Individual and environmental factors associated with death of cyclists involved in road crashes in Spain: a cohort study Molina Soberanes, Daniel Martínez Ruiz, Virginia Ana Lardelli Claret, Pablo Pulido Manzanero, José Martín de los Reyes, Luis Miguel Moreno Roldán, Elena Jiménez Mejías, Eladio Objective To quantify the magnitude of associations between cyclist fatalities and both cyclist and environment related characteristics in Spain during the first 24 hours after a crash. Results Non-use of a helmet was directly associated with death (IDR 1.43, 95% CI 1.25 to 1.64). Among other cyclist characteristics, age after the third decade of life was also directly associated with death, especially in older cyclists (‘over 74’ category, IDR 4.61, 95% CI 3.49 to 6.08). The association with death did not differ between work-related cycling and other reasons for cycling. There was an inverse association with death for crashes in urban areas and on community roads. Any adverse meteorological condition also showed a direct association with death, whereas altered road surfaces showed an inverse association. Crashes during nighttime were directly associated with death, with a peak between 3:00 and 5:59 am (IDR 1.58, 95% CI 1.03 to 2.41). Conclusions We found strong direct and inverse associations between several cyclist and environment related variables and death. These variables should be considered in efforts to prioritise public health measures aimed at reducing the number of cycling-related fatalities. 2020-01-15T07:54:26Z 2020-01-15T07:54:26Z 2019 info:eu-repo/semantics/article Molina-Soberanes D, Martínez-Ruiz V, Lardelli- Claret P, et al. Individual and environmental factors associated with death of cyclists involved in road crashes in Spain: a cohort study. BMJ Open 2019;9:e028039 http://hdl.handle.net/10481/58744 10.1136/ bmjopen-2018-028039 eng http://creativecommons.org/licenses/by-nc/3.0/es/ info:eu-repo/semantics/openAccess Atribución-NoComercial 3.0 España BMJ