Bicycling crashes on streetcar (tram) or train tracks: Mixed methods to identify prevention measures

Abstract

Background
Streetcar or train tracks in urban areas are difficult for bicyclists to negotiate and are a cause of crashes and injuries. This study used mixed methods to identify measures to prevent such crashes, by examining track-related crashes that resulted in injuries to cyclists, and obtaining information from the local transit agency and bike shops.

Methods
We compared personal, trip, and route infrastructure characteristics of 87 crashes directly involving streetcar or train tracks to 189 crashes in other circumstances in Toronto, Canada. We complemented this with engineering information about the rail systems, interviews of personnel at seven bike shops about advice they provide to customers, and width measurements of tires on commonly sold bikes.

Results
In our study, 32 % of injured cyclists had crashes that directly involved tracks. The vast majority resulted from the bike tire being caught in the rail flangeway (gap in the road surface alongside rails), often when cyclists made unplanned maneuvers to avoid a collision. Track crashes were more common on major city streets with parked cars and no bike infrastructure, with left turns at intersections, with hybrid, racing and city bikes, among less experienced and less frequent bicyclists, and among women. Commonly sold bikes typically had tire widths narrower than the smallest track flangeways. There were no track crashes in route sections where streetcars and trains had dedicated rights of way.

Conclusions
Given our results, prevention efforts might be directed at individual knowledge, bicycle tires, or route design, but their potential for success is likely to differ. Although it may be possible to reach a broader audience with continued advice about how to avoid track crashes, the persistence and frequency of these crashes and their unpredictable circumstances indicates that other solutions are needed. Using tires wider than streetcar or train flangeways could prevent some crashes, though there are other considerations that lead many cyclists to have narrower tires. To prevent the majority of track-involved injuries, route design measures including dedicated rail rights of way, cycle tracks (physically separated bike lanes), and protected intersections would be the best strategy.

Full text

R E S E A R C H A R T I C L E Open Access
Bicycling crashes on streetcar (tram) or
train tracks: mixed methods to identify
prevention measures
Kay Teschke
1*
, Jessica Dennis
2
, Conor C. O. Reynolds
3
, Meghan Winters
4
and M. Anne Harris
2,5
Abstract
Background: Streetcar or train tracks in urban areas are difficult for bicyclists to negotiate and are a cause of
crashes and injuries. This study used mixed methods to identify measures to prevent such crashes, by examining
track-related crashes that resulted in injuries to cyclists, and obtaining information from the local transit agency
and bike shops.
Methods: We compared personal, trip, and route infrastructure characteristics of 87 crashes directly involving
streetcar or train tracks to 189 crashes in other circumstances in Toronto, Canada. We complemented this with
engineering information about the rail systems, interviews of personnel at seven bike shops about advice they
provide to customers, and width measurements of tires on commonly sold bikes.
Results: In our study, 32 % of injured cyclists had crashes that directly involved tracks. The vast majority resulted
from the bike tire being caught in the rail flangeway (gap in the road surface alongside rails), often when cyclists
made unplanned maneuvers to avoid a collision. Track crashes were more common on major city streets with
parked cars and no bike infrastructure, with left turns at intersections, with hybrid, racing and city bikes, among less
experienced and less frequent bicyclists, and among women. Commonly sold bikes typically had tire widths
narrower than the smallest track flangeways. There were no track crashes in route sections where streetcars and
trains had dedicated rights of way.
Conclusions: Given our results, prevention efforts might be directed at individual knowledge, bicycle tires, or route
design, but their potential for success is likely to differ. Although it may be possible to reach a broader audience
with continued advice about how to avoid track crashes, the persistence and frequency of these crashes and their
unpredictable circumstances indicates that other solutions are needed. Using tires wider than streetcar or train
flangeways could prevent some crashes, though there are other considerations that lead many cyclists to have
narrower tires. To prevent the majority of track-involved injuries, route design measures including dedicated rail
rights of way, cycle tracks (physically separated bike lanes), and protected intersections would be the best strategy.
Keywords: Bicycling injuries, Bike safety, Bike lanes, Public transport, Streetcar, Train, Built environment
* Correspondence: kay.teschke@ubc.ca
1
School of Population and Public Health, University of British Columbia, 2206
East Mall, Vancouver, BC V6T 1Z3, Canada
Full list of author information is available at the end of the article
© 2016 The Author(s). Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver
(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Teschke et al. BMC Public Health (2016) 16:617
DOI 10.1186/s12889-016-3242-3
Content courtesy of Springer Nature, terms of use apply. Rights reserved.

Background
Both bicycling and public transport are seen as means to
increase physical activity in the population and to reduce
air emissions that induce climate change [1]. Among
public transport modes, streetcars (North American
term) or trams (European term) have many benefits
(higher ridership and low carbon footprint) and are
often promoted over buses [2, 3]. Bicycling is often
identified as a means to access public transport, but the
potential impact of a transit system on bicycling injuries
has rarely been studied. In recent years, research has
begun to report high numbers and high risks of injuries
to bicyclists riding near streetcar or train tracks [3–9].
These studies include one we conducted in the cities
of Vancouver and Toronto, Canada [4, 6, 7]. The study
included 690 adults who were sufficiently injured in a
bicycling crash to require treatment at a hospital emer-
gency department. Of these, 14 % had a crash that dir-
ectly involved streetcar or train tracks [6]. A three-fold
increased risk of injury was observed when cycling on
routes with streetcar or train tracks, with a higher risk in
the street segments between intersections than at inter-
sections themselves [4, 7]. Unlike Vancouver, Toronto
has an extensive streetcar system (the largest in North
America) and 32 % of participating cyclists injured there
had crashes that directly involved tracks, compared to
2.5 % in Vancouver.
In this paper, we examine the Toronto crashes in more
detail, to describe the circumstances, infrastructure at
the crash sites, trip conditions, and characteristics of the
injured cyclists and their bicycles. Our goal was to
identify factors that are associated with increased or de-
creased potential for crashes on tracks. We also obtained
engineering information about the tracks from the tran-
sit authority and visited a sample of bicycle shops to
measure tire sizes and interview staff about this issue.
The overall aim was to identify ways to prevent such
crashes in the future.
Methods
The injury study
The procedures for the injury study have been described
in detail elsewhere [4, 6, 7]. The following is a summary
of the Toronto component relevant to the analyses
presented in this paper. The study population consisted
of adult (≥19 years) residents of Toronto who were in-
jured while riding a bicycle in the city and treated within
24 h in the emergency departments of St. Michael’s
Hospital, Toronto General Hospital or Toronto Western
Hospital between May 18, 2008 and November 30, 2009.
All hospitals were located in the central business district,
and one was a regional trauma centre.
Eligible participants were interviewed in person by
trained interviewers about personal characteristics, trip
conditions, and crash circumstances, using a structured
questionnaire [10] as soon as possible after the injury to
maximize recall. Crash circumstances were derived from
participants’answers to the following questions:
In your own words, please describe the
circumstances of the injury incident.
Was this a collision between you and a motor
vehicle, person, animal or object (including
holes in the road)?
If yes, what did you collide with? (response options:
car, SUV, pick-up truck, or van; motorcycle or
scooter; large truck; bus or streetcar; pedestrian;
cyclist; animal; other non-motorized wheeled
transport; pot hole or other hole; streetcar or train
track)
Personal characteristics queried in the interview and
used in analyses presented here included sex, age, and
three factors potentially related to cycling skill: whether
they had taken an urban cycling training course; whether
they considered themselves an experienced cyclist; and
the number of times they had cycled in the last year
(reported by season and summed). Trip characteristics
included weather, purpose, bike type, and whether medi-
cations, alcohol or marijuana were used in the 6 h prior.
Bike type was queried with a poster of photos showing
an example of each of the following types: city, touring,
hybrid, racing, folding, cruiser, mountain and recum-
bent. Participants were also able to specify other bike
types.
Structured site observations were made to document
characteristics of injury and control sites, and allow
route infrastructure classification [4, 7, 11]. The observa-
tions were made blind to whether an injury took place at
the site or not. In the current analyses, only the injury
site data were used. Infrastructure characteristics used in
these analyses were selected primarily if they were
shown to be related to injury risk in previous analyses:
route type, intersection location or not, grade, and pres-
ence of construction [4, 7]. Route type at an intersection
was defined as the route type the cyclist arrived from.
To determine whether a crash directly involved street-
car or train tracks, several steps were involved [6]. The
blinded and objective site observation data were used to
identify whether the crash was at a site where tracks
were present. Wherever this was the case, the closed-
ended interview response about what the participant
collided with and the open-ended interview response de-
scribing the crash circumstances were reviewed. Each
crash resulting from the participant’s bike slipping on a
track rail, hitting a track component, or its tire being
caught in the rail flangeway was separately coded and
counted. These circumstances were classified as “injury
Teschke et al. BMC Public Health (2016) 16:617 Page 2 of 10
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directly involved a streetcar or train track”; all other
injuries were classified as “other or unknown injury cir-
cumstance”. The interview data were also used to clas-
sify whether a motor vehicle was involved in the crash
(i.e., a collision with a motor vehicle or a crash after a
maneuver to avoid a collision with a motor vehicle).
Data analyses were performed using JMP 11 (SAS
Institute, Cary, NC). Descriptive data on crash circum-
stances, infrastructure at the crash site, trip conditions
and personal characteristics were compared for injuries
involving streetcar or train tracks vs. other or unknown
circumstances. The Chi
2
test (categorical independent
variables) and t-test (continuous independent variables)
were used to identify factors that differed between
categories of the dependent variable: injury directly
involved streetcar or train tracks vs. other or unknown
injury circumstances. Variables that were significant in
the bivariate analyses (p< 0.05) were offered to multiple
logistic regression. Two independent variables were
strongly associated with each other (experienced cyclist
and cycling frequency). Of the two, only cycling
frequency was significant in multiple regression and
retained in the final model.
Streetcar tracks in Toronto
The Toronto Transit Commission Streetcar Department
was contacted to obtain the engineering specifications of
the streetcar rails and flangeways (gap in the road sur-
face alongside rails) and other characteristics of the
streetcar rail infrastructure, and to provide comparisons
to train infrastructure in the city.
Survey of Toronto bike shops
In the summer of 2015, we sought input from eight bi-
cycle shops within 7 km of the Toronto central business
district and recognized by investigators as frequented by
commuter cyclists. Five of the shops were in the down-
town core, two to the east, and one to the north. Each
shop was sent an introductory letter explaining the pur-
pose of the survey and the procedures involved. This
was followed with a phone call requesting participation
and setting up a time to visit the shop. The survey was
open to all shop employees; the position of the staff
member interviewed was not recorded. The following
open-ended questions were asked:
What types of cyclists shop at this store?
Do any shoppers ask about ways to avoid streetcar
track injuries? What advice do you give? To your
knowledge, does this store have a policy or standard
recommendation for customers concerned about
streetcar track injuries?
There are hundreds of tire sizes and styles. Do you
sell any tires (or do you know of any tires) that are
less likely to get caught in a streetcar track groove
or slip on streetcar track surfaces?
Do you think there are any other bicycle, wheel, or
tire design elements that could reduce the risk of
streetcar track injuries?
We asked to be shown popular bikes and to measure
their tires. The following data were recorded: bike type;
tire manufacturer; tire size as imprinted on the tire; and
measured tire width (including knobs, if present). Bike
type was recorded as described by bike shop personnel.
Measurements (tire width, tire depth, wheel width) were
taken on inflated tires mounted on bicycle wheels, using
calipers (Capri Tools, CP20001, Pomona, California).
Tire widths were summarized overall and by bike type
as means, minima and maxima. Overall proportions
narrower and wider than Toronto streetcar flangeways
were calculated. The measured tire widths were
compared to the widths printed by the manufacturer
on the tire.
Results
Streetcar and train tracks in Toronto
Toronto’s streetcar system has about 80 km of double
track (one set in each direction) (personal communica-
tion, Stephen Lam, Toronto Transit Commission, May
2015). Most of the eleven routes operate in mixed traffic,
but three operate in dedicated rights of way (for street-
cars only, except at intersections). Streetcar tracks in
Toronto are typically constructed with two types of rail
(Fig. 1): girder rails and tee rails. Wheels ride on the rail
surface and are held in position by a larger diameter
flange on one side of the wheel (Fig. 1c) that rides in a
slot beside the rail: the “flangeway”. In girder rails, the
flangeway is part of the cast steel rail, whereas flange-
ways for tee rails are constructed as they are laid in the
street concrete. Most straight sections of Toronto street-
car tracks are constructed with tee rails and most curves
use girder rails. The flangeway of girder rail used in
Toronto has a typical width at the top of 37.5 mm
(millimeter) and a width just below the surface of
34.5 mm, though the width changes as the railhead is
worn. Tee rail flangeways vary in width; US guidelines
indicate widths in similar systems of 38 to 50 mm [12].
Railway train rights of way are private except at road
crossings (personal communication, Stephen Lam,
Toronto Transit Commission, May 2015). Tracks are
constructed with tee rails that sit atop railway ties for
most of their distance. At road crossings, the rail is em-
bedded in the road surface material (concrete or asphalt)
and flangeways are constructed as for streetcar tracks. Rail-
ways in Canada can use the same tee rail as the Toronto
streetcar system (Fig. 1b), though on high tonnage lines,
heavier rail with the same profile is used [13].
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The injury study
Our study included 276 people who had been injured
while cycling and attended one of the three participating
Toronto emergency departments. Of these, 139 had
crashes at sites where streetcar or train tracks were
present and 87 of those had crashes that directly
involved the tracks. Three of the people who crashed at
a streetcar track location could not remember enough
detail about their crash to determine if the tracks were
directly involved; these were classified as having
unknown circumstances. None of the study participants
had a collision with a streetcar or train.
The vast majority (85 %) of the track crashes resulted
from the bicycle tire being caught in the flangeway
(Table 1). The remainder resulted from tires slipping on
the rail surface (just over half of slips occurred during
rain, snow or fog conditions). Table 1 provides sample
descriptions of the circumstances leading to track-
involved crashes. None of the track crashes included
collisions with other parties, but a common feature was
sudden maneuvers to avoid collisions (mainly with
motor vehicles, but also cyclists and pedestrians); these
resulted in unanticipated track crossings or crossings at
shallower angles than planned.
Table 2 summarizes data on the crash circumstances,
route infrastructure at the crash site, trip conditions,
and personal characteristics of the cyclists injured in
streetcar or train track crashes vs. in other circum-
stances. Six factors had significant associations with
crashes that directly involved tracks. A higher propor-
tion of track crashes than other crashes were on major
streets with parked cars and no bike infrastructure
(Fig. 2). A slightly higher proportion of track crashes
than other crashes were at intersections, mainly because
of a much higher proportion of left turn crashes. Bike
types with higher proportions involved in track crashes
were hybrid, racing, and city bikes. Women and inexperi-
enced cyclists had higher proportions of track crashes.
People who had track crashes cycled on average less
frequently than those who had other crash circumstances.
Other characteristics did not significantly differ be-
tween track-involved and other crash circumstances, but
provide a picture of the crashes. Of track crashes, 41 %
involved motor vehicles, 60 % occurred on flat grades,
and 15 % occurred where construction was present.
Most track crashes happened on clear days (60 %), and
about half happened on commutes to work or school or
on the job. Cyclists had rarely used prescription medica-
tions (6 %), alcohol (12 %) or marijuana (1 %) in the 6 h
prior to the trip. The majority of those injured on street-
car or train tracks were ages 20 to 39 (67 %). Few had
urban cycling training (6 %).
Fig. 1 Toronto rails, flangeways and wheels. aProfile of girder rail (NP4aMOD) with integrated flangeway. bProfile of tee rail (115 lb AREA)
showing flangeway created by gap between side of rail and adjacent concrete. cStreetcar or train wheels on tee rail, showing larger diameter
flanges that hold wheels in place. dExample of how flangeway widths can vary along a streetcar line. (Image c: Wikimedia Commons, Pantoine)
Teschke et al. BMC Public Health (2016) 16:617 Page 4 of 10
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In multiple logistic regression (Table 3), route type,
intersection status, sex and cycling frequency were
significantly associated with whether a crash directly
involved a streetcar or train track vs. not. Major
streets with parked cars and no bike infrastructure
had higher odds of a track-involved crash than all
other route types. Left turns at intersections had
much higher odds of a track-involved crash com-
pared to other intersection movements and non-
intersections. People who cycled more frequently had
lower odds of a track-involved crash. Women had
higher odds than men of a track-involved crash.
Survey of Toronto bike shops
Seven of the eight invited bike shops participated in the
survey. As expected given the shop selection, commuter
cyclists were their main customers (50 to 85 %) and they
mainly bought commuter, hybrid, comfort or city bikes.
Recreational cyclists were the next largest group (15 to
50 %), buying mountain bikes in addition to the bike
types typically purchased by commuters. Smaller niche
groups bought fat, road, racing, or recumbent bikes or
trikes. Most stores had more male than female cus-
tomers, though several reported 40 % or more of their
customers as women. One store catered to families.
All bike shop personnel reported that some customers,
particularly those who were less experienced, asked
about how to handle streetcar tracks, including asking
whether wider tires or mountain bikes would help. All
indicated that they advised such customers to be aware
of tracks and cross them at appropriate angles: at least
45°, 90° optimally. Shop personnel reported selling wide
tires to concerned customers, but many were reluctant
to advise this, for several reasons: they considered wide
tires to be slower and less efficient for commuting; they
thought very wide tires (e.g., fat bike tires that are over
100 mm wide) would be needed to avoid being caught in
all flangeways; they thought that some wide tires may
still get caught especially if they have knobs on them;
and they thought that wide tires would still have the risk
of slipping on track surfaces. Other advice that shop
personnel reported giving to concerned customers in-
cluded planning their routes to avoid streets with street-
car tracks, making two-stage left turns at intersections
with tracks, being extra cautious in wet and icy weather,
and keeping tires inflated. Most shop personnel indi-
cated that there were no tires that could prevent slipping
on rail surfaces, but one mentioned slick tires with
grooves to help move water away from the center, and
two mentioned tires made from “tackier”rubber com-
pounds, though they thought these wear more quickly.
Table 4 summarizes width measurements of tires on
bikes commonly sold at the participating shops. The
widths spanned a wide range, from 24.8 mm on a single
speed racing style bike to 112 mm on a fat bike. Most of
the tires were narrow enough to be caught in the nar-
rowest streetcar track flangeways (34.5 mm) and only a
few were wider than the widest likely flangeways in
Toronto (50 mm). Some bike types had consistent tire
sizes (e.g., single speed bikes had consistently narrow
tires < 30 mm; touring or road bikes medium width tires
from 33 to 37 mm; and cruiser bikes wide tires ≥49 mm),
whereas others, particularly city and hybrid bikes, had
broad ranges of tire widths. We compared measured tires
widths with the manufacturer widths imprinted on the tire
and found they agreed very well (mean |difference| =
1.7 mm, SD (standard deviation) = 1.1 mm, range 0 to
Table 1 Circumstances of crashes directly involving streetcar
(N= 83) or train tracks (N= 4), with examples
a
Tire caught in track flangeway, N= 74 (85.1 % of track injuries)
Intersection examples
I had been cycling on the right side of the road but I wanted to
make a left turn and while moving to the centre of the lane my bike
wheels got caught in the streetcar tracks.
As I approached an intersection, there was a car in front of me
turning right. To go straight, I moved around the car into the left lane
but as I did, my front tire got stuck in the streetcar track.
I had a green light so I proceeded through the light. A cyclist turned
right onto the bike path I came from. I swerved to avoid her and my
wheel got caught in the train track.
Non-intersection examples
As I was cycling in the curb lane, a truck passed me, stopped and
turned on his hazards. I went around him on the left which put me
between the street car tracks. As I was going over the street car
tracks my back wheel got caught.
There was an ambulance coming from behind me and a car parallel
parking in front of me. I moved across the tracks to avoid the car.
When I attempted to move back into the right lane, my back wheel
got caught in the streetcar track.
I was biking in the right hand lane and in front of me a woman opened
her car door. I moved to the center lane, but as I was moving back to
the right lane my front tire got caught in a streetcar track.
There were three big trucks parked in the curb lane. I moved into
thelanebesidemetoavoidthem.Ilookedbacktomoveback
into the curb lane when my front tire got caught in the streetcar
tracks.
There was another cyclist ahead of me. I moved into the left lane and
passed her. When I attempted to move back into the right lane, my
front wheel got caught in a street car track.
Tire slipped on track rail, N= 13 (14.9 % of track injuries)
The roads were very wet and slick. I was travelling south, turning left.
I was leaning into the turn. I hopped over the first streetcar rail and
was getting ready to cross the next rail when my back tire slipped on
the track.
I came to two sets of railway tracks. I slowed down and crossed the
first set but when I started to cross the second set, my front tire slid
on the wet track.
a
As described by injured cyclists in Toronto
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4.4 mm). Toronto has a public bike share program in the
downtown core (1000 bikes in 2014); its bikes have
49.5 mm tires (personal communication, Scott Hancock,
Motivate Company Toronto, January 2016).
Discussion
The 87 cyclists injured in track-involved crashes in
this study, recruited at three Toronto emergency
departments over an 18-month period, appear to
comprise the largest case series involving streetcar
and train tracks reported to date. Three other studies
identified cases in a single hospital over a similar
time period: 41 emergency department cases in
Sheffield [3]; ten hospitalized cases in Amsterdam [9];
and five emergency department cases (all e-bike
users) in Bern [5]. A Dutch study in 13 hospitals
reported on four emergency department cases [14].
As in our study, the dominant scenario for track
crashes in most European studies was bike tires being
caught in the flangeway [3, 5, 9]. The exception was
that all four Dutch cases involved bicycle wheels
Table 2 Crash circumstances, crash site infrastructure, trip
conditions and cyclist characteristics, 276 cyclists injured in Toronto
Crash directly
involved
streetcar or
train track
Other or
unknown
crash
circumstance
N% N %
87
a
31.5 189
a
68.5
Crash circumstances
Motor vehicle involved 36
b
41.4 97
c
51.9
Infrastructure at Crash Site
Route type
d
Major street with parked cars,
no bike infrastructure
49 56.3 53 28.0
Major street, no parked cars,
no bike infrastructure
26 29.9 58 30.7
Major street with painted bike lane 7 8.0 29 15.3
Residential street 2 2.3 20 10.6
Sidewalk or multiuse path 3 3.4 29 15.3
Intersection status
d
Non-intersection 59 67.8 143 75.7
Intersection, straight through 13 14.9 42 22.2
Intersection, right turn 2 2.3 3 1.6
Intersection, left turn 13 14.9 1 0.5
Grade
Downhill 28 32.2 75 39.7
Flat 52 59.8 91 48.1
Uphill 7 8.0 23 12.2
Construction present 13 14.9 21 11.1
Trip Conditions
Weather during trip
Clear 52 59.8 127 69.4
Cloud cover 20 23.0 35 19.1
Rain, snow or fog 12 13.8 13 7.1
Wind 3 3.4 8 4.4
Trip purpose
Multiple 4 4.6 12 6.3
Personal business 21 24.1 31 16.4
Recreation 9 10.3 33 17.5
Social reasons 11 12.6 37 19.6
Commute to work or school, job 42 48.3 76 40.2
Bike type used on trip
d
Hybrid 37 42.5 49 25.9
Racing, track, fixed gear 14 16.1 24 12.7
City 6 6.9 9 4.8
Mountain 17 19.5 57 30.2
Touring/road 9 10.3 32 16.9
Other: BMX, cruiser, folding 4 4.6 18 9.5
Table 2 Crash circumstances, crash site infrastructure, trip
conditions and cyclist characteristics, 276 cyclists injured in Toronto
(Continued)
Drugs or alcohol used in 6 h prior to trip
Medication 5 5.7 17 9.0
Alcohol 10 11.5 18 9.5
Marijuana 1 1.1 4 2.1
Cyclist characteristics
Age
20–29 32 36.8 60 31.7
30–39 26 29.9 57 30.2
40–49 13 14.9 29 15.3
50–59 11 12.6 26 13.8
60 + 5 5.7 17 9.0
Sex
d
Female 52 59.8 69 36.7
Male 35 40.2 119 63.3
Urban cycling training course taken
Yes 5 5.7 7 3.7
No 82 94.3 182 96.3
Experienced cyclist
d
Yes 74 85.1 181 95.7
No 13 14.9 8 4.2
Cycling frequency (times per year)
d
mean 123
(SD 72.4)
mean 149
(SD 74.0)
a
% of all 276 injured cyclists
b
% of 87 injuries on tracks (applies to all following % in this column)
c
% of 189 injuries not on tracks (applies to all following % in this column)
d
Variable distribution significantly different (p< 0.05) for “crash directly
involved streetcar or train track”vs. “other or unknown crash circumstance”
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being deflected by tram rails [14]. Two European
studies described the types and severity of injuries
(dominantly fractures and about a quarter of cases
admitted to hospital) [3, 9]. We did not gather data
on the types of injury, but we examined some aspects
of injury severity in an earlier analysis [15]. We did
not find greater severity (e.g., transport by ambulance,
hospital admission) among cyclists injured at sites
with streetcar or train tracks.
Personal characteristics
We examined personal, trip and infrastructure charac-
teristics related to track-involved crashes vs. other
crash circumstances. Females were over-represented in
track crashes (60 % female) compared to other crashes
(37 %) and compared to the Toronto cycling population
(34 %) [16]. The European studies did not provide com-
parisons, but reported that the majority of those injured
on tracks were male [3, 5, 9]. We found that younger
adults (ages 20 to 39, 67 %) were also somewhat over-
represented in the track-involved crashes but not
significantly so compared to other crashes (62 %). The
injured cyclists in our study appear to have been youn-
ger than Toronto cyclists in general, based on a report
that used different age categories (ages 15 to 34, 37 %),
perhaps because our study area included large univer-
sities, many of whose students commute by bike [16].
Inexperience and less frequent cycling were associated
with track-involved crashes in our study. The Sheffield
study began immediately after their first tram line be-
came operational and they found that cycling injuries
Fig. 2 Examples of route types with streetcars in Toronto. aMajor
street with parked cars, no bike infrastructure. bMajor street, no
parked cars, no bike infrastructure. cMajor street with painted bike
lane. dMajor street with dedicated streetcar right of way. eComplex
network of rails and flangeways at intersection of two streets with
streetcar lines. (Photos a, b, e: Wikimedia Commons, Hallgrimsson)
Table 3 Factors associated with crashes directly involving
streetcar or train track vs. other or unknown circumstances
OR
a
95 % CI
b
Route type
Major street with parked cars,
no bike infrastructure
1.0 ref
Major street, no parked cars,
no bike infrastructure
0.44 (0.22, 0.86)
Major street with painted bike lane 0.15 (0.04, 0.43)
Residential street 0.12 (0.02, 0.46)
Sidewalk or multiuse path 0.12 (0.03, 0.38)
Intersection status
Non-intersection 1.0 ref
Intersection, straight through 0.84 (0.38, 1.77)
Intersection, right turn 1.03 (0.12, 7.26)
Intersection, left turn 43.4 (7.54, 838)
Sex
Male 1.0 ref
Female 2.10 (1.13, 3.92)
Cycling frequency
Additional 100 times cycling per year 0.67 (0.44, 0.99)
a
Odds ratios (OR) from multiple logistic regression, N= 276 injured cyclists in
Toronto. Bold indicates odds ratio is statistically significant
b
95 % confidence interval (CI)
Teschke et al. BMC Public Health (2016) 16:617 Page 7 of 10
Content courtesy of Springer Nature, terms of use apply. Rights reserved.

peaked 3 to 6 months later, then declined by about
50 % [3]. They attributed this to media attention to
the issue, supporting the idea that knowledge related
to tracks could be helpful. Bike shop personnel con-
tacted in this study all felt that the best protection
for cyclists was to know how to behave near tracks,
including being alert and crossing the tracks at a
perpendicular angle. Similar guidance is provided in
an Ontario government cycling skills guide, and adds
waiting for breaks in traffic and potentially dismount-
ing to cross tracks [17]. Since left turns can make
perpendicular track crossing difficult (especially where
there are complicated track patterns, Fig. 2e) and
resulted in much higher odds of track-involved
crashes, education materials could also encourage
two-stage left turns.
Our results provide some support for the idea that
increased knowledge or maneuvering skill may help,
given that certain demographic groups were over-
represented in track-involved crashes (e.g., less fre-
quent cyclists, women), however a number of factors
suggest education may not make a great difference.
Those crashing on tracks were not especially inex-
perienced (average cycling frequency of 123 trips per
year). Many of the crashes resulted from sudden ma-
neuvers to avoid collisions with motor vehicles, other
cyclists and pedestrians, situations that did not allow
prior knowledge to be used as planned. Some cyclists
(children, people with certain disabilities or who do
not speak English) may not be reached by or be able
to implement guidance about tracks. Finally, informa-
tion about how to ride near tracks is long-standing
and common in Toronto, yet the injury toll is very
high. These caveats underscore the need for other
approaches.
Bike tire characteristics
Bike shop personnel reported that some cyclists request
tires wide enough not to be caught in track flangeways.
Our analyses showed that bike type was associated with
whether injury circumstances were track-involved or
not. Bike types more frequently in track-involved
crashes had either consistently narrow tire widths
(racing, single speed) or wide ranges of tire widths
(hybrid, city) in the bike shop survey. Over half the tires
on commonly sold bicycles were so narrow that they
would fit in any of the track flangeways in Toronto.
Although bike shop staff thought that only fat bike tires
would be guaranteed not to be caught in the flange-
ways, tires of ~ 50 mm or greater on cruiser, comfort,
and bike share bikes may reduce the likelihood of being
caught in many, perhaps most, flangeways and are
worthy of further study.
Route characteristics
Route type was associated with track-involved crashes.
On major streets with no bike infrastructure, it mattered
whether there were parked cars or not (Fig. 2). These
two route types have similar presence of streetcar or
train tracks [7], but those without parked cars had less
than half the odds of track-involved crashes. The
absence of car parking provides cyclists with more room
to maneuver and avoid track crashes when something
unexpected takes place in front of them (Table 1).
Removing car parking on streets with streetcar lines
would improve conditions for cycling, especially if the
space freed up were used for cycle tracks (as discussed
below). Painted bike lanes, residential streets, and side-
walks or multiuse paths all had considerably lower odds
of track-involved crashes than major streets with no bike
infrastructure. This was almost certainly because these
Table 4 Measured tire widths of bicycles commonly sold in seven Toronto bike shops, by bike type
N Mean width
(mm)
Minimum width
(mm)
Maximum width
(mm)
Proportion
<34.5 mm
a
Proportion
>50mm
b
All bike types 37 37.5 24.8 112 54 % 8 %
Single speed, fixed gear 5 27.1 24.8 29.8
Commuter 9 34.4 29.9 38.8
City 7 34.4 27.1 47.8
Hybrid 8 35.2 25.6 55.7
Touring, road 3 35.6 32.7 37.1
Cruiser 2 54.5 49.0 60.0
Other: comfort, cargo, fat 3 67.9 41.8 112
Bike Share Toronto bikes
c
49.5
mm millimeter
a
Narrow enough to be caught in most Toronto streetcar flangeways
b
Widest flangeway specified in US guidelines for streetcar systems similar to Toronto’s[12]
c
Personal communication, Scott Hancock, Motivate Company Toronto, January 2016
Teschke et al. BMC Public Health (2016) 16:617 Page 8 of 10
Content courtesy of Springer Nature, terms of use apply. Rights reserved.

route types were much less likely to have streetcar or
train tracks [7].
In the Netherlands, cyclists on major streets are
typically provided cycle tracks (also called physically pro-
tected, segregated or separated bike lanes) and on-street
tram lines typically have their own rights of way [14, 18].
This may account for the low numbers of tram-related
crashes observed in the Dutch study [14]. Our injury
study showed that cycle tracks greatly reduced injury
risk to bicyclists [4, 7], but at the time of the study all
examples of this infrastructure were in Vancouver, not
Toronto. One Toronto streetcar line had its own right of
way during the study period (Fig. 2) and all train lines
did. We did a post-hoc check of whether any of the
track-involved crashes were along these lines. None of
track crashes between intersections were along them,
but some were at their intersections (where there is no
separation). Even if cycle tracks or designated rail rights
of way would prevent only crashes that are not at inter-
sections, track-involved crashes would be substantially
reduced, since most (68 %) were not at intersections.
Left turns at intersections were highly overrepresented
in track-involved crashes. This problem could also be
addressed with Dutch-style infrastructure, often called
“protected intersections”. Such intersections commonly
feature corner islands that direct cyclists coming from
cycle tracks to make two-stage left turns, as pedestrians
do [19]. This would make it much easier to cross tracks
at right angles, but could add long delays at intersections
unless signal timing is optimized for cyclists and pedes-
trians, as in the Netherlands.
Protected intersections, cycle tracks and designated
rail rights of way all follow the Swedish “Vision Zero”
transport safety principle: acknowledging the inevitabil-
ity of human error and providing route designs that
minimize its consequences [20]. This vision aims to
eliminate deaths and serious injuries related to transpor-
tation and is beginning to be adopted by other jurisdic-
tions in Europe and North America.
Strengths and limitations
This study benefitted from a large case series of track-
involved crashes, a comparison group with other crash
circumstances, and systematic data on crash circum-
stances, personal and trip characteristics, and route in-
frastructure at the crash sites. The mixed methods
approach also collected data about advice provided to
cyclists by bike shop personnel, widths of commonly
sold bike tires, and engineering specifications of system
rails and flangeways to provide a broader understanding
of the problem and potential solutions.
Additional data would be helpful in future studies. We
did not request data from the injured cyclists about their
tire widths. This would be worthwhile to collect, so
widths of tires involved in crashes can be compared to
flangeway widths and risk related to tire width can be
directly determined. Other characteristics (tire pressure,
presence of tire knobs, weight of the cyclist) may alter
the effective tire width and should be measured to see if
they change the tire size needed to avoid being caught in
flangeways. Direct measurements of flangeway widths
throughout the rail system would be useful, though
taking measurements in situ would be a dangerous
endeavor. Similarly, field tests of different tire widths
with bicycling track interaction maneuvers would be in-
formative but risky to participants. In cities with street-
car or tram systems, it would be interesting to survey
cyclists to see if they know how to reduce their individ-
ual risk of track crashes, and to survey planners and
engineers to see whether they are familiar with design
measures to reduce population risk of track crashes.
This study was conducted in one city in North America.
Research conducted in other areas of the world with dif-
ferent cycling infrastructure, streetcar or tram infrastruc-
ture, and bicycle types would help determine whether
these influence risk. Comparisons between cities and
countries would be a great way to discover best practices.
Unfortunately, such comparisons are difficult because the
most common coding system for traffic injuries, the
World Health Organization’s International Classification
of Diseases [21], provides coding for collisions with a
streetcar or train, but codes collisions involving tracks in a
broad category of unspecified “stationary objects”. Crash
and injury reporting systems that provide sufficient speci-
ficity to identify track-related crashes would allow admin-
istrative data to be used to tally these events, a crucial first
step in understanding their impact [14].
Conclusions
In a city with an extensive streetcar system, one-third of
bicycling crashes directly involved streetcar or train
tracks. Certain demographics were more likely to have
track-involved crashes, suggesting that increased know-
ledge about how to avoid them might be helpful. How-
ever, such advice is long-standing and common in
Toronto, yet the injury toll is very high, underscoring
the need for other solutions. Tires wider than streetcar
or train flangeways (~50 mm in the Toronto system) are
another individual-based approach, but population-
based measures are likely to provide the optimal
solution. Our results showed that route infrastructure
makes a difference to the odds of track-involved injuries.
Dedicated rail rights of way, cycle tracks, and protected
intersections that direct two-stage left turns are policy
measures concordant with a Vision Zero standard. They
would prevent most of the track-involved injury scenarios
observed in this study.
Teschke et al. BMC Public Health (2016) 16:617 Page 9 of 10
Content courtesy of Springer Nature, terms of use apply. Rights reserved.

Abbreviations
CI, confidence interval; mm, millimeter; N, number; OR, odds ratio;
SD, standard deviation
Acknowledgements
We thank the injury study participants, bike shop survey participants, Toronto
Transit Commission staff and Bike Share Toronto staff for generously giving
their time. Bike shops that kindly participated were Bateman’s Bicycle
Company, Broom Wagon Cyclery, Curbside Cycle, The Cyclepath Danforth,
Duke’s Cycle, Sweet Pete’s, and Urbane Cyclist. We appreciate the crash
circumstance classification system developed by Theresa Frendo, and the
many contributions of University of Toronto faculty and staff (Mary Chipman,
Lee Vernich, Vartouji Jazmaji, Kevin McCurley, Andrew Thomas), hospital
personnel (Michael Cusimano, Steve Friedman, Nada Elfeki), and city
personnel (David Tomlinson, Barbara Wentworth) to the injury study.
Funding
The injury study was funded by the Heart and Stroke Foundation of Canada
and the Canadian Institutes of Health Research (Institute of Musculoskeletal
Health and Arthritis, and Institute of Nutrition, Metabolism and Diabetes).
MAH and MW were supported by awards from the Michael Smith
Foundation for Health Research. JD, MAH, CCOR, and MW were supported
by awards from the Canadian Institutes of Health Research. No funding body
was involved in the design of the study, the collection, analysis or
interpretation of the data, or writing the manuscript.
Availability of data and materials
Data for this study may be made available upon request to the corresponding
author, pending agreement of the relevant ethics board(s). The request should
state the component of the data being requested, and the title and aim of the
research for which the data is being requested.
Authors’contributions
KT, MAH, CCOR, MW and JD were responsible for initial conception and design
of the study. JD and MAH implemented the bike shop survey. KT was
responsible for data analyses. KT, MAH and JD drafted the article. All authors
contributed to analysis decisions, interpretation of results and critical revision
and final approval of the article, and agree to be accountable for all aspects of
the work.
Competing interests
KT, CCOR, and MW have held consultancies related to their transportation or
bicycling expertise. MAH and JD have no financial or other relationships or
activities that could appear to have influenced the submitted work.
Consent for publication
Not applicable.
Ethics approval and consent to participate
The injury study protocol was reviewed and approved by the St. Michael’s
Hospital Research Ethics Office and the Toronto Academic Health Sciences
Network Human Subjects Board. The bike shop survey protocol was
reviewed and approved by the Ryerson University Research Ethics Board. All
injured bicyclists and bike shop personnel were adults and provided written
informed consent to participate.
Author details
1
School of Population and Public Health, University of British Columbia, 2206
East Mall, Vancouver, BC V6T 1Z3, Canada.
2
Dalla Lana School of Public
Health, University of Toronto, Toronto, Canada.
3
Institute for Resources,
Environment and Sustainability, University of British Columbia, Vancouver,
Canada.
4
Faculty of Health Sciences, Simon Fraser University, Burnaby,
Canada.
5
School of Occupational and Public Health, Ryerson University,
Toronto, Canada.
Received: 17 February 2016 Accepted: 18 June 2016
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