Trends in Cycling, Walking & Injury Rates in New Zealand

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Tends in Cycling, Walking & Injuy Rates in New Zealand Walking and cycling, minutes/week SUMMAR Estimates of walking and cycling fom 9 Household Tavel suveys in New Zealand, conducted etween 1989 and 2012, wee comined with pulicly-availale injuy statistics on dischages fom pulic hospitals. The infomation was used to compae tends in the safety of cyclists and pedestians since NZ s icycle helmet law was intoduced in Januay 1994. Fom 1989 to 2011, aveage time spent cycling (on oads and footpaths) fell y 79% fo childen aged 5-12 (fom 28 to 6 minutes pe peson pe week) and 81% fo 13-17 yea olds (52 to 10 mins/peson/week). Adult cycling declined fom 8 to 5 minutes/peson/week then tended ack up to 8 minutes. Fo cyclists of all ages, the oveall eduction in time spent cycling was 47%. Declines in pedestian activity of 24% ove the same peiod of time wee moe modest. Reductions fo specific age goups wee: 34% (childen 5-14 yeas, fom 92 to 61 mins/peson/week), 23% (15-24 yea olds, fom 98 to 75 mins/peson/week) and 11% (25-24 yea olds, fom 57 to 51 mins/peson/week). Injuies of cyclists and pedestians dischaged fom pulic hospitals wee sudivided into those due to moto vehicle taffic cashes and othe causes. Injuy ates pe million hous of activity wee calculated y dividing injuies pe million people y estimated aveage hous cycled o walked pe peson pe yea. edestian injuies fom moto vehicle cashes fell y 42% fom 3.5 to 2.0 pe million hous. This suggests the oads ecame safe, offset y a small incease in pedestian injuies not involving moto vehicles (fom 0.5 to 0.7 pe million hous). The latte includes falls, tips and collisions with cyclists, ut it was not possile to detemine fom pulicly-availale data whethe thee was any change in the popotion of pedestian injuies involving cyclists. Cyclist injuies fom collisions with moto vehicles declined y 27% (fom 8.2 to 6.0 pe million hous), pehaps (as indicated y the 42% dop in the pedestian injuies) a esult of the safe oad envionment. In contast, cycling injuies not involving moto vehicles inceased damatically, quadupling in 15-19 yea olds (fom 11.6 to 45.9 injuies pe million hous) and moe than douling fo childen (fom 39.5 to 85.4 pe million hous) and adults (fom 15.9 to 32.3 pe million hous). In 1989, only 27% of cycling injuies wee to adults, ut in 2012, afte the 79% and 81% eductions in child and teenage cycling, 67% of injuies wee to adults, with only 11% of injuies to cyclists aged 15-19 and 22% to cyclists aged 5-14 yeas. The aove esults fo the isk of cycling injuies pe million hous ae appoximations, ecause the pulished age categoies in the NZ household tavel suvey (5-12, 13-17 and 18 o olde) did not coespond exactly with 0 20 40 60 80 100 Fig 1 C X t c x a icycle helmet law C X t C C C C C C C X X X X X X X c t c t t c t c c c t x t t x c a a a x a x ax a x a x a x c Tends in walking and cycling (minutes pe peson pe week) in New Zealand c Cyclists 5-12 ys t Cyclists 13-17 ys a Cyclists 18+ x All cyclists ove 5 C edestians 5-14 edestians 15-24 X All pedestians ove 5 the 5 yea age categoies (5-9, 10-14 etc) classifying the injuy statistics. Rates pe million hous wee calculated fom the neaest age categoy (injuies fo age 5-14 vs cycling fo age 5-12; injuies fo age 15-19 vs cycling fo age 13-17, injuies fo age 20 & ove vs cycling fo age 18 & ove). The declines in cycling wee vey simila fo age 5-12 (79%) and 13-17 (81%), so this is not expected to have a majo impact on the esults. DETAILS 1) Tends in walking and cycling Fig 1 (left) show tends in walking and cycling (minutes/peson/week) fom the NZ household tavel suveys. Fom 1989 to 2011, aveage time spent cycling (on oads and footpaths) fell y 79% fo childen aged 5-12 (fom 28 to 6 minutes/peson/week) and 81% fo 13-17 yea olds (52 to 10 mins/peson/week). Adult cycling declined fom 8 to 5 mins pe

Fatal & seious injuies pe million hous peson/week then tended ack up to 8 mins/peson/week. The oveall eduction fo cyclists of all ages was 47%. The decline in pedestian activity of 24% ove the same peiod was moe modest. Reductions fo specific age goups wee: 34% (childen aged 5-14, fom 92 to 61 mins/peson/week), 23% (15-24 yea olds, fom 98 to 75 mins/peson/week) and 11% (25-24 yea olds, fom 57 to 51 mins/peson/week). In ode to diffeentiate etween tends and the effect of the helmet law, post-law estimates wee pojected ackwads using spline cuves. Fo all age goups (childen, teenages and adults), ackwad pojections wee sustantially less than the amount of cycling oseved in the 1989/90 suvey, implying a sustantial eduction in cycling coinciding with the helmet law. Aveage cycle use in the fist suvey afte the helmet law (1997/98) was 40% less (9 mins/peson/week) than the 15 mins/peson/week in the pe-law suvey. This contasts with the almost identical estimates of pedestian activity (68 mins/peson/week in 1997/98 vs 72 in 1989/90), and suggests that the helmet law esulted in a sustantial eduction in the amount of cycling on oads and pathways. The NZ Household Tavel suveys did not cove mountain iking. An estimate of the popotion of time spent mountain iking was povided y the Active NZ suvey. In 2007/08, in an aveage month, 10.7% of New Zealandes paticipated in oad cycling, compaed to 2.9% in mountain iking. 2 This suggests that total cycling in 2007/08 was aout 27% highe than the estimate in the household tavel suvey. Some cae is theefoe equied in the intepetation of injuy ates. Mountain ikes iding off-oad tails ae not at isk of colliding with moto vehicles, so estimate of injuies pe million hous of cycling fom collisions with moto vehicles should not include time spent mountain iking. Howeve, the oveall isk fo injuies fom non-moto-vehicle cashes might e inflated y the exclusion of the 21% of cycling descied in 2007/08 as mountain iking; compaisons etween yeas o time peiods might e affected y any changes in the pecentage of time spent mountain-iking. 0 10 20 30 40 ike/mv ike only edestian/mv p ed - no MV Ratio ike:ed MV injuies Fig 2 helmet law Fatal & seous injuies pe million hous, all cyclists & pedestians ove 5 p p p p p p p p p p p p p p p p p p 2) Tends in injuy ates Fatalities and injuies to cyclists, (classified y age goup and whethe o not the injuy was fom a moto vehicle taffic cash), wee downloaded fom the NZ National Injuy Quey System (NZNIQS). 3 Injuies to cyclists and pedestians (aged 5 yeas and ove) wee comined with data fom the NZ Household Tavel Suveys (see Appendix) on total time cycled and walked y New Zealandes aged at least 5 yeas to calculate injuies pe million hous of cycling, fo yeas coveed y (o within a yea of) the tavel suveys. As shown in Fig 2, fom 1989/90 to 2010/12, fatal and seious injuies fom collisions with moto vehicles pe million hous tended down y 42% fo pedestians. The decline fo cyclists (27%) was moe modest. The atio of cyclist to pedestian injuies fom collisions involving moto vehicles is shown y the puple line, dawn using the ight hand scale of Fig 2. efoe the helmet law, fo moto vehicle taffic cash injuies, cyclists had aout 2.3 times the isk of pedestians. Howeve, y 2005 the isk had inceased to aout 3.2 times that of pedestians, suggesting that cyclist safety post-helmet law had deteioated compaed to pedestians. Howeve, the most damatic change ove time was the sustantial incease in the isk of injuies fom non moto vehicle cashes, as shown in Fig 2. Details up ae povided in Figs 3 and 4, which show a quadupling of the isk of injuy fom non-moto vehicle collisions fo 15-19 yea olds (fom 11.6 to 45.9 injuies pe million hous), moe than douling fo childen (fom 39.5 to 85.4 pe million hous) and douling fo adults (fom 15.9 to 32.3 pe million hous). 1.0 1.5 2.0 2.5 3.0 3.5 Ratio of cyclist and pedestian injuies pe hou fom collisions with MV

Fatal & seious injuies pe million hous Fatal & seious injuies pe million hous 0 20 40 60 80 100 Note that the esults fo diffeent age goups ae appoximations ecause the age categoies in the NZ household tavel suvey (5-12, 13-17 and 18 o olde) do not coespond exactly with the 5 yea intevals (5-9, 10-14 etc) used to classify the injuy statistics. Rates pe million hous wee theefoe calculated fom the neaest age categoy (injuies fo age 5-14 vs cycling fo age 5-12; injuies fo age 15-19 vs cycling fo age 13-0 5 10 15 20 25 30 17, injuies fo age 20 & ove vs cycling fo age 18 & ove). This is not expected to have a majo impact on the esults, ecause the eductions in cycling wee vey simila fo age 5-12 (79%) and 13-17 (81%). One possile explanation fo the lage incease in the isk of injuy fom nonmoto vehicle cashes was povided y D Glen Kooey, who investigated all cycling fatalities on NZ oads fom Januay 2006 to Deceme 2012. His sumission to a coonial inquiy into cycling safety noted: Only nine victims wee noted as not weaing a helmet, simila to cuent national helmet weaing ates (92%). This highlights the fact that helmets ae geneally no potection to the seious foces involved in a majo moto vehicle cash; they ae only designed fo falls Thee is a suspicion that some people (childen in paticula) have een ovesold on the safety enefits of thei helmet and have een less cautious in thei iding style as a esult. 4 The estimates pesented hee fo injuies pe million hous of cycling stongly suggest that the helmet law has not geneated enefits, ut instead esulted in lage eductions in childen s cycling and lage inceases in the isk fo injuy in non-moto vehicle cashes. Although fatal and seious injuies fom cashes involving moto vehicles have declined, cyclists have not enjoyed the same eductions in injuy ates as pedestians. p ike/mv ike only edestian/mv p ed - no MV Ratio ike:ed MV injuies ike/mv ike only edestian/mv ed - no MV Ratio ike:ed MV injuies p p p p p p p p Fatal & seous injuies pe million hous, cyclists 20+ & peds 15-24 yeas Fig 4 Fig 3 helmet law p p p p helmet law p p p p p p p p p p p p p p p p p p p p p p p p 1 2 3 4 Ratio of cyclist and pedestian injuies pe hou fom collisions with MV Fatal & seious injuies pe million hous 0 10 20 30 40 50 1.0 1.5 2.0 2.5 3.0 3.5 4.0 4.5 Ratio of cyclist and pedestian injuies pe hou fom collisions with MV p ike/mv ike only edestian/mv ed - no MV Ratio ike:ed MV injuies helmet law p p p p p p p p p p p p p p p p p p 1.0 1.5 2.0 2.5 3.0 3.5 Ratio of cyclist and pedestian injuies pe hou fom collisions with MV Fatal/seous injuies pe million hs, cyclists & peds 5-15 yeas Fatal/seous injuies pe million hs, cyclists 15-20 & peds 15-24 yeas

Fo adults, the fist post-law suvey found a 38% eduction in cycling, which slowly tended ack to pe-law levels. If the slow upwad tend had happened without the immediate post-law decline, adult cycling would now e 60% aove pe-law levels. As with childen and teenages, the isk of injuy to adult cyclists fom nonmoto vehicle cashes appeas to have inceased sustantially and, although thee was some eduction in injuies fom moto vehicle cashes, it was not as favouale as fo adult pedestians. Thus fo all age goups, injuy ates ae sustantially highe than what would have een expected without the helmet law, and the amount of cycling is lowe than would have een expected without the law. This suggests that the NZ helmet law has een detimental to health. The lage inceases in cashes not involving moto vehicles suggest a possile move away fom geneal onoad cycling to potentially moe dangeous off-oad activities. Although mountain iking was noted to epesent only 21% of cycling, it may account fo a dispopotionate nume of hospital admissions. Results fom Austalia suggest that enfoced helmet laws discouage cycling 5, ut this may e paticulaly tue fo tanspot cycling, whee, unlike spots cycling and mountain iking, many paticipants did not wea helmets efoe legislation. Reseach into isk compensation in Noway suggested that at least pat of the eason why helmet laws do not appea to e eneficial is that they dispopotionately discouage the safest cyclists. 6 Such esults, and in paticula the lage incease in injuies to cyclists in NZ fom cashes not involving moto vehicles, suggests that NZ s helmet law has not educed the isk of injuy to cyclists, and may even have inceased it. 3) Compaison with othe studies This study was ased on pulicly-availale data on patients admitted to pulic hospitals ecause of injuies as pedestians o cyclists. Day patients (who wee dischaged efoe midnight on the day of admission) and eadmissions fo the same injuy wee excluded. An inteesting compaison is with esults fom Raising the ofile of Walking and Cycling in New Zealand (RWCNZ). 1 Figue 9 of RWCNZ shows a gadual decline in numes of pedestians killed o hospitalised Figues 6, 8, 9 and 10 fom Raising the ofile of Walking and Cycling in New Zealand 1 Fig 4

fom cashes involving moto vehicles on pulic oads fom aout 800 to just unde 700 pe yea. The oveall eduction (aout 15%) is consistent with the 15% eduction in time spent walking, shown in Figue 6 of RWCNZ. In contast, injuies to cyclists tended upwads fom aout 255 to 330, despite the lage eduction in cycling, especially the 13-17 age goup (Figs 8 and 10 of RCWCNZ, epoduced aove). Total police-epoted injuies 7,8 (which include less seious injuies as well as hospital admissions) pesent a somewhat diffeent pictue (Fig 5, left). Injuies to cyclists followed a steepe downwad tend than pedestians Fig 5 1200 1000 800 600 400 200 0 1 9 8 8 olice-repoted injuies and fatalities to cyclists and pedestians fom cashes with moto vehicles on New Zealand oads (souce: NZ Ministy of Tanspot) 1 9 9 0 ikes eds 1 9 9 2 1 9 9 4 1 9 9 6 1 9 9 8 2 0 0 0 2 0 0 2 2 0 0 4 until 1999, then inceased until aout 2007, esulting in a simila oveall decline as pedestians fom 1988-2012. Only a small popotion of injuies ae epoted to police, and the popotion may change ove time, so the intepetation of police-epoted injuies equies consideale cae. A compaison of cyclist hospital admissions with police-epoted injuies in Westen Austalia (WA), found that only 21% of cyclist hospital admissions wee fom cashes epoted to the police. Thee was also a notale change in epoting ates afte the helmet law. e-law, fom 1988-91, the aveage epoting ate was 25.4%. Fom 1993-98 (post-law), the aveage epoting ate was 17.5%. 9 A possile explanation is that non-helmeted cyclists (who might e concened aout eing fined) ae moe eluctant to epot ike/moto vehicle cashes to the police. It is also inteesting to compae the esults of the cuent study with an ealie study of injuies on pulic oads in NZ. 10 The esults fo moto vehicle cash injuies wee vey simila to the NZNIQS data epoted hee. 3 Howeve, thee wee consideale diffeences etween non-moto vehicle injuies in the ealie study (annual aveages of 592 fo 1988-91, 327 fo 1996-99 and 427 fo 2003-07) and NZNQIS non-oad-taffic injuies (annual aveages of 911 fo 1988-91, 898 fo 1996-99 and 1022 fo 2003-07). In NZNIQS data, nonmoto-vehicle injuies epesented 72% all cyclist hospital admissions pe-law in 1988-91, compaed to 83% and 85% in 1996-99 and 2003-07 (the two post-law time peiods consideed in the ealie study). In New Zealand, helmet legislation applies only to on-oad cycling. The inceasing discepancy fo nonmoto-vehicle injuies etween the pevious study and NZNIQS hospital admissions data could suggest a move away fom elatively safe activities such as cycling fo tanspot on quiet oads o pathways towads spots cycling and mountainiking (which epesented 21% of cycling in 2007/08 2 ). The fact that the helmet law does not apply to off-oad cycling may also have encouaged cyclists to ide off-oad. Cyclists injued while not weaing a helmet might also claim to have een iding off-oad to avoid isking a penalty. 4) Discussion and Conclusions Fo injuies fom collisions with moto vehicles, the oveall conclusion is that, as shown y the puple line epesenting the atio of the isk pe million hous fo cyclists compaed to pedestians in Figs 2 to 4, the oveall safety of cyclists compaed to pedestians seems to have deteioated, especially fo childen and teenages. at of the polem may elate to educed cycling and educed safety in numes 11. As well as diect discouagement, helmet laws may also contiute to the failue of pulic ike schemes that might othewise have led to a esugence in the populaity of cycling 12. The lagest change ove time was fo non-moto-vehicle cashes, whee injuies quadupled fo 15-19 yea olds (fom an estimated 11.6 to 45.9 injuies pe million hous), moe than douled fo childen (fom 39.5 to 85.4 pe million hous) and douled fo adults (fom 15.9 to 32.3 pe million hous). Risk compensation could 2 0 0 6 2 0 0 8 2 0 1 0 2 0 1 2

have contiuted to this incease in cycling injuies afte helmet laws. One study found that when childen an an ostacle couse weaing a helmet and wist guads, tipping, falling and umping into things inceased y 51% compaed to without 13. A Nowegian study also suggested that at least pat of the eason why helmet laws do not appea to e eneficial is that they dispopotionately discouage the safest cyclists 6. In 2002, a cost-enefit analysis suggested that New Zealand s helmet was cost-saving in the youngest age goup, ut that lage costs fom the law wee imposed on adult cyclists 14. Howeve, the estimated cost-saving fo younge cyclists was ased on the pemises of: 1 zeo health and envionmental enefits fom cycling, and 2 no incease in injuy ates pe million hous of cyclist. The evidence pesented hee suggests that the 2 is unealistic. A NZ Govenment pulication questioned 1 noting that inceased numes of walkes and cyclists can stimulate economic activity, pomote accessiility and community cohesion, educe congestion, impove safety, educe tanspot emissions and impove pulic health 1. An Austalian govenment epot noted that the economic enefits pe kilomete walked o cycled ae: decongestion (20.7 cents pe kilomete walked o cycled), health (up to 168.0 cents pe kilomete), vehicle opeating costs (35.0 cents pe kilomete), infastuctue savings (6.8 cents pe kilomete) and envionment (5.9 cents pe kilomete) 15. In 1987/88, efoe the intoduction of helmet laws, 4.4% of New Zealandes cycled to wok, 11.6% cycled to pimay school and 18.6% to seconday school 16. y 2004/08, only 2.2% and cycled to wok, 4.3% to pimay school and 4.9% to seconday school 16. Given the lage eductions in cycling, and the sustantial incease in injuies to cyclists, a compehensive eview is equied of the costs and enefits of New Zealand s icycle helmet laws, taking account of the health and envionmental costs of educed cycling, aies to successful pulic ike hie schemes, isk compensation and educed safety in numes. 4) Appendix NZ Household tavel suvey esults minutes of cycling and walking pe week y age goup.

Tale 3, aove, is fo the 2009-2013 suvey. Numes of cyclists & pedestians killed o injued in moto vehicles cashes and cyclist injuies fom non-moto vehicle cashes (NZNIQS data). Cashes involving moto vehicles (MV) Non-MV cashes ea ed Inj ed Inj ike Inj ike Fatal ike Inj ike Fatal 1988 700 83 358 18 1000 4 1989 598 81 311 22 898 1 1990 642 97 327 26 921 2 1991 555 85 298 23 819 0 1992 579 77 253 17 802 2 1993 547 67 291 18 964 4 1994 607 48 272 16 840 4 1995 592 66 217 14 867 1 1996 576 61 201 13 868 3 1997 505 45 180 12 904 1 1998 520 64 156 16 960 1 1999 444 57 162 7 851 4 2000 402 34 162 16 905 2 2001 408 38 169 10 862 2 2002 450 38 136 14 878 4 2003 415 54 139 5 962 0 2004 363 36 164 6 943 4 2005 370 29 162 12 1026 1 2006 408 46 197 9 1024 2 2007 375 43 168 14 1146 4 2008 426 35 191 10 1104 4 2009 381 34 164 9 1189 3 2010 369 34 169 9 1180 8 2011 358 31 179 9 1078 2012 362 31 163 8 1104 2012, %89/90 58% 35% 51% 33% 121% ed = pedestian; inj=(non-fatal) injuy cash. Changes in numes of injuies should e compaed with the 24% eduction in pedestian and 47% eduction in cycling activity.

5) Refeences 1. NZ Ministy of Tanspot, Raising the ofile of Walking and Cycling in New Zealand. Availale at: http://www.tanspot.govt.nz/ouwok/land/raisingthepofileofwalkingandcycling/, 2008. 2. Spot New Zealand, Spot and Receation ofile: Cycling-Findings fom the 2007/08 Active New Zealand Suvey, 2009, Spot New Zealand: Wellington. 3. Otago Univesity, National Injuy Quey System. Injuy evention Reseach Unit. http://ipu3.otago.ac.nz/niqs/index.php, 2014. 4. Kooey, G.F., New Zealand Chief Coone s Inquiy into Cycling Deaths Evidence. Availale at: can.og.nz/system/files/cooneinquest-notes-gkooey-v2.4-jun2013.pdf, 2013. 5. Roinson, D.L., No clea evidence fom counties that have enfoced the weaing of helmets. MJ, 2006. 332: p. 722-725. 6. Fyhi, A., T. jonskau, and A. acke-gondahl, icycle helmets - A case of isk compensation? Tanspotation Reseach at F: Taffic sychology and ehaviou, 2012. 15(5): p. 612-624. 7. NZ Ministy of Tanspot, Moto Vehicle Cashes in New Zealand 2102. Section 5 edal cyclist casualties and cashes [XLS, 128 K] Availale at: http://www.tanspot.govt.nz/eseach/oadcashstatistics/motovehiclecashesinnewzealand/motovehicle-cashes-in-new-zealand-2012/, 2013. 8. NZ Ministy of Tanspot, Moto Vehicle Cashes in New Zealand 2102. Section 6 edestian casualties and cashes [XLS, 122 K]Availale at: http://www.tanspot.govt.nz/eseach/oadcashstatistics/motovehiclecashesinnewzealand/motovehicle-cashes-in-new-zealand-2012/, 2013. 9. Meulenes, L.., et al., icycle Cashes and Injuies in Westen Austalia 1987-2000. RR131, 2003, Injuy Reseach Cente, School of opulation Health, Univesity of Westen Austalia. 10. Tin, S.T., A. Woodwad, and S. Ameatunga, Injuies to pedal cyclists on New Zealand oads, 1988-2007. MC pulic health, 2010. 10(1): p. 655. 11. Tune, S.A., A.. Roozenug, and T. Fancis, edicting Accident Rates fo Cyclists and edestians, 2006, eca Infastuctue Ltd, Chistchuch, New Zealand. Availale at: http://www.nzta.govt.nz/esouces/eseach/epots/289/. 12. Fishman, E., S. Washington, and N. Hawoth, aies and facilitatos to pulic icycle scheme use: A qualitative appoach. Tanspotation eseach pat F: taffic psychology and ehaviou, 2012. 15(6): p. 686-698. 13. Moongiello,.A.,. Walpole, and J. Laseny, Undestanding childen's injuy-isk ehavio: Weaing safety gea can lead to inceased isk taking. Accid Anal event, 2007. 39(3): p. 618-23. 14. Taylo, M. and. Scuffham, New Zealand icycle helmet law-do the costs outweigh the enefits? Injuy evention, 2002. 8: p. 317-320. 15. Austalian Govenment, Walking, Riding and Access to ulic Tanspot. Suppoting active tavel in Austalian communities. Ministeial statement, 2013, Depatment of Infastuctue and Tanspot. 16. NZ Ministy of Tanspot How New Zealandes Tavel. Speadsheed availale at: http://www.tanspot.govt.nz/eseach/tavelsuvey/latestesults/. 2009.