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Bicycle safety for children: Overview of evidence-based
good practices
Morag Mackay & Joanne Vincenten European Child Safety Alliance
ECSA Workshop
Brussels, December 6, 2012
Child deaths due to cycling by age group Europe age standardised rate per 100 000 population 0-19 years by gender (using three year averages 2008-2010 or most recent three years of data available)
Source: WHO Extended Mortality Database
Child deaths due to cycling in ECSA partner countries Europe age standardised rate per 100 000 population 0-19 years by gender (using three year averages 2008-2010 or most recent three years of data available; Cyprus, Iceland, Luxembourg and Malta excluded due to small numbers; Greece excluded as ICD9 coding does not allow breakout)
Source: WHO Extended Mortality Database
Rates of injury death related to cycling vary by a magnitude of 40x between countries with highest and lowest rates!
• Limited to mortality data in many countries
• Police reports are not always comparable and it is not always possible to link to mortality/morbidity data
• Few countries have exposure data to assist in interpreting mortality and morbidity data
• Most data sources have little information on circumstances and are unreliable with respect to whether a helmet was worn at the time of the injury
Data challenges -
Factors related to risk of injury while cycling
Phase
Human
Vector or vehicle
Physical environment
Social Environment
Pre-event • age • judgement • coordination
• bicycle condition
• cycling surface • exposure to
traffic • # of cyclists
• vehicle speeds • behaviour of
drivers and other cyclists
Event • helmet use • helmet worn
correctly
• bicycle design
• social norms re: helmet use
• helmet law • enforcement of
helmet law
Post-event • age • physical
condition
• time to treatment
• availability of rehab programmes
• training of first responders
• training of EMS personnel
Evidence-based good practices to prevent/reduce cycling injuries
Phase
Human
Vector or vehicle
Physical environment
Social Environment
Pre-event • bicycle skills training*
• bicycle maintenance*
• bicycle paths • bicycle lanes • speed reducing
structures
• speed limits • enforcement of
speed limits • policies encouraging
safe cycling
Event • safe bicycle design*
• promotional campaigns on helmet use, driver awareness, safe cycling
• helmet law • enforcement of
helmet law
Post-event • EMS system set up to minimise time to treatment
• rehab programmes
• trained first responders
• trained of EMS personnel
* Evidence more limited
Effective child cycling safety combines: v Layers of protection to 1) prevent injury
incidents and 2) reduce the severity of injury in the event of an incident
v A combination of education, engineering and enforcement strategies
v Special attention to inequities
v Cooperation of and collaboration between multiple disciplines and organisations
What the Child Safety Report Card assessment can and cannot tell us: • 15 countries have legislation requiring children
to wear helmets (2 others legislation in progress) – Age at which helmet is required varies by country and
most helmet laws are specific to children – Enforcement is an issue for many, with most checks
resulting in warnings – Many countries depend on regular/on-going
promotional efforts to increase compliance
• 22 countries have conducted a national media campaigns on cycling safety in the past 5 years
• Limited to national level policies thus no information on regional, municipal activities