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Cycle commuters face greater risk of injury, finds new study – authors call for safe infrastructure

People who travel to work by bike are less prone to cardiovascular disease, cancer and premature death, however

A major new study has found that people who commute by bike in the UK are significantly more likely to be admitted to hospital due to injury than those who travel to work by other modes of transport. At the same time, however, researchers found that they also had a lower risk of cardiovascular disease, cancer, and premature death than non-cycle commuters.

Researchers from the University of Glasgow, who reached their conclusions after assessing data from 230,390 commuters who participate in the UK Biobank study, say that the findings highlight the need to provide safe infrastructure for cyclists.

The data revealed that 2.5 per cent of participants – 5,704 individuals – cycled to work. After a follow-up period of 8.9 years, it was discovered that 4.4 per cent of all subjects had been admitted to hospital because of injury at least once during that time, or had died due to an injury.

That rose to 7 per cent among those who cycled to work, with the study, published in the BMJ, finding that they had a 45 per cent greater risk of injury compared to those travelling by “non-active” modes such as cars or public transport.

The risk of injury for cyclists also increased with the length of their commute.

In common with previous research, however, the study also found that people cycling to work were less likely than non-active commuters to contract heart disease, cancer and suffer early death.

The risk of cardiovascular disease was 21 per cent lower, that of a first diagnosis of cancer 11 per cent lower, and of premature death 12 per cent lower.

The study said: “Compared with non-active commuting to work, commuting by cycling was associated with a higher risk of hospital admission for a first injury and higher risk of transport related incidents specifically.

“These risks should be viewed in context of the health benefits of active commuting and underscore the need for a safer infrastructure for cycling in the UK.”

Lead author Dr Paul Welsh of the University of Glasgow commented: “Now, as a result of this research, we can to some extent quantify the risk associated with this form of commuting.

“If 1,000 people incorporate cycling into their commute for 10 years we would expect 26 more injuries, but 15 fewer cancers, four fewer heart disease events, and three fewer deaths.

“So, the benefits offset the risks, and this should be encouraging, but more needs to done to make commuter cycling safe,” he added.

Simon joined road.cc as news editor in 2009 and is now the site’s community editor, acting as a link between the team producing the content and our readers. A law and languages graduate, published translator and former retail analyst, he has reported on issues as diverse as cycling-related court cases, anti-doping investigations, the latest developments in the bike industry and the sport’s biggest races. Now back in London full-time after 15 years living in Oxford and Cambridge, he loves cycling along the Thames but misses having his former riding buddy, Elodie the miniature schnauzer, in the basket in front of him.

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25 comments

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Pyro Tim | 4 years ago
0 likes

Why do cyclist injuries always mean more infra? It's bullshit. You are suggesting it's impossible for drivers to actually drive safely. Injuries mean we need to improve standards of driving. More education and more enforcement.

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eburtthebike replied to Pyro Tim | 4 years ago
8 likes

"Why do cyclist injuries always mean more infra?"

Ummm, because that's what the evidence shows?  Yes, it wouldn't be necessary if all drivers drove responsibly and carefully all the time, but it is more effective and quicker to build proper infrastructure than to retrain 30 million people, who would be reluctant students.

When enough infra has been built to get the cycling rate up to say 10%, there will be enough cyclists to make the drivers more responsible and more aware of them, and hopefully a change in the societal and media perception of cyclists as a problem.  You certainly could try implementing an education system for drivers, but it would require huge resources, both financial and human and would take years anyway, and with no guarantee of success.  We know what succeeds, so let's start with that.

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Pyro Tim replied to eburtthebike | 4 years ago
3 likes

Bollocks does it. Infra is a red herring. It's not the reason the Dutch cycle or anyone else. The infra came long after most were cycling over there. We need to change cultural attitudes. Painting a white line or putting up shared use signs is a pointless waste of time and energy. Even the cycle superways of London are slow, inconvenient and indirect. Separating bikes from traffic means drivers are less able to deal with them when there isn't infra, or simply treat us awfully for not using it. Education and enforcement is the cheapest and easiest way to change the attitudes. 

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eburtthebike replied to Pyro Tim | 4 years ago
9 likes

Pyro Tim wrote:

Bollocks does it. Infra is a red herring. It's not the reason the Dutch cycle or anyone else. The infra came long after most were cycling over there. We need to change cultural attitudes. Painting a white line or putting up shared use signs is a pointless waste of time and energy. Even the cycle superways of London are slow, inconvenient and indirect. Separating bikes from traffic means drivers are less able to deal with them when there isn't infra, or simply treat us awfully for not using it. Education and enforcement is the cheapest and easiest way to change the attitudes. 

That's funny, every authoritative, knowledgeable person and organisation thinks the best way to get more people cycling is infra, and that is what the evidence shows.  Perhaps you could post some references to support your totally opposing view?

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mr_pickles2 replied to Pyro Tim | 4 years ago
10 likes

The UK actually had higher rates of cycling than the Netherlands up until the 1950s and early 60s, so the argument that it is a cultral thing is false. Cycling levels had fallen drastically by the early 70s in both countries due to motor traffic dominating the roads, but the Netherlands decided to persue a policy of building quality cycle infrastructure from the 70s onwards, unlike the UK which is why we have such a difference between the countries in terms of cycling as modal share today. 

It's great that you are comfortable and able to cycle in heavy motor traffic along roads which have been designed or reconfigured only to serve the needs of motorists, but I know that my mother, sisters and most friends would never hop onto a bike instead of use the car to make their short local journeys because they're scared of mixing with other faster, more powerful vehicles. Cycle-specific infrastructure allows everyone to benefit from cycling by increasing the perception of and actual safety, and still doesn't stop you from using the main carriageway if you wish.

There have been hundreds of driver education/awareness campaigns over the decades in loads of different countries, yet nowhere has managed to actually get drivers to stick to what they're taught to the extent that they enjoy high cycling modal shares with no infrastructure investment, i.e. these campaigns fail every time. Even with draconian, all-seeing enforcement which could make them effective, in the long-run it would just be cheaper to invest that money in provien-to-work infrastructure which by design enforces certain behaviours.

And as for the argument about drivers not being able to deal with cyclists: if there was a comprehensive national and local-level network of infratructure, more people would be cycling in the first place (so they're more common on the roads) and the vast majority of drivers would themselves be cyclists some of the time, or know someone who does cycle and would be careful around and be able to handle interacting with bikes fine as a result. It's also a bit paradoxial to expect all drivers to be good enough to be re-educated to behave better around cyclists, but also say that they're too thick to cope when they come across a cyclist on the road. 

There's plenty of cases where cyclists mix with motor traffic in the Netherlands (which I have expereicned first hand) yet somehow drivers can regulate thier behaviour and still follow rules!

Note: I do agree that shared-use pavements and white lines are not infrastructure, and am referring to infrastructure = dutch-style cycle design.
 

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Gimpl replied to mr_pickles2 | 4 years ago
4 likes

mr_pickles2 wrote:

And as for the argument about drivers not being able to deal with cyclists: if there was a comprehensive national and local-level network of infratructure, more people would be cycling in the first place (so they're more common on the roads) and the vast majority of drivers would themselves be cyclists some of the time, or know someone who does cycle and would be careful around and be able to handle interacting with bikes fine as a result. 

It's often touted that infrastructure is the answer but I'm not sure it is - definitely not on it's own.

Living in Milton Keynes we have a completly seperate infrastructure for walking and cycling; well away from the roads (for the most part).  It certainly hasn't encouraged everyone here to cycle. I commuted into CMK for about 9 months recently and I would get completely blank looks from my colleagues when they asked me where I park - 'right outside, my bike's chained to a lampost'. Cue incredulation from people who were driving a couple of miles in heavy traffic and still having to walk for 5-10 minutes to get into the office from where they had managed to find a space. It didn't matter that I got home quicker than them it just would not compute. Hell - even my own Stepdaughter wouldn't commute in by bike and her journey was less than a mile!

And then we can talk about how well that infrastructure is maintained - National cycle route 51 runs parallel to the A5 up to the bridge over the A5 and railway line - in that 9 month commute not once was it ever cleared of debris or leaves or maintained in any way at all. It was absolutely bloody lethal when all the leaves dropped off the trees. You frequently see smashed glass, block paving missing, tree roots and all manner of other debris - I'm not sure it's maintained at all.

So, I don't agree that infrastructure would encourage more people to ride; I don't think that infrastructure on it's own is enough to pursuade people to leave their cars and if new infrastructure is put in place there needs to be accountability for the maintenance too. 

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dave atkinson replied to Gimpl | 4 years ago
7 likes

Milton Keynes is a town entirely designed around the motor vehicle, so it's no surprise people drive into it: all the visual cues suggest that's exactly what you should do. To increase active travel you need to make it the attractive option, and that means making driving unattractive.

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Gimpl replied to dave atkinson | 4 years ago
0 likes

Yes - MK has arguably the best road network in the UK however it also has arguably the best shared use path network in the UK too. This is something that I see touted on here all the time about being the solution to all our problems. It really isn't - as you quite rightly say there needs be incentives for people to actually use it!

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ktache replied to Gimpl | 4 years ago
2 likes

But wasn't MK built as a motorists paradise.

If the cycling infrastructure, which I do hear can be badly maintained, is anything like Bracknell's, which are fairly good, you very rarely know where you are or where you are going, signposting is nonexistant and there are very few visual cues, much like riding on Birmingham's canals.  You need "local knowledge", which is often gained by getting lost a bit, which is never good on the commute.  I, for one, stick quite ridgedly to commuting routes, exploring and finding out "ooh, I wonder what's down there?" is not something you can do on a morning commute, and find difficult to find the energy for in the evening.  I properly need a good reason, that road is too effing dangerous, and there are good maps, it's often not an easy ask.    It does get done, though, and can give multiple routes for different needs, shops and floods and closures.

They also feature many of the "Dreaded Underpasses", dark, secluded and smell places, something that the NLs seems to manage without.

The NLs has also alongside quality infrastructure, which increased cycling, which meant more infrastructure in a virtuous cycle, made motoring slightly more difficult, or at least not as easy.  Much as Brum is attempting with it's modular city centre.  With associated cries of outrage.

Apparently constantly sitting in congestion doesn't make driving everywhere difficult enough.

I have one co worker who seems obsessed in how awful my ride in MUST be.  I get the sights, sounds and smells of the world, the nuances of the changes of season.  I might get filthy and wet, but I really look forward to it.  I have seen the beautiful flash of blue of Kingfishers.  TWICE!

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eburtthebike replied to Gimpl | 4 years ago
1 like

I've had the dubious pleasure of cycling around MK, and it is anything but Dutch level cycle provision, and even the locals didn't know where it went.

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Gimpl replied to eburtthebike | 4 years ago
0 likes

No - it's probably better as it's completely segregated from the road. Also it's really very scenic for the most part, you see a completely different side to the city. Signposting is ok, but could be better. Maps are available too. 

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dave atkinson replied to Pyro Tim | 4 years ago
13 likes

Pyro Tim wrote:

Painting a white line or putting up shared use signs is a pointless waste of time and energy. 

don't think you'll have many people arguing with you there. what you need is to take space away from cars, and give it to active travel. like they did in Amsterdam.

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kevvjj replied to Pyro Tim | 4 years ago
6 likes

you need to read some history... the Dutch (children mostly) were being massacred by cars and a lack of infra. The Dutch protested and infra was built, THEN the masses took up cycling.

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Boopop replied to Pyro Tim | 4 years ago
2 likes

Pyro Tim wrote:

Bollocks does it. Infra is a red herring. It's not the reason the Dutch cycle or anyone else. The infra came long after most were cycling over there. We need to change cultural attitudes. Painting a white line or putting up shared use signs is a pointless waste of time and energy. Even the cycle superways of London are slow, inconvenient and indirect. Separating bikes from traffic means drivers are less able to deal with them when there isn't infra, or simply treat us awfully for not using it. Education and enforcement is the cheapest and easiest way to change the attitudes. 

Wind your neck in pal. Indeed the Dutch did cycle long before their cycle infrastructure. But then the powers that be decided they needed to redesign their roads to accomodate for more cars, and fewer cyclists. Then what started happening? More cyclist deaths. Then the Stop De Kindermoord (Stop Murdering Children) protests started, and that is what brought about change and a re-investment in good cyclist friendly infrastructure. Guess what? Cycling in the Netherlands is now once again very safe. Please do your research before spouting your ignorant views to others. At least here you'll get called out for it, I'm sure if you said this in some car loving facebook group you'd be received warmly.

I'm currently reading "Copenhagenize" by Mikael Colville-Andersen. I suggest you do the same if you'd like to learn.

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grOg replied to eburtthebike | 4 years ago
0 likes

Why do cyclists need separate infra? this bloke is a comedian,so he's a bit like Clarkson trolling for an impact but his attitude does reflect the attitude a lot of motorists have about cyclists and cyclists are also an easy target for unsociable yobbo's that may throw things,close-pass or even deliberately hit a cyclist.

I'd also like to be able to cycle further away from traffic pollution as well..

https://www.youtube.com/watch?v=KfD3sh0glZY

https://www.youtube.com/watch?v=8qWQD5Wf_lk

https://www.youtube.com/watch?v=W2VaTMnj9Jw

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eburtthebike replied to grOg | 4 years ago
2 likes

grOg wrote:

Why do cyclists need separate infra? this bloke is a comedian,so he's a bit like Clarkson trolling for an impact but his attitude does reflect the attitude a lot of motorists have about cyclists and cyclists are also an easy target for unsociable yobbo's that may throw things,close-pass or even deliberately hit a cyclist.

I'd also like to be able to cycle further away from traffic pollution as well..

https://www.youtube.com/watch?v=KfD3sh0glZY

https://www.youtube.com/watch?v=8qWQD5Wf_lk

https://www.youtube.com/watch?v=W2VaTMnj9Jw

Australian humour does seem to have gone rather downhill since Dame Edna.

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Philh68 replied to eburtthebike | 4 years ago
3 likes

That’s not representative of Australian humour. That’s just representative of the kind of pigswill that happens when YouTube gives everyone a platform to be a complete dick, and monetises them so it can monetise itself.

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kevvjj replied to Pyro Tim | 4 years ago
3 likes

Pyro Tim wrote:

Why do cyclist injuries always mean more infra? It's bullshit. You are suggesting it's impossible for drivers to actually drive safely. Injuries mean we need to improve standards of driving. More education and more enforcement.

There's quite a difference between driving safely and having an accident. Many accidents aren't a result of driving unsafely. Motor vehicles are driven by humans, this in itself is a reason to separate bicycles from motor vehicles where possible.

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eburtthebike | 4 years ago
4 likes

“These risks should be viewed in context of the health benefits of active commuting and underscore the need for a safer infrastructure for cycling in the UK.”

Hello?  Boris?  Are you listening?

We need billions to be spent on proper cycle facilities to encourage more people to ride, improve health, reduce obesity, pollution, climate change and the carnage on the roads, so what does the government do?  Spends £27bn on more roads while claiming to be green.  It's getting so utterly absurd that even the BBC might be forced to mention it.

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mikem22 | 4 years ago
2 likes

I guess there is a context right? I've been admitted 3 times to hospital in 20 years of commuting but never as a result of a crash on the track, out in the hills or on a club ride with the road club.

I think commutes are higher risk partly due to the early morning starts (An unseen patch of Morning Ice on a dark commute causing one of my hospitalisations) and also the lack of daylight in the winter months combined with the relative inflexibility of time of the journey.. so you need to go whatever the weather/light rather than wait for a few hours for a break (a cause of another hospitalisation when on a really evil Scottish evening I had a run in with a car, if I had had a choice, I wouldn't have been out on my bike).

So, in my experience, it is the increased nuber of journeys in extreme conditions that have resulted in me being thrown into the back of an ambulance mid-commute. 

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grahamTDF replied to mikem22 | 4 years ago
3 likes

Commutes maybe also higher risk because there is less choice of route, would never chose the roads I commute on for a weekend ride.

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ktache replied to grahamTDF | 4 years ago
4 likes

You are also using the same roads as mostly asleep, running late drivers in the mornings, and tired and impatient drivers in the evenings.

One of the most terrifying times to be on the roads are the bits before school closing time when we share the roads with late running parents driving in a rush to pick up their precious offspring.

In previous jobs I sometimes had been allowed to come in a bit late and then leave late to avoid the worst of it.  And it is very strange how everything out there calms down a bit on the stroke of 9.

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Sniffer replied to ktache | 4 years ago
1 like

I am lucky. My 2 × 5 mile commute is almost all done off road. I ride 5-6K a year so I am comfortable on the road with traffic, but when on an icey dark morning I switch to treated roads rather than untreated paths the half asleep drivers scare the shit out of me. It is enough for me to consider getting back in the car.

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leaway2 | 4 years ago
5 likes

I wish someone had told my body. I've been cycle commuting to work (2x 8 miles) for years and I've just had quad bypass surgery 😂

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grOg replied to leaway2 | 4 years ago
1 like

Heart disease is often genetic..you can inherit a pre-disposition for atherosclerosis;also,it's related to diet,so exercise while good,is not a panacea.

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