Bicycle safety for children: Overview of evidence-based

good practices

Morag Mackay & Joanne Vincenten European Child Safety Alliance

ECSA Workshop

Brussels, December 6, 2012

Child deaths due to cycling by age group Europe age standardised rate per 100 000 population 0-19 years by gender (using three year averages 2008-2010 or most recent three years of data available)

Source: WHO Extended Mortality Database

Child deaths due to cycling in ECSA partner countries Europe age standardised rate per 100 000 population 0-19 years by gender (using three year averages 2008-2010 or most recent three years of data available; Cyprus, Iceland, Luxembourg and Malta excluded due to small numbers; Greece excluded as ICD9 coding does not allow breakout)

Source: WHO Extended Mortality Database

Rates of injury death related to cycling vary by a magnitude of 40x between countries with highest and lowest rates!

•  Limited to mortality data in many countries

•  Police reports are not always comparable and it is not always possible to link to mortality/morbidity data

•  Few countries have exposure data to assist in interpreting mortality and morbidity data

•  Most data sources have little information on circumstances and are unreliable with respect to whether a helmet was worn at the time of the injury

Data challenges -

Factors related to risk of injury while cycling

Phase

Human

Vector or vehicle

Physical environment

Social Environment

Pre-event • age •  judgement • coordination

• bicycle condition

• cycling surface • exposure to

traffic • # of cyclists

• vehicle speeds • behaviour of

drivers and other cyclists

Event • helmet use • helmet worn

correctly

• bicycle design

• social norms re: helmet use

• helmet law • enforcement of

helmet law

Post-event • age • physical

condition

•  time to treatment

• availability of rehab programmes

•  training of first responders

•  training of EMS personnel

Evidence-based good practices to prevent/reduce cycling injuries

Phase

Human

Vector or vehicle

Physical environment

Social Environment

Pre-event • bicycle skills training*

• bicycle maintenance*

• bicycle paths • bicycle lanes • speed reducing

structures

• speed limits • enforcement of

speed limits • policies encouraging

safe cycling

Event • safe bicycle design*

• promotional campaigns on helmet use, driver awareness, safe cycling

• helmet law • enforcement of

helmet law

Post-event • EMS system set up to minimise time to treatment

•  rehab programmes

•  trained first responders

•  trained of EMS personnel

* Evidence more limited

Effective child cycling safety combines: v  Layers of protection to 1) prevent injury

incidents and 2) reduce the severity of injury in the event of an incident

v  A combination of education, engineering and enforcement strategies

v  Special attention to inequities

v  Cooperation of and collaboration between multiple disciplines and organisations

What the Child Safety Report Card assessment can and cannot tell us: •  15 countries have legislation requiring children

to wear helmets (2 others legislation in progress) –  Age at which helmet is required varies by country and

most helmet laws are specific to children –  Enforcement is an issue for many, with most checks

resulting in warnings –  Many countries depend on regular/on-going

promotional efforts to increase compliance

•  22 countries have conducted a national media campaigns on cycling safety in the past 5 years

•  Limited to national level policies thus no information on regional, municipal activities

Thank you! www.childsafetyeurope.org

This presentation uses results from the projects CSAP and TACTICS, which has received funding from the European Union, in the framework of the Health Programme.