007-06-01 | 12.5893415 | 2007-06-01 | 7.94390476 | 2007-06-01 | 32.8163705 | 2007-06-01 | 4.11846487 |
2007-07-01 | 12.62386 | 2007-07-01 | 7.94404119 | 2007-07-01 | 32.8392917 | 2007-07-01 | 4.11561942 |
2007-08-01 | 12.6583785 | 2007-08-01 | 7.94417762 | 2007-08-01 | 32.8622129 | 2007-08-01 | 4.11277397 |
2007-09-01 | 12.6928969 | 2007-09-01 | 7.94431405 | 2007-09-01 | 32.8851341 | 2007-09-01 | 4.10992852 |
2007-10-01 | 12.7274154 | 2007-10-01 | 7.94445048 | 2007-10-01 | 32.9080552 | 2007-10-01 | 4.10708307 |
2007-11-01 | 12.7619339 | 2007-11-01 | 7.94458691 | 2007-11-01 | 32.9309764 | 2007-11-01 | 4.10423763 |
2007-12-01 | 12.7964524 | 2007-12-01 | 7.94472334 | 2007-12-01 | 32.9538976 | 2007-12-01 | 4.10139218 |
2008-01-01 | 12.8309709 | 2008-01-01 | 7.94485977 | 2008-01-01 | 32.9768188 | 2008-01-01 | 4.09854673 |
2008-02-01 | 12.8654894 | 2008-02-01 | 7.9449962 | 2008-02-01 | 32.99974 | 2008-02-01 | 4.09570128 |
2008-03-01 | 12.9000079 | 2008-03-01 | 7.94513263 | 2008-03-01 | 33.0226611 | 2008-03-01 | 4.09285583 |
2008-04-01 | 12.9345263 | 2008-04-01 | 7.94526906 | 2008-04-01 | 33.0455823 | 2008-04-01 | 4.09001038 |
2008-05-01 | 12.9690448 | 2008-05-01 | 7.94540549 | 2008-05-01 | 33.0685035 | 2008-05-01 | 4.08716493 |
2008-06-01 | 13.0035633 | 2008-06-01 | 7.94554192 | 2008-06-01 | 33.0914247 | 2008-06-01 | 4.08431949 |
2008-07-01 | 13.0380818 | 2008-07-01 | 7.94567835 | 2008-07-01 | 33.1143458 | 2008-07-01 | 4.08147404 |
2008-08-01 | 13.0726003 | 2008-08-01 | 7.94581478 | 2008-08-01 | 33.137267 | 2008-08-01 | 4.07862859 |
2008-09-01 | 13.1071188 | 2008-09-01 | 7.94595121 | 2008-09-01 | 33.1601882 | 2008-09-01 | 4.07578314 |
2008-10-01 | 13.1416373 | 2008-10-01 | 7.94608764 | 2008-10-01 | 33.1831094 | 2008-10-01 | 4.07293769 |
2008-11-01 | 13.1761557 | 2008-11-01 | 7.94622407 | 2008-11-01 | 33.2060306 | 2008-11-01 | 4.07009224 |
2008-12-01 | 13.2106742 | 2008-12-01 | 7.9463605 | 2008-12-01 | 33.2289517 | 2008-12-01 | 4.06724679 |
2009-01-01 | 13.2451927 | 2009-01-01 | 7.94649693 | 2009-01-01 | 33.2518729 | 2009-01-01 | 4.06440135 |
2009-02-01 | 13.2797112 | 2009-02-01 | 7.94663336 | 2009-02-01 | 33.2747941 | 2009-02-01 | 4.0615559 |
2009-03-01 | 13.3142297 | 2009-03-01 | 7.94676979 | 2009-03-01 | 33.2977153 | 2009-03-01 | 4.05871045 |
2009-04-01 | 13.3487482 | 2009-04-01 | 7.94690622 | 2009-04-01 | 33.3206364 | 2009-04-01 | 4.055865 |
2009-05-01 | 13.3832666 | 2009-05-01 | 7.94704265 | 2009-05-01 | 33.3435576 | 2009-05-01 | 4.05301955 |
2009-06-01 | 13.4177851 | 2009-06-01 | 7.94717908 | 2009-06-01 | 33.3664788 | 2009-06-01 | 4.0501741 |
2009-07-01 | 13.4523036 | 2009-07-01 | 7.94731551 | 2009-07-01 | 33.3894 | 2009-07-01 | 4.04732865 |
2009-08-01 | 13.4868221 | 2009-08-01 | 7.94745194 | 2009-08-01 | 33.4123212 | 2009-08-01 | 4.04448321 |
2009-09-01 | 13.5213406 | 2009-09-01 | 7.94758837 | 2009-09-01 | 33.4352423 | 2009-09-01 | 4.04163776 |
2009-10-01 | 13.5558591 | 2009-10-01 | 7.9477248 | 2009-10-01 | 33.4581635 | 2009-10-01 | 4.03879231 |
2009-11-01 | 13.5903776 | 2009-11-01 | 7.94786123 | 2009-11-01 | 33.4810847 | 2009-11-01 | 4.03594686 |
2009-12-01 | 13.624896 | 2009-12-01 | 7.94799766 | 2009-12-01 | 33.5040059 | 2009-12-01 | 4.03310141 |
2010-01-01 | 13.6594145 | 2010-01-01 | 7.94813409 | 2010-01-01 | 33.5269271 | 2010-01-01 | 4.03025596 |
2010-02-01 | 13.693933 | 2010-02-01 | 7.94827052 | 2010-02-01 | 33.5498482 | 2010-02-01 | 4.02741051 |
2010-03-01 | 13.7284515 | 2010-03-01 | 7.94840696 | 2010-03-01 | 33.5727694 | 2010-03-01 | 4.02456507 |
2010-04-01 | 13.76297 | 2010-04-01 | 7.94854339 | 2010-04-01 | 33.5956906 | 2010-04-01 | 4.02171962 |
2010-05-01 | 13.7974885 | 2010-05-01 | 7.94867982 | 2010-05-01 | 33.6186118 | 2010-05-01 | 4.01887417 |
2010-06-01 | 13.832007 | 2010-06-01 | 7.94881625 | 2010-06-01 | 33.6415329 | 2010-06-01 | 4.01602872 |
2010-07-01 | 13.8665254 | 2010-07-01 | 7.94895268 | 2010-07-01 | 33.6644541 | 2010-07-01 | 4.01318327 |
2010-08-01 | 13.9010439 | 2010-08-01 | 7.94908911 | 2010-08-01 | 33.6873753 | 2010-08-01 | 4.01033782 |
2010-09-01 | 13.9355624 | 2010-09-01 | 7.94922554 | 2010-09-01 | 33.7102965 | 2010-09-01 | 4.00749237 |
2010-10-01 | 13.9700809 | 2010-10-01 | 7.94936197 | 2010-10-01 | 33.7332177 | 2010-10-01 | 4.00464693 |
2010-11-01 | 14.0045994 | 2010-11-01 | 7.9494984 | 2010-11-01 | 33.7561388 | 2010-11-01 | 4.00180148 |
2010-12-01 | 14.0391179 | 2010-12-01 | 7.94963483 | 2010-12-01 | 33.77906 | 2010-12-01 | 3.99895603 |
2011-01-01 | 14.0736364 | 2011-01-01 | 7.94977126 | 2011-01-01 | 33.8019812 | 2011-01-01 | 3.99611058 |
2011-02-01 | 14.1081548 | 2011-02-01 | 7.94990769 | 2011-02-01 | 33.8249024 | 2011-02-01 | 3.99326513 |
2011-03-01 | 14.1426733 | 2011-03-01 | 7.95004412 | 2011-03-01 | 33.8478235 | 2011-03-01 | 3.99041968 |
2011-04-01 | 14.1771918 | 2011-04-01 | 7.95018055 | 2011-04-01 | 33.8707447 | 2011-04-01 | 3.98757424 |
2011-05-01 | 14.2117103 | 2011-05-01 | 7.95031698 | 2011-05-01 | 33.8936659 | 2011-05-01 | 3.98472879 |
2011-06-01 | 14.2462288 | 2011-06-01 | 7.95045341 | 2011-06-01 | 33.9165871 | 2011-06-01 | 3.98188334 |
2011-07-01 | 14.2807473 | 2011-07-01 | 7.95058984 | 2011-07-01 | 33.9395083 | 2011-07-01 | 3.97903789 |
2011-08-01 | 14.3152657 | 2011-08-01 | 7.95072627 | 2011-08-01 | 33.9624294 | 2011-08-01 | 3.97619244 |
2011-09-01 | 14.3497842 | 2011-09-01 | 7.9508627 | 2011-09-01 | 33.9853506 | 2011-09-01 | 3.97334699 |
2011-10-01 | 14.3843027 | 2011-10-01 | 7.95099913 | 2011-10-01 | 34.0082718 | 2011-10-01 | 3.97050154 |
2011-11-01 | 14.4188212 | 2011-11-01 | 7.95113556 | 2011-11-01 | 34.031193 | 2011-11-01 | 3.9676561 |
2011-12-01 | 14.4533397 | 2011-12-01 | 7.95127199 | 2011-12-01 | 34.0541141 | 2011-12-01 | 3.96481065 |
2012-01-01 | 14.4878582 | 2012-01-01 | 7.95140842 | 2012-01-01 | 34.0770353 | 2012-01-01 | 3.9619652 |
2012-02-01 | 14.5223767 | 2012-02-01 | 7.95154485 | 2012-02-01 | 34.0999565 | 2012-02-01 | 3.95911975 |
2012-03-01 | 14.5568951 | 2012-03-01 | 7.95168128 | 2012-03-01 | 34.1228777 | 2012-03-01 | 3.9562743 |
2012-04-01 | 14.5914136 | 2012-04-01 | 7.95181771 | 2012-04-01 | 34.1457989 | 2012-04-01 | 3.95342885 |
2012-05-01 | 14.6259321 | 2012-05-01 | 7.95195414 | 2012-05-01 | 34.16872 | 2012-05-01 | 3.9505834 |
2012-06-01 | 14.6604506 | 2012-06-01 | 7.95209057 | 2012-06-01 | 34.1916412 | 2012-06-01 | 3.94773796 |
2012-07-01 | 14.6949691 | 2012-07-01 | 7.952227 | 2012-07-01 | 34.2145624 | 2012-07-01 | 3.94489251 |
2012-08-01 | 14.7294876 | 2012-08-01 | 7.95236343 | 2012-08-01 | 34.2374836 | 2012-08-01 | 3.94204706 |
2012-09-01 | 14.7640061 | 2012-09-01 | 7.95249986 | 2012-09-01 | 34.2604047 | 2012-09-01 | 3.93920161 |
2012-10-01 | 14.7985245 | 2012-10-01 | 7.95263629 | 2012-10-01 | 34.2833259 | 2012-10-01 | 3.93635616 |
2012-11-01 | 14.833043 | 2012-11-01 | 7.95277272 | 2012-11-01 | 34.3062471 | 2012-11-01 | 3.93351071 |
2012-12-01 | 14.8675615 | 2012-12-01 | 7.95290915 | 2012-12-01 | 34.3291683 | 2012-12-01 | 3.93066526 |
2013-01-01 | 14.90208 | 2013-01-01 | 7.95304558 | 2013-01-01 | 34.3520895 | 2013-01-01 | 3.92781982 |
2013-02-01 | 14.9365985 | 2013-02-01 | 7.95318201 | 2013-02-01 | 34.3750106 | 2013-02-01 | 3.92497437 |
2013-03-01 | 14.971117 | 2013-03-01 | 7.95331844 | 2013-03-01 | 34.3979318 | 2013-03-01 | 3.92212892 |
2013-04-01 | 15.0056354 | 2013-04-01 | 7.95345487 | 2013-04-01 | 34.420853 | 2013-04-01 | 3.91928347 |
2013-05-01 | 15.0401539 | 2013-05-01 | 7.9535913 | 2013-05-01 | 34.4437742 | 2013-05-01 | 3.91643802 |
2013-06-01 | 15.0746724 | 2013-06-01 | 7.95372773 | 2013-06-01 | 34.4666954 | 2013-06-01 | 3.91359257 |
2013-07-01 | 15.1091909 | 2013-07-01 | 7.95386416 | 2013-07-01 | 34.4896165 | 2013-07-01 | 3.91074712 |
2013-08-01 | 15.1437094 | 2013-08-01 | 7.95400059 | 2013-08-01 | 34.5125377 | 2013-08-01 | 3.90790168 |
2013-09-01 | 15.1782279 | 2013-09-01 | 7.95413702 | 2013-09-01 | 34.5354589 | 2013-09-01 | 3.90505623 |
2013-10-01 | 15.2127464 | 2013-10-01 | 7.95427345 | 2013-10-01 | 34.5583801 | 2013-10-01 | 3.90221078 |
2013-11-01 | 15.2472648 | 2013-11-01 | 7.95440988 | 2013-11-01 | 34.5813012 | 2013-11-01 | 3.89936533 |
2013-12-01 | 15.2817833 | 2013-12-01 | 7.95454631 | 2013-12-01 | 34.6042224 | 2013-12-01 | 3.89651988 |
2014-01-01 | 15.3163018 | 2014-01-01 | 7.95468274 | 2014-01-01 | 34.6271436 | 2014-01-01 | 3.89367443 |
2014-02-01 | 15.3508203 | 2014-02-01 | 7.95481917 | 2014-02-01 | 34.6500648 | 2014-02-01 | 3.89082898 |
2014-03-01 | 15.3853388 | 2014-03-01 | 7.9549556 | 2014-03-01 | 34.672986 | 2014-03-01 | 3.88798354 |
2014-04-01 | 15.4198573 | 2014-04-01 | 7.95509203 | 2014-04-01 | 34.6959071 | 2014-04-01 | 3.88513809 |
2014-05-01 | 15.4543758 | 2014-05-01 | 7.95522846 | 2014-05-01 | 34.7188283 | 2014-05-01 | 3.88229264 |
2014-06-01 | 15.4888942 | 2014-06-01 | 7.95536489 | 2014-06-01 | 34.7417495 | 2014-06-01 | 3.87944719 |
2014-07-01 | 15.5234127 | 2014-07-01 | 7.95550132 | 2014-07-01 | 34.7646707 | 2014-07-01 | 3.87660174 |
2014-08-01 | 15.5579312 | 2014-08-01 | 7.95563776 | 2014-08-01 | 34.7875918 | 2014-08-01 | 3.87375629 |
2014-09-01 | 15.5924497 | 2014-09-01 | 7.95577419 | 2014-09-01 | 34.810513 | 2014-09-01 | 3.87091084 |
2014-10-01 | 15.6269682 | 2014-10-01 | 7.95591062 | 2014-10-01 | 34.8334342 | 2014-10-01 | 3.8680654 |
2014-11-01 | 15.6614867 | 2014-11-01 | 7.95604705 | 2014-11-01 | 34.8563554 | 2014-11-01 | 3.86521995 |
2014-12-01 | 15.6960051 | 2014-12-01 | 7.95618348 | 2014-12-01 | 34.8792766 | 2014-12-01 | 3.8623745 |
2015-01-01 | 15.7305236 | 2015-01-01 | 7.95631991 | 2015-01-01 | 34.9021977 | 2015-01-01 | 3.85952905 |
2015-02-01 | 15.7650421 | 2015-02-01 | 7.95645634 | 2015-02-01 | 34.9251189 | 2015-02-01 | 3.8566836 |
2015-03-01 | 15.7995606 | 2015-03-01 | 7.95659277 | 2015-03-01 | 34.9480401 | 2015-03-01 | 3.85383815 |
2015-04-01 | 15.8340791 | 2015-04-01 | 7.9567292 | 2015-04-01 | 34.9709613 | 2015-04-01 | 3.8509927 |
2015-05-01 | 15.8685976 | 2015-05-01 | 7.95686563 | 2015-05-01 | 34.9938824 | 2015-05-01 | 3.84814726 |
2015-06-01 | 15.9031161 | 2015-06-01 | 7.95700206 | 2015-06-01 | 35.0168036 | 2015-06-01 | 3.84530181 |
2015-07-01 | 15.9376345 | 2015-07-01 | 7.95713849 | 2015-07-01 | 35.0397248 | 2015-07-01 | 3.84245636 |
2015-08-01 | 15.972153 | 2015-08-01 | 7.95727492 | 2015-08-01 | 35.062646 | 2015-08-01 | 3.83961091 |
2015-09-01 | 16.0066715 | 2015-09-01 | 7.95741135 | 2015-09-01 | 35.0855672 | 2015-09-01 | 3.83676546 |
2015-10-01 | 16.04119 | 2015-10-01 | 7.95754778 | 2015-10-01 | 35.1084883 | 2015-10-01 | 3.83392001 |
2015-11-01 | 16.0757085 | 2015-11-01 | 7.95768421 | 2015-11-01 | 35.1314095 | 2015-11-01 | 3.83107457 |
2015-12-01 | 16.110227 | 2015-12-01 | 7.95782064 | 2015-12-01 | 35.1543307 | 2015-12-01 | 3.82822912 |
2016-01-01 | 16.1447455 | 2016-01-01 | 7.95795707 | 2016-01-01 | 35.1772519 | 2016-01-01 | 3.82538367 |
2016-02-01 | 16.1792639 | 2016-02-01 | 7.9580935 | 2016-02-01 | 35.200173 | 2016-02-01 | 3.82253822 |
2016-03-01 | 16.2137824 | 2016-03-01 | 7.95822993 | 2016-03-01 | 35.2230942 | 2016-03-01 | 3.81969277 |
2016-04-01 | 16.2483009 | 2016-04-01 | 7.95836636 | 2016-04-01 | 35.2460154 | 2016-04-01 | 3.81684732 |
2016-05-01 | 16.2828194 | 2016-05-01 | 7.95850279 | 2016-05-01 | 35.2689366 | 2016-05-01 | 3.81400187 |
2016-06-01 | 16.3173379 | 2016-06-01 | 7.95863922 | 2016-06-01 | 35.2918578 | 2016-06-01 | 3.81115643 |
2016-07-01 | 16.3518564 | 2016-07-01 | 7.95877565 | 2016-07-01 | 35.3147789 | 2016-07-01 | 3.80831098 |
2016-08-01 | 16.3863748 | 2016-08-01 | 7.95891208 | 2016-08-01 | 35.3377001 | 2016-08-01 | 3.80546553 |
2016-09-01 | 16.4208933 | 2016-09-01 | 7.95904851 | 2016-09-01 | 35.3606213 | 2016-09-01 | 3.80262008 |
2016-10-01 | 16.4554118 | 2016-10-01 | 7.95918494 | 2016-10-01 | 35.3835425 | 2016-10-01 | 3.79977463 |
2016-11-01 | 16.4899303 | 2016-11-01 | 7.95932137 | 2016-11-01 | 35.4064636 | 2016-11-01 | 3.79692918 |
2016-12-01 | 16.5244488 | 2016-12-01 | 7.9594578 | 2016-12-01 | 35.4293848 | 2016-12-01 | 3.79408373 |
2017-01-01 | 16.5589673 | 2017-01-01 | 7.95959423 | 2017-01-01 | 35.452306 | 2017-01-01 | 3.79123829 |
2017-02-01 | 16.5934858 | 2017-02-01 | 7.95973066 | 2017-02-01 | 35.4752272 | 2017-02-01 | 3.78839284 |
2017-03-01 | 16.6280042 | 2017-03-01 | 7.95986709 | 2017-03-01 | 35.4981484 | 2017-03-01 | 3.78554739 |
2017-04-01 | 16.6625227 | 2017-04-01 | 7.96000352 | 2017-04-01 | 35.5210695 | 2017-04-01 | 3.78270194 |
2017-05-01 | 16.6970412 | 2017-05-01 | 7.96013995 | 2017-05-01 | 35.5439907 | 2017-05-01 | 3.77985649 |
2017-06-01 | 16.7315597 | 2017-06-01 | 7.96027638 | 2017-06-01 | 35.5669119 | 2017-06-01 | 3.77701104 |
2017-07-01 | 16.7660782 | 2017-07-01 | 7.96041281 | 2017-07-01 | 35.5898331 | 2017-07-01 | 3.77416559 |
2017-08-01 | 16.8005967 | 2017-08-01 | 7.96054924 | 2017-08-01 | 35.6127543 | 2017-08-01 | 3.77132015 |
2017-09-01 | 16.8351152 | 2017-09-01 | 7.96068567 | 2017-09-01 | 35.6356754 | 2017-09-01 | 3.7684747 |
2017-10-01 | 16.8696336 | 2017-10-01 | 7.9608221 | 2017-10-01 | 35.6585966 | 2017-10-01 | 3.76562925 |
2017-11-01 | 16.9041521 | 2017-11-01 | 7.96095853 | 2017-11-01 | 35.6815178 | 2017-11-01 | 3.7627838 |
2017-12-01 | 16.9386706 | 2017-12-01 | 7.96109496 | 2017-12-01 | 35.704439 | 2017-12-01 | 3.75993835 |
2018-01-01 | 16.9731891 | 2018-01-01 | 7.96123139 | 2018-01-01 | 35.7273601 | 2018-01-01 | 3.7570929 |
2018-02-01 | 17.0077076 | 2018-02-01 | 7.96136782 | 2018-02-01 | 35.7502813 | 2018-02-01 | 3.75424745 |
2018-03-01 | 17.0422261 | 2018-03-01 | 7.96150425 | 2018-03-01 | 35.7732025 | 2018-03-01 | 3.75140201 |
2018-04-01 | 17.0767445 | 2018-04-01 | 7.96164068 | 2018-04-01 | 35.7961237 | 2018-04-01 | 3.74855656 |
2018-05-01 | 17.111263 | 2018-05-01 | 7.96177711 | 2018-05-01 | 35.8190449 | 2018-05-01 | 3.74571111 |
2018-06-01 | 17.1457815 | 2018-06-01 | 7.96191354 | 2018-06-01 | 35.841966 | 2018-06-01 | 3.74286566 |
2018-07-01 | 17.1803 | 2018-07-01 | 7.96204997 | 2018-07-01 | 35.8648872 | 2018-07-01 | 3.74002021 |
2018-08-01 | 17.2148185 | 2018-08-01 | 7.9621864 | 2018-08-01 | 35.8878084 | 2018-08-01 | 3.73717476 |
2018-09-01 | 17.249337 | 2018-09-01 | 7.96232283 | 2018-09-01 | 35.9107296 | 2018-09-01 | 3.73432931 |
2018-10-01 | 17.2838555 | 2018-10-01 | 7.96245926 | 2018-10-01 | 35.9336507 | 2018-10-01 | 3.73148387 |
2018-11-01 | 17.3183739 | 2018-11-01 | 7.96259569 | 2018-11-01 | 35.9565719 | 2018-11-01 | 3.72863842 |
2018-12-01 | 17.3528924 | 2018-12-01 | 7.96273212 | 2018-12-01 | 35.9794931 | 2018-12-01 | 3.72579297 |
2019-01-01 | 17.3874109 | 2019-01-01 | 7.96286856 | 2019-01-01 | 36.0024143 | 2019-01-01 | 3.72294752 |
2019-02-01 | 17.4219294 | 2019-02-01 | 7.96300499 | 2019-02-01 | 36.0253355 | 2019-02-01 | 3.72010207 |
2019-03-01 | 17.4564479 | 2019-03-01 | 7.96314142 | 2019-03-01 | 36.0482566 | 2019-03-01 | 3.71725662 |
2019-04-01 | 17.4909664 | 2019-04-01 | 7.96327785 | 2019-04-01 | 36.0711778 | 2019-04-01 | 3.71441117 |
2019-05-01 | 17.5254849 | 2019-05-01 | 7.96341428 | 2019-05-01 | 36.094099 | 2019-05-01 | 3.71156573 |
2019-06-01 | 17.5600033 | 2019-06-01 | 7.96355071 | 2019-06-01 | 36.1170202 | 2019-06-01 | 3.70872028 |
2019-07-01 | 17.5945218 | 2019-07-01 | 7.96368714 | 2019-07-01 | 36.1399413 | 2019-07-01 | 3.70587483 |
2019-08-01 | 17.6290403 | 2019-08-01 | 7.96382357 | 2019-08-01 | 36.1628625 | 2019-08-01 | 3.70302938 |
2019-09-01 | 17.6635588 | 2019-09-01 | 7.96396 | 2019-09-01 | 36.1857837 | 2019-09-01 | 3.70018393 |
2019-10-01 | 17.6980773 | 2019-10-01 | 7.96409643 | 2019-10-01 | 36.2087049 | 2019-10-01 | 3.69733848 |
2019-11-01 | 17.7325958 | 2019-11-01 | 7.96423286 | 2019-11-01 | 36.2316261 | 2019-11-01 | 3.69449303 |
2019-12-01 | 17.7671143 | 2019-12-01 | 7.96436929 | 2019-12-01 | 36.2545472 | 2019-12-01 | 3.69164759 |
2020-01-01 | 17.8016327 | 2020-01-01 | 7.96450572 | 2020-01-01 | 36.2774684 | 2020-01-01 | 3.68880214 |
2020-02-01 | 17.8361512 | 2020-02-01 | 7.96464215 | 2020-02-01 | 36.3003896 | 2020-02-01 | 3.68595669 |
2020-03-01 | 12.2488317 | 2020-03-01 | 4.2460801 | 2020-03-01 | 23.6195693 | 2020-03-01 | 1.37182677 |
2020-04-01 | 21.8515038 | 2020-04-01 | 4.80741945 | 2020-04-01 | 42.840773 | 2020-04-01 | 2.94677418 |
2020-05-01 | 31.454176 | 2020-05-01 | 5.36875879 | 2020-05-01 | 62.0619766 | 2020-05-01 | 4.52172159 |
2020-06-01 | 41.0568482 | 2020-06-01 | 5.93009813 | 2020-06-01 | 81.2831803 | 2020-06-01 | 6.096669 |
2020-07-01 | 24.4320716 | 2020-07-01 | 15.0605644 | 2020-07-01 | 49.7980215 | 2020-07-01 | 8.68180177 |
2020-08-01 | 23.580332 | 2020-08-01 | 13.8663049 | 2020-08-01 | 47.6694335 | 2020-08-01 | 7.83414697 |
2020-09-01 | 22.7285924 | 2020-09-01 | 12.6720455 | 2020-09-01 | 45.5408455 | 2020-09-01 | 6.98649218 |
2020-10-01 | 21.8768528 | 2020-10-01 | 11.4777861 | 2020-10-01 | 43.4122575 | 2020-10-01 | 6.13883738 |
2020-11-01 | 21.0251132 | 2020-11-01 | 10.2835266 | 2020-11-01 | 41.2836695 | 2020-11-01 | 5.29118259 |
2020-12-01 | 20.1733737 | 2020-12-01 | 9.08926719 | 2020-12-01 | 39.1550815 | 2020-12-01 | 4.44352779 |
2021-01-01 | 19.3216341 | 2021-01-01 | 7.89500776 | 2021-01-01 | 37.0264935 | 2021-01-01 | 3.595873 |
2021-02-01 | 18.4698945 | 2021-02-01 | 6.70074833 | 2021-02-01 | 34.8979055 | 2021-02-01 | 2.74821821 |
2021-03-01 | 17.6181549 | 2021-03-01 | 5.50648889 | 2021-03-01 | 32.7693175 | 2021-03-01 | 1.90056341 |
Period | Low disadvantage | High disadvantage | Nonracialized | Racialized | ||||
---|---|---|---|---|---|---|---|---|
Monthly change | p value | Monthly change | p value | Monthly change | p value | Monthly change | p value | |
Pre-pandemic | 0.035 | 0.07 | 0.000 | 0.98 | 0.023 | 0.36 | -0.003 | 0.71 |
First month of lockdown | -15.19 | <0.01 | -4.28 | 0.24 | -31.90 | <0.01 | -3.89 | 0.15 |
Remainder of first lockdown | 9.60 | <0.01 | 0.56 | 0.68 | 19.22 | <0.01 | 1.57 | 0.12 |
First month of reopening | -15.77 | <0.01 | 10.32 | <0.01 | -29.36 | <0.01 | 3.43 | 0.18 |
Remainder of follow-up | -0.85 | 0.28 | -1.19 | 0.03 | 2.13 | 0.12 | -0.85 | 0.02 |
Discussion
In this study of data from Quebec, hospitalization rates for cycling injuries increased significantly during the first COVID-19 lockdown. The increase in cycling injury hospitalizations was highest among adolescents and adults, and among individuals from socioeconomically advantaged neighbourhoods with low racialized group concentration.
The lockdown was marked by a predominance of cycling-related fractures and injuries to the head and neck. Most of the increase in the number of cycling injuries was due to falls rather than collisions. The findings suggest that cycling behaviours and associated injuries changed considerably during the pandemic, and that cycling should be included in injury prevention policies to reduce morbidity during lockdowns.
A number of studies have examined bike injuries experienced by children and adolescents less than 18 years old during the pandemic, as this group was thought to be most at risk of sustaining cycling accidents.Footnote 8 Footnote 9 Between March and October 2020, the average number of emergency department visits for cycling injuries in this population reached 84.5 per month in Canada, an amount considerably greater than the average of 33.7 visits per month seen in the two years preceding the pandemic.Footnote 8 Children aged 6 to 10 years were more likely to present to emergency rooms for bike injuries than younger children (0–5 years) or older children and adolescents (11–18 years).Footnote 8
In Australia, pediatric emergency department visits and hospital admissions for cycling-related injuries among individuals younger than 16 went up by 43% and 49%, respectively, during the first lockdown compared with the previous year.Footnote 9 We found that cycling injury hospitalization rates increased primarily for adolescents aged 10 to 19 years.
Adults' cycling injuries have received less attention. A multicentre study from the United Kingdom found that emergency referrals for scooter and bike injuries increased for patients aged 19 to 65 years between March and June 2020.Footnote 10 Bike injuries, however, were not specifically examined.Footnote 10 Rajput et al.Footnote 16 observed a significant increase in bike injuries during lockdown among adults, but examined only road traffic collisions. In Ireland, Foley et al.Footnote 17 reported no difference in emergency room visits for cycling injuries during the first lockdown compared with 2019, although the data combined adults and adolescents. Other studies of cycling injuries in the general population did not report rates separately for adults and adolescents.Footnote 18 Footnote 19
Our data show that adults' cycling injury hospitalization rates increased considerably during the first lockdown. As exercise facilities were closed during lockdowns,Footnote 1 cycling may have been the sport of choice for many adults as a way of complying with social distancing measures.Footnote 4 Adults may also have used bikes to ride to work or to run errands as a way of avoiding public transportation.
During the pandemic, many cities promoted cycling by closing streets to motor vehicle traffic.Footnote 4 This, together with an expanded network of bike paths, as documented in Montréal,Footnote 4 the largest city in Quebec, may have enticed more people to try cycling. Bicycle sales increased by 39%,Footnote 4 and it is possible that many individuals took up cycling for the first time or after a long break. One study found that less experienced cyclists were 69% more likely to sustain injuries requiring medical attention.Footnote 7 These factors together may have resulted in a higher number of inexperienced cyclists and exacerbated cycling injury hospitalizations, particularly among adults.
Increased availability of bike lanes along with reduced motor vehicle traffic may have led to more fall-related injuries rather than collisions. A study in Ireland found that emergency department visits decreased for injuries due to motor vehicle collisions, while those due to isolated cycling crashes increased substantially.Footnote 17 Similarly, a multicentre study from Scotland reported a decrease in the number of cycling injuries involving car collisions, while the number of orthopaedic interventions for falls from bikes increased compared with the period preceding the pandemic.Footnote 18 Our study found that patients admitted to hospital for cycling injuries during the first lockdown were 47% more likely to have had isolated falls; collisions were rare. Efforts to increase the safety of bike paths may be needed to decrease the burden of injury not due to collisions.
Other factors may have contributed to the overall increase in cycling hospitalizations, as the risk of injury was not evenly distributed across racialized and socioeconomic backgrounds at the neighbourhood level. The first lockdown was marked by an increase in cycling injuries in neighbourhoods with low racialized group concentration and high socioeconomic advantage. A recent study of 22 major American cities found that the presence of dedicated cycling lanes correlated strongly with bike commuting in neighbourhoods with high socioeconomic status and few Hispanic residents.Footnote 20 Remote work during lockdowns was more prevalent among individuals with high socioeconomic status and may have increased the leisure time available for cycling,Footnote 21 as commuting was no longer needed. Thus, cycling routes may have benefited socioeconomically advantaged groups during the pandemic, but also led to more injuries in this population. Individuals in socioeconomically disadvantaged neighbourhoods with high concentrations of racialized people may have been less likely to cycle, despite the overall greater availability of bike paths during the pandemic.Footnote 4
The type and anatomical site of cycling injuries during the pandemic appears to have changed. A single-centre study from the U.S. found that fractures from pediatric bike accidents increased during the first month of the pandemic,Footnote 22 while other Canadian and Australian investigations found no difference.Footnote 8 Footnote 9 In Scotland, the proportion of cycling injuries requiring surgery for fractures increased in the general population.Footnote 18 The first lockdown also led to an increase in fractures in our study population. However, head and neck injuries increased more than those of spine/thorax/pelvis, lower limb and upper limb. This differs from Ireland, where head injuries decreased.Footnote 17 In both Ireland and Scotland, upper limb injuries increased more.Footnote 17 Footnote 18 Some of the difference may be due to helmet laws in Quebec, where cyclists are not required to wear helmets except while using electric bikes.Footnote 23 Greater emphasis on use of helmets and other safety equipment while cycling may be beneficial.
Prior studies have not considered long-term trends in cycling injuries. The pandemic has only been compared with the period immediately preceding it.Footnote 8 Footnote 9 Footnote 10 Footnote 16 Footnote 17 Footnote 18 Footnote 19 Yet, our data suggest that cycling injuries began increasing many years prior to the pandemic. As a result, it is not clear if some of the increase reported in other studies reflects secular trends in cycling injuries,Footnote 15 rather than the pandemic itself. We eliminated the effect of secular trends by using an autoregressive interrupted time series,Footnote 15 allowing us to attribute the increase in cycling injuries seen at the beginning of the pandemic to the first lockdown.
Strengths and limitations
This study has a number of limitations. The data we used are rigorously validated,Footnote 11 but coding errors can occur, resulting in misclassification of outcomes or other characteristics. We could not identify minor cycling injuries that did not require hospital admission, and we did not have information on the number of hours spent cycling per day, the types of roads used for travel, the use of reserved bike lanes and the extent to which cycling routes were expanded during the pandemic. Data on helmet use or other protective equipment were also not available.
Statistical power was limited for the second lockdown, although this limitation may be because winter conditions decreased the number of cyclists. Our study reflects the situation in the population of Quebec, where cycling is a common means of transportation.Footnote 24 Data from other provinces were not available. It remains unclear whether our findings can be applied to regions where cycling is less prevalent.
Conclusion
The first COVID-19 lockdown led to a significant rise in cycling injury hospitalizations among adolescents and adults in Quebec, while the reopening period and second lockdown had a more limited effect. Individuals from socioeconomically advantaged and less racialized neighbourhoods were most affected by cycling injuries. Falls not involving a collision were the principal mechanism of injury. Fractures and injuries to the head and neck also increased. Awareness campaigns promoting bike safety and helmet use to prevent severe cycling injuries should be ongoing, even during public health crises such as a pandemic.
Acknowledgements
This work was supported by the Canadian Institutes of Health Research (WI2-179928) and the Fonds de recherche du Québec – Santé (296785). The study sponsors had no role in the study design, collection, analysis and interpretation of data, writing of the report, or decision to submit the report for publication.
Conflicts of interest
The authors have no conflicts of interest to declare.
Authors' contributions and statement
NA – Conceptualization, Study design, Writing – Original Draft; AL – Conceptualization, Writing – Review & Editing; ÉB – Conceptualization, Study design, Formal analysis, Visualization, Writing – Original Draft; AA – Conceptualization, Study design, Writing – Review & Editing; CB – Conceptualization, Writing – Review & Editing; TML – Conceptualization, Writing – Review & Editing.
All authors read and approved the final manuscript.
The content and views expressed herein are those of the authors and do not necessarily reflect those of the Government of Canada.
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