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Trauma: Crash research, risk & safety

Improving cyclist safety by lowering risk is one of the most important reasons we campaign for better bicycle facilities. Most crashes are not accidents as, when you look into the circumstances of the crash, it is obvious they could be avoided. That's why we avoid talking about cycle accidents, and instead refer to cycle crashes.

Helmets headed for Holland

30 May 2013. Dutch road safety authorities are trying to get children to don helmets in a nation that has been notoriously soft-headed when it comes to acknowledging the injury prevention effect of helmets.

In a trial in Zeeland more than 27,000 helmets have been handed out to elementary school students. As a result about 16 per cent of the students are wearing them.

Generally, about 3-5 per cent of Dutch kids wear helmets.

In the campaign, "A cool head wears a helmet", tens of thousands of handicraft kits, handouts, brochures, rucksacks and posters were distributed. 

Most schools featured a children’s theatre group to impress on children the benefits and necessity of wearing a bicycle helmet.

Furthermore, a special book to be read out at primary schools was produced as well as a DVD for parent-teacher meetings. 

A few weeks after the helmets were handed out, the project’s mascot Coolie visited each school to see how many children were wearing them.

The results so far are inconclusive, and is is not clear whether the campaign will have a lasting effect. 

The young cyclists will be observed for 5 years, during which time it will be noted whether the number of children with brain injuries following a bike accident has diminished and if that is attributable to the wearing of helmets.

Australian research has shown that helmets reduce brain injuries to a major extent, a fact known to Dutch safety authorities. However local cycling organisations and large section of the bike riding public in Holland continue to oppose the promotion of helmets.

Helmet-free: five times the risk

16 May 2013. A new study of bike crashes in Sydney has shown that riders without a helmet have more than five times the risk of severe head injury than riders wearing a helmet.

The study looked at cyclist admissions to seven major trauma centres in Sydney— Liverpool, St George, Royal Prince Alfred, Westmead, Royal North Shore, St Vincent’s and Prince of Wales hospitals—between July 2008 and June 2009.

Severe head injuries were defined as any with significant brain haemorrhage, complex skull fracture or brain swelling.

The study was led by Michael Dinh, an Emergency Physician and Co-Director of Trauma Services at Royal Prince Alfred Hospital Sydney.

The results were published in the Medical Journal of Australia.

The study also found that the in-hospital care costs of bike riders wearing helmets was one third of the cost of those not wearing helmets.

It found also that when it came to severe head injuries, the bike riders with helmets fared better than motorcyclists wearing helmets when involved in a crash.

Dinh said that its has been estimated that each new case of severe brain injury costs Australia A$4.5 million.

"Some 70% of such patients end up on a ventilator in intensive care units; many patients with severe head injuries are left with permanent brain damage", he said.

"But it’s the things that can’t be calculated that are perhaps more crippling – the long-term personality changes, the seizures, the post-traumatic adjustment, and the interminable stress on family and carers."

The study also tested the claim that helmets, rather than being protective, could actually exacerbate head injury severity by causing the head to twist quickly on impact, thus creating rotational forces on the brain.

The study found no reports of such injuries among the cyclists in the study.

Single bike crashes an international concern

3 April 2013. Infrastructure that separates cars from bikes certainly makes riders feel safer, but as Europe is discovering, riders still find ways to crash even with no other traffic in sight.

Recent research in Sweden by the Swedish National Road and Transport Research Institute reports that the majority of people injured in bike crashes are not involved with other travellers.

In an investigation of 36000 injury crashes between 2007 to 2011, 77% were single vehicle incidents, 12% involved bicycles and motor vehicles, and in 7% of cases cyclists collided with each other.

Head and facial injuries are predominant. According to the Swedish researchers many of the cyclists with serious head injuries were not wearing a helmet, justifying the recommendation to wear cycle helmets.

Besides the large number of head injuries, the number of hip injuries also stood out.

Slipperiness caused by snow and frost was the most important cause of single vehicle accidents in Sweden. Collisions with road curbs took second place.

Proportionally more accidents occurred on poorly maintained roads.

Helmets: old study, new information

18 march 2013. A recently unearthed study into the impact of helmet legislation in South Australia has further dented claims that helmet laws did not have a beneficial effect when introduced in Australia.

The study, Evaluation of the Compulsory Helmet Wearing Legislation for Bicyclists in South Australia, was published by the Office of Road Safety in 1994.

It has not previously been publicly available, but a copy was recently provided to Bicycle Network, which is making it available to interested researchers.

It reports that potentially preventable injuries dropped 24.7 per cent in the two years after the 1991 legislation compared to the two years before.

During the period helmet wearing rates increased significantly to over 90 per cent.

Despite being unavailable for examination, the report has been referred to by anti-helmet advocates as evidence against the efficacy of compulsory helmets.

The study says that the value of helmets could be significantly greater than shown by the study because 49 per cent of commuters, and 15 per cent of all cyclists over 15, were already wearing helmets before the legislation.

Bikes a priority in new safety plan

7 March  2013. Victoria's new Road Safety Strategy has given a high priority to cutting cycling injuries, pledging a new funding program to improve troublespots.

The strategy undertakes to deliver a new grants program for local government to provide safer walking and cycling infrastructure.

It also commits the government to improve bike rider safety by developing a new pedestrian/ cyclist ‘black area’ program

The other key strategy is the improvement the safety of on and off road cycling paths, reduced vehicle speeds around cyclists and road safely through education and enforcement.

The strategy argues that improved infrastructure and safer vehicle speeds will reduce risk and support the uptake of sustainable travel modes.

"Cyclists crash most frequently at intersections, when leaving a path or driveway to enter
a road or when a car door is opened in their path," the document says.

"Wearing a bicycle helmet reduces the risk of a cyclist incurring a head injury in the event of a crash by up to 60 per cent."

It also reports that public opinion surveys supported higher penalties including fines the same as drivers, more bike lanes and paths and education for drivers.

(The public is generally unaware that fines for bike riders are already high in Victoria, one of the reasons why rider behaviour and rider risk management is markedly better here than in other states.)

The strategy was accompanied by a Road Safety Action Plan.

it says that a cyclist hit by a vehicle travelling at 50km/h is four times more likely to be killed or seriously injured than if hit at 40km/h.

"Experts estimate that the number of pedestrians and cyclist injuries in Melbourne’s strip shopping centres that have introduced a 40km/h speed zone has reduced by nearly 17 per cent," the Action Plan says.

"The proportion of crashes involving cyclists is currently significantly higher at roundabouts than elsewhere. In Victoria cyclists are involved in nine per cent of fatal and serious injury crashes, while at roundabouts 25 per cent of fatal and serious injury crashes involve cyclists.

Other actions include:

Right cross linked to rising injury toll

20 February 2013. The rising toll of serious injuries to bike riders has been linked to driver behaviour at intersections, especially where right-turning drivers fail to give way to oncoming bikes.

In a study of 61 admissions to Royal Adelaide Hospital over three years from 2008 to 2010, 40 per cent of the crashes involved right turning cars failing to give way to oncoming cyclists.

The study suggests that many drivers, especially those who are not also bike riders, have a poor appreciation of the approach speed of bicycles, and thus miscalculate their turns.

The research was undertaken by VL Lindsay at the Centre for Automotive Safety Research (CASR), University of Adelaide.

"Injured cyclist profile—an in-depth study of a sample of cyclists injured in road crashes in South Australia" can be downloaded here.

As well as a high incidence of right cross crashes, the study found a significant proportion of the serious injury crashes involved cars failing to give way to the right, and of turning left across the path of a bike rider travelling straight ahead.

The study reported that in South Australia bike crashes resulting in an hospital admission increased from 12 percent of all traffic crash admissions to 17.4 percent over a ten year period.

Cyclists involved in crashes were generally found to be experienced road users who undertook road cycling activities on a regular basis.

The study reports: "On average, cyclists self reported that their road cycling exposure involved close to 10,000 kilometres per annum. Male cyclists between the ages of 36 and 55 years were found to be the group most frequently involved in crashes involving a motorised vehicle.

"Vehicle drivers undertaking a turning manoeuvre posed the biggest threat to cyclists who were generally travelling straight on a carriageway. Those drivers undertaking a right turn manoeuvre were found to pose the greatest threat, particularly those turning across multiple traffic lanes and in peak hour traffic conditions. These crashes were more likely to involve young drivers.

"The most serious injuries incurred by cyclists were fractures, followed by those who sustained internal organ injuries. Close to a third of cyclists experienced a loss of consciousness following the crash.

"Those cyclists who struck the side of a vehicle were generally found to sustain more serious injuries when compared with other crash types and resulted in hospitalisation for longer periods.

Two thirds of the cyclists in the study were travelling on road bikes. Length of ownership averaged three years. Close to half of the cyclists were understood to own two or more bicycles. Three of the bikes in the study cost in the vicinity of $15,000 to $18,000.

Anti-helmet theory takes a header

7 February 2013. A key theory of anti-helmet campaigners—that helmets lead bike riders to take more risks while riding—has been thrown on its head by new research into bike crashes.

It had been claimed that riders not wearing helmets were safer riders because they were more careful and that riders with helmets were less safe because they took more risks.

It was speculated that the helmeted riders took more risks because they believed they were protected by their helmets.

The theory, known as 'risk compensation', has been used to underpin anti-helment campaigns, particularly in Europe.

But new research from the University of New South Wales, which studied nine years of data from bike-on-car crashes—debunks the argument.

Bike riders without helmets are not only more likely to be injured in a crash, but are more likely to have been riding recklessly at the time, the study found.

The riders with helmets were actually the careful ones.

The study examined 6745 bike rider injury collisions involving motor vehicles motor vehicles in NSW from 2001 to 2009.

The case-control study, led by Dr Mike Bambach and Dr Rebecca Mitchell and co-authored by Dr Jake Olivier and Prof Raphael Grzebieta, was carried out by linking detailed information on admissions to all hospitals in NSW with police reports on road traffic collisions in which cyclists were injured or killed.

A pre-publication version of the study is available here. It has been formally published in the journal Accident Analysis and Prevention.

The study found that non-helmeted cyclists were almost three times as likely to have disobeyed traffic controls as helmeted riders, and more than four times as likely to have been above the blood alcohol limit.

One in four of the cyclists who crashed were not wearing a helmet (These are NSW figures). These riders were more likley to be involved in more severe crashes with cars and trucks.

Non-helmeted cyclists were also more likely to be seriously injured in body regions other than the head.

Co-author Dr Olivier said the benefits of helmets were clear in the study. "Cyclists without helmets had up to 3.9 times the risk of sustaining a head injury, compared with those who wore helmets," he said

"The more severe the injury, the greater the benefit: Helmet use reduced the risk of moderate head injury by 49 per cent, of serious head injury by 62 per cent, and of severe head injury by 74 per cent”.

Teenagers were the most likely to sustain skull fractures and brain injuries. Around one half of children and adolescents less than 19 years were not wearing a helmet.

The study also overturned a belief widely held in anti-helmet circles, that helmets were not effective in impacts involving motor vehicles. All crashes in the study involved motor vehicles and helmets were shown to be very protective.

Another speculative proposition—that helmets did not help or may result in increased severity of certain kinds of brain injury (diffuse axonal injury)—is also weakened by the publication of this research, which indicates that such injuries are likely to be rare and thus insignificant in the assessment of helmet effectiveness.

Keep the lid on it!

13 December 2013. A recent Canadian study has re-confirmed that wearing a helmet significantly reduces reduces a bike rider's risk of death from head injury.

The researchers from the Office of the Chief Coroner in Ontario looked at 129 deaths examined by the Coroners Office between 2006 and 2010.

They used a case control design comparing deaths that involved head injuries and those from other causes where the exposure variable was the non-use of a helmet.

Not wearing a helmet while cycling was associated with an increased risk of dying as a result of sustaining a head injury. The result is in accord with the findings of other studies into helmet use.

Seventy-seven percent of the fatal collisions in the study involved a motor vehicle. You can find the study here.

Helmet benefit continues

31 October 2012. New research from the University of New South Wales confirms that helmets have lowered head injury rates in the years since mandatory helmet laws were introduced.

Furthermore, the research also found that head injuries were further reduced in the years after 2006, likely because of better bicycle infrastructure.

The study, "Long term bicycle related head injury trends for New South Wales, Australia following mandatory helmet legislation", follows an earlier examination of the effect of helmet laws at the time of their introduction.

The earlier study compared bike crash injuries to riders' arms and to heads before and after the adoption of helmets. It found that after riders started wearing helmets, the ratio of arm injuries to head injuries diverged, establishing that helmets reduced head injuries. (See below at 14 July 2011)

The new paper looked at crashes between 2001 and 2010 and overall, arm injuries were higher than head injuries throughout the study period, with bicycle head injuries 46% less than arm injuries by 2006.

"There is a notable additional safety benefit after 2006 that is associated with an increase in cycling infrastructure spending. This implies that the effect of MHL is ongoing and progress in cycling safety in NSW has and will continue to benefit from focusing on broader issues such as increasing cycling infrastructure," the paper states.

"Our study shows that the beneficial effect of MHL in NSW has been maintained since enactment of the law over 20 years ago.

"This signals a need to focus on other aspects of bicycle safety in order to further reduce cycling-related injuries.

"Collisions involving motor vehicles clearly have a high risk of head injury indicating that the interaction between cyclists and motor vehicles is a key area for inter- vention through further changes to transport infrastructure and modification of cyclist and motorist behaviour."

Separation and speed key risk factors

14 October 2012. More separated infrastructure and the introduction of low speed limits in residential neighbourhoods with significant bicycle traffic are two of the key suggestions in a new study into the risk of severe injury bike crashes.

The research found the majority of cyclist crashes occurred in urban areas (94.6%) and about half (48.1%) on roads with speed limits of 60 km/h, with over one-third (34.5%) occurring on roads with speed limits of 40–50km/h.

Another 11.4% occurred on roads with speed limits between 70 and 90 km/h and 6% on roads with speed limit of 100 km/h and over.

The likelihood of being severely injured increased with increasing road speed limits with the risk of severe injury 51% higher when crashes occurred on roads with speed limits of 100 km/h or more compared to those occurring on roads with 40–50 km/h speed limits.

The study "Risk factors for severe injury in cyclists involved in traffic crashes in Victoria", was carried out by Soufiane Boufous et al from the George Institute at The University of Sydney.

It examined 6432 cyclist crashes reported to the police in Victoria between 2004 and 2008 with 2181 (33.9%) resulting in severe injury of the cyclist involved, assessing the associations between cyclist, vehicle and road characteristics and the severity of injury in cyclists involved

The researchers investigated whether characteristics related to the cyclist (age, gender, and bicycle helmet usage), the road (road type, road geometry, speed limit, rural or urban location) and the crash (time and day of the crash, other vehicle involved,type of crash) were associated with injury severity of cyclists involved in traffic crashes.

The analysis found that factors that increase the risk of severe injury in cyclists involved in traffic crashes were:

"The vast majority of cyclist crashes (78.4%) occurred during weekdays. Morning and afternoon peak hours between 6 am to 10 am and 2 pm to 6 pm were the periods with the highest proportion of cyclist crashes (30.5% and 32.1% respectively)," the author's reported.

"Overall, three quarters of cyclist crashes occurred in day light and one in ten occurred during dusk/dawn. Another 11.1% of crashes occurred in the dark in areas with street lights and 2.5% occurred in the dark on unlit streets.

"The majority of cyclist crashes reported to the police (90%) involved another vehicle. The majority (83.7%) involved car-type vehicles (cars, SUVs, utility and light trucks), 3.6% involved heavy vehicles and 1.4% involved other cyclists. Single vehicle crashes made up 6.4% of cyclist crashes reported to the police.

"The majority of cyclist crashes occurred in urban areas (94.6%) and about half (48.1%) on roads with speed limits of 60 km/h with over one-third (34.5%) occurring on roads with speed limits of 40–50km/h.

"Another 11.4% occurred on roads with speed limits between 70 and 90 km/h and 6% on roads with speed limit of 100 km/h and over. Most cyclist crashes occurred at an intersection (58.5%).

"The most common intersection types for crashes were T-intersection (28.9%) and cross intersection (27.7%). Almost all cyclist crashes occurred on straight sections of the road (98.7%) and on paved roads (96.3%). Nearly nine in ten cyclist crashes occurred on dry road surfaces (88.7%) with another 7.9% occurring on wet or muddy roads.

Overall, injury severity of cyclists involved in traffic crashes increased with age, with those aged 60 years and over twice as likely to be severely injured as a result of a crash as the youngest age group (0–9 years). Those aged 50–59 years were 72% more likely to be severely injured as a result of a crash than the youngest age group.

The analysis also showed that not wearing a helmet increased the odds of severe injury by 56%.

"The findings indicate that in order to reduce the severity of injury in cyclists involved in traffic crashes, there is a need for further promotion and enforcement of helmet use, particularly among younger cyclists," the report states

The study was funded by VicRoads.

Central Melbourne goes 40kph

1 October 2012. New 40 kph speed limits will make some of central Melbourne's busy, broad streets more hospitable to bike riders.

Although peak time congestion keeps speed under control on most CBD streets, some drivers treated through-routes such as King and Spencer Streets as if they were high speed arterials.

If the new limits are enforced on such streets, they will be more ridable, with less risk of crash and injury.

The new speed limit will come into effect progressively as 270 new speed zone signs are installed across the CBD, a process expected to take about six weeks.

The map, click here for larger version, shows the extent of the new limits. The City of Melbourne had requested a more extensive area, and had strongly argued for lower limits around the pedestrian-dense Queen Victoria market precinct.

The 40kph speed limit will be introduced on the streets bordered by, and including, Flinders, Spring, La Trobe and Spencer streets.

Riders will notice some glaring omissions, such as Elizabeth Street north and La Trobe Street west of Spencer.

It is understood that VicRoads opposed expanding the new zones outside of the central area to avoid confusing motorists.

The RACV has trenchantly criticised the new lower speed zones on some streets, claiming the low speeds would cause drivers to become 'frustrated' and as a consequence, drive with less care. Using this logic you would do away with traffic lights because bringing drivers to a stop will make them frustrated and a safety risk.

Melbourne City Council estimates 40kph zones will prevent an estimated 25 casualty crashes every year.

Lord Mayor Robert Doyle said the move to a 40kph speed limit across the central city would improve safety for drivers, pedestrians and cyclists without impacting on traffic flow or congestion.

“We know that if you’re a pedestrian and you get hit by a car that’s travelling over 40kph, your chances of surviving are minimal,” the Lord Mayor said.

“Research shows if we reduce the speed limit to 40kph, we will prevent one fatality, nine serious injury crashes and up to 25 casualty crashes every year. If it saves a single life, it’s worth doing.”

The Lord Mayor was joined for the announcement by Victoria Police Superintendent Rod Wilson near the intersection of Lonsdale Street and Spring Street, a city black spot where in the past five years there have been 17 crashes, seven of which involved pedestrians.

Superintendent Wilson supported the 40kph zones and said pedestrian-related collisions continued to be a significant road trauma challenge for police in the CBD.

"Pedestrians are some of our most vulnerable road users and the number of pedestrian collisions in the CBD is a major concern for police," Superintendent Wilson said. "We regularly conduct high visibility operations in the CBD focussed around pedestrian safety.

"By lowering the speed limit we hope to see a reduction in the number of serious injury collisions."

Patricia Liew, Regional Director, VicRoads Metropolitan North West, said VicRoads supported the safety initiative and said it would have minimal impact on travel times across the city.

“The introduction of 40kph speed limits throughout central Melbourne and along King and Spencer streets, will provide a safer environment for the significant volume of pedestrians that use these streets, and will create a safer environment for cyclists,” Ms Liew said.

“In the five years from 2007 to 2011, there were 426 pedestrian casualty crashes within the CBD (an average of 85 per year), including three fatalities.

The high pedestrian activity makes the 40kph speed limit a good move for safety with little to no impact on vehicle mobility.”

The invisible cyclist re-appears

5 September 2012. The spectre of the invisible cyclist who appears out of no-where and crashes into law abiding motorists has made an alarming re-appearance—this time in the latest State Government road safety initiative. Yes, its all our fault, apparently.

In a survey by the Department of Justice on behalf of the Ministerial Council for Road Safety, launched today and heavily promoted by the Herald-Sun newspaper, a crude attempt is made to imply bike riders are to blame when drivers collide with them.

In a key question in the public consultation survey, people are asked if they agree that cyclists should be forced to wear "special high visibility clothes".

This is yet another attempt to blame the cyclists victim in "failure to observe" crashes.

It is totally the responsibility of the driver to be be aware of their surroundings and observe other traffic on the road.

Drivers crash into riders not because they couldn't be seen, but because the drivers were not looking. Driver distraction is rampant on the roads with widespread illegal use of devices, texting, and interaction with children and pets.

All the high visibility clothing in the world won't help if the driver is busy composing a text message.

Many riders who have been crashed into have been highly visible, many wearing special hi-vis clothing at the time of the crash. Yet drivers said they did not see the cyclist.

Make sure you take the survey and let the government know your view on this and other issues. Many important issues are raised which deserve your input.

Another puzzling question is about increasing fines for cycling offences.

Penalties for key offences such as running red lights, and dangerous riding, are already high in Victoria—some of the highest in Australia and the world—and near-equivalent to those that apply to drivers.

These severe penalties have been highly effective at keeping the rate of offences low in Victoria, making our riders some of the best behaved anywhere.

So why would the survey be suggesting they be made higher?

The survey is to be used to develop a road safety strategy in conjunction with the the Department of Justice, Victoria Police, TAC, VicRoads and other experts in the field.

Speed review gives and takes

22 August, 2012 VicRoads has released its 2011-12 Victorian Speed Limit Review – and there is both promise and dread for people on bikes.

Among a series of recommendations aimed at simplifying Victoria’s speed limit regime is that VicRoads will move to develop comprehensive guidelines to introduce 40 km/h zones around areas like schools “where and when the risk of pedestrian crash is high”.

There is no evidence in the review document to suggest that the requirements of bike riders were given particular attention.

The description of “pedestrian activity zones” includes mention of school zones, a particular area of interest for our Ride2School program team.

VicRoads will allow local councils to change permanent 40 km/h school speed zones into time-based 40 km/h zones. The same thinking will apply in other areas.

“A number of different types of pedestrian zones already exist on Victorian roads. These include school zones, 40 km/h strip shopping centre speed zones, 40 km/h areas in residential precincts and 50 km/h town centre speed limits,” the report said.

“VicRoads believes that where and when the risk of a pedestrian crash is high, a 40 km/h speed zone should be in place. However, once pedestrian activity at these locations decreases, the speed limit can be increased.”

The review, based on consideration of 600 submissions, includes recommendations aimed at reducing “sign clutter” and making speed limits clear, consistent, logical and easy to comply with. The upshot is that dozens of roads across Melbourne with multiple speed zones will be changed.

International best practise for areas shared by different transport modes – residential areas, strip shopping centres and around major hubs like hospitals, schools and parks - is 30km/h.

Changes that mean that 40 km/h speed limits might increase are hardly likely to encourage children, for example, to get back on their bikes beyond the small window at the start and finish of each school day.

Even less welcome was the recommendation to increase speeds from 50 to 60km/h on collector streets. These streets are not just collectors of vehicles to sieve them into the busier flow of arterial roads, but are important active transport collectors that rider often use. Many schools and commuter routes are con collector streets.

The full report can be found here

Crashes familiar territory for riders

9 August 2012. Riders travelling frequently on regular routes are more likely to crash than when riding less familiar territory, according to new research from Melbourne.

Riders who rode more than twice a week at a location where they crashed were significantly more likely to be involved in multi road user crashes than were those who rode at the location less than once a fortnight.

The finding reinforces the understanding that riders often become less cautious when riding in familiar surrounds where they lose concentration and make errors resulting in crashes.

The Monash Alfred Cycle Crash Study was a pilot collaborative research study of Alfred Health and Monash University Accident Research Centre (MUARC). It was carried out by Paul Biegler, Stuart Newstead, Marilyn Johnson, James Taylor, Biswadev Mitra and Sarah Bullen.

It sought to provide an in-depth analysis of bicycle crash causation and injury outcome to inform the development of effective counter measures.

Participants were riders presenting to the emergency departments of the Alfred and Sandringham Hospitals, which often treat patients who have crashed on the Beach Road route.

Participants were administered an in-depth questionnaire covering demographic details, prior health issues, cycling experience, bicycle and clothing used in the crash, events leading up to the crash and the road environment, and the events of the crash itself.

The study found that 45 per cent of helmets sustained damaged in a crash. The implications is that if the force of a crash is sufficient to damage a helmet, it would be sufficient to cause head injury if the rider was not wearing a helmet.

The use of bicycle lights was found to significantly predict lower injury severity resulting from a crash, independent of time of day. Absence of cloudy weather at the time of the crash also predicted lower injury severity. Together, these findings suggest that increased cyclist visibility plays a preeminent role in mitigating the gravity of injury outcomes from bicycle crashes.

A plausible explanation is that, in multi user crashes, greater cyclist visibility allows more time for the various collision partners to take evasive action, such as braking or swerving, lessening impact severity.

Other findings included:

Speed: lower limits looming

16 May 2012. All the signs are pointing to a move to lower speed limits in Victoria, with central Melbourne taking the lead and introducing 40 kph by the middle of next year.

The lower limits for the city have been proposed since 2006, but were never implemented as a succession of nervous Roads Ministers sat on their hands.

But the week the Herald-Sun uncovered that the city council had budgeted $350,000 for new 40 kph speed signs for next financial year.

Clearly the council is anticipating the go-ahead from VicRoads and the government to proceed within the changes in the next 12 months.

Lower limits will be welcome by bike riders as they have been shown around the world to significantly reduce crash and injury risk to people on bikes. Pedestrians and event those in cars benefit. As well the time taken for car trips hardly changes.

Lower speeds also lead to more people cycling and walking, and the lower noise levels results in more activity at street level in retailing areas.

Now that Melbourne is planning the move other inner Melbourne councils will surely follow. The City of Port Phillip has publicly backed lower limits as a way of making communities safer.

Melbourne's latest draft Transport Strategy also targets lower speed limits by 2016.

The council is understood to be planning the lower speed zones in the CBD grid, plus a section of the city north to include the Queen Victoria market.

Last year VicRoads conducted a major review of the State's speed limit policies. No final report has yet emerged although it is known that the review found a hodge-podge of anomalous speed zones in many areas, and established that there was a need for a more coherent approach.

Canberra study backs bike lanes

22 March 2012. A study of bike crashes over a six month period in Canberra has confirmed that dedicated on-road bike lanes reduce crash and injury rates.

But the findings suggest that the national capital's off-road bike network has problems and that crashes on them were more common than unexpected.

Overall most riders (65 per cent) fell without involvement of any other road users. And 49 per cent of single vehicle crashes involved a loss of control on a straight road (or path).

Of all the riders whose crashes involved other riders, half had completed rider safety training programs.

The study, 'Factors Associated with Bicycle Crashes and Injury Severity in the ACT' was undertaken by Liz De Rome, Soufiane Boufous, Teresa Senserrick, Drew Richardson and Rebecca Ivers from The George Institute for Global Health, the University of Sydney Medical School, and the Australian National University.

The authors say the study confirms the value of on-road lanes reserved exclusively for cyclists as a means of reducing their crash and injury rates but raises questions as to the safety of cycling on shared paths and pedestrian areas.

"It has been suggested that cycling facilities that are most likely to reduce the risk of crashes to cyclists are those that are marked for cyclists, do not share the space with parked cars and are designed to reduce the potential for conflict between cyclists and motorists at intersections," the authors say.

"The latter can be achieved by the provision of facilities such as advanced green lights for cyclists and cyclist activated traffic signals at key intersections."

"The high proportion of crashes between cyclists is also a matter of concern as almost half of all multi-vehicle crashes were between bicycles.

"Whereas better traffic management such as centre lines and warning signs on shared paths should reduce such conflicts, it is apparent that behavioural factors such as speed and riding in close packed groups should also be addressed.

"Other cyclist dependent factors associated with crashes included alcohol, usage of shoe cleats, carrying unbalanced loads such as back packs and shopping bags and poor bicycle maintenance."

The study found that full body coverage including gloves, shoes, long sleeved tops and full length pants, regardless of the materials used, provided a significant benefit in preventing or reducing injuries.

The study made a number of recommendations, including:

New driver health standards

23 February 2012. New medical standards for determining assessing whether private and commercial vehicle drivers are fit to drive safely will come into effect from 1 March this year.

Developed by the National Transport Commission, Assessing Fitness to Drive contains medical standards to provide guidance to health professionals and driver licencing bodies on the health assessment of private and commercial drivers of heavy vehicles, light vehicles and motorbikes.

The move is in response to rising community concern that the medical profession and the driver licensing
authorities are failing to act to ground drivers whose medial condition impacts negatively on their fitness to drive.

The reforms were announced in the same week that police apprehended an 80 year old driver who had towed a caravan for 12 km along the wrong side of the M1 into oncoming traffic.

National Transport Commission (NTC) Chief Executive Nick Dimopoulos said ensuring that drivers are fit to drive safely is a crucial element to improving road safety.

“As part of the NTC’s role in maintaining reforms, the standards have been thoroughly updated in line with advances in medical knowledge and regulatory best practice,” said Mr Dimopoulos.

“The standards now provide a more relevant and informed assessment of drivers and their abilities. The focus has moved to how the symptoms of a person’s condition may affect their driving rather than just the diagnosis of that condition,” said Mr Dimopoulos.

“This change results in a fairer system where drivers are assessed based on their ability to drive safety, rather than just on their health condition.”

Other notable changes include improved guidance for health professionals with respect to multiple medical conditions and age-related change, and the inclusion of flow charts to facilitate clinical decision making.

The publication also includes information about the roles and responsibilities of health professionals, driver licensing authorities and drivers, the assessment and reporting process and useful contacts.

Administrative arrangements such as the health conditions reporting process do not form part of the medical standards and therefore were not included in the NTC’s review.

An electronic version of Assessing Fitness to Drive, as well as supporting materials, can now be downloaded from the Austroads website. 

Meanwhile VicRoads has confirmed that it is opposed to the mandatory medical reporting of patients who may not be fit to drive.

VicRoads director of road user safety James Holgate told The Age the question of whether doctors should report drivers with medical conditions, whether or not they were age-related, had been reviewed by the State Coroner and the parliamentary road safety committee and neither were in support.

"There could be adverse road safety consequences associated with mandatory reporting by medical practitioners, due to patients hiding details of their condition from their doctor to avoid being reported and subsequently driving untreated, which increases their crash risk and potentially their health risk," he told The Age.

Police bosses fail on dooring death

10 November 2011. A driver responsible for the 'dooring' death of a bike rider was not charged by police after senior officers blocked any prosecution.

The unexplained decision was revealed at the inquest into the March 2010 death of James Cross, 22, of Hawthorn, who was 'doored' and propelled under the wheels of a five tonne trailer being pulled by a dump truck.

Cross, a Monash University student, died at the scene of chest and pelvic injuries.

The inquest was told that police were not able obtain a statement from the driver, Mrs Ellen Richards, 60, until some three months after the crash. The statement had already been vetted by Mrs Richards' solicitor.

Mrs Richard's told the inquest that although she looked in the mirror of her black BMW, she failed to see Mr Cross. She maintained that she only opened her door 12 centimetres although witness reported the door being opened sufficiently wide for a driver to alight from the vehicle.

The Coroner, Heather Spooner, found that Cross was riding appropriately in a shared bike and parking lane with bike markings.

Under questioning at the inquest Senior Constable Linda Kane, who prepared the Coronial Brief, acknowledged that the potential police charge of opening a vehicle door to the danger of another was not pursued.

She said she has spoken to her 'bosses' at Boroondara Station who informed her that a charge against Mrs Richards would not be authorised.

Coroner Spooner said that with cyclist numbers growing across the state, ensuring their safety was of paramount importance if cycling is to be promoted as a legitimate form of transport.

"Cyclist have a right to ride in safety and not be fearful of being hit by a car door", she said.

"Motorists need to be more aware of their responsibility to thoroughly check for cyclists before opening a car door."

She recommended that VicRoads work closely with local government to promote the reconfiguration of bicycle and parking lanes to place the bike lanes adjacent to the curb, Copenhagen-style.

She also recommended that VicRoads implement a communication campaign to educate motorists of the need to thoroughly check before opening their car door, and to increase awareness among cyclists of the need to remain vigilant when riding past car doors.

The Findings are now available here.

The Herald-Sun story is here.

More hit the door

11 August 2011. There has been a spike in car door collisions during the past year, according to the latest figures on crashes experienced by Bicycle Network Victoria members.

In the 2010-11 year to June 30, there were 43 recoded 'doorings' of members, well up from 19 in the previous 12-month period.

Until this sudden doubling, member doorings were in the low twenties each year.

The data comes from Bicycle Network Victoria's Riders Rights unit, which records members crashes for legal and insurance reasons.

The crash reports don't reveal any specific reasons for the dramatic one-year increase.

Whilst some road users behaviours appear to be on the improve, riders still report a high incidence of drivers and passengers careless opening doors into the path of riders.

During the past year the police have successfully blitzed the behaviour in a number of operations. It is understood that Police data shows a worrying level of such behaviour in some areas of Melbourne.

Also last year there was the death of a rider in Hawthorn attributed to a door opening incident.

It is possible that the Coroner investigating the death could make some findings and recommendations for action by the authorities when the report is finalised later in the year.

While it is never the rider's fault when hit by an opening door, everyone should remain aware of the risk and positions the bike so that any chance of a collision is reduced.

Helmet laws positive: new study

14 July 2011. A major study into the introduction of helmets laws in NSW in 1991 has revealed that head injuries immediately dropped 29 per cent.

The study, conducted at the University of NSW, is described as the most comprehensive analysis yet into head injury risk after mandatory helmet law introduction.

For many years there has been speculation that Australia's compulsory helmet laws made little or no difference to the risk of injury, and there have been occasional calls for the removal of the law.

But the repeal of compulsory helmet laws cannot be justified, the researches have concluded.

Bicycle-related head injuries fell significantly in the months after mandatory helmet legislation came into effect in NSW, according to hospital admissions data.

The study is titled "The impact of compulsory cycle helmet legislation on cyclist head injuries in New South Wales, Australia, by Scott R. Walter, Jake Oliviera, Tim Churches, and Raphael Grzebietaa

“We set out to perform the most comprehensive analysis possible on the subject while addressing any data limitations and possible confounding factors,” said study author Dr Jake Olivier.

“What we found provides compelling evidence that the legislation has served its purpose in reducing bike-related head injuries and any repeal of the laws would only put lives at risk,” he said.

UNSW’s Chair of Road Safety and study co-author Professor Raphael Grzebieta said the study backs up overwhelming evidence from biomechanical experiments and in-depth accident case analyses that helmets prevent head injury. “It shows what we’ve suspected for a long time — that you would be unwise to ‘hit the road’ without a helmet,” he said.

Last year, a Sydney University study found the laws had failed and should be repealed because compulsory helmet wearing could be a disincentive to cycling. The academic paper was later retracted due to serious data and arithmetic errors.

In the new UNSW study, researchers from the Injury Risk Management Research Centre and the Sax Institute examined trends in NSW hospital admissions for cyclists and pedestrians, comparing the rate of head injury relative to arm injury, and separately for head injury relative to leg injury, in the months before and after the legislation was introduced.

They found the decrease in head injury rates was significantly greater for cyclists compared to pedestrians, and cyclist head injuries decreased more than limb injuries, pointing to the positive effect of mandatory helmet wearing at the population level.

“We endeavoured to identify the effect of the legislation on head injury rates as distinct from other road safety interventions and we’ve shown that the improvements could only have come from the helmet legislation,” Dr Olivier said.

However, while the findings support the maintenance of mandatory helmet laws, the paper’s authors caution against seeing helmets as a panacea for bike safety: “Cyclist safety is a complex issue driven by a range of factors."

Evidence fractures helmet opposition

16 June 2011. A major review of the benefits and disadvantages of bike helmets commissioned by the Queensland Government has concluded that helmets have more than halved the number of head injuries experienced by Queensland cyclists.

And its finds that there is little evidence that helmets discourage bike riding, or that there is a large body of people who would take up cycling if the legislation was changed.

"A review of the most scientifically rigorous research concluded that bicycle helmets that meet national standards protect against head, brain, and facial injuries," the policy paper says.

"Helmet wearing was associated with a 69% reduction in the likelihood of head or brain injury and a 74% reduction in the likelihood of severe brain injury.

"The benefit was the same whether a motor vehicle was involved in the crash or not. Helmet wearing reduced the likelihood of injury to the upper and mid-face by 65%".

The review was conducted by the Centre for Accident Research & Road Safety - Queensland (CARRS-Q). The contributing authors were Narelle Haworth, Amy Schramm, Mark King, and Dale Steinhardt.

It was commissioned in response to media stories challenging the effectiveness of helmet legislation, especially in the context of the launch of the bike share scheme in Brisbane.

It examined the available evidence on the issue from around the world.

The paper says that bike riding does have significant health benefits and therefore should be encouraged in ways that reduce the risk of the most serious of injuries.

"Head injuries not only have the potential for death but that they are among the most disabling of non-fatal injuries (in some ways more than spinal injuries).

"Infrastructure and speed management approaches to improving the safety of cycling should be undertaken as part of a Safe System approach, but protection of the individual by simple and cost-effective methods such as bicycle helmets should also be part of an overall package of measures," the study concluded.

Among other findings:

Separated lanes cut injuries [updated]

10 March 2011. Bike riders in separated bike lane have a 28 per cent lower injury rate than if they were riding in with car traffic, a new study has found.

The Harvard Medical School of Public Health examined the safety profile of the urban bike lane system first set up two decades ago in Montreal, Canada.

Injury and crash rates for six cycle lanes in Montreal were compared with alternative street routes. The lanes and alternate streets (which lacked biking lanes) were characterized as posing similar "traffic dangers" to riders in terms of the type, number, and speed of cars on the road.

All the bike lanes featured two-way cycle traffic on one side of the road, from which they were separated by raised pavement, parking lanes, and/or posts. Most of the alternate streets ran parallel to the cycle track roads, and came to the same end-point intersections as the tracks.

Two way separated paths are common in Montreal, and some have been built in Sydney. The concept has been treated warily in Melbourne.

"Of course, intersections do have to be well-designed, ideally with red and green bicycle signals," Lead author Dr Anne Lusk said. "And even then, we're not suggesting that cycle tracks have zero risk. But rigorous research does show that the difference in the accident rate is real."

Dr Lusk attacked the vehicular cycling movement for holding back the the growth of bike riding by opposing separated lanes.

"For long time they have discouraged the creation of bike lane because instead they wanted to teach everyone to be assertive—including children, women, seniors, and parents with children on their bicycles—they were going to taught how to be assertive and take, meaning you pull in front of the car.

The study found that 2.5 times as many bikers used the cycle tracks compared with street routes without separated bike lanes.

[The original version of this story used an incorrect figure to compare the relative rates of injury]

Helmet cam confirms driver inattention

23 November 2010. A research project which fitted cameras to bike helmets to observe traffic has confirmed what riders have long suspected—drivers are not paying attention.

Of all the incidents recorded by the cameras drivers were at fault 87 per cent of the time, and in 83 per cent of those cases the drivers appeared oblivious of their errors. Drivers of 4WD vehicles were highly likely to failure to observe cyclists.

On the positive side the bad driving did not generally have serious consequences for riders because the videos suggested that cyclists were highly aware and could react rapidly to traffic situations and avoid collisions and near-collisions.

"Overall, on-road commuter cyclists rode in a safe and legal manner and used cycling facilities when available," the study said. "In addition, cyclists rode in a manner that was anticipatory (avoiding potential collisions) and defensive or reactive to the surrounding vehicular traffic as drivers did not appear to see them.

"Cyclists made frequent head checks throughout their commuter trips, which suggests cyclists have high situational awareness."

The study, NATURALISTIC CYCLING STUDY: IDENTIFYING RISK FACTORS FOR ON-ROAD COMMUTER CYCLISTS, was conducted by Marilyn Johnson, Judith Charlton, Jennifer Oxley, and Stuart Newstead of the Monash University Accident Research Centre (MUARC).

It found the most frequent event in which the driver was at fault (55.5%) was where the driver manoeuvred left, including turning left and turning left across the path of the cyclist .

"There may be a role for educating or training cyclists to ride more defensively around cars and be particularly vigilant of drivers turning left across their path at intersections, particularly vehicles with poor visibility traits such as large vehicles and 4WDs," the study reported.

When the vehicle’s indicator could be observed, only 57 per cent of drivers did indicate (or signal) before they changed course. Of the drivers who did indicate, half indicated for only 1-3 seconds before changing course.

"Drivers’ lane change behaviour appeared to be motivated by a gap in the adjacent vehicle lane. At times, this resulted in a sudden lane change and often drivers did not indicate (signal), despite the Australian Road Rule that all drivers must indicate for at least 5 seconds prior to turning left or right.

"Drivers did not appear to be aware of the cyclist travelling alongside or behind them. While this behaviour did not appear to impact surrounding vehicular traffic, sudden vehicle lane change had a dramatic impact on the cyclist. Successful collision avoidance was reliant on the cyclist’s bike handling skills and reaction time," according to the study.

The study aim was to identify risk factors for collisions/near-collisions involving on-road commuter cyclists and drivers. The cyclists wore helmet-mounted video cameras capturing cyclists’ perspective of the road and traffic behaviours including head checks, reactions and manoeuvres.

The study concluded: "Lastly, it is important to consider the role of the road infrastructure and cycling facilities in cyclist safety. A bicycle lane was present in less than half of the observed events and across all event severities.

"The cycling lanes observed were disjointed and often ended abruptly, frequently where the road narrowed, without a viable option for the cyclist who then either continued in the lane along the kerbside, directly competing with vehicular traffic for space, or rode (illegally) on the footpath.

"Greater consistency in cycling facility design is needed. A review of existing cycling facilities is also required to improve continuity and provide intuitive end-point options to ensure the road space afforded to cyclists is identifiable."

Participants in the study were adult cyclists and each filmed 12 hours of commuter cycling trips over a 4-week period. In total, 127 hours and 38 minutes were analysed for 13 participants, 54 events were identified: 2 collisions, 6 near-collisions and 46 incidents.

Car safety focus a bike minus

30 September 2010. Measures which have made roads safer for cars occupants may have done little to improve cyclist safety, according to a new study into cycling injuries in Australia.

While bike riders were over-represented in injuries relative to their exposure to traffic, they appeared to be under-represented in interventions aimed at reducing crashes and injuries.

The authors suggest that the large difference between Australian rider safety and that of other wealthy nations, and the difference between rider and car occupant safety within Australia indicated 'a safety blind spot'.

In addition they say that some factors that improve the safety of motor vehicle occupants may actually increase the risk to vulnerable road users (e.g., larger and heavier vehicles, bull bars).

They say that other research has indicated that as people in cars are made to feel safer, their driving causes more problems for other road users.

The findings are in a study "Cycling injuries in Australia: Road safety's blind spot", by J. Garrard, S Greaves, and A. Ellison from Deakin and Sydney Universities.

"A key factor for cyclist safety is vehicle speed, but Australia’s urban speed limits are high by international standards", the researchers say. "And the safety of cyclists and other vulnerable road users is afforded a lower priority than the achievement of small improvements in motor vehicle travel time.

"While road conditions affect both driver and cyclist safety, road hazards can have a greater impact on cyclists because bicycles, unlike cars, are single-track vehicles.

"It is important to acknowledge these basic differences, rather than ‘blaming’ cyclists for what are often perceived to be erratic or dangerous behaviours.

"It seems that in Australia, there is a low tolerance for cyclist mistakes and relatively little protection when they occur", they stated.

The report says that international experience demonstrates that cycling safety can be improved markedly using the same sort of strategic planning that has been used to improve safety for car occupants.

Improved cycling conditions that are likely to contribute to increased cycling safety include:

Riders no outlaws, says new research

15 September 2010. Media articles and surveys portraying bike riders as risk-takers who disobey traffic regulations were wrong, according to a new study which looked at all the bike crashes in Queensland over an eight year period.

In fact the analyses showed that the motor vehicle was at fault in 56 per cent of crashes which involved both a bike and a motor vehicle.

Interestingly, 85 per cent of those drivers copped a traffic violation, and most of those violations related to various forms of failing to give way to riders.

The study was undertaken by the Centre for Accident Research and Road Safety, Queensland (CARRS-Q) and examined 6774 bicycle crashes reported to police between January 2000 and December 2008.

The Queensland figures may not be directly applicable to Victoria as other research has found that driver behaviour is different (better) in places where there are larger numbers of cyclists on the road.

When cyclists were at fault in bike-motor vehicle crashes, the contributing factors were more often rider conditions (inattention/negligence or inexperience/lack of expertise) than traffic violations (28%).

As well as being less common, the nature of the traffic violations by riders differed from those of drivers. Disobeying a traffic light was the most common for cyclists.

The researchers were unable to draw reliable conclusions from the data relating to single bike crashes. Most of these were caused by riders taking evasive action to avoid another road user, or from lack of attention to road conditions.

One pattern to emerge in research was the timing of accidents with most occurring between 6am and 7am when recreational users headed out; or from 4.30pm to 5.30pm when commuter cyclists returned home from work.

Riders under 21 years or older than 80 had contributed to a significant number of accidents by taking risks or not following traffic rules.

This research indicated the diverse ages of people cycling in Queensland where the majority of cyclists involved in crashes have reached an age where they can hold a drivers licence. However a substantial portion are younger than 16 (29.9%), with 10.5% aged 11 or younger.

The researchers said a major limitation of this study was the low reporting of bicycle crashes with almost 90% of bicycle crashes go un-reported.

The researchers were critical of the Queensland Road Safety Strategy, which they said were designed to benefit vehicle occupants rather than cyclists and vulnerable road users in general.

"This research demonstrates that to improve the safety of cyclists, several strategies could be beneficial," they said.

"Younger bicycle riders could benefit from improved education regarding the road rules, and possibly improving skills when riding with traffic.

"A greater understanding of the impact of poor road surfaces on cycling safety may also reduce the risk of injury to cyclists.

"Rigorous enforcement of minor traffic offences for all road users, such as observing stop and give way signs, may result in greater improvements in cyclist safety in on-road situations. General education campaigns for all motorists emphasising the importance of focusing on the road, and of obscure traffic regulations (the requirement to open a car door safely) could also improve the safety of cyclists, and other road users."

The report is available here

Crash statistics

One of the best and most easily accessible sources of information is the VicRoads database of all road crashes in Victoria that have been reported by police. It is called Crash Stats.

It records such details about the crashes as where, when, types of vehicles involved, crash description and more.

You can search Crash Stats to answer all sorts of questions about cycling safety. You can also produce crash maps. The picture shows a crash map of the City of Stonnington. Chapel St has the highest number of bike crashes of any road in Victoria.

Questions include:

For instance, on St Kilda Rd we have been counting cyclists numbers at Southbank Boulevard for six years.

We can compare these numbers against the number of crashes on St Kilda Rd between St Kilda Junction and Southbank Blvd to show that the bike lanes have encouraged more cycling while crash numbers have remained relatively static.

In general the most crashes tend to be where the most cycling is, as there can't be a cycle crash without a cyclis.

It is important to note that the VicRoads Crash Stats only records on-road crashes reported to police. That means that police attended the crash or it was reported to them later.

It is generally accepted that lesser injuries (non-hospitalisations) are vastly under-reported in crash statistics, and that only about 20% are actually reported to police.

Also, Crash Stats only reports on-road crashes and does not usually include injuries and deaths that occur outside a road reserve, eg on a railway reserve, off-road path or stunt park.

In fact most bike crashes occur off-road and the only way to track them is through coronial information and hospital admissions data.

The Monash Accident Research Centre tracks this data and we have reported on it in our 1996 and 1998 review of bicycle crashes.

Bicycle Network Victoria also takes crash reports from our members as part of insurance claims, but this information has not been properly analysed or tracked year to year.

That said, Crash Stats is a consistent source of information for crashes and is generally comparable year to year. It also shows only the tip of the iceberg, but is a good reflection of what is under the water (or goes unreported in our analogy).

Bicycle Network Victoria seeks the coroner's report on all cycle deaths in Victoria and writes to the coroner on any cycle deaths we see in the papers or that come to our knowledge.

VicRoads also has other bicycle safety information and the Traffic Accident Commission and police also report on road deaths.