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Inj Prev 19:303-310 doi:10.1136/injuryprev-2012-040561
  • Original article

Comparing the effects of infrastructure on bicycling injury at intersections and non-intersections using a case–crossover design

Open Access
  1. Kay Teschke6
  1. 1School of Occupational and Public Health, Ryerson University, Toronto, Ontario, Canada
  2. 2Liu Institute for Global Issues, University of British Columbia, Vancouver, British Columbia, Canada
  3. 3Department of Civil Engineering, University of Minnesota, Minneapolis, Minnesota, USA
  4. 4Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada
  5. 5Department of Mechanical Engineering, University of British Columbia, Vancouver, British Columbia, Canada
  6. 6School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
  7. 7Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
  8. 8Division of Neurosurgery and Injury Prevention Research Office, Keenan Research Centre, St. Michael's Hospital, Toronto, Ontario, Canada
  9. 9Departments of Surgery and Education and Public Health, University of Toronto, Toronto, Ontario, Canada
  10. 10Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
  11. 11Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
  12. 12Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
  13. 13University Health Network, Toronto, Ontario, Canada
  1. Correspondence to Dr M Anne Harris, School of Occupational and Public Health, Ryerson University, Toronto, ON M5B 2K3, Canada; anne.harris{at}ryerson.ca
  • Received 17 July 2012
  • Revised 4 December 2012
  • Accepted 14 December 2012
  • Published Online First 14 February 2013

Abstract

Background This study examined the impact of transportation infrastructure at intersection and non-intersection locations on bicycling injury risk.

Methods In Vancouver and Toronto, we studied adult cyclists who were injured and treated at a hospital emergency department. A case–crossover design compared the infrastructure of injury and control sites within each injured bicyclist's route. Intersection injury sites (N=210) were compared to randomly selected intersection control sites (N=272). Non-intersection injury sites (N=478) were compared to randomly selected non-intersection control sites (N=801).

Results At intersections, the types of routes meeting and the intersection design influenced safety. Intersections of two local streets (no demarcated traffic lanes) had approximately one-fifth the risk (adjusted OR 0.19, 95% CI 0.05 to 0.66) of intersections of two major streets (more than two traffic lanes). Motor vehicle speeds less than 30 km/h also reduced risk (adjusted OR 0.52, 95% CI 0.29 to 0.92). Traffic circles (small roundabouts) on local streets increased the risk of these otherwise safe intersections (adjusted OR 7.98, 95% CI 1.79 to 35.6). At non-intersection locations, very low risks were found for cycle tracks (bike lanes physically separated from motor vehicle traffic; adjusted OR 0.05, 95% CI 0.01 to 0.59) and local streets with diverters that reduce motor vehicle traffic (adjusted OR 0.04, 95% CI 0.003 to 0.60). Downhill grades increased risks at both intersections and non-intersections.

Conclusions These results provide guidance for transportation planners and engineers: at local street intersections, traditional stops are safer than traffic circles, and at non-intersections, cycle tracks alongside major streets and traffic diversion from local streets are safer than no bicycle infrastructure.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/

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