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      Cyclists injured in traffic crashes in Hong Kong: A call for action

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      1 , 2 , 1 , * , 3
      PLoS ONE
      Public Library of Science

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          Abstract

          Background

          Perceived as a minor transportation mode mainly for recreation, cycling and its related safety issues have not been treated as a citywide concern in Hong Kong and have thus received inadequate research efforts. Our study aimed to illuminate the safety challenges faced by cyclists in Hong Kong.

          Methods

          We examined the police crash records from 1998 to 2017 and developed a Bayesian Poisson state space model to evaluate the longitudinal change in traffic injuries to cyclists. We then used quasi-induced exposure to measure the annual relative risk of crash involvement for cycling. Based on an officially published travel characteristics survey, we further measured the risk of injury for cycling per minutes cycled.

          Results

          Between 1998 and 2017, Hong Kong witnessed a more than twofold increase in the number of cyclist injuries, with an average annual increase rate of 5.18% (95% CI: 0.53%–12.77%). By 2017, cyclists were 2.21 (1.82–2.69) times more likely to be involved in traffic crashes than in 1998. Per 10 million minutes, the injury rates for cycling were 28.64 (27.43–29.70) and 42.54 (41.07–44.02) on weekdays during 2001–2003 and 2010–2012. After adjusting for sex and age groups, cyclists were 1.95 (1.43–2.61) times more likely to be injured in 2010–2012 than in 2001–2003. Per minutes traveled, cyclists also sustained significantly higher risks of fatality and injury than pedestrians, private car drivers and passengers, taxi passengers, public bus passengers, and minibus passengers. A comparison of Hong Kong with other regions suggests that Hong Kong is among the most dangerous areas for cycling in terms of fatality rate per minutes cycled.

          Conclusions

          Cyclist injuries have become a substantial public health burden in Hong Kong. A range of countermeasures with proven effectiveness should be promptly implemented to improve the safety of these vulnerable road users.

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          Most cited references44

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          The health risks and benefits of cycling in urban environments compared with car use: health impact assessment study

          Objective To estimate the risks and benefits to health of travel by bicycle, using a bicycle sharing scheme, compared with travel by car in an urban environment. Design Health impact assessment study. Setting Public bicycle sharing initiative, Bicing, in Barcelona, Spain. Participants 181 982 Bicing subscribers. Main outcomes measures The primary outcome measure was all cause mortality for the three domains of physical activity, air pollution (exposure to particulate matter <2.5 µm), and road traffic incidents. The secondary outcome was change in levels of carbon dioxide emissions. Results Compared with car users the estimated annual change in mortality of the Barcelona residents using Bicing (n=181 982) was 0.03 deaths from road traffic incidents and 0.13 deaths from air pollution. As a result of physical activity, 12.46 deaths were avoided (benefit:risk ratio 77). The annual number of deaths avoided was 12.28. As a result of journeys by Bicing, annual carbon dioxide emissions were reduced by an estimated 9 062 344 kg. Conclusions Public bicycle sharing initiatives such as Bicing in Barcelona have greater benefits than risks to health and reduce carbon dioxide emissions.
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            Prior distributions for variance parameters in hierarchical models

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              Exposure measurement in bicycle safety analysis: A review of the literature.

              Cycling, as an active mode of transportation, has well-established health benefits. However, the safety of cyclists in traffic remains a major concern. In-depth studies of potential risk factors and safety outcomes are needed to ensure the most appropriate actions are taken to improve safety. However, the lack of reliable exposure data hinders meaningful analysis and interpretation. In this paper, we review the bicycle safety literature reporting different methods for measuring cycling exposure and discuss their findings.
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                Author and article information

                Contributors
                Role: Data curationRole: Formal analysisRole: InvestigationRole: Writing – original draftRole: Writing – review & editing
                Role: Writing – review & editing
                Role: ResourcesRole: SupervisionRole: Writing – review & editing
                Role: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                9 August 2019
                2019
                : 14
                : 8
                : e0220785
                Affiliations
                [1 ] Department of Civil Engineering, The University of Hong Kong, Hong Kong, China
                [2 ] School of Transportation and Logistics, Southwest Jiaotong University, Chengdu, Sichuan, China
                [3 ] School of Traffic and Transportation Engineering, Central South University, Changsha, Hunan, China
                University of British Columbia, CANADA
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                http://orcid.org/0000-0003-1169-7045
                Article
                PONE-D-19-13954
                10.1371/journal.pone.0220785
                6688837
                31398211
                f68580d6-37f6-4d2f-ae90-dac8b78e13ea
                © 2019 Xu et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 17 May 2019
                : 23 July 2019
                Page count
                Figures: 3, Tables: 3, Pages: 12
                Funding
                Funded by: Joint Research Scheme of National Nature Science Foundation of China/Research Grants Council of Hong Kong
                Award ID: N_HKU707/15
                Award Recipient :
                Funded by: Joint Research Scheme of National Nature Science Foundation of China/Research Grants Council of Hong Kong
                Award ID: 71561167001
                Award Recipient :
                Funded by: Natural Science Foundation of China
                Award ID: 71601163
                Award Recipient :
                Funded by: Natural Science Foundation of China
                Award ID: 71671100
                Award Recipient :
                Funded by: Francis S Y Bong Professorship in Engineering
                Award Recipient :
                Funded by: Research Postgraduate Studentship
                Award Recipient :
                This work was supported by grants from the Joint Research Scheme of National Nature Science Foundation of China/Research Grants Council of Hong Kong (Project Nos. 71561167001 and N_HKU707/15) and the Natural Science Foundation of China (Project No. 71601163; 71671100). SCW and PX were respectively supported by the Francis S Y Bong Professorship in Engineering and a Research Postgraduate Studentship from the University of Hong Kong. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
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                People and places
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                Hong Kong
                Medicine and Health Sciences
                Public and Occupational Health
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                Traffic Safety
                Engineering and Technology
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                Custom metadata
                The datasets are owned and were made accessible to the authors by the Hong Kong Transport Department. Access to the data can be obtained, subject to compliance with the terms of service, by signing an agreement with the Hong Kong Transport Department. The authors confirm that they did not have any special access to the data that others would not have.

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