The association of cycling with all-cause, cardiovascular and cancer mortality: findings from the population-based EPIC-Norfolk cohort

Objectives
To investigate associations between modest levels of total and domain-specific (commuting, other utility, recreational) cycling and mortality from all causes, cardiovascular disease and cancer.

Design
Population-based cohort study (European Prospective Investigation into Cancer and Nutrition study-Norfolk).

Setting
Participants were recruited from general practices in the east of England and attended health examinations between 1993 and 1997 and again between 1998 and 2000. At the first health assessment, participants reported their average weekly duration of cycling for all purposes using a simple measure of physical activity. At the second health assessment, participants reported a more detailed breakdown of their weekly cycling behaviour using the EPAQ2 physical activity questionnaire.

Participants
Adults aged 40–79 years at the first health assessment.

Primary outcome measure
All participants were followed for mortality (all-cause, cardiovascular and cancer) until March 2011.

Results
There were 22 450 participants with complete data at the first health assessment, of whom 4398 died during follow-up; and 13 346 participants with complete data at the second health assessment, of whom 1670 died during follow-up. Preliminary analyses using exposure data from the first health assessment showed that cycling for at least 60 min/week in total was associated with a 9% reduced risk of all-cause mortality (adjusted HR 0.91, 95% CI 0.84 to 0.99). Using the more precise measures of cycling available from the second health assessment, all types of cycling were associated with greater total moderate-to-vigorous physical activity; however, there was little evidence of an association between overall or domain-specific cycling and mortality.

Conclusions
Cycling, in particular for utility purposes, was associated with greater moderate-to-vigorous and total physical activity. While this study provides tentative evidence that modest levels of cycling may reduce the risk of mortality, further research is required to confirm how much cycling is sufficient to induce health benefits.

Occupational light vehicle-use: a research driven strategy to improve surveillance and inform policy

Background: Occupational light vehicles (OLV) are light passenger and loadshaped vehicles used for work. The OLV-associated injury burden is as great as that of heavy vehicle users, but has been largely ignored by occupational health and safety (OHS) regulators. Contingent employment growth has accentuated existing gaps in the policy framework between OHS and road-safety. Frequent burden shifting from OHS to road-related health systems undermines the evidence base necessary to inform policy development. Aims: To provide evidence-based recommendations for the collection of OLVuser surveillance data and to underpin OHS procedures and policies for OLVusers. Method: The literature was systematically analyzed to identify OLV-user OHS policy and practice gaps. Strategies to improve and co-ordinate surveillance systems were developed to address the identified limitations. Results: Gaps were identified in OLV-user legislation, data collection, and riskmanagement. These require strategies to improve identification of all OLV-users and to co-ordinate surveillance and OHS practice. Discussion: Contemporary reform of road and OHS, policy, provides a timely opportunity for the implementation of strategic responses to this serious road safety and occupational, public health problem.

Occupational light vehicle use: characterising the at-risk population

Previous occupational light vehicle research has concentrated on employees using cars. The aim of this study was to identify and characterise the total occupational light vehicle-user population and compare it with the privately-used light vehicle population. Occupational light vehicle and private light vehicle populations were identified through use-related 2003 registration categories from New South Wales Roads and Traffic Authority data. Key groups of occupational light vehicle registration variables were comparatively assessed as potential determinants of occupational light vehicleuser risks. These comparisons were expressed as odds ratios with 95% Confidence Intervals. The occupational light vehicle population vehicles (n=646,201) comprised 18% of all light vehicle registrations. A number of statistical differences emerge between the two populations. For instance, 86% of occupational light vehicle registrants were male versus 65% of private registrants, and 56% of the occupational users registered load shape vehicles versus 20% of the private registrants. Occupational light vehicles registered for farming or taxi use were more than six times more likely to belong to sole-traders than organisations. Sole-traders were nearly twice as likely to register light-trucks, and twice as likely to register older vehicles, than organisations. This study demonstrates that the occupational light vehicle user population is larger and more diverse than previously shown with characteristics likely to increase the relative risks of motor vehicle crashes. More occupational light vehicles were load shapes and therefore likely to have poorer crashworthiness ratings than cars. Occupational light vehicles are frequently used by sole-traders for activities with increased OHS risks including farming and taxi use. Further exploration of occupational light vehicle-user crash risks should include all vehicle types, work arrangements and small ‘fleets’.