Factors associated with a history of acute traumatic cycling injuries in 60 941 cycling race entrants in South Africa: SAFER study XLII

BACKGROUND: Information on acute traumatic cycling injuries (ATCIs) in the 12 months prior to entry in a cycling race and the predisposing factors have not been well-researched. OBJECTIVE: Determine factors associated with a history of ATCIs sustained in the previous 12 months by race entrants of a 109 km cycling race. METHODS: Descriptive, cross-sectional study on 60 941 Cape Town Cycle Tour race entrants from 2016 to 2020. Data on a history of ATCIs sustained in the previous 12 months were obtained through an online pre-race medical screening questionnaire (mandatory in 2016, and voluntary in 2017-2020). Factors investigated were demographics, cycling/training history and history of chronic disease, collapse, cramping, allergies and regular chronic prescription medication usage. We calculated the prevalence ratio (PR) for reporting a history of an ATCI in the previous 12 months for each category (multiple regression model). RESULTS: Factors associated with an increased PR for a history of ATCIs gathered from race entrants (34% of the total entrants) were: increased years of participation in distance cycling events >2 hours (PR=1.05 per 5 years of distance cycling, p<0.0001), increased weekly average training/racing distance of a cyclist in the past 12 months (PR=1.11 per 50 km increase in weekly cycling). Other factors were: increased number of chronic diseases reported (PR=1.53, per two additional chronic diseases reported, p<0.0001), history of collapse (PR=1.75, p=0.0005), history of cramping (PR=1.65, p<0.0001) and history of allergies (PR=1.49, p<0.0001). CONCLUSIONS: Subgroups of recreational cyclists at higher risk for ATCIs were identified. This information could assist in developing and implementing future strategies to mitigate ATCIs.