Abstract
Objective
Safety concerns deter cycling. The Bicyclists’ Injuries and the Cycling Environment (BICE) study quantified the injury risk associated with 14 route types, from off-road paths to major streets. However, when it comes to injury risk, there may be discordance between empirical evidence and perceptions. If so, even if protective infrastructure is built people may not feel safe enough to cycle. This paper reports on the relationship between perceived and observed injury risk.
Methods
The BICE study is a case-crossover study that recruited 690 injured adult cyclists who visited emergency departments in Toronto and Vancouver. Observed risk was calculated by comparing route types at the injury sites with those at randomly selected control sites along the same route. The perceived risk was the mean response of study participants to the question "How safe do you think this site was for cyclists on that trip?", with responses scored from +1 (very safe) to -1 (very dangerous). Perceived risk scores were only calculated for non-injury control sites, to reduce bias by the injury event.
Results
The route type with the greatest perceived risk was major streets with shared lanes and no parked cars (mean score = -0.21, 95% confidence interval [CI]: -0.54–0.11), followed by major streets without bicycle infrastructure (-0.07, CI -0.14–0.00). The safest perceived routes were paved multi-use paths (0.66, CI 0.43–0.89), residential streets (0.44, CI 0.37–0.51), bike paths (0.42, CI 0.25–0.60) and residential streets marked as bike routes with traffic calming (0.41, CI 0.32–0.51). Most route types that were perceived as higher risk were found to be so in our injury study; similarly, most route types perceived as safer were also found to be so. Discrepancies were observed for cycle tracks (perceived as less safe than observed) and for multiuse paths (perceived as safer than observed).
Conclusions
Route choices and decisions to cycle are affected by perceptions of safety, and we found that perceptions usually corresponded with observed safety. However, perceptions about certain separated route types did not align well. Education programs and social media may be ways to ensure that public perceptions of route safety reflect the evidence.
Key terms: Safety, transportation, injury, environmental design
Mots clés: sécurité, transports, traumatismes, conception de l’environnement
Résumé
Objectif
Les préoccupations quant à la sécurité ont un effet dissuasif sur le cyclisme. L’étude BICE (Bicyclists’ Injuries and the Cycling Environment) a quantifié le risque de blessure associé à 14 types de routes - des sentiers hors route aux grandes artères. Lorsqu’il s’agit du risque de blessure, il peut y avoir discordance entre les preuves empiriques et les perceptions. Quand c’est le cas, même si l’on construit des infrastructures de protection, les gens peuvent ne pas se sentir suffisamment en sécurité pour faire du vélo. Notre article porte sur la relation entre le risque de blessure subjectif et observé.
Méthode
L’étude BICE est une étude de type «case-crossover» pour laquelle nous avons recruté 690 cyclistes adultes s’étant rendus aux services d’urgence de Toronto et de Vancouver après un accident de vélo. Nous avons calculé le risque observé en comparant le type de route sur le lieu de l’accident avec les types de routes sur des lieux sélectionnés au hasard le long du même parcours. Le risque subjectif était la réponse moyenne des participants de l’étude à la question: «Quel était le niveau de sécurité de cet endroit pour les cyclistes durant ce trajet?»; les réponses ont été classées de +1 (très sûr) à -1 (très dangereux). Les scores de risque subjectif n’ont été calculés que pour les lieux témoins (sans accident) afin de réduire le biais induit par l’accident.
Résultats
Les types de routes présentant le plus grand risque subjectif étaient les grandes artères avec voie partagée, sans voitures garées (score moyen = -0,21, intervalle de confiance [IC] de 95 %: -0,54–0,11), suivies des grandes artères sans infrastructures cyclables (-0,07, IC -0,14–0,00). Les routes perçues comme étant les plus sûres étaient les sentiers multi-usages asphaltés (0,66, IC 0,43–0,89), les rues résidentielles (0,44, IC 0,37–0,51), les pistes cyclables (0,42, IC 0,25–0,60) et les rues résidentielles marquées pour les bicyclettes et comportant des mesures de modération de la circulation (0,41, IC 0,32–0,51). La plupart des types de routes perçues comme étant plus dangereuses étaient de fait plus dangereuses dans notre étude; de même, la plupart des types de routes perçues comme étant moins dangereuses l’étaient effectivement. Des divergences ont été notées pour les pistes cyclables (le risque subjectif étant plus élevé que le risque observé) et pour les sentiers multi-usages (le risque observé étant plus élevé que le risque subjectif).
Conclusions
Le choix d’une route et la décision de faire du vélo sont influencés par les perceptions de la sécurité, et nous avons constaté que ces perceptions correspondent généralement à la sécurité objective. Toutefois, les perceptions de certains types de voies séparées concordent moins avec la réalité. Des programmes de sensibilisation du public et dans les médias sociaux pourraient faire en sorte que les perceptions de la sécurité des routes par le public reflètent les données probantes.
Footnotes
Acknowledgements: The study was funded by the Heart and Stroke Foundation of Canada and the Canadian Institutes of Health Research (Institute of Musculoskeletal Health and Arthritis, and Institute of Nutrition, Metabolism and Diabetes)._effrey R. Brubacher is a Michael Smith Foundation for Health Research Scholar. Michael D. Cusimano is funded by the Canadian Institutes of Health Research and the Ontario Neurotrauma Foundation. We thank all the study participants for generously contributing their time. We appreciate the work of study staff (Evan Beaupré, Niki Blakely, Jill Dalton, Vartouhi Jazmaji, Martin Kang, Kevin McCurley, Andrew Thomas), hospital personnel (Barb Boychuk, Jan Buchanan, Doug Chisholm, Nada Elfeki, Kishore Mulpuri) and our collaborators from the city (Peter Stary, David Tomlinson, Barbara Wentworth) and community (Bonnie Fenton, David Hay, Nancy Smith Lea, Fred Sztabinski)
Conflict of Interest: None to declare
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