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The Role of Environment in Cyclist Injuries in Toronto — Some Methodological Questions

Author(s): Kumar Balasubramanian, Mary L Chipman, Michael Escobar, Anne Harris, Conor, C. O. Reynolds, Kay Teschke, Meghan Winters

Slidedeck Presentation:

3C Balasubramanian_The Role of Environment in Cyclist Injuries in Toronto

Abstract:

Cycling has become a very popular means of transportation in urban areas. This paper uses data from
the Bicyclists’ Injury and Cycling Environment study (BICE) conducted in Vancouver and Toronto to examine
environmental factors that might influence cyclist injuries in downtown Toronto. It also examines
the effectiveness of matching on intersections as compared to adjusting for intersection status in a randomly
matched model.
We extracted Toronto data (n=276) from the overall BICE data set (n=690). Adult cyclists who had
been injured and treated at one of three emergency departments in Toronto were recruited. Interviewers
identified three sites along the route the cyclist was following: one where the injury occurred (case)
and two other sites (controls), one of which was randomly selected and the other randomly selected
after matching on whether the injury occurred at an intersection or not. The characteristics of each site
were compared using conditional logistic regression.
Comparing case sites with random control sites, injuries were significantly more likely at locations with
a downhill grade compared to level sites (OR 3.06; 1.77-5.29). Proximity to streetcar tracks also increased
the odds of injury (OR 3.68; 2.13-6.37), as did proximity to junctions (OR 3.03; 1.29-7.09). Injuries
were significantly less common at intersections than elsewhere on the route (OR 0.63; 0.41-0.96).
When case sites were compared to intersection-matched control sites, downhill grade and the presence
of streetcar tracks remained significant.
These results suggest that the physical environment of Toronto’s streets plays an important part in determining
the injury risks for cyclists and needs improvement to safeguard them.