Aggravating and mitigating factors associated with cyclist injury severity in Denmark.

INTRODUCTION Denmark is one of the leading cycling nations, where cycling trips constitute a large share of the total trips, and cycling safety assumes a top priority position in the agenda of policy makers. The current study sheds light on the aggravating and mitigating factors associated with cyclist injury severity on Danish roads by examining a comprehensive set of accidents involving a cyclist and a collision partner between 2007 and 2011. METHOD This study estimates a generalized ordered logit model of the severity of cyclist injuries because of its ability to accommodate the ordered-response nature of severity while relaxing the proportional odds assumption. RESULTS Model estimates show that cyclist fragility (children under 10 years old and elderly cyclists over 60 years of age) and cyclist intoxication are aggravating individual factors, while helmet use is a mitigating factor. Speed limits above 70-80 km/h, slippery road surface, and location of the crash on road sections are aggravating infrastructure factors, while the availability of cycling paths and dense urban development are mitigating factors. Heavy vehicle involvement and conflicts between cyclists going straight or turning left and other vehicles going straight are aggravating vehicle involvement factors. Practical applications: The results are discussed in the context of applied policies, engineering, and traffic management solutions for bicycle safety in Denmark.

[1]  Gudmundur F. Ulfarsson,et al.  A note on modeling pedestrian-injury severity in motor-vehicle crashes with the mixed logit model. , 2010, Accident; analysis and prevention.

[2]  J. S. Long,et al.  Regression Models for Categorical and Limited Dependent Variables , 1997 .

[3]  J. Pucher,et al.  Infrastructure, programs, and policies to increase bicycling: an international review. , 2010, Preventive medicine.

[4]  Joanne M Wood,et al.  Drivers' and cyclists' experiences of sharing the road: incidents, attitudes and perceptions of visibility. , 2009, Accident; analysis and prevention.

[5]  C. Boissonnet,et al.  Dyslipidemia in seven Latin American cities: CARMELA study. , 2010, Preventive medicine.

[6]  Gudmundur F. Ulfarsson,et al.  Bicyclist injury severities in bicycle-motor vehicle accidents. , 2007, Accident; analysis and prevention.

[7]  Fan Zhang,et al.  How to make more cycling good for road safety? , 2012, Accident; analysis and prevention.

[8]  W. Y. Szeto,et al.  Perception of safety of cyclists in Dublin City. , 2013, Accident; analysis and prevention.

[9]  Dominique Lord,et al.  The statistical analysis of highway crash-injury severities: a review and assessment of methodological alternatives. , 2011, Accident; analysis and prevention.

[10]  Carlo Giacomo Prato,et al.  Safety perceptions and reported behavior related to cycling in mixed traffic: A comparison between Brisbane and Copenhagen , 2014 .

[11]  Andres Monzon,et al.  Analysis of Perceptions of Utilitarian Cycling by Level of User Experience , 2012 .

[12]  Luc Int Panis,et al.  A prospective cohort study on minor accidents involving commuter cyclists in Belgium. , 2012, Accident; analysis and prevention.

[13]  J. Pucher,et al.  Bicycling renaissance in North America? An update and re-appraisal of cycling trends and policies , 2011 .

[14]  Mette Møller,et al.  Cyclists' perception of risk in roundabouts. , 2008, Accident; analysis and prevention.

[15]  R Honkanen,et al.  The role of alcohol in nonfatal bicycle injuries. , 1990, Accident; analysis and prevention.

[16]  Martina Bílová,et al.  Critical factors in fatal collisions of adult cyclists with automobiles. , 2010, Accident; analysis and prevention.

[17]  Søren Underlien Jensen,et al.  How to obtain a healthy journey to school , 2008 .

[18]  Tove Hels,et al.  The effect of roundabout design features on cyclist accident rate. , 2007, Accident; analysis and prevention.

[19]  Giancarlo Bacchieri,et al.  Cycling to work in Brazil: users profile, risk behaviors, and traffic accident occurrence. , 2010, Accident; analysis and prevention.

[20]  Richard Williams Generalized Ordered Logit/Partial Proportional Odds Models for Ordinal Dependent Variables , 2006 .

[21]  Rune Elvik,et al.  Publication bias and time-trend bias in meta-analysis of bicycle helmet efficacy: a re-analysis of Attewell, Glase and McFadden, 2001. , 2011, Accident; analysis and prevention.

[22]  Michael Smart,et al.  US immigrants and bicycling: Two-wheeled in Autopia , 2010 .

[23]  Romain Meeusen,et al.  Commuting by bike in Belgium, the costs of minor accidents. , 2010, Accident; analysis and prevention.

[24]  Eric Minikel Cyclist safety on bicycle boulevards and parallel arterial routes in Berkeley, California. , 2012, Accident; analysis and prevention.

[25]  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.

[26]  Nikolaos Yiannakoulias,et al.  Mapping commuter cycling risk in urban areas. , 2012, Accident; analysis and prevention.

[27]  Rune Elvik,et al.  Incomplete Accident Reporting: Meta-Analysis of Studies Made in 13 Countries , 1999 .

[28]  Karla A. Lawson,et al.  Alcohol, bicycling, and head and brain injury: a study of impaired cyclists' riding patterns R1. , 2010, The American journal of emergency medicine.

[29]  Rune Elvik,et al.  Total costs of bicycle injuries in Norway: correcting injury figures and indicating data needs. , 2007, Accident; analysis and prevention.

[30]  Mary Sissons Joshi,et al.  A diary study of the risk perceptions of road users , 2001 .

[31]  Jan Garrard,et al.  Cycling down under: a comparative analysis of bicycling trends and policies in Sydney and Melbourne , 2011 .

[32]  S. Washington,et al.  Statistical and Econometric Methods for Transportation Data Analysis , 2010 .

[33]  Tove Hels,et al.  Road Accidents and Road Fatalities in Denmark from 1968 to 2004 , 2008 .

[34]  Yinhai Wang,et al.  Estimating the risk of collisions between bicycles and motor vehicles at signalized intersections. , 2004, Accident; analysis and prevention.

[35]  P. Crocker,et al.  Self-reported alcohol use is an independent risk factor for head and brain injury among cyclists but does not confound helmets' protective effect. , 2012, The Journal of emergency medicine.

[36]  M. Raschke,et al.  Bicycle accidents - do we only see the tip of the iceberg? A prospective multi-centre study in a large German city combining medical and police data. , 2012, Injury.

[37]  Olle Bunketorp,et al.  Cycling and alcohol. , 2002, Injury.

[38]  Ralph Buehler,et al.  Making Cycling Irresistible: Lessons from The Netherlands, Denmark and Germany , 2008 .

[39]  L Aultman-Hall,et al.  Toronto bicycle commuter safety rates. , 1999, Accident; analysis and prevention.

[40]  A. Khattak,et al.  Factors Influencing Bicycle Crash Severity on Two-Lane, Undivided Roadways in North Carolina , 1999 .

[41]  R G Attewell,et al.  Bicycle helmet efficacy: a meta-analysis. , 2001, Accident; analysis and prevention.

[42]  L Aultman-Hall,et al.  Ottawa-Carleton commuter cyclist on- and off-road incident rates. , 1998, Accident; analysis and prevention.

[43]  R. Brant Assessing proportionality in the proportional odds model for ordinal logistic regression. , 1990, Biometrics.

[44]  J P Schepers,et al.  Road factors and bicycle-motor vehicle crashes at unsignalized priority intersections. , 2011, Accident; analysis and prevention.