Bicyclists’ Injuries and the Cycling Environment: The Impact of Route Infrastructure

Abstract

Safety concerns have contributed to low bicycling rates in North America. Injury rates are lower and cycling is more common in northern European countries where route infrastructure is designed for cyclists, yet few studies have examined the relationship between the cycling environment and injuries. A total of 690 people injured while cycling were recruited via emergency departments in Toronto and Vancouver, Canada. Conditional logistic regression compared route infrastructure at each injury site to that of a randomly selected control site from the same trip. The case-crossover design controlled for exposure to risk and for personal characteristics and other factors that are stable within a trip. Of 15 route types, cycle tracks (physically separated paths alongside city streets) had the lowest risk, about 9 times lower than the reference (arterials and collectors with parked cars and no bike infrastructure). Bike lanes on arterials and collectors with no parked cars, local streets, and off street bike paths had 2-fold risk reductions. Risks on arterials and collectors were lower when parked cars were not present. Other infrastructure characteristics were associated with increased risks: downhill grades; streetcar or train tracks; and construction. The results of this study indicate that the design approach used in northern Europe is effective in North America. The following route types are the best choices for common urban transportation locations and would lower injury risks to cyclists: alongside arterials and collectors – cycle tracks; on local streets – designated bikeways with traffic diversion; and off-street – bike paths.

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