Cycling Health and Safety: A Review
Prepared By:
Chris Cavacuiti BA, MD, CCFP, MHSc, ASAM
Staff Physician
St. Michael's Hopsital
Department of Family and Community Medicine
410 Sherbourne St
Toronto, Ontario
M4X 1K2
Introduction
I became interested in cycling health and safety in 2006 after being hit by truck while I was riding my bike. The collision left me with fractured ribs, a broken collarbone, and a shoulder blade that was shattered into a number of small pieces. The truck driver was charged and convicted for making an unsafe turn.
Bikes have always been a big part of my life (I’m the medical director for a professional women’s cycling team, I commute to work by bike and I’m a competitive cyclist who races in triathlons and on master men’s cycling team) so this collision wasn’t just a blow to by body, but also to my sense of self: after this collision, I wasn’t sure I wanted to be a cyclist any more.
As a physician with an interest in research, I used my recovery time to do some reading on cycling health and safety. I quickly came to realize that there is powerful evidence that with the proper investment in cycling infrastructure accidents like mine would happen far less often.
That alone would have been enough to make me a cycling advocate. But the reading I did convinced me that even people far less invested in the cycling community than I am would gladly start advocating for cycling safety if they new how strong the evidence for investing in cycling is.
As you will see from this review, it’s not only people who care about cycling safety that should be advocating for investing in cycling…
Anyone who cares about social justice issue should care about cycling:
Unlike cars, bikes are available to people of all ages and incomes. Most utilitarian cycling in cities like Toronto happens in the inner city (1, 2), in fact, over half of all households in central Toronto do not own a car and must rely on bikes and other forms of transportation (1, 3). Support for the concept of "complete streets" (roads with bike lanes, sidewalks and room for mass transit) is gaining support from a diverse range of people, including advocates for senior citizens and the disabled (4).
Anyone who cares about the environment should care about cycling:
While almost 50% of car trips are <5 km, bicycling accounted for an average of 1.2% of work trips in Canada in 2001 (5) Using bikes more and cars less for short trips such as these is an incredibly effective way to reduce greenhouse gas emissions.
Anyone who cares about their health (or their children’s health) should care about cycling:
Health issues related to an inactive lifestyle (such as obesity in childhood and heart disease in adults) are much less common in countries where more people ride their bikes (6, 7). The health benefits of cycling are calculated to outweigh the risks by 20:1 (8, 9).
Anyone who cares about the economy should care about cycling:
Physically active citizens are good for the economy as they have higher productivity, fewer sick days and need less medical treatment (6). In fact, a Danish cost-benefit analysis suggests that for every dollar invested in cycling infrastructure we can save over ten dollars in reduced health care costs and other savings (6).
Heck…Even anyone who drives a car and never EVER intends to ride a bike should care about cycling:
As many studies have shown (10, 11, 11, 12) when motorists are willing to sacrifice a little bit of road space to give cyclists a safe place to ride then a lot more people will stop driving their cars and start riding their bikes which in turn leads to significant reductions in traffic congestion and makes the lives of motorists easier.
On the subject of cars, I want to be clear that while this review highlights the difficulties that exist between cars and cyclists, it is not intended to be an attack on motorists. I own a car myself and live in a big city so I understand the frustrations car drivers face. What is clear from my reading of the studies is that if we had the policies and infrastructure in place to make cycling safe, then to cyclists and cars could be allies instead of adversaries.
In reviewing the cycling health and safety research, my hope is that this information can be used to find solutions rather than assign blame. Also, please remember it is the data, not me (or even the researchers) who are saying cars and cyclists need to find better ways of sharing the road.
I think motorists are more likely to be convinced by evidence than angry anti-car diatribes, so as much as possible I’ve tried to get the information for this document from reputable sources such as peer reviewed journals, departments of transportation and other government offices and mainstream media.
I hope you enjoy this review!
Chris Cavacuiti MD
