Why bicycling infrastructure is so important Photo: Ken Ohrn primary vs. secondary prevention
Primary prevention: Prevents disease Prevents exposure to risk Photo: Paul Krueger
Secondary prevention: Reduces disease symptoms, speeds recovery Reduces exposures at the person
Transportation: multifaceted approach to MV injuries route infrastructure primary - prevent crashes divided highways wide shoulders curve radius increases, grade decreases reflectors street lighting left turn bays, traffic signal redesigns slow speed zones, traffic calming motor vehicle driver driver licensing & education impaired driving laws cell phone bans speeding enforcement ABS brakes running lights head rests shatter-proof windshields chassis design seatbelts, airbags secondary mitigate injury
Transport Canada, Road Safety in Canada, 2011 The major safety measure for bicyclists is to wear a helmet that meets safety standards. Secondary prevention: helmets reduce injuries after a crash
Angela Merkel, Chancellor of Germany, 2013 Eurobike Conference We have to make sure the right infrastructure exists so that those who want to switch to the bicycle as a mode of transport can do it. Primary prevention: Separated infrastructure prevents crashes from occurring Photo: Paul Krueger
British Columbia Helmet law, 75% wear helmet Most routes: little or no cycling infrastructure Photos: Jack Becker, Third Wave Cycling Flickr, W.D. Vanlue Photo Flickr: Café Mama
Holland, Denmark Most routes: separated cycling infrastructure Helmet use rare: 2-10% Photo: Mark Treasure Photo Flickr: Café Mama
Cycling injury rates? Deaths / 100 million km travelled What if? 2.6 1.5 1.1 death rate 43-58% lower
But... Denmark & Holland are so far ahead, Won t it take years for us to build the same infrastructure & achieve these injury reductions?
Cycling injuries: primary vs. secondary prevention... news from Australia 1800 1500 Injury hospitalizations New South Wales 1200 900 Head injuries Arm injuries 600 300 0 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Data source: Olivier J, Walter SR, Grzebieta RH, Accid Anal Prev, 2013;50:1128-1134 Calculations: Teschke K, Cycling in Cities, University of British Columbia
1800 Helmet law, 1991 Helmet use from ~17% to 80% Cycling 16% in initial year HEAD injury hospitalizations 25-29% 1500 Injury hospitalizations New South Wales 1200 900 Head injuries Arm injuries 600 Arm injuries also go down, indicating cycling in initial years 300 0 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Data source: Olivier J, Walter SR, Grzebieta RH, Accid Anal Prev, 2013;50:1128-1134 Calculations: Teschke K, Cycling in Cities, University of British Columbia
1800 1500 Injury hospitalizations New South Wales 1200 900 600 300 Head injuries Arm injuries 0 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Data source: Olivier J, Walter SR, Grzebieta RH, Accid Anal Prev, 2013;50:1128-1134 Calculations: Teschke K, Cycling in Cities, University of British Columbia
2005 Road & Traffic Authority guidelines spur infrastructure improvements...
1800 Separated cycling infrastructure cycling 29% HEAD injury hospitalizations 45% ARM injury hospitalizations 23% ALL hospitalizations (est.) 30% Expected based on cycling Injury hospitalizations New South Wales 1500 1200 900 Expected based on cycling 600 300 Head injuries Arm injuries 0 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Data source: Olivier J, Walter SR, Grzebieta RH, Accid Anal Prev, 2013;50:1128-1134 Calculations: Teschke K, Cycling in Cities, University of British Columbia
Back to British Columbia ~ 1000 police reported cycling injuries/year ~ 130 head injuries (~ 60 saved by helmets) Photos: Jack Becker, Third Wave Cycling Flickr, W.D. Vanlue Photo Flickr: Café Mama
Easy to imagine? All Injuries, N = 1000-60 -425-300 -575 Head Injuries, N = 130-60 -55-75 -58 British Columbia BC, if like Denmark BC, if like Holland BC, if like NSW
Small changes in NSW... Why so effective?
Safety in numbers 16 Fatalities per million work trips by bike In 50 major North American cities 14 12 10 8 6 4 2 0 0% 2% 4% 6% % of work trips by bike Sources: Urban Systems; US Census 2010; Statistics Canada, National Household Survey, 2011
Canadian cities: huge opportunity for safety in numbers 0 2 4 6 8 10 ONTARIO Toronto Ottawa Kingston % of work trips by bike, 2011 ALBERTA Calgary Edmonton Canmore BRITISH COLUMBIA Burnaby Port Moody Powell River Langford North Vancouver Colwood Central Saanich North Saanich View Royal Vancouver Victoria Source: Statistics Canada, National Household Survey, 2011
Secondary prevention Helmets Don t prevent crashes Mitigate head injuries after a crash 25-35% of HEAD injuries = 4-8% of ALL injuries Don t make people feel safe Don t encourage cycling, may deter it
Primary prevention Cycle tracks, bikeways, bike paths Prevent crashes Prevent injuries of all types 30-60% of ALL injuries including 30-60% of HEAD injuries Make people feel safe & comfortable Motivate cycling Photo: Ken Ohrn
Why motivating cycling is important... 32
Benefits vs. risks of cycling 9-96 lives saved 1 life lost In spite of the hostile environment in which most cyclists currently ride, the benefits in terms of health promotion & longevity far outweigh the loss of life years in injury on the roads.!!british Medical Association. Cycling: Towards Health and Safety. Oxford: Oxford University Press, 1992
Primary prevention Cycle tracks, bikeways, bike paths Prevents injuries Motivates cycling Prevents chronic diseases Photo: Ken Ohrn
That s why bicycling infrastructure is so important
cyclingincities.spph.ubc.ca cyclingincities.spph.ubc.ca @kteschke