Modelling the effect on injuries and fatalities when changing mode of transport from car to bicycle.

BACKGROUND Several studies have estimated the health effects of active commuting, where a transport mode shift from car to bicycle reduces risk of mortality and morbidity. Previous studies mainly assess the negative aspects of bicycling by referring to fatalities or police reported injuries. However, most bicycle crashes are not reported by the police and therefore hospital reported data would cover a much higher rate of injuries from bicycle crashes. The aim of the present study was to estimate the effect on injuries and fatalities from traffic crashes when shifting mode of transport from car to bicycle by using hospital reported data. METHODS This present study models the change in number of injuries and fatalities due to a transport mode change using a given flow change from car to bicycle and current injury and fatality risk per distance for bicyclists and car occupants. RESULTS show that bicyclists have a much higher injury risk (29 times) and fatality risk (10 times) than car occupants. In a scenario where car occupants in Stockholm living close to their work place shifts transport mode to bicycling, injuries, fatalities and health loss expressed in Disability-Adjusted Life Years (DALY) were estimated to increase. The vast majority of the estimated DALY increase was caused by severe injuries and fatalities and it tends to fluctuate so that the number of severe crashes may exceed the estimation with a large margin. CONCLUSION Although the estimated increase of traffic crashes and DALY, a transport mode shift is seen as a way towards a more sustainable society. Thus, this present study highlights the need of strategic preventive measures in order to minimize the negative impacts from increased bicycling.

[1]  Maria Krafft,et al.  Cyclist injuries leading to permanent medical impairment in sweden and the effect of bicycle helmets , 2013 .

[2]  A. Bauman,et al.  Health benefits of cycling: a systematic review , 2011, Scandinavian journal of medicine & science in sports.

[3]  Anna Niska,et al.  An international review of the frequency of single-bicycle crashes (SBCs) and their relation to bicycle modal share , 2014, Injury Prevention.

[4]  W. Marshall,et al.  Research Article: Evidence on Why Bike-Friendly Cities Are Safer for All Road Users , 2011 .

[5]  C. Matthews,et al.  Influence of exercise, walking, cycling, and overall nonexercise physical activity on mortality in Chinese women. , 2007, American journal of epidemiology.

[6]  H. Nijland,et al.  Do the Health Benefits of Cycling Outweigh the Risks? , 2010, Environmental health perspectives.

[7]  Charlotte Glümer,et al.  Health Impact Assessment of increased cycling to place of work or education in Copenhagen , 2012, BMJ Open.

[8]  Nicola Orsini,et al.  Systematic review and meta-analysis of reduction in all-cause mortality from walking and cycling and shape of dose response relationship , 2014, International Journal of Behavioral Nutrition and Physical Activity.

[9]  Heather K. Neilson,et al.  Re: "Influence of exercise, walking, cycling, and overall nonexercise physical activity on mortality in Chinese women". , 2007, American journal of epidemiology.

[10]  Dominique Lord,et al.  Poisson, Poisson-gamma and zero-inflated regression models of motor vehicle crashes: balancing statistical fit and theory. , 2005, Accident; analysis and prevention.

[11]  Claes Tingvall,et al.  The combined effect of vehicle frontal design, speed reduction, autonomous emergency braking and helmet use in reducing real life bicycle injuries , 2014 .

[12]  M. Schroll,et al.  All-cause mortality associated with physical activity during leisure time, work, sports, and cycling to work. , 2000, Archives of internal medicine.

[13]  J. Tuomilehto,et al.  The joint associations of occupational, commuting, and leisure-time physical activity, and the Framingham risk score on the 10-year risk of coronary heart disease. , 2007, European heart journal.

[14]  D. Thompson,et al.  Cochrane Review : Helmets for preventing head and facial injuries in bicyclists , 2017 .

[15]  Peter Cummings,et al.  Freeway speed limits and traffic fatalities in Washington State. , 2002, Accident; analysis and prevention.

[16]  A. de Nazelle,et al.  Severity of injuries in different modes of transport, expressed with disability-adjusted life years (DALYs) , 2014, BMC Public Health.

[17]  Ari Rabl,et al.  Benefits of shift from car to active transport , 2012 .

[18]  Alan D. Lopez,et al.  Common values in assessing health outcomes from disease and injury: disability weights measurement study for the Global Burden of Disease Study 2010 , 2012, The Lancet.

[19]  A. Woodward,et al.  Moving urban trips from cars to bicycles: impact on health and emissions , 2011, Australian and New Zealand journal of public health.

[20]  M. Hamer,et al.  Active commuting and cardiovascular risk: a meta-analytic review. , 2008, Preventive medicine.

[21]  Jake Olivier,et al.  Bicycle injuries and helmet use: a systematic review and meta-analysis. , 2016, International journal of epidemiology.