Child Bicyclists: Where they are getting injured and built environment risk factors

Author(s): Aucoin, Zanotto, HubkaRao, Doan, Beno, Stang, Howard, McCormack, Nettel-Aguirre, Winters, Hagel

Slidedeck Presentation:

Slide deck link

Abstract:

Background:

While bicycling is a healthy form of physical activity with potential long-lasting benefits, it can result in a significant number of injuries in children and is a public health concern that must be addressed through interventions. Modifications to the built environment have been suggested as a key strategy to address these injury rates; however, little research to date has been child specific. There is a need for additional research about the built environment features present where children are injured and along the routes that they choose to bicycle.

Aims:

To determine where child bicyclists are getting injured in three Canadian cities and compare the frequency of the presence of different built environment features at injury locations to control locations along their routes.

Methods:

Children aged 5-17 years injured while riding their bicycle within city limits and who presented to a designated children's hospital within one of the three cities (Vancouver, Calgary, and Toronto) from May 2018 to October 2021 were recruited for participation. Participants completed a 30-minute interviewer-administered questionnaire that captured demographics, circumstances of the injury, injury location and details about their injury route. Following the interview, the research team conducted audits of the injury site along with randomly selected two control sites along the injured child’s route to capture objective data on the built environment. Descriptive statistics such as frequencies and proportions will be used to look at the circumstances surrounding the injuries and the built environment features of the injury and control locations.

Results:

To date, 347 participant interviews and audits have been completed (Vancouver – 140, Calgary – 82, Toronto – 125). When comparing their injury and control sites, preliminary results suggest child bicyclists were more frequently injured at off road sites (40% vs 29%), areas where there was no path (11% vs 4%) and in back lanes/alleys (8% vs 4%). Surface quality and debris may also contribute to child bicyclist injury. Children were more frequently injured at locations with large bumps >5 cm compared with control sites (13% vs 4%), and at locations with small bumps between 2-5 cm (25% vs 19%). Presence of gravel was more frequently observed at injury sites compared with control sites (21% vs 7%).

Discussion:

Preliminary findings suggest that certain built environment components may be contributing to child bicyclist injury risk. Next steps include completing additional analyses on route types, presence of infrastructure, speed, grade, and other forms of debris at both injury and control sites. This research is part of a much larger case-crossover study which will aim to inform key stakeholders at municipal, provincial, and federal levels as they develop policy and interventions to increase child bicyclist safety.

Conclusions:

Additional information on child bicyclist injuries and built environment features from this study can inform the development of primary prevention interventions. By carefully examining the potential built environment risk factors for child bicyclist injuries we will improve the evidence base for recommendations to create safer built environments for children while encouraging bicycling across Canada.