Cyclist injuries leading to long‐term consequences are common and therefore important to identify in order to design a more sustainable road transport system. The aim of this study was to apply impairment scaling to those injuries to reflect long‐term consequences. The Risk of Permanent Medical Impairment (RPMI) was measured for cyclist injuries and compared with the Injury Severity Score (ISS). Type and location of the crash as well as injury distribution were analyzed. The effect of the bicycle helmet was also calculated using induced exposure techniques. The material was Swedish hospital records for the period 2003‐ 2012.

In total 77% of all bicycle crashes in Sweden were single bicycle crashes, most of which were not policereported. The number of impaired cyclists was more than 3 times larger than those with ISS 9+. Of all impairing injuries, almost 70% were to the upper and lower extremities. Furthermore, almost 10% were head injuries. The most common injuries to the upper extremities were to the shoulder and the wrist (AIS 2). Bicycle helmets were found to reduce head‐impairing injuries by 62%, and severe impairing injuries by 68%. The effectiveness in reducing face injuries was lower (37% and 49%, respectively).

Traditional prevention of cyclist injuries has been focused on helmets. However, the findings of the present study indicate a need for other strategies to also prevent other injuries, especially to the upper extremities.