Ontario Cycling Death Review

The coroner’s office for the province of Ontario recently released an analysis of the 129 cycling fatalities that had occurred in the province between 2006 and 2010 and within it are some interesting patterns and conclusions.

Much of these won't be a shock and mirror other studies. More fatalities are men. More fatalities occur during warm weather months. About half of all fatalities occur at night or twilight. etc...

About 2/3 of the fatalities were among recreational cyclists and 1/3 commuters, with a trace amount during racing.

On the subject of fault:

In 44 cases, contributing factors on the part of the cyclist alone were identified. In 33 cases, contributing factors on the part of the driver of a vehicle alone were identified. In 48 cases, contributing factors were identified on the part of both the cyclist and the driver.

Which would make cyclists appear to be more at fault....

But of the cases where only the cyclist was at fault, 21 of them were single bike crashes and 2 were bike-bike crashes. So if we remove these crashes from consideration and look at only bike-motor vehicle crashes, as we should, that drops the first category above to 21 cases where contributing factors on the part of the cyclist alone were identified, compared to 33 for drivers. And they note that

In those cases where the circumstances of the collision were reported solely by the driver, it is recognized that an inherent bias existed which may have led to the under-representation of driver factors.

Still in 2 out of 3 cases, cyclist behavior contributed to the crash.

Their recommendations include

1. Adoption of a “complete streets” approach
2. Development of a Cycling Plan
3. A comprehensive cycling safety public awareness and education strategy, starting in public schools, and continuing through the purchase of every new and used bicycle and through driver’s license testing.
4. Legislative change aimed at ensuring clarity and consistency regarding interactions between cyclists and other road users.
5. Strategies to promote and support helmet use for cyclists of all ages.
6. Implementation of mandatory helmet legislation for cyclists of all ages, within the context of an evaluation of the impact of this legislation on cycling activity.
7. Establishment of a “one-meter” rule for vehicles when passing cyclists.
8. Prioritizing the development of paved shoulders on provincial highways.
9. Mandatory side-guards for heavy trucks.
10. Enforcement, education and public safety activities targeted to the specific issues of cycling safety identified in a given community.

Of these recommendations, DC has addressed all but #3, 6 and 9, with 8 being NA. Others, like enforcement could certainly be beefed up. And #6 is ill-advised as I address below.

Because the study was completed by doctors, it naturally recommended mandatory helmet laws and cited Victoria, Australia as an example of success, even though that result was achieved via a large drop in bicycling (and was matched by reductions in head injuries to other users). This would be contrary to one of their other statements.

cycling is an excellent way to achieve the physical activity goals of a healthy society. As a society, it is critical that physical activity and active transportation – including cycling - be promoted and supported.

Which they admittedly allowed for in their conclusions above.

This was, as you can guess, the source of some real controversy in Ontario and drew the focus away from the other recommendations. 

Sadly, such suggestions were all but ignored by the media and both the rabid and deranged anti-cycling nut-jobs and the humourless, wannabe-martyrs pro-cycling zealots. Instead, these bright lights focused on the coroner’s recommendation that helmets should be mandatory, as they are in British Columbia, Nova Scotia and New Brunswick. At present only Ontarians 18 and under are required by law to wear a helmet.

The data they have on helmet use and fatalities is noteworthy.

In this Review, only 34 of 129 cyclists (26%) sustaining a fatal injury were wearing a helmet. Of particular concern was that observation that, despite existing legislation, only 7 of 16 cyclists (44%) under the age of 18 who died were wearing a helmet.

In 71 of the 129 cases (55%), the cyclist sustained a head injury which caused or contributed to their death. In 43 of those 71 (60%), a head injury alone (with no other significant injuries) caused the death. Those whose cause of death included a head injury were three times less likely to be wearing a helmet as those who died of other types of injuries.

I wish they had the raw data, but I think I can back it out - and please check my math. I think what we have is 71 fatalities involving a head injury of which only 10 were wearing helmets; but of the 58 fatalities that don't involve a head injury 24 were wearing helmets. So, assuming that people who die of non-head related injuries represent a cross section of cyclists - since the helmet will not change the outcome, that means 41% of cyclists wear helmets (24/58). But only 14% of those who die of head injuries wear helmets. So if everyone wore a helmet then there would have been about 47 fewer fatalities [71 head injury deaths - 10 helmeted head injury deaths/41% helmet rate] or about 1/3 fewer total.

Of course, that's all reliant on the validity of their "who was wearing a helmet" reporting.

And, it still doesn't mean mandatory helmet laws are a good idea. In part because, as noted above for children, helmet laws don't even double the number of people wearing helmets

those who demand a mandatory helmet law miss the unintended consequences that may occur. Hardcore helmet-haters will ignore the law. Casual riders, meanwhile, will be intimidated. You can kiss the Bixi bike sharing program good-bye. These folks don’t carry around bicycle helmets with them just in case they want to ride a bike. Cities such as Vancouver and Seattle, where helmet laws are in place, are watching their bike-share programs die.

And fewer cyclists on the road makes us all less safe. Besides, we could probably save a lot of lives with mandatory motorist helmets, but that doesn't mean we race out to do that either. The reason why seat belt laws are different is that they can help a driver regain control of the car or keep motorists from become projectiles that kill others, so they save lives other than your own.

As the author of the Globe and Mail article suggests 

What if we increased bike infrastructure and education and most cyclists wore helmets?

I have no problem with that.

And I'll end with this quote from the same author

The more we can get people on bicycles, the fewer will be in cars and the fewer people there are in cars, the less traffic there will be and the easier it will be for me to drive around in my car.

Shout it from the rooftops.

Comments

[charlie]

side guards for trucks.

Given that half of fatalities occur at night, mandatory lighting rules seems more useful than helmet rules.

Looking at injuries -- rather than deaths -- might be a better approach.

Are we to assume 130 bike fatalities in Ontario for that time period?

[Jonathan Krall]

Hmmmm... Elvik [Accident Analysis and Prevention, 2011] found that helmets tend to reduce head injuries but increase neck injuries resulting in "no net protective effect." Unfortunately, the authors of this latest report seem not to have read the scientific literature and have not approached the problem in a way that would allow them to clearly obtain disagreement (or agreement) with the earlier research.

[Tom]

I noticed that AAA sent out some tweets encouraging bicyclists to wear helmets because they reduce injuries by 89%.. something like that. I've heard helmets give you a third better chance.. sounds more realistic and in line with your findings, right?

[unclejed]

DC has a “one-meter” rule for vehicles when passing cyclists? That is not my experience. Yesterday, a Metro bus going 20 to 30 mph gave me a close shave. When I caught the driver to politely ask for a little more room, he replied with a finger.

[Michael H.]

Some local jurisdictions have mandatory lighting rules for cyclists. I think it's a good idea. Unfortunately, too many people are unaware of the law or they choose to ignore it. I agree that it may be more important than helmet use in avoiding injury during nighttime rides.

If I pass by someone riding at night without a light, I'll usually offer up a polite reminder that they should have a light. (I don't do this if the person looks angry or crazed or aggressive. Usually that's not the case.)

[washcycle]

Tom, that 89% number has been widely debunked - even by the original studies own authors.

unclejed - we have 3 foot law. It is not that well known among drivers and as far as I know never enforced.

[JeffB]

Mandatory lighting rules are not a bad idea.

So would drivers recognizing that speed limits are often a day time maximum and a reduced speed is called for at night.

[JeffB]

The standard for a drivers should be not that they can see and avoid the Eiffel tower but they can see and avoid unlit objects.

[washcycle]

Charlie, I think it was 129 fatalities.

[Steve]

The biggest problem with interpreting the data of the Ontario study is the assumption that the only difference between those wearing a helmet and those not wearing a helmet is whether or not they were wearing a helmet. This is a poor assumption.