An in-depth analysis of self-reported cycling injuries in single and multiparty bicycle crashes in Denmark

Introduction: Cycling is one of the main forms of transportation in Denmark. However, while the number of traffic crash fatalities in the country has decreased over the past decade, the frequency of cyclists killed or seriously injured has increased. The high rate of serious injuries and fatalities associated with cycling emphasizes the increasing need for mitigating the severity of such crashes. Method: This study conducted an in-depth analysis of cyclist injury severity resulting from single and multiparty bicycle-involved crashes. Detailed information was collected using self-reporting data undertaken in Denmark for a 12-month period between 1 November 2012 and 31 October 2013. Separate multilevel logistic (MLL) regression models were applied to estimate cyclist injury severity for single and multiparty crashes. The goodness-of-fit measures favored the MLL models over the standard logistic models, capturing the intercorrelation among bicycle crashes that occurred in the same geographical area. Results: The results also showed that single bicycle-involved crashes resulted in more serious outcomes when compared to multiparty crashes. For both single and multiparty bicycle crash categories, non-urban areas were associated with more serious injury outcomes. For the single crashes, wet surface condition, autumn and summer seasons, evening and night periods, non-adverse weather conditions, cyclists aged between 45 and 64 years, male sex, riding for the purpose of work or educational activities, and bicycles with light turned-off were associated with severe injuries. For the multiparty crashes, intersections, bicycle paths, non-winter season, not being employed or retired, lower personal car ownership, and race bicycles were directly related to severe injury consequences. Practical Applications: The findings of this study demonstrated that the best way to promote cycling safety is the combination of improving the design and maintenance of cycling facilities, encouraging safe cycling behavior, and intensifying enforcement efforts.     

Are you an ambitious cyclist? Results of the cyclist profile questionnaire in Germany

Abstract

Objective: A number of studies have already grouped cyclists according to different aspects of their mobility behavior. This could be used e.g., to improve the bicycle infrastructure planning, to detect critical spots and, to reduce obstacles for cycling. This wide, preexisting, range of cyclist typologies usually concentrates on one or two influence factors and differs, content-wise, in both factors used, as well as, methodically. Based on existing cyclist typologies we extracted all possible influence factors to integrate them in one single questionnaire. The objective of this study, using an empirical, based approach, is to compare this typology of cyclists with existing ones, integrating all known influence factors of recent studies.

Methods: To address these issues, we conducted a Germany-wide online survey on cycling behavior, covering all relevant aspects we derived from both literature and especially, former cyclist typology studies including: social factors; the impact of environmental, individual; and route factors; as well as motives. The main goal was to identify distinct types of cyclists, and describe them as detailed as possible. The heterogeneous sample included a total of 10,294 responses.

Results: Using factor and cluster analyses, a multidimensional typology with four groups of cyclists was derived which were interpreted as: ambitious, functional, pragmatic, and passionate cyclists. In addition, socio-economic factors, cyclist’s motivation, and crash history were analyzed.

Conclusion: The results produced by grouping different characteristics of cyclists can lead to policy recommendations or communal bicycle traffic planning. Policy planners can estimate reactions of the different types on interventions and adjust their decisions which can serve to support already passionate cyclists or, encourage normally under-represented infrequent cyclists to cycle more. The extent of perceived safety plays here an important role in the classification, e.g., the handling of high-risk areas for crashes.     

Mobile phone use while riding a motorcycle and crashes among university students

Objective: Motorcycle crashes are a significant road safety challenge, particularly in many low- and middle-income countries where motorcycles represent the vast majority of their vehicle fleet. Though risky riding behaviors, such as speeding and riding under the influence of alcohol, have been identified as important contributors to motorcycle crashes, little is understood about the effect of using a mobile phone while riding on motorcycle crash involvement. This article investigates crash involvement among motorcycle riders with risky riding behaviors, particularly using a mobile phone while riding.

Methods: Data were obtained from an online survey of university students’ risky riding behaviors in Vietnam administered between March and May 2016 (n?=?665).

Results: Results show that 40% of motorcycle riders reported to have experienced a crash/fall and nearly 24% of motorcycle riders indicated that they had been injured in a crash/fall. Effects of mobile phone use while riding on safety of motorcycle riders are highlighted. Specifically, more frequent use of a mobile phone for texting or searching for information while riding is associated with a higher chance of being involved in a crash/fall. The results also show that drink riding is associated with a higher chance of being injured.

Conclusions: Overall this article reveals significant safety issues of using a mobile phone while riding a motorcycle, providing valuable insight for designing education and publicity campaigns.     

Characteristics of bicycle crashes among children and the effect of bicycle helmets

Abstract

Objective: Focusing on children (0–17?years), this study aimed to investigate injury and accident characteristics for bicyclists and to evaluate the use and protective effect of bicycle helmets.

Method: This nationwide Swedish study included children who had visited an emergency care center due to injuries from a bicycle crash. In order to investigate the causes of bicycle crashes, data from 2014 to 2016 were analyzed thoroughly (n?=?7967). The causes of the crashes were analyzed and categorized, focusing on 3 subgroups: children 0–6, 7–12, and 13–17?years of age. To assess helmet effectiveness, the induced exposure approach was applied using data from 2006 to 2016 (n?=?24,623). In order to control for crash severity, only bicyclists who had sustained at least one Abbreviated Injury Scale (AIS) 2+ injury (moderate injury or more severe) in body regions other than the head were included.

Results: In 82% of the cases the children were injured in a single-bicycle crash, and the proportion decreased with age (0–6: 91%, 7–12: 84%, 13–17: 77%). Of AIS 2+ injuries, 8% were head injuries and 85% were injuries to the extremities (73% upper extremities and 13% lower extremities). Helmet use was relatively high up to the age of 10 (90%), after which it dropped. Helmets were much less frequently used by teenagers (14%), especially girls. Consistently, the share of head injuries increased as the children got older. Bicycle helmets were found to reduce all head injuries by 61% (95% confidence interval [CI], 10: +/? 10%) and AIS 2+ head injuries by 68% (95% CI, 12: +/? 12%). The effectiveness in reducing face injuries was lower (45% CI +/? 10% for all injuries and 54% CI +/? 32% for AIS2+ injuries).

Conclusions: This study indicated that bicycle helmets effectively reduce injuries to the head and face. The results thus point to the need for actions aimed at increasing helmet use, especially among teenagers. Protective measures are necessary to further reduce injuries, especially to the upper extremities.     

The effect of speed limit reductions in urban areas on cyclists’ injuries in collisions with cars

Abstract

Objective: Impact speed is one of the most important factors explaining the severity of injuries to cyclists when they collide with passenger cars. To reduce injury severity (especially for vulnerable road users), since 2008, Swedish municipalities have the authority to lower the speed limit to 30 or 40?km/h in urban areas as appropriate. The aim of this study was to evaluate how this speed limit reduction has influenced the injury severity for cyclists in this type of collision.

Method: Data from 1,953 collisions between bicycles and passenger cars were collected using information from third-party-liability insurance claims from 2005 to 2017. The change of speed limit distribution, influenced by the reduction of speed limits in urban areas, where car-to-cyclist collisions occurred was studied. Following that, injury severity for cyclists was evaluated regarding collisions occurring in areas with different speed limits.

Results: The results show that, in collisions with cars, cyclists have a significantly lower risk of a moderate-to-fatal (MAIS 2+) injury when the speed limit is 30–40?km/h compared to 50–60?km/h. During the last decade, while the speed-limit has been lowered on many road-sections in urban areas from 50–60?km/h to 30–40?km/h the risk of a cyclist getting a MAIS 2+ injury decreased by 25%. In 2005 to 2011, 16% of the crashes happened on a road with a speed limit of 30–40?km/h; in 2016–2017, this percentage had increased to approximately 50%. Thus, in recent years more crashes occurred on roads with lower speed limits, and in these crashes, there was a lower risk of severe injuries to cyclists. Unfortunately, it was not possible to evaluate the risk of a crash for specific speed limits; since one limitation of this study was the lack of exposure data, nor do we know the impact speed or the actual speed of the vehicles.

Conclusions: This study is an important follow-up on the implementation of measures that can influence bicycle safety. The insurance data used, made it possible to quantify a positive effect on injury severity for cyclists in passenger car-to-cyclist collisions when the speed limit was reduced in urban areas. Insurance claims cover collisions of all crash severity, so they include data covering all types of injuries—not just the most severe/fatal ones. This aspect is especially important in the speed intervals evaluated here, since moderate (MAIS 2) injuries are very frequent in lower-speed crashes and even these injuries can result in long-term consequences.     

Exploring the severity of bicycle–vehicle crashes using latent class clustering approach in India

IntroductionBicyclists are vulnerable users in the shared asset like roadways. However, people still prefer to use bicycles for environmental, societal, and health benefits. In India, the bicycle plays a role in supporting the mobility to more people at lower cost and are often associated with the urban poor. Bicyclists represents one of the road user categories with highest risk of injuries and fatalities. According to the report by the Ministry of Road Transport and Highways (Accidents, 2017) in India, there is a sharp increase in the number of fatal victims for bicyclists in 2017 over 2016. The number of cyclists killed jumped from 2,585 in 2016 to 3,559 in 2017, a 37.7% increase. Method: Few studies have only investigated the crash risk perceived by the bicyclists while interacting with other road users. The present paper investigates the injury severity of bicyclists in bicycle-vehicle crashes that occurred in the state of Tamilnadu, India during the nine year period (2009–2017). The analyses demonstrate that dividing bicycle-vehicle collision data into five clusters helps in reducing the systematic heterogeneity present in the data and identify the hidden relationship between the injury severity levels of bicyclists and cyclists demographics, vehicle, environmental, temporal cause for the crashes. Results: Latent Class Clustering (LCC) approach was used in the present study as a preliminary tool for the segmentation of 9,978 crashes. Later, logistic regression analysis was used to identify the factors that influence bicycle crash severity for the whole dataset as well as for the clusters that were obtained from the LCC model. Results of this study show that combined use of both techniques reveals further information that wouldn’t be obtained without prior segmentation of the data. Few variables such as season, weather conditions, and light conditions were significant for certain clusters that were hidden in the whole dataset. This study can help domain experts or traffic safety researchers to segment traffic crashes and develop targeted countermeasures to mitigate injury severity.     

Serious road injuries in The Netherlands dissected

Objective: This article discusses the characteristics and injury patterns of serious road injuries (Maximum Abbreviated Injury Scale [MAIS] 2+ inpatients) in The Netherlands.

Methods: In The Netherlands, the actual number of serious injuries is estimated by linking police data to hospital data. The distribution of serious road injuries over (1) travel mode and gender and (2) crash type and age are compared for the years 2000 and 2011. Moreover, the distribution of the injuries over the body regions is illustrated using colored injury body profiles.

Results: The number of serious injuries is higher for men than for women and increased from 16,500 in 2000 to 19,700 in 2011. In 2011, about half (51%) of the serious road injuries were due to a bicycle crash not involving a motor vehicle. The share of casualties aged 60 years and older is relatively high (43% in 2011) in these crashes. The injury body profiles show that head injuries (31%) and injuries to the lower extremities (37%) are most prevalent. Compared to other travel modes, pedestrians and riders of powered 2-wheelers relatively often sustain lower-leg injuries compared to other travel modes. Head injuries are most prevalent in cyclists who are injured in a crash with a motorized vehicle. Cyclists who are injured in a crash not involving a motor vehicle and casualties of 60 years and older relatively often include hip or upper-leg injuries.

Conclusion: The characteristics of serious road injuries differ from those of fatalities and the distribution of injuries over the body differs by travel mode, gender, and age.     

Crash histories,safety perceptions,and attitudes among Virginia bicyclists

IntroductionCycling injury and fatality rates are on the rise, yet there exists no comprehensive database for bicycle crash injury data.MethodWidely used for safety analysis, police crash report datasets are automobile-oriented and widely known to under-report bicycle crashes. This research is one attempt to address gaps in bicycle data in sources like police crash reports. A survey was developed and deployed to enhance the quality and quantity of available bicycle safety data in Virginia. The survey captures bicyclist attitudes and perceptions of safety as well as bicycle crash histories of respondents.ResultsThe results of this survey most notably show very high levels of under-reporting of bicycle crashes, with only 12% of the crashes recorded in this survey reported to police. Additionally, the results of this work show that lack of knowledge concerning bicycle laws is associated with lower levels of cycling confidence. Count model results predict that bicyclists who stop completely at traffic signals are 40% less likely to be involved in crashes compared to counterparts who sometimes stop at signals. In this dataset, suburban and urban roads with designated bike lanes had more favorable injury severity profiles, with lower percentages of severe and minor injury crashes compared to similar roads with a shared bike/automobile lane or no designated bike infrastructure.     

Global bike share: What the data tells us about road safety

IntroductionBike share has emerged as a rapidly growing mode of transport in over 800 cities globally, up from just a handful in the 1990s. Some analysts had forecast a rise in the number of bicycle crashes after the introduction of bike share, but empirical research on bike share safety is rare. The goal of this study is to examine the impact of bike share programs on cycling safety.MethodsThe paper has two substudies. Study 1 was a secondary analysis of longitudinal hospital injury data from the Graves et al. (2014) study. It compared cycling safety in cities that introduced bike share programs with cities that did not. Study 2 combined ridership data with crash data of selected North American and European cities to compare bike share users to other cyclists.ResultsStudy 1 indicated that the introduction of a bike share system was associated with a reduction in cycling injury risk. Study 2 found that bike share users were less likely than other cyclists to sustain fatal or severe injuries.ConclusionsOn a per kilometer basis, bike share is associated with decreased risk of both fatal and non-fatal bicycle crashes when compared to private bike riding.Practical ApplicationsThe results of this study suggest that concerns of decreased levels of cycling safety are unjustified and should not prevent decision makers from introducing public bike share schemes, especially if combined with other safety measures like traffic calming.     

An Analysis of Young Driver Crash Types and the Associated Lifetime Care Cost in Victoria,Australia

Objective: The elevated crash involvement rate of young drivers is well documented. Given the higher crash risk of young drivers and the need for innovative policy and programs, it remains important to fully understand the type of crashes young drivers are involved in, and knowledge of the lifetime care cost of crashes can support effective policy development. The aim of this article is to document the number and type of young driver crashes, as well as the associated lifetime care cost over a 9-year period (2005–2013) in Victoria, Australia.

Methods: In Victoria, Australia, the Transport Accident Commission (TAC) has legislated responsibility for road safety and the care of persons injured in road crashes, irrespective of fault. TAC claims data for the period 2005–2013 were used to document the number and type of young driver crashes. Lifetime care costs (past and future payment liabilities) were calculated by Taylor Fry actuarial consultancy. License and population data were used to define the crash involvement rate of young drivers.

Results: Over the 9-year period, 16,817 claims were lodged to the TAC by drivers 18–25 years of age following a crash. There were 646 fewer drivers aged 18–25 killed and injured in 2013, compared to 2005, representing an unadjusted change of ?28.7% (?29.8% males; ?28.4% females). The total lifetime care cost of young drivers killed and injured in Victoria for the period 2005–2013 was estimated to be AU$634 million (US$493 million). Differences between males and females, single- and multivehicle crashes, and fatalities and injuries were found to be statistically significant. Run-off-road crashes and crashes from opposing direction were overrepresented in the lifetime care costs for young driver claimants. Twenty-eight injured drivers were classified as high-severity claims. These 28 claimants require additional long-term care, which was estimated to be AU$219 million; of these 28, 24 were male (85.7%). The long-term care costs for these 28 drivers (0.16%) accounts for 34.5% of the total lifetime care cost of all 18- to 25-year-old injured drivers.

Conclusions: By using no-fault lifetime care costs that account for medical and like expenses, rehabilitation, and social reintegration costs, a more accurate understanding of the cost of young driver crashes can be determined. Application of these costs to specific crash types highlights new priorities and opportunities for developing programs to reduce young driver crashes.     

Differences in Long-term Medical Consequences Depending on Impact Direction Involving Passenger Cars

Objective: There is limited knowledge of the long-term medical consequences for occupants injured in car crashes in various impact directions. Thus, the objective was to evaluate whether injuries leading to permanent medical impairment differ depending on impact direction.

Methods: In total, 36,743 injured occupants in car crashes that occurred between 1995 and 2011 were included. All initial injuries (n = 61,440) were classified according to the Abbreviated Injury Scale (AIS) 2005. Injured car occupants were followed for at least 3 years to assess permanent medical impairment. The data were divided into different groups according to impact direction and levels of permanent impairment. The risk of permanent medical impairment was established for different body regions and injury severity levels, according to AIS.

Results: It was found that almost 12% of all car occupants sustained a permanent medical impairment. Given an injury, car occupants involved in rollover crashes had the highest overall risk to sustain a permanent medical impairment. Half of the head injuries leading to long-term consequences occurred in frontal impacts. Far-side occupants had almost the same risk as near-side occupants. Occupants who sustained a permanent medical impairment from cervical spine injuries had similar risk in all impact directions (13%) except from rollover (17%). However, these injuries occurred more often in rear crashes. Most of the injuries leading to long-term consequences were classified as minor injuries by AIS for all impact directions.

Conclusions: Studying crash data from a perspective of medical impairment is important to identify injuries that might not be prioritized only considering the AIS but might lead to lower quality of life for the occupant and also costs for society. These results can be used for road transport system strategies and for making priority decisions in vehicle design.     

Built environment effects on bike crash frequency and risk in Beijing

IntroductionBuilding a safe biking environment is crucial to encouraging bicycle use. In developed areas with higher density and more mixed land use, the built environment factors that pose a crash risk may vary. This study investigates the connection between biking risk factors and the compact built environment, using data for Beijing.MethodIn the context of China, this paper seeks to answer two research questions. First, what types of built environment factors are correlated with bike-automobile crash frequency and risk? Second, how do risk factors vary across different types of bikes? Poisson lognormal random effects models are employed to examine how land use and roadway design factors are associated with the bike-automobile crashes.ResultsThe main findings are: (1) bike-automobile crashes are more likely to occur in densely developed areas, which is characterized by higher population density, more mixed land use, denser roads and junctions, and more parking lots; (2) areas with greater ground transit are correlated with more bike-automobile crashes and higher risks of involving in collisions; (3) the percentages of wider streets show negative associations with bike crash frequency; (4) built environment factors cannot help explain factors contributing to motorcycle-automobile crashes.Practical ApplicationsIn China's dense urban context, important policy implications for bicycle safety improvement drawn from this study include: prioritizing safety programs in urban centers, applying safety improvements to areas with more ground transit, placing bike-automobile crash countermeasures at road junctions, and improving bicycle safety on narrower streets.     

Injury Outcome in Crashes with Guardrail End Terminals

Objective: The goal of this study is to evaluate the crash performance of guardrail end terminals in real-world crashes. Guardrail end terminals are installed at the ends of guardrail systems to prevent the rail from spearing through the car in an end-on collision. Recently, there has been a great deal of controversy as to the safety of certain widely used end terminal designs, partly because there is surprisingly little real-world crash data for end terminals. Most existing studies of end terminal crashes used data from prior to the mid-1990s. Since then, there have been large improvements to vehicle crashworthiness and seat belt usage rates, as well as new roadside safety hardware compliant with National Cooperative Highway Research Program (NCHRP) Report 350, “Recommended Procedures for the Safety Performance Evaluation of Highway Features.” Additionally, most existing studies of injury in end terminal crashes do not account for factors such as the occurrence of rollover. This analysis uses more recent crash data that represent post-1990s vehicle fleet changes and account for a number of factors that may affect driver injury outcome and rollover occurrence.

Methods: Passenger vehicle crashes coded as involving guardrail end terminals were identified in the set of police-reported crashes in Michigan in 2011 and 2012. End terminal performance was expected to be a function of end terminal system design. State crash databases generally do not identify specific end terminal systems. In this study, the coded crash location was used to obtain photographs of the crash site prior to the crash from Google Street View. These site photographs were manually inspected to identify the particular end terminal system involved in the crash. Multiple logistic regression was used to test for significant differences in the odds of driver injury and rollover between different terminal types while accounting for other factors.

Results: A total of 1,001 end terminal crashes from the 2011–2012 Michigan State crash data were manually inspected to identify the terminal that had been struck. Four hundred fifty-one crashes were found to be suitable for analysis. Serious to fatal driver injury occurred in 3.8% of end terminal crashes, moderate to fatal driver injury occurred in 11.8%, and 72.3% involved property damage only. No significant difference in moderate to fatal driver injury odds was observed between NCHRP 350 compliant end terminals and noncompliant terminals. Car drivers showed odds of moderate to fatal injury 3.6 times greater than LTV drivers in end terminal crashes. Rollover occurrence was not significantly associated with end terminal type.

Conclusions: Car drivers have greater potential for injury in end terminal crashes than light truck/van/sport utility vehicle drivers. End terminal designs compliant with NCHRP 350 did not appear to carry different odds of moderate driver injury than noncompliant end terminals. The findings account for driver seat belt use, rollover occurrence, terminal orientation (leading/trailing), control loss, and the number of impact events. Rollover and nonuse of seat belts carried much larger increases in injury potential than end terminal type. Rollover did not appear to be associated with NCHRP 350 compliance.     

Fatal and serious collisions involving pedal cyclists and trucks in London between 2007 and 2011

Objective: Increased numbers of people riding pedal cycles have led to a greater focus on pedal cycle safety. The aim of this article is to explore factors that are associated with fatal and a small number of serious-injury pedal cyclist crashes involving trucks that occurred in London between 2007 and 2011.

Methods: Data were collected from police collision files for 53 crashes, 27 of which involved a truck (≥3.5 tonnes) and a pedal cycle. A systematic case review approach was used to identify the infrastructure, vehicle road user, and management factors that contributed to these crashes and injuries and how these factors interacted.

Results: Trucks turning left conflicting with pedal cyclists traveling straight ahead was a common crash scenario. Key contributory factors identified included the pedal cyclists not being visible to the truck drivers, road narrowing, and inappropriate positioning of pedal cyclists.

Conclusions: Crashes involving trucks and pedal cyclists are complex events that are caused by multiple interacting factors; therefore, multiple measures are required to prevent them from occurring.     

Using latent class clustering and binary logistic regression to model Australian cyclist injury severity in motor vehicle–bicycle crashes

Introduction: In recent years, Australia is seeing an increase in the total number of cyclists. However, the rise of serious injuries and fatalities to cyclists has been a major concern. Understanding the factors affecting the fatalities and injuries of bicyclists in crashes with motor vehicles is important to develop effective policy measures aimed at improving the safety of bicyclists. This study aims to identify the factors affecting motor vehicle-bicycle (MVB) crashes in Victoria, Australia and introducing effective countermeasures for the identified risk factors. Method: A data set of 14,759 MVB crash records from Victoria, Australia between 2006 and 2019 was analyzed using the binary logit model and latent class clustering. Results: It was observed that the factors that increase the risk of fatalities and serious injuries of bicyclists (FSI) in all clusters are: elderly bicyclist, not using a helmet, and darkness condition. Likewise, in areas with no traffic control, clear weather, and dry surface condition (cluster 1), high speed limits increase the risk of FSI, but the occurrence of MVB crashes in cross intersection and T-intersection has been significantly associated with a reduction in the risk of FSI. In areas with traffic control and unfavorable weather conditions (cluster 2), wet road surface increases the risk of FSI, but the areas with give way sign and pedestrian crossing signs reduce the risk of FSI. Practical Applications: Recommendations to reduce the risk of fatalities or serious injury to bicyclists are: improvement of road lighting and more exposure of bicyclists using reflective clothing and reflectors, separation of the bicycle and vehicle path in mid blocks especially in high-speed areas, using a more stable bicycle for the older people, monitoring helmet use, improving autonomous emergency braking, and using bicyclist detection technology for vehicles.     

The potential of vehicle and road infrastructure interventions in fatal bicyclist accidents on Swedish roads—What can in-depth studies tell us?

Abstract

Objective: The objective of this article is to describe the characteristics of fatal crashes with bicyclists on Swedish roads in rural and urban areas and to investigate the potential of bicycle helmets and different vehicle and road infrastructure interventions to prevent them. The study has a comprehensive approach to provide road authorities and vehicle manufacturers with recommendations for future priorities.

Methods: The Swedish Transport Administration’s (STA) in-depth database of fatal crashes was used for case-by-case analysis of fatal cycling accidents (2006–2016) on rural (n?=?82) and urban (n?=?102) roads. The database consists of information from the police, medical journals, autopsy reports, accident analyses performed by STA, and witness statements. The potential of helmet use and various vehicle and road infrastructure safety interventions was determined retrospectively for each case by analyzing the chain of events leading to the fatality. The potential of vehicle safety countermeasures was analyzed based on prognoses on their implementation rates in the Swedish vehicle fleet.

Results: The most common accident scenario on rural roads was that the bicyclist was struck while cycling along the side of the road. On urban roads, the majority of accidents occurred in intersections. Most accidents involved a passenger car, but heavy trucks were also common, especially in urban areas. Most accidents occurred in daylight conditions (73%). Almost half (46%) of nonhelmeted bicyclists would have survived with a helmet. It was assessed that nearly 60% of the fatal accidents could be addressed by advanced vehicle safety technologies, especially autonomous emergency braking with the ability to detect bicyclists. With regard to interventions in the road infrastructure, separated paths for bicyclists and bicycle crossings with speed calming measures were found to have the greatest safety potential. Results indicated that 91% of fatally injured bicyclists could potentially be saved with known techniques. However, it will take a long time for such technologies to be widespread.

Conclusions: The majority of fatally injured bicyclists studied could potentially be saved with known techniques. A speedy implementation of important vehicle safety systems is recommended. A fast introduction of effective interventions in the road infrastructure is also necessary, preferably with a plan for prioritization.