No pain, no gain?No pain, no gain?

Preventing cycling injuries in Preventing cycling injuries in a world of expanding waist-a world of expanding waist-

lines.lines.

Rob Benington

Injury Prevention Manager, Avonsafe Co-ordinator

NHS Bristol

Cycling is good for Cycling is good for youyou

Physical activity is strongly associated Physical activity is strongly associated with improvements in:with improvements in:

Mental wellbeingMental wellbeingRisk of cancerRisk of cancerWeight managementWeight managementCardiovascular healthCardiovascular healthReduced CO2 emissions/ urban liveability, Reduced CO2 emissions/ urban liveability,

etc.etc.

NHS Bristol wants more people to cycle more often and for longer.

Injury is not inevitableInjury is not inevitable

We can reduce risk of injury and We can reduce risk of injury and increase health benefits at the increase health benefits at the

same time.same time.

Injuries are bad for Injuries are bad for youyou

Non-Collision Cycling Incidents

A road safety issue• Caused c.95,000 cyclists to seek emergency treatment last year

in England

• Caused 69% of cycling-injury admissions in England between (2006-11)

• On average, cause less serious injuries than collisions but can be fatal. (70% cause no injury that requires treatment).

A cycle advocacy issue• NCIs are preventable and removable and removing hazards

makes cycling easier and more attractive.

“A total of 3,192 people were killed or seriously injured on UK roads while riding a bicycle last year”.

The Times, 5-11-12

A total of 17,653 English cyclists were admitted to hospital with an injury during 2011-12, an increase of 1,611 (9%) on 2010-11.

www.hesonline.nhs.uk

c. 13% of all attendances at emergency departments are admitted.

Ormel, 1999

c. 135,700 cyclists from England and c. 160,000 from the UK were admitted to hospital or treated in an emergency department during 2011-12.

NHS Bristol, 2012

Cyclist injuries resulting in admission (England)

2011-12

Collision: Pedestrian / animalCollision: Pedestrian / animal 117117

Collision: Other cyclistCollision: Other cyclist 396396

Collision: 2-3 wheeled motor vehicleCollision: 2-3 wheeled motor vehicle 7676

Collision: Car, pick up truck or vanCollision: Car, pick up truck or van 2,4502,450

Collision: Heavy transport vehicle or busCollision: Heavy transport vehicle or bus 180180

Collision: Railway train or railway vehicleCollision: Railway train or railway vehicle 22

Collision: Other non-motor vehicleCollision: Other non-motor vehicle 2424

Collision: Fixed and stationary objectCollision: Fixed and stationary object 681681

Non-collision incidentNon-collision incident 12,30112,301

Other and unspecifiedOther and unspecified 1,4261,426

Total Cyclists 17,653

(Total car occupants) 14,573

Travel and transport Travel and transport injuriesinjuries

0100020003000400050006000700080009000

1000011000120001300014000150001600017000

Number of admissions

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Mo

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Transport type

Numbers of injuries requiring hospital admission by mode of transport (2011-12)

Non

-colli

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in

juri

es

Why are you here?Why are you here?

Helping travellers prevent serious injury?

Modal shift?

Improving performance against NI047 and NI048 / KSI indicators?

Reducing demand on acute healthcare services?

Active travel = CHD, healthy weight, diabetes, depression?

Low carbon travel?

What causes non-What causes non-collisions? collisions?

1. 1. Slippery road surfaces Slippery road surfaces

2. 2. Poor road surfacesPoor road surfaces

3. 3. Kerbs and rail linesKerbs and rail lines

““An introduction to non-collision An introduction to non-collision cycling incidentscycling incidents”, NHS Bristol ”, NHS Bristol 2012. 2012.

www.tinyurl.com\avonsafecyclingwww.tinyurl.com\avonsafecycling

Proposed strategyProposed strategy

TrainingTraining EngineeringEngineering PolicyPolicy OtherOther

ChildrenChildrenBikeabilityBikeability

++

Just Just startingstarting

BikeabilityBikeability

++

Kerbs; Kerbs;

rail lines; rail lines;

road road maintenancemaintenance

Travel to Travel to Work, Work, Inclement Inclement WeatherWeather

Bike Bike maintenancemaintenance

Commuter Commuter functionalfunctional

BikeabilityBikeability

++

Travel to Travel to Work, Work, Inclement Inclement WeatherWeather

Bike Bike maintenancemaintenance

ExperienceExperiencedd

CommunicatiCommunicationon

Travel to Travel to Work, Work, Inclement Inclement WeatherWeather

?School travel

ResearchResearch

?

EngineeringEngineering

Other/Communication (re. Ice) Other/Communication (re. Ice)

TrainingTraining

LSTF elementsLSTF elements

EngineeringEngineering

Ice risk managementIce risk management

1. 1. Remove the riskRemove the risk

2. 2. Avoid the riskAvoid the risk

3.3. Mitigate the riskMitigate the risk

4.4. Accept and adapt to the riskAccept and adapt to the risk

5. 5. Take the riskTake the risk

2. Avoidance2. Avoidance

3. Mitigation3. Mitigation

4. Adaptation

www.icebikes.orgwww.icebikes.org

5. 5. Acceptance – Acceptance – Informed Informed consentconsent

(Thanks to the Highways Agency who designed the poster)

Training (Bikeability +)Training (Bikeability +) Safe riding strategy Safe riding strategy

(Explicit consideration of alternative mode of travel if weather (Explicit consideration of alternative mode of travel if weather conditions, personal health or bike maintenance require it).conditions, personal health or bike maintenance require it).Spot Hazards – List of significant hazards could be included in Spot Hazards – List of significant hazards could be included in L2L2

How to traverse kerbs and rail lines How to traverse kerbs and rail lines (While mentioned in L3 an observed demonstration should be (While mentioned in L3 an observed demonstration should be required)required)

Uneven road surfaces Uneven road surfaces (L3; Speed can be good)(L3; Speed can be good)

+ Others? Blue Light runs, RRAGAR, + Others? Blue Light runs, RRAGAR,

Local Sustainable Local Sustainable Transport FundTransport Fund

School and area travel plansSchool and area travel plans Awareness of staff working on LSTFAwareness of staff working on LSTF Employer travel plansEmployer travel plans Bikeability +Bikeability + LSTF funded community projectsLSTF funded community projects EngineeringEngineering CommunicationCommunication

Keeping cyclists safe, Keeping cyclists safe,

keeps cyclists cycling.keeps cyclists cycling.

www.tinyurl.com\avonsafecyclingwww.tinyurl.com\avonsafecycling

Rob.benington@bristol.nhs.ukRob.benington@bristol.nhs.uk