Route Infrastructure and the Risk of Injuries to Bicyclists: A Case-Crossover Study

The authors compared cycling injury risks of 14 route types and other route infrastructure features. They recruited 690 city residents injured while cycling in Toronto or Vancouver, Canada. A case-crossover design compared route infrastructure at each injury site to that of a randomly selected control site from the same trip.

  • Of the fourteen route types, cycle tracks had the lowest risk, about one ninth the risk of the reference: major streets with parked cars and no bike infrastructure. Risks on major streets were lower without parked cars and with bike lanes. Local streets also had lower risks. Other infrastructure characteristics were associated with increased risks: streetcar or train tracks, downhill grades, and construction.
  • Of the 690 injured cyclists in the study, 59% were male. The injury trips were mainly on weekdays (77%), less than 5 km long (68%), and for utilitarian purposes (74%). Of the injury events, 72% were collisions (with motor vehicles, route features, people, or animals) and 28% were falls.
  • The authors found that route infrastructure does affect the risk of cycling injuries. The most commonly observed route type was major streets with parked cars and no bike infrastructure. It had the highest risk. In comparison, the following route types had lower risks (starting with the safest route type): cycle tracks (also known as “separated” or “protected” bike lanes) alongside major streets (about 1/10 the risk) residential street bike routes (about 1/2 the risk) major streets with bike lanes and no parked cars (about 1/2 the risk) off-street bike paths (about 6/10 the risk) The following infrastructure features had increased risk: streetcar or train tracks (about 3 times higher than no tracks) downhill grades (about 2 times higher than flat routes) construction (about 2 times higher than no construction).
  • The lower risks on quiet streets and with bike-specific infrastructure along busy streets support the route-design approach used in many northern European countries. Transportation infrastructure with lower bicycling injury risks merits public health support to reduce injuries and promote cycling.

Teschke, K., M. A. Harris, et al. (2012). Route Infrastructure and the Risk of Injuries to Bicyclists: A Case-Crossover Study. American Journal of Public Health 102(12): 2336-2343.

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