Bicycle helmet research : CARRS-Q monograph 5

Recent research on bicycle helmets and concerns about how public bicycle hire schemes will function in the context of compulsory helmet wearing laws have drawn media attention. This monograph presents the results of research commissioned by the Queensland Department of Transport and Main Roads to review the national and international literature regarding the health outcomes of cycling and bicycle helmets and examine crash and hospital data. It also includes critical examinations of the methodology used by Voukelatos and Rissel (2010), and estimates the likely effects of possible segmented approaches to bicycle helmet wearing legislation. The research concludes that current bicycle helmet wearing rates are halving the number of head injuries experienced by Queensland cyclists. Helmet wearing legislation discouraged people from cycling when it was first introduced but there is little evidence that it continues to do so. Cycling has significant health benefits and should be encouraged in ways that reduce the risk of the most serious injuries. Infrastructure and speed management approaches to improving the safety of cycling should be undertaken as part of a Safe System approach, but protection of the individual by simple and cost-effective methods such as bicycle helmets should also be part of an overall package of measures.

Developing an international survey of bicycle and helmet usage

The European Union‐funded collaborative network, COST Action TU1101: Towards safer bicycling through optimization of bicycle helmets and usage, aims to increase scientific knowledge about bicycle helmets in regards to traffic safety and to disseminate this knowledge to stakeholders, including cyclists, legislators, manufacturers, and the scientific community. The COST research team has developed a uniform international survey to better understand attitudinal and other factors that may influence bicycle and helmet usage, as well as crash risk. The online survey is being distributed by project partners in Europe, Israel, Australia, and potentially the US and Canada. The survey contains four types of questions: (1) biographical data, (2) frequency of cycling and amount of cycling for different purposes (e.g., commuting, health, recreation) and in different environments (e.g., bicycle trails, bike lanes, on sidewalks, in traffic), (3) frequency and circumstances for use and non‐use of helmets, attitudes and reasons for it, and; (4) crash involvement and level of reporting to the police. While the potential value of comparative data across countries with very different cycling cultures and safety levels is substantial, there are numerous challenges in developing, conducting, and analyzing the results of the survey. This presentation will focus on the scope of the international study, methodological issues and pitfalls of such a collaborative effort, and on initial results from one country (Israel). To illustrate, two findings from the preliminary Israeli survey indicate that: (1) none of the crashes were reported to the police including the ones involving hospital admission. Although underreporting of bicycle crashes by police is well documented in all countries the extent is unknown, and can be extreme. (2) Older riders tend to ride more for health/exercise reasons, while younger riders tend to ride more for commuting. Thus there is an interaction between riders’ age and the place and times of riding.

Final report of Working Group 2: Traffic psychology [A COST Action TU1101 / HOPE collaboration]

BACKGROUND The workgroup of Traffic Psychology is concerned with the social, behavioral, and perceptual aspects that are associated with use and non-use of bicycle helmets, in their various forms and under various cycling conditions. OBJECTIVES The objectives of WG2 are to (1) share current knowledge among the people already working in the field, (2) suggest new ideas for research on and evaluation of the design of bicycle helmets, and (3) discuss options for funding of such research within the individual frameworks of the participants. Areas for research include 3.1. The patterns of use of helmets among different users: children, adults, and sports enthusiasts. 3.2. The use of helmets in different environments: rural roads, urban streets, and bike trails. 3.3. Concerns bicyclists have relative to their safety and convenience and the perceived impact of using helmets on comfort and convenience. 3.4. The benefit of helmets for enhancing visibility, and how variations in helmet design and colors affect daytime, nighttime, and dusktime visibility. 3.5. The role of helmets in the acceptance of city-wide pickup-and-drop-off bicycles. 3.6. The impact of helmets on visual search behaviour of bicyclists.

International survey of bicycling exposure, crash involvement, behaviors, and attitudes: Preliminary results

This paper presents some results from preliminary analyses of the data of an international online survey of bicycle riders, who reported riding at least once a month. On 4 July 2015, data from 7528 participants from 17 countries was available in the survey, and were subsequently cleaned and checked for consistency. The median distance ridden ranged from 30 km/week in Israel to 150 km/week in Greece (overall median 54 km/week). City/hybrid bicycles were the most common type of bicycle ridden (44%), followed by mountain (20%) and road bikes (15%). Almost half (47%) of the respondents rode “nearly daily”. About a quarter rode daily to work or study (27%). Overall, 40% of respondents reported wearing a helmet ‘always’, varying from 2% in the Netherlands to 80% in Norway, while 25% reported ‘never’ wearing a helmet. Thus, individuals appeared to consistently either use or not use helmets. Helmet wearing rates were generally higher when riding for health/fitness than other purposes and appeared to be little affected by the type of riding location, but some divergences in these patterns were found among countries. Almost 29% of respondents reported being involved in at least one bicycle crash in the last year (ranging from 12% in Israel to 53% in Turkey). Among the most severe crashes for each respondent, about half of the crashes involved falling off a bicycle. Just under 10% of the most severe crashes for each respondent were reported to police. Among the bicycle-motor vehicle crashes, only a third were reported to police. Further analyses will address questions regarding the influence of factors such as demographic characteristics, type of bicycle ridden, and attitudes on both bi-cycle use and helmet wearing rates.

Dental injuries in association with facial fractures

PURPOSE: The aim of the study was to investigate the association between dental injuries and facial fractures. MATERIALS AND METHODS: We performed a prospective study of 273 patients examined at a level 1 trauma center in Switzerland from September 2005 until August 2006 who had facial fractures. Medical history and clinical and radiologic examination findings were recorded to evaluate demographics, etiology, presentation, and type of facial fracture, as well as its relationship to dental injury site and type. RESULTS: In 273 patients with dentition, we recorded 339 different facial fractures. Of these patients, 130 (47.5%) sustained a fracture in the non-tooth-bearing region, 44 (16%) had a fractured maxilla, and 65 (24%) had a fractured mandible. Among 224 patients with dentition who had a facial fracture in only 1 compartment, 140 injured teeth were found in 50 patients. Of 122 patients with an injury limited to the non-tooth-bearing facial skeleton, 12 sustained dental trauma (10%). In patients with fractures limited to the maxilla (n = 41), 6 patients had dental injuries (14.5%). In patients with fractures to the mandible (n = 61), 24 sustained dental injuries (39%). When we compared the type of tooth lesion and the location, simple crown fractures prevailed in both jaws. Patients with a fracture of the mandible were most likely to have a dental injury (39.3%). The highest incidence of dental lesions was found in the maxilla in combination with fractures of the lower jaw (39%). This incidence was even higher than the incidence of dental lesions in the lower jaw in combination with fractures of the mandible (24%). CONCLUSIONS: Knowledge of the association of dental injuries and maxillofacial fractures is a basic tool for their prevention. Our study showed that in cases of trauma with mandibular fracture, the teeth in the upper jaw might be at higher risk than the teeth in the lower jaw. Further larger-scale studies on this topic could clarify this finding and may provide suggestions for the amelioration of safety devices (such as modified bicycle helmets).

Motorized bicycle (moped). Findings of a survey.

Mode of access: Internet.

Initial CFD investigation of an MR fluid in a bicycle ergometer

A bicycle ergometer is a scientific device used by exercise physiologists which attempts to mimic on-road cycling characteristics such as foot technique, EMG activity, VO2, VCO2 and rider cardiology in a laboratory environment. Presently there are no known useful scientific ergometers that mimic these characteristics and are able to provide a satisfactory controlled resistance that is independent of speed. Previous research has suggested the use of a Magneto-Rheological (MR) Fluid as part of the ergometer design, as when used in a rotary brake application it is able to be controlled electronically to increase resistance instantly and independent of speed. In the target application, MR fluids are subject to immense tribological wear and temperature during viscous shearing, and will eventually show some degree of deterioration which is usually manifested as an increase in off-state viscosity. It is not known exactly how the fluid fails, however the amount of deterioration is related to the shear rate, temperature and duration and directly related to the power dissipation. Currently, there is very little literature that investigates the flow and thermal characteristics of MR fluid tribology using CFD. In this paper, we present initial work that aims to improve understanding of MR fluid wear via CFD modelling using Fluent, and results from the model are compared with those obtained from a experimental test rig of an MR fluid-based bicycle ergometer.

Bicycle helmet wearing among adolescents

Adolescents experience many benefits from bicycling; however, there are also potentially significant injury consequences. One effective counter-measure for the prevention of adolescent bicycling injuries is to promote bicycle helmet wearing. An overview is provided of injury risks of bicycle riding with particular attention to the role of helmet wearing and associated countermeasures such as legislation and school and community approaches. The findings are presented of a study conducted in Australia that examined the effectiveness of a theory-based injury prevention program, Skills for Preventing Injury in Youth (SPIY) for ninth-grade students (age 13 to 14 years). The findings showed a significant, 20.2% decrease in cycling without a helmet among the intervention students (n = 360) and no change for the students in the comparison group (n = 363) after 6 months. In addition, it was found that failing to wear a helmet was significantly associated with engaging in other transport-related risks, being male, having friends who do not wear a helmet and are specific targets of change in the SPIY program, showing a negative attitude toward risk, failing to intervene in friends' risk-taking, and having low knowledge of first aid. Overall, the SPIY program appeared to be an effective theory-based intervention to increase helmet wearing among early adolescents, a group not often targeted in school and community helmet-wearing programs.

The role of traffic violations in police-reported bicycle crashes in Queensland

Media articles have promoted the view that cyclists are risktakers who disregard traffic regulations, but little is known about the contribution of cyclist risk-taking behaviours to crashes. This study examines the role of traffic violations in the 6774 police-reported bicycle crashes in Queensland between January 2000 and December 2008. Of the 6328 crashes involving bicycles and motor vehicles, cyclists were deemed to be at fault in 44.4% of the incidents. When motorists were determined to be at-fault, ‘failure to yield’ violations accounted for three of the four most reported contributing factors. In crashes where the cyclist was at fault, attention and inexperience were the most frequent contributing factors. There were 67 collisions between bicycles and pedestrians, with the cyclist at fault in 65.7%. During the data period, 302 single-bicycle crashes were reported. The most frequent contributing factors were avoidance actions to miss another road user and inattention or negligence.

Should we be concerned about alcohol in bicycle crashes?

This paper sets out to examine from published literature and crash data analyses whether alcohol in bicycle crashes is an issue about which we should be concerned. It discusses factors that have the potential to increase the number of bicycle crashes in which alcohol is involved (such growth in the size and diversity of the cyclist population, and balance and coordination demands) and factors which may reduce the importance of alcohol in bicycle crashes (such as time of data factors and child riders). It also examines data availability issues that contribute to difficulties in determining the true magnitude of the issue. Methods: This paper reviews previous research and reports analyses of data from Queensland, Australia, that examine the role of alcohol in Police-reported road crashes. In Queensland it is an offence to ride a bicycle or drive a motor vehicle with a BAC exceeding 0.05% (or lower for novice and professional drivers). Results: In the five years 2003-2007, alcohol was reported as involved in 165 bicycle crashes (4%). The bicycle rider was coded as “under the influence” or “over the prescribed BAC limit” in 15 were single unit crashes (12%). In multi-vehicle bicycle crashes, alcohol involvement was reported for 16 cyclists (0.4%) and 110 operators of other vehicles (3%). Additional analyses including characteristics of the cyclist crashes involving alcohol and the importance of missing data will be discussed in the paper. Conclusion: The increase in participation in cycling and the vulnerability of cyclists to injuries support the need to examine the role of alcohol in bicycle crashes. Current data suggest that alcohol on the part of the vehicle driver is a larger concern than alcohol on the part of the cyclist, but improvements in data collection are needed before more precise conclusions can be drawn.

Evaluating the benefits of public bicycle schemes needs to be undertaken carefully

A letter in response to an article by David Rojas-Rueda, Audrey de Nazelle, Marko Tainio, Mark J Nieuwenhuijsen, The health risks and benefits of cycling in urban environments compared with car use: health impact assessment study. BMJ 2011;343:doi:10.1136/bmj.d4521 (Published 4 August 2011) This paper sets out to compare the health benefits of the Bicing scheme (Barcelona's public bicycle share scheme) with possible risks associated with increased bicycle riding. The key variables used by the researchers include physical activity, exposure to air pollution and road traffic injury. The authors rightly identify that although traffic congestion is often a major motivator behind the establishment of public bicycle share schemes (PBSS), the health benefits may well be the largest single benefit of such schemes. Certainly PBSS appear to be one of the most effective methods of increasing the number of bicycle trips across a population, providing additional transport options and improving awareness of the possibilities bicycles offer urban transport systems. Overall, the paper is a useful addition to the literature, in that it has attempted to assess the health benefits of a large scale PBSS and weighed these against potential risks related to cyclists exposure to air pollution and road traffic injuries. Unfortunately a fundamentally flawed assumption related to the proportion of Bicing trips replacing car journeys invalidates the results of this paper. A future paper with up to date data would create a significant contribution to this emerging area within the field of sustainable transport.

On the relationships between self-reported bicycling injuries and perceived risk among cyclists in Queensland, Australia

The focus of governments on increasing active travel has motivated renewed interest in cycling safety. Bicyclists are up to 20 times more likely to be involved in serious injury crashes than drivers so understanding the relationship among factors in bicyclist crash risk is critically important for identifying effective policy tools, for informing bicycle infrastructure investments, and for identifying high risk bicycling contexts. This study aims to better understand the complex relationships between bicyclist self reported injuries resulting from crashes (e.g. hitting a car) and non-crashes (e.g. spraining an ankle) and perceived risk of cycling as a function of cyclist exposure, rider conspicuity, riding environment, rider risk aversion, and rider ability. Self reported data from 2,500 Queensland cyclists are used to estimate a series of seemingly unrelated regressions to examine the relationships among factors. The major findings suggest that perceived risk does not appear to influence injury rates, nor do injury rates influence perceived risks of cycling. Riders who perceive cycling as risky tend not to be commuters, do not engage in group riding, tend to always wear mandatory helmets and front lights, and lower their perception of risk by increasing days per week of riding and by increasing riding proportion on bicycle paths. Riders who always wear helmets have lower crash injury risk. Increasing the number of days per week riding tends to decrease both crash injury and non crash injury risk (e.g. a sprain). Further work is needed to replicate some of the findings in this study.

An evaluation framework for assessing the impact of public bicycle share schemes

INTRODUCTION • Public bicycle share schemes have emerged as a method of increasing rates of bicycle riding. • The overwhelming majority of schemes have begun since 2005, taking advantage of various tracking and payment technologies making short term rental practical and affordable. • Very little research has been undertaken to determine their potentially broad impact on transport behaviour and consequently, it is difficult to understand the performance of these schemes in terms of reduced emissions and congestion, as well as possible increases in physical activity.

Bicycling injuries and perceived risk

Introduction Government promotion of active transport has renewed interest in cycling safety. Research has shown that bicyclists are up to 20 times more likely to be involved in serious injury crashes than drivers. On-road cycling injuries are under-reported in police data, and many non-serious injuries are not recorded in any official database. This study aims to explore the relationships between rider characteristics and environmental factors that influence per kilometre risk of bicycle-related crash and non-crash injuries. Method A survey of 2,532 Queensland adults who had ridden at least once in the past year was conducted from October 2009 to March 2010, with most responses received online (99.3%). Riders were asked where they rode (footpath, bike path, road etc.), average travel speed, purpose of riding, type of bike ridden, how far and how often they rode in. Measures of rider experience, skill, safety perceptions, safety behaviours, crash involvement and demographic characteristics were also collected. RESULTS Increasing exposure and having more expensive bicycles were shown to reduce the risk per km of crash and non-crash injury rates, and to reduce perceived risk. Never wearing bright coloured clothing related to increased crash risk, use of fluorescent and reflective clothing had no effect on crash risk. Riding in low-speed environments, never using a front light, and riding in low-speed environments were associated with reduced non-crash injury risk. Perceived risk was influenced by exposure, use of conspicuity aids and helmets, riding for utilitarian reasons, and group-riding behaviours. DISCUSSION Perceived risk does not appear to influence injury rates and injury rates do not appear to influence the perceived risk of cycling. Riders who perceive cycling to be risky tend not to be commuters, do not engage in group riding and always wear helmets. Not all measures of conspicuity were associated with risk, with rear lights found to have no relationship to injury. The risks of experiencing a crash or non-crash injury were similar, therefore injury prevention strategies should expand their scope to include other factors such as the importance of bicycle set-up.