Risk of injury for bicycling on cycle tracks versus in the street

Abstract

Most individuals prefer bicycling separated from motor traffic. However, cycle tracks (physically separated bicycle-exclusive paths along roads, as found in The Netherlands) are discouraged in the USA by engineering guidance that suggests that facilities such as cycle tracks are more dangerous than the street. The objective of this study conducted in Montreal (with a longstanding network of cycle tracks) was to compare bicyclist injury rates on cycle tracks versus in the street. For six cycle tracks and comparable reference streets, vehicle/bicycle crashes and health record injury counts were obtained and use counts conducted. The relative risk (RR) of injury on cycle tracks, compared with reference streets, was determined. Overall, 2.5 times as many cyclists rode on cycle tracks compared with reference streets and there were 8.5 injuries and 10.5 crashes per million bicycle-kilometres. The RR of injury on cycle tracks was 0.72 (95% CI 0.60 to 0.85) compared with bicycling in reference streets. These data suggest that the injury risk of bicycling on cycle tracks is less than bicycling in streets. The construction of cycle tracks should not be discouraged.

Full text

Risk of injury for bicycling on cycle tracks versus in
the street
Anne C Lusk,
1
Peter G Furth,
2
Patrick Morency,
3,4
Luis F Miranda-Moreno,
5
Walter C Willett,
1,6
Jack T Dennerlein
7,8
ABSTRACT
Most individuals prefer bicycling separated from motor
traffic. However, cycle tracks (physically separated
bicycle-exclusive paths along roads, as found in The
Netherlands) are discouraged in the USA by engineering
guidance that suggests that facilities such as cycle
tracks are more dangerous than the street. The objective
of this study conducted in Montreal (with a longstanding
network of cycle tracks) was to compare bicyclist injury
rates on cycle tracks versus in the street. For six cycle
tracks and comparable reference streets, vehicle/bicycle
crashes and health record injury counts were obtained
and use counts conducted. The relative risk (RR) of injury
on cycle tracks, compared with reference streets, was
determined. Overall, 2.5 times as many cyclists rode on
cycle tracks compared with reference streets and there
were 8.5 injuries and 10.5 crashes per million bicycle-
kilometres. The RR of injury on cycle tracks was 0.72
(95% CI 0.60 to 0.85) compared with bicycling in
reference streets. These data suggest that the injury risk
of bicycling on cycle tracks is less than bicycling in
streets. The construction of cycle tracks should not be
discouraged.
Bicycling could address obesity, cancer, stroke,
diabetes, asthma, mortality and pollution;
1 2
however, the bicycling environment is a limiting
factor. The predominant bicycle facilities in The
Netherlands and Denmark are cycle tracks, or
bicycle paths along streets that are physically
separated from motor traffic, bicycle-exclusive and
with a parallel sidewalk.
3
Due to the separation
from vehicles afforded by 29 000 km of cycle tracks
in The Netherlands plus other initiatives,
4
27% of
Dutch trips are by bicycle, 55% are women, and the
bicyclist injury rate is 0.14 injured/million km.
5
In
the USA, 0.5% of commuters bicycle to work, only
24% of adult cyclists are women,
6
and the injury
rate of bicyclists is at least 26 times greater than in
The Netherlands.
5
The chief obstacle to bicycling,
especially for women,
7
children
8
and seniors
9
is
perceived danger of vehicular traffic. This perceived
danger from cars appears to be real,
10
as corrobo-
rated by survey participants who prefer cycle tracks
over roads.
11
Cycle track construction has been hampered in
the USA by engineering guidance in the American
Association of State Highway and Transportation
Officials (AASHTO) ‘Guide for the development of
bicycle facilities’
12
which cautions against building
two-way paths along, but physically separated
from, a parallel road. AASHTO states that sidewalk
bikeways are unsafe and implies the same about
shared-use paths parallel to roads, listing numerous
safety concerns and permitting their use only in
special situations. Cycle tracks, which can be one or
two-way and resemble shared-use paths, are not
mentioned in the AASHTO bike guide. A long-
standing, and yet not rigorously proved, philosophy
in the USA has suggested instead that ‘bicyclists
fare best when they behave as, and are treated as,
operators of vehicles.’
13
The details about cycle
tracks in the Dutch bicycle design manual CROW
3
and crash rate comparisons between the USA and
The Netherlands
5
have been dismissed by vehicular
cycling proponents,
14
with arguments of non-
transferability to the American environment. Cycle
tracks have been controversial, especially due to
conflicting studies with warnings of increased crash
rates.
15
The warnings, which in the USA result in
striped bike lanes but not cycle tracks, come
without any substantial study of the safety of
North American cycle tracks. Using existing crash
and injury data from Montreal, Canada, a city with
a network of cycle tracks in use for more than
20 years, this study compared bicyclists’injury and
crash rates with published data and bicyclists’
injury rates on cycle tracks versus in the street.
METHODS
We studied six cycle tracks in Montreal that are
two-way on one side of the street. Each cycle track
was compared with one or two reference streets
without bicycle facilities that were considered
alternative bicycling routes. One reference street
was a continuation of the street with the cycle
track; the remaining streets were parallel to the
cycle track with the same cross streets as endpoints
and, therefore, subject to approximately the same
intersection frequency and cross traffic as the cycle
track.
Injury and vehicle/bicycle crash rates per
bicycle-kilometre
The injury and crash rates for each cycle track were
determined from the emergency medical response
(EMR) database
16
and police-recorded vehicle/
bicycle crashes and estimated on the cycle tracks
per bicycle-km. Automated 24-h bicycle counts on
Montreal cycle tracks are available for selected
years, with 20e64 days in each sample from May
to September. We used linear interpolation between
the 2000 and 2008 samples to determine average
daily use for the date ranges of the injury and crash
counts. Average daily use was converted to annual
use by multiplying by 200 ‘effective days’in the
1 April to 15 November bicycling season (when
seasonal cycle tracks are open), recognising that
1
Department of Nutrition,
Harvard School of Public Health,
Boston, MA USA
2
Department of Civil and
Environmental Engineering,
Northeastern University, Boston,
MA USA
3
Direction de sante
´publique de
Montre
´al, Montre
´al, Que
´bec,
Canada
4
De
´partement de Me
´decine
Sociale et Pre
´ventive, Universite
´
de Montre
´al, Montre
´al, Que
´bec,
Canada
5
Department of Civil Engineering
and Applied Mechanics, McGill
University, Montre
´al, Que
´bec,
Canada
6
Department of Epidemiology,
Harvard School of Public Health,
Boston, MA, USA
7
Department of Environmental
Health, Harvard School of Public
Health, Boston, MA, USA
8
Department of Orthopaedic
Surgery, Brigham and Women’s
Hospital, Harvard Medical
School, Boston, MA, USA
Correspondence to
Dr Anne Lusk, Harvard School of
Public Health, 665 Huntington
Avenue, Building II, Room 314,
Boston, MA 02115, USA;
annelusk@hsph.harvard.edu
Accepted 1 December 2010
Published Online First
9 February 2011
This paper is freely available
online under the BMJ Journals
unlocked scheme, see http://
injuryprevention.bmj.com/site/
about/unlocked.xhtml
Injury Prevention 2011;17:131e135. doi:10.1136/ip.2010.028696 131
Brief report

bicycle use tends to be less in April, October and November than
in the sampled months. Use estimates were converted to bicycle-
km by multiplying by segment length and the fraction of the
cycle track’s length ridden per cyclist. This fraction, which
ranged from 0.6 to 0.9, was determined using expert judgement
considering the cycle track length and opportunities for turning
on and off.
Relative Risk (RR) of injury for cycle tracks
The RR of the cycle track compared with the reference street
was estimated using bicyclist counts and injuries from the EMR
database.
16
Although injury (EMR) and bicycle/vehicle crash
data from police records overlap strongly, the injury data have
been shown to be more exhaustive
17
and were available for
a longer period. Injury counts were determined for the 1 April to
15 November bicycling season and within 15 m of each street
centerline. For comparability with exposure data, it was
important to exclude individuals injured at intersections who
may have been riding on a cross street; however, the EMR
database does not indicate which street the injured cyclist was
using. Therefore, using the police crash database we determined
for each section studied the fraction of bicycle/vehicle crashes
involving cyclists who were riding on cross streets, and reduced
injury counts by that fraction.
Historical bicycle counts were available for the cycle tracks
but not the reference streets. To obtain an unbiased measure of
relative exposure, simultaneous 2 h bicycle counts were
conducted at parallel counting sites on each cycle track and its
reference street(s). Using a ratio of simultaneous counts elimi-
nates systematic effects on bicycle use such as weather, time and
day. The simultaneous counts were made during mild weather
commuting hours in 2009.
The RR of injury for each cycle track was calculated as:
RR ¼
injuriestrack
bikestrack
injuriesref
bikesref
where injuries
track
and injuries
ref
are the count of injuries on the
cycle track and reference street(s), respectively, and bikes
track
and
bikes
ref
are the corresponding cyclist counts.
Ninety-five percent CI were calculated using the variance of
log(ratio) based on a Poisson distribution for incidents. CI that
did not include 1 were considered statistically significant. RR for
all cycle tracks was calculated similarly using the summed data
from all the observations.
Relative danger from vehicular traffic
Reference streets were selected with vehicular traffic danger
(volume, speed, heavy vehicles) as similar as possible to their
cycle track; however, it was impossible to achieve exact simi-
larity. Therefore, to compare the vehicular traffic danger, we
also calculated the ratio of motor vehicle occupant (MVO)
injuries on the cycle track street to MVO injuries on the refer-
ence street. MVO injury counts are considered a surrogate for
traffic danger a bicyclist might face on a given street apart from
any treatment.
RESULTS
All six cycle tracks were two-way on one side of the street and
separated from traffic by raised medians, parking lanes, or
delineator posts. There were 8.5 injuries and 10.5 crashes per
million bicycle-km. The Brébeuf and Maisonneuve cycle tracks
stand out as safer than the other four (table 1).
Table 1 Injury and vehicle/bicycle crash rates for cycle tracks in Montreal, Quebec*
Cycle track Configuration Separation
Lengthy
(km)
Length
factorz
Cyclists/day,
1999e2008 x
Bike-km/year
(millions){**
Injuries/
year yy
Crashes/
yearzz
Injuries per
million bike-km
Crashes per
million bike-km
1. Bre
´beuf (seasonal) 2-Way, 1 side of one-way street,
street level
Delineator posts and parking lane 1.0 0.9 5316 0.96 3.9 1.8 4.1 1.9
2. Rachel 2-Way, 1 side of two-way street,
street level
Raised median, delineator posts,
parking lane
3.5 0.6 2581 1.08 12.6 17.0 11.6 15.7
3. Berri 2-Way, 1 side of two-way street,
street/sidewalk level
Raised median, delineator posts,
and parking lane
1.4 0.8 2778 0.62 7.8 10.2 12.5 16.4
4. Maisonneuve, w. island
(seasonal)
2-Way, 1 side of one-way street,
street level
Delineator posts 1.9 0.9 2379 0.81 1.9 2.6 2.3 3.2
5. Chr Colombe (seasonal) 2-Way, 1 side of two-way street,
sidewalk level
Curb and (part) planting strip 3.7 0.7 921 0.48 6.7 9.2 14.1 19.3
6. Rene
´-Levesque 2-Way, 1 side of two-way street,
street level
Raised median, delineator posts,
parking lane
1.3 0.8 1108 0.23 2.8 3.2 12.3 13.9
All 4.18 35.7 44.0 8.5 10.5
*Whole segments of the cycle track were studied and not just intersections.
yLength of the section studied, which may be less that the entire cycle track length for comparability with reference streets.
zFraction of the study section’s length ridden by a typical rider.
xAverage for the May to September period over the period 1999e2008.
{‘Year’ is the 7.5 month period (1 April to 15 November) when the seasonal cycle tracks are open.
**Demand is lower in April, October and November and, therefore, bicycle volume for a ‘year’ is assumed to be 200 times the daily volume.
yyInjuries (data source eemergency medical response) between 1 April and 15 November for the period 1 April 1999 to 31 July 2008 divided by 9.53.
zzBicycleemotor vehicle crashes (data source epolice reports) between 1 April and 15 November 2002e6, divided by 5.
132 Injury Prevention 2011;17:131e135. doi:10.1136/ip.2010.028696
Brief report

Compared with bicycling on a reference street, the overall RR
of injury on a cycle track was 0.72 (95% CI 0.60 to 0.85); thus,
these cycle tracks had a 28% lower injury rate. Three of the cycle
tracks exhibited RR less than 0.5, and none showed a signifi-
cantly greater risk than its reference street. Overall, 2.5 times as
many cyclists used the cycle tracks compared with the reference
streets (table 2).
The relative danger from vehicular traffic of the cycle tracks
compared with their reference streets was close to 1.0 overall,
but with a wide range (table 3). Not surprisingly, the Brébeuf
and Maisonneuve cycle tracks with lowest crash rate and rela-
tive injury risk (tables 1 and 2) also had the lowest relative
danger from vehicular traffic (table 3). Yet even for the four cycle
tracks on streets with vehicular traffic danger similar to or
greater than its reference street, the cycle tracks still had less or
a similar risk of injury.
DISCUSSION
Contrary to AASHTO’s safety cautions about road-parallel
paths and its exclusion of cycle tracks, our results suggest that
two-way cycle tracks on one side of the road have either lower
or similar injury rates compared with bicycling in the street
without bicycle provisions. This lowered risk is also in spite of the
less-than-ideal design of the Montreal cycle tracks, such as lacking
parking setbacks at intersections, a recommended practice.
18
While the goal of this study was to consider both one and two-
way cycle tracks, all of the Montreal cycle tracks were two-way
with half the bicyclists riding in a direction opposite to that of
the closest vehicular traffic, a practice not favoured by AASHTO.
Although the Montreal cycle tracks were two-way, they had
lower or similar risk compared with the road. The Dutch CROW
bicycle guidelines suggest that one-way cycle tracks are even
safer.
3
The crash rate for Montreal’s cycle tracks (10.5 crashes per
million bicycle-km) is low compared with the few and incon-
sistent crash rates in the literature. When calculated to include
only vehicle/bicycle crashes, these rates range from 3.75
5
to 54
19
in the USA and from 46
20
to 67
21
in Canada. The injury rate (8.5
injuries per million bicycle-km) lacks comparable data in the
literature, partly because few communities have accessible
bicycle-incident ambulance records. Although the Brébeuf and
Maisonneuve cycle tracks were safer, the sample of six cycle
Table 2 RR of injury for cycle tracks compared to similar on-street routes for Montreal, Quebec*
Cycle trackyReference streetzLimiting cross streets
Length
(km)
Cycle track Reference street
RR (95% CI){
2-h
bike
count
EMR-
reported
injuriesx
2-h
bike
count
EMR-
reported
injuriesx
1. Bre
´beuf St Denis (N) Rachel eLaurier 1.0 1193 37 437 32 0.42 (0.26 to 0.68)
2. Rachel Mont Royal St Urbain eMarquette 3.5 990 120 613 63 1.18 (0.87 to 1.60)
3. Berri St Denis (S) Cherrier eViger 1.4 763 74 134 27 0.48 (0.31 to 0.75)
4. Maisonneuve Both Claremont eWood 1.9 547 18 176** 18 0.32 (0.17 to 0.62)
Sherbrooke (W) 129 14 0.30
Ste Catherine 47 40.39
5. Christophe Colomb Both Gouin eJarry 3.7 407 64 122 19 1.01 (0.61 to 1.68)
Saint-Hubert 45 90.79
Christophe Colomb (S) Villeray eRosemont 2.3 77 10 1.21
6. Rene
´Levesque Sherbrooke (E) Lorimier eSt Hubert 1.3 109 27 130 32 1.01 (0.60 to 1.68)
All 15.1 4009 340 1612 191 0.72 (0.60 to 0.85)
*Statistically significant comparisons are shown in bold.
yAll cycle tracks are two-way on one side of the street.
zAn on-street bike route on a parallel street in close proximity of the cycle track.
xInjuries recorded by emergency medical response (EMR) services between 1 April 1999 and 31 July 2008 for the season 1 April to 15 November.
{95%CI calculated using the variance of log(RR) based on a Poisson distribution.
**For comparisons having two reference streets, the total number of bicyclists is used from both streets.
Table 3 Relative danger from vehicular traffic*
Cycle track street Reference street
MVO injuriesy
Relative traffic danger of cycle
track street (95% CI)z
Cycle track
street
Reference
street
1. Bre
´beuf St Denis (N) 8900.09 (0.04 to 0.18)
2. Rachel Mont Royal 86 69 1.25 (0.91 to 1.73)
3. Berri St Denis (S) 127 116 1.09 (0.85 to 1.41)
4. Maisonneuve Both 13 59x0.22 (0.12 to 0.40)
Sherbrooke (W) 72
Ste Catherine 46
5. Christophe Colomb Both 367 217x1.69 (1.43 to 2.00)
Saint-Hubert 268
Christophe Colomb (S) 166
6. Rene
´Levesque Sherbrooke (E) 196 205 0.96 (0.79 to 1.16)
All All 797 756 1.05 (0.95 to 1.16)
*Statistically significant comparisons are shown in bold.
yInjuries to motor vehicle occupants recorded by emergency medical respons e (EMR) services between 1 January 1999 and 31 July
2008.
z95% CI calculated using the variance of log(RR) based on a Poisson distribution.
xFor comparisons having two reference streets, the average number of injuries of the reference streets is used.
MVO, motor vehicle occupant.
Injury Prevention 2011;17:131e135. doi:10.1136/ip.2010.028696 133
Brief report

tracks was too small to determine which factors make some
safer.
In one of the few comparisons of bicycling in the street versus
bicycling on a separated path parallel to the street in the USA,
Wachtel and Lewiston
22
determined a relative crash risk of 1.8
for bicycling on sidewalks which had been designated as bike-
ways, compared with bicycling in the adjacent street in Palo
Alto, California. However, their study considered only intersec-
tion crashes, omitting non-intersection crashes that include
being hit from behind, sideswiped, or struck by a car door. The
authors, though, reported that 26% of cyclistemotor vehicle
collisions city-wide in Palo Alto were non-intersection crashes. If
non-intersection crashes are included to match this 26%
proportion, reanalysis of the Wachtel and Lewiston
22
data in the
article shows that there is no significant difference in risk
between the sidewalk bikeway and the street (table 4). For
bicyclists riding in the same direction as traffic, as would be case
with one-way cycle tracks, sidewalk bikeways carried only half
the risk of the street. Therefore, the Wachtel and Lewiston
22
data, when corrected to include non-intersection crashes,
corroborate our findings that separated paths are safer or at least
no more dangerous than bicycling in the street. Furthermore, as
the most common cause of fatal bicyclist collisions in urban
areas is overtaking,
23
it is probable that an analysis accounting
for the severity of injury would be still more favourable towards
cycle tracks.
Our study considered whole segments of cycle tracks and not
just intersections, measured bicycle exposure directly, and
included appropriate comparison groups. The study, though,
only included analysis of six cycle tracks, all of which were two-
way and in the same city, and lacked injury severity data. This
research underscores the need for better bicycle counting and
injury surveillance and for additional safety studies, particularly
of one-way cycle tracks, intersections, injury severity and other
factors that affect cycle track safety.
IMPLICATIONS FOR POLICY
Public health and bicycling advocates in the USA have faced
a dichotomy, believing from surveys and European experience
that cycle tracks encourage more bicycling, yet being warned
that they lead to higher crash and injury rates. Our results
suggest that cycle tracks lessen, or at least do not increase, crash
and injury rates compared with the street. The construction of
cycle tracks should not be discouraged.
Acknowledgements The authors would like to thank Kevin Manaugh (McGill
University) and Nathalie Valois (Montreal police), who performed the geographical
queries to extract data from the crash database, and Qi Sun and Elaine Hoffman for
a review of the statistics.
Funding ACL was supported by a Ruth L Kirschstein National Research Service
Award, F32 HL083639 from the National Institutes for Health, National Heart, Lung
and Blood Institute. LFM-M is supported for data collection by the Natural Sciences
and Engineering Research Council of Canada (discovery grant eindividual).
Competing interests None.
Ethics approval The Harvard School of Public Health IRB reviewed this protocol and
found that approval was not required. The HSPH IRB made an exemption
determination.
Contributors PGF had full access to the data in the study and takes responsibility for
the integrity of the data and the accuracy of the data analysis. Conception and design:
ACL and PGF. Acquisition of data: ACL, PGF, PM and LFM-M. Analysis and
interpretation of data: ANL, PGF, PM, LFM-M, WCW and JTD. Drafting of manuscript:
ACL, PGF. Critical revision for intellectual content: ACL, PGF, PM, LFM-M, WCW and
JTD. Statistical expertise: ACL, PGF, PM, LFM-M, WCW and JTD. Administrative,
technical or material support: WCW. Study supervision: PGF, WCW and JTD.
Table 4 Crash RR from Wachtel and Lewiston
22
data with non-intersection crashes included*
Sidewalk Roadway All RR, sidewalk versus
in-street (95% CI)yp ValuezRiders Crashes Riders Crashes Riders Crashes
Intersection onlyx
All cyclists 971 41 2005 48 2976 89 1.76 (1.16 to 2.68) 0.01
Bicycling in same direction
as closest traffic lane
656 13 1897 43 2553 56 0.87 (0.47 to 1.63) 0.56
All crashes{
All cyclists 971 41 2005 79 2976 120 1.07 (0.73 to 1.56) 0.79
Bicycling in same direction
as closest traffic lane
656 13 1897 71 2553 84 0.53 (0.29 to 0.96) 0.02
*Statistically significant comparisons are shown in bold.
y95% CI calculated using the variance of log(IRR) based on a Poisson distribution.
zSignificance, calculated using the variance of log(IRR) based on a Poisson distribution (for comparison with original article).
xAuthors’ original data.
{Non-intersection crashes amounting to 26% of total crashes added to roadway crashes.
What is already known on this subject
<Individuals, in particular women, children, and seniors, prefer
to bicycle separated from motor traffic.
<Cycle tracks (physically-separated bicycle-exclusive paths
along roads) exist and continue to be built in The Netherlands
where 27% of all trips are by bicycle and 55% of bicycle riders
are female.
<Engineering guidance in the United States has discouraged
bicycle facilities that resemble cycle tracks, including parallel
sidepaths and sidewalk bikeways, suggesting that these
facilities and cycle tracks are more dangerous than bicycling
in the street.
What this study adds
<Overall, 2 ½ times as many cyclists rode on the cycle tracks
compared with the reference streets.
<There were 8.5 injuries and 10.5 crashes per million-bicycle
kilometers respectively on cycle tracks compared to published
injury rates ranging from 3.75 to 67 for bicycling on streets.
The relative risk of injury on the cycle track was 0.72 (95%
CI=0,60-0.85) compared with bicycling in the reference
streets.
<Cycle tracks lessen, or at least do not increase, crash and
injury rates compared to bicycling in the street.
134 Injury Prevention 2011;17:131e135. doi:10.1136/ip.2010.028696
Brief report

Provenance and peer review Not commissioned; externally peer reviewed.
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Dog attacks in Canada’s North
Following a recent mauling of a 6-year-old girl by four dogs in an Inuit community, a study by
a veterinarian in Thunder Bay, Ontario, based on media reports, revealed that ‘native commu-
nities suffer bite wounds or mauling deaths from dogs at rates more than 100 times that of the
rest of Canada’. (Postmedia news, Gazette, December 17, 2010)
Collected and edited by Barry Pless
Injury Prevention 2011;17:131e135. doi:10.1136/ip.2010.028696 135
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