BACKGKROUND: Traffic-related trauma is an important contributor to morbidity and mortality in Canada, especially among children and young adults. Comparing exposure-based injury rates between travel modes and jurisdictions is a valuable tool towards improving safety.
We used injury data from the British Columbia Motor Vehicle Branch, trip diary data from the Metro Vancouver transportation authority, and population and provincial travel data from the Census to calculate crude fatality and injury rates for motor vehicle occupants, bicyclists, and pedestrians. We used three different denominators: population; person-trip; and distance travelled.
Motor vehicle occupants had the lowest fatality rates using exposure-based denominators: 9.6 per 100 million person-trips and 0.97 per 100 million km. Bicyclists and pedestrians had similar fatality rates using one denominator (13.8 vs. 14.7 per 100 million person-trips, respectively), but bicyclists had a lower rate using the other (2.60 vs. 7.37 per 100 million km). For injuries, pedestrians had the lowest rate and bicyclists the highest using the person-trip denominator, whereas motor vehicle occupants had the lowest rate using the distance denominator, and bicycling and walking had similar rates.
Risks of driving, walking and bicycling in British Columbia were similar to their risks in the United States. The injury and fatality rates for these three travel modes were intermediate compared to much higher rates among US motorcyclists and much lower rates among US bus passengers. Data improvements would enable transportation trauma rate calculations for Canada as a whole and for other modes of travel (transit, motorcycling).
[Show abstract][Hide abstract] ABSTRACT: Objective
To examine the relationship between cycling injury severity and personal, trip, route and crash characteristics.
Data from a previous study of injury risk, conducted in Toronto and Vancouver, Canada, were used to classify injury severity using four metrics: (1) did not continue trip by bike; (2) transported to hospital by ambulance; (3) admitted to hospital; and (4) Canadian Triage and Acuity Scale (CTAS). Multiple logistic regression was used to examine associations with personal, trip, route and crash characteristics.
Of 683 adults injured while cycling, 528 did not continue their trip by bike, 251 were transported by ambulance and 60 were admitted to hospital for further treatment. Treatment urgencies included 75 as CTAS=1 or 2 (most medically urgent), 284 as CTAS=3, and 320 as CTAS=4 or 5 (least medically urgent). Older age and collision with a motor vehicle were consistently associated with increased severity in all four metrics and statistically significant in three each (both variables with ambulance transport and CTAS; age with hospital admission; and motor vehicle collision with did not continue by bike). Other factors were consistently associated with more severe injuries, but statistically significant in one metric each: downhill grades; higher motor vehicle speeds; sidewalks (these significant for ambulance transport); multiuse paths and local streets (both significant for hospital admission).
In two of Canada's largest cities, about one-third of the bicycle crashes were collisions with motor vehicles and the resulting injuries were more severe than in other crash circumstances, underscoring the importance of separating cyclists from motor vehicle traffic. Our results also suggest that bicycling injury severity and injury risk would be reduced on facilities that minimise slopes, have lower vehicle speeds, and that are designed for bicycling rather than shared with pedestrians.
BMJ Open 01/2015; 5(1):e006654. DOI:10.1136/bmjopen-2014-006654 · 2.27 Impact Factor
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