Using hospital data to strengthen cycle advocacy

1. Using hospital data to strengthen cycle advocacy Rob Benington Injury Prevention Manager, Avonsafe Co-ordinator

2. http://www.theguardian.com/environment/bike-blog/2013/jan/16/cycling-parliamentary-inquiry-evidencehttp://www.theguardian.com/environment/bike-blog/2013/jan/16/cycling-parliamentary-inquiry-evidence http://travel.cnn.com/sydney/play/cyclists-revolution-bike-paths-cover-sydney-509438

3. Public Health Outcomes • Excess weight 4-5 and 10-11 year olds • Excess weight in adults • Proportion of physically active and inactive adults • Childhood emergency admissions due to injury • Road Safety (KSI) • Utilisation of outdoor space for exercise / health • Mortality due to air pollution, causes considered preventable, cancer, and CVD • Carbon management Balance?

4. An integrated approach

5. What encourages cycling? • Improved infrastructure • Confidence (Training, road danger reduction) • Confidence (Fewer incidents and injuries) • Cycle friendly employers • Relevant image

6. What’s stopping us cycling? • Perception of risk and hazard • Traffic speeds • Reported and previous injuries • Lack of convenience • Severance and lack of permeability • Poor or undesirable infrastructure • Lack of confidence • Physical ability • Image of cyclists and cycling

7. Injuries (risk) = x exposure hazard

8. People Hours (Exposure) Injury Burden (Emergency admissions) x Aggregate Hazard = n (

10. “A total of 3,192 people were killed or seriously injured on UK roads while riding a bicycle last year”. The Times, 5-11-12 A total of 17,653 English cyclists were admitted to hospital with an injury during 2011-12. www.hesonline.nhs.uk c. 13% of all attendances at emergency departments are admitted. Ormel, 1999 c. 135,700 cyclists from England and c. 160,000from the UK were admitted to hospital or treated in an emergency department during 2011-12. NHS Bristol, 2012

12. Travel and transport injuries Non-collision injuries

13. What causes non-collisions Slippery road surfaces Poor road surface Kerbs and rail lines Cyclist related causes “An introduction to non-collision cycling incidents”. NHS Bristol, 2012. www.tinyurl.com\avonsafecycling

14. What we don’t know What works? What makes some children more likely to sustain NCIs

15. Summary • Injury (and hazard) discourages people from cycling • Managing hazard will facilitate cycling • Most cycling injuries are caused by non-collision incidents

16. What might reduce the hazard of NCI’s? • Improved infrastructure • Training • Fewer incidents and injuries • Cycle friendly employers • Improved image (= more cycling = better cyclists)

17. 1. Infrastructure

26. 2. Training • Safe riding strategy (Explicit consideration of alternative mode of travel if weather conditions, personal health or bike maintenance require it). Spot Hazards – List of significant hazards could be included in L2 • How to traverse kerbs and rail lines (While mentioned in L3 an observed demonstration should be required) • Uneven road surfaces (L3; Speed can be good) • + Others? Blue Light runs, RRAGAR

27. Addressing non-collision cycling hazards will help make cycling a more attractive travel option. It is optimal to pursue public health priorities through an integrated approach. Research is at an embryonic stage.

28. www.tinyurl.com\avonsafecycling Robert.benington@bristol.gov.uk