• 763 motorcyclists’ hospital records linked to crash data and forensic blood tests;
• Crash characteristics and injuries examined and compared to 1617 car drivers;
• Motorcyclists were younger, more likely men and learners, less likely over .05 BAC;
• More likely crash in 50 and 80km/h area, daylight, weekends, dry roads and weather;
• Higher severity, longer in hospital, more likely injured in multiple body regions.
Motorcycle riders have a high risk of serious injury if they crash. To assist with identification of countermeasures, the present study examined records from the Royal Adelaide Hospital (RAH) in South Australia for 763 motorcyclists (including scooter riders) admitted between January 2008 and November 2010 and between April 2014 and December 2016. Records were linked with police-reported crash data and results of forensic blood tests for alcohol and drugs. When compared with 1617 car drivers admitted to the RAH over the same periods, motorcyclists were younger, were more commonly male, more likely to hold a learner permit, less likely to hold a provisional licence and less likely to be over the legal alcohol limit. Their crashes were more likely to be single vehicle crashes and were more common on weekends, during the afternoon, on sloping roads, on curved roads, on roads with speed limits of 50 and 80 km/h, during daylight hours, in dry weather and on dry roads. They had a higher severity of injury than car drivers, spent longer in hospital, and were more likely to sustain injuries to multiple body regions. Linear regression showed that older age, higher blood alcohol concentration and higher speed limit increased injury severity for motorcyclists. Based on present findings, motorcycling safety can be improved through countermeasures related to Graduated Licensing Systems, infrastructure, motorcycle technology and protective clothing.