Reducing the rate of serious injuries to cyclists

Comprehensive application of the Safe System approach is needed to protect vulnerable road users

The number of road fatalities in Victoria among motor vehicle occupants and motorcyclists declined significantly between 2007 and 2015, by about 4% per year. This has not been the case for pedal cyclists and pedestrians. Further, rates of traffic-related serious injuries have not changed for most road users, while the numbers of cycling injuries have increased 8% annually. The article by Beck and his co-authors in this issue of the MJA1 calls for increased investment in road safety to reduce the burden of traffic-related injury, particularly to pedal cyclists. Victoria already has a mandatory helmet law that is saving many cyclists from death and serious head injury, but this alone is not enough if, as a society, we aspire to eliminate traffic-related deaths and serious injuries altogether.

The Safe System approach to reducing road safety traffic injuries was adopted internationally, including Australia, more than a decade ago. It is founded on the biomechanical criterion that any forces imparted to those involved in a traffic accident must be survivable, allowing full recovery of health for the people involved. For example, the impact speed of a motor vehicle striking a person crossing a road or walking on a footpath should not exceed 30 km/h if the pedestrian is to survive the impact without permanent disabling injury. The same applies to cyclists and motorcyclists as vulnerable road users; however, the added advantage of wearing a helmet increases survivability in an accident.2-4

During the past decade, application of the Safe System approach in Australia has focused on improving the crashworthiness of cars through the Australasian New Car Assessment Program (ANCAP), which includes rating vehicles for the effects of impacts with vulnerable road users, and on installing flexible roadside and median crash barriers that safely redirect straying vehicles, installing rumble strips that rouse drowsy drivers, and widening road shoulders to assist steering recovery. Despite these efforts, serious injury rates have remained unchanged, although fatality numbers are falling. More efforts are clearly needed.

The report by Beck and colleagues1 particularly highlights the need for more to be done to reduce the risk of serious injury to cyclists. The increased burden of cycling crashes might be related to the rise in popularity of cycling in Australia. In 2015, 17.4% of Australians (more than 4 million) had ridden their bicycle in the previous week, compared with 16.5% in 2013.5 This is a positive trend, and more needs to be done to ensure the safety of riders.

Investing in cycling infrastructure achieved a high return in New South Wales in terms of reducing the number of cycling-related hospitalisations;6 it also increases the perception of safety among cyclists, and therefore increases cycling rates.7 Bicycle paths are more likely to reduce crash risks when they do not share space with parked cars, are marked for cyclists, and reduce the potential for conflict between cyclists and motorists at intersections with facilities such as advanced green lights and cyclist-activated traffic signals.8

Other aspects of the Safe System approach relevant to cycling include safe speeds and safe vehicles. There is strong evidence that reducing the general speed limit for motor vehicles improves the safety of cyclists, particularly reducing traffic speed to 30 km/h in residential areas.9 Speed is also an important factor for motor vehicle occupants; on an undivided road, for instance, the maximum speed should not exceed 70 km/h for a head-on crash or a frontal crash into a solid object for the crash to be survivable.

Recent advances in vehicle technology that may improve safety include vulnerable road user warning systems with radar and camera-based detection, and wireless technology that allows communication between cyclists and motor vehicles.10

In many European countries, reduced motor vehicle speed, separated bicycle paths, intersection treatments, and presumed liability laws (under which the onus is on drivers to prove that a collision with a cyclist or a pedestrian was not their fault) are all key measures credited with improving bicycle safety.11

For Australia, the focus should be on reducing the burden of serious injuries by expanding the implementation of the Safe System approach. Key elements include infrastructure that segregates motor vehicles from vulnerable road users, lower speed limits when inadequate infrastructure has been provided, personal protection devices, innovative technology, and legislation that protects vulnerable road users.