With plans to increase cycling participation and the increase in use of child carriers and cargo bikes in Australia, there is a need for research to support evidence-based safety improvements for cyclists and their passengers. While there is an increasing amount of research investigating the safety of adult cyclists, very little is known about the safety of children transported as the passenger on an adult’s bicycle. This research addresses a significant gap in current knowledge by investigating the safety of an increasing yet vulnerable road user group: child passengers on bicycles. In order to obtain a better understanding of the safety implications of transporting children by bicycle, this study specifically examined: • the characteristics of people who transport children, the types of carriers used and the factors influencing their use • the type, nature and mechanisms of child carrier related injuries • measures and initiatives that have the potential to reduce the incidence and severity of child carrier injuries. Three research activities were undertaken to explore these issues in detail: an analysis of hospital injury data, a comprehensive national survey of cyclists, and discussions with cycling stakeholders. Hospital injury data was extracted from the Victorian Admitted Episodes Dataset and Victorian Emergency Minimum Dataset from 1999 to 2014. A total of 17,859 emergency department presentations and 4,794 hospitalisations were identified for child cyclists, including passengers, under the age of 10 years. They were classified into three age groups representing children most likely to be injured as a passenger on a bicycle (0-3 years), children transitioning between passengers and riders (4-6 years) and children who are most likely to be injured while riding a bicycle (7-10 years). For emergency department presentations, the most commonly injured body parts included the head (35%) and wrist and hands (16%). For hospital admissions, the head was also the most commonly injured body region (37%) followed by the elbow and forearm (27%). Comparisons of injured body regions between age groups revealed that children under the age of four years were statistically significantly more likely to sustain injuries to the head and neck that required hospital admissions, or presentation to an emergency department compared to older age groups. For emergency department presentations the most common injury types included open wounds (30%), fractures (19%) and superficial injuries (18%). Fractures were the most common injury requiring hospitalisation (47%), followed by open wounds (28%). Compared to older children, children under the age of three had a statistically significantly higher number of open wound injuries that required presentation to an emergency department or hospital admission. Children under the age of three were significantly more likely to require a hospital stay of less than two days than older children. A national online survey was undertaken of cyclists who were the parent of a child aged five years or younger. The survey collected information on: demographics, cycling behaviour, crash history, near misses, non-crash incidents, child transportation practices and experience, injuries to child passengers in crash and non-crash incidents, risk management, and other transport use. A sample of 100 participants (74% male) aged 24 to 58 years completed the survey. The majority of the sample (94%) reported transporting at least one child aged up to five years by bicycle. There were 12 reported cases of child passengers involved in a crash; none of the children were injured. There were eight cases in which child passengers were injured in a non-crash incident, most commonly involving the bicycle tipping over due to the passenger’s negative effect on the bicycle’s balance. All injuries were minor and none required treatment at a hospital. The most common types of carrier used by participants were seats attached either in front of or behind the rider. Common practices adopted by participants when transporting children included using different routes compared to when riding alone, modifying a usual route to reduce the risk of a crash, riding at times when there is less traffic and riding more often on the footpath and main roads with bike lanes. Survey participants suggested the best means to reduce the risk of injury when transporting children was to improve cycling infrastructure. In order to gain some understanding of the availability and use of carriers, consultations with relevant stakeholders were undertaken. A number of cycling agencies and organisations were contacted to seek their knowledge of child transportation practices and types of carriers, safety concerns associated with child carriers, and the suitability of infrastructure when transporting children. Two organisations participated in this process. Findings from these discussions included: • Concerns for the safety of child passengers due to their increased vulnerability. • Concerns about rider experience and their ability to carry child passengers, particularly due to increased weight and changes to the balance and handling characteristics of the bicycle. • Some cycling infrastructure (i.e. lane width) is not suitable for wider carriers (e.g., trailers, tricycles). The findings from this study demonstrate that there is a real risk of injury to child passengers, although there are a number of strategies that can be employed by cyclists, road managers, and society to mitigate these risks. A lack of data precluded any analysis of differences in safety performance of different types of carriers. With an expected increase in the number of cyclists and the variety of child carriers in use, this research offers practical advice to enable parents and caregivers to make informed choices regarding the carriers they use and other strategies they can employ to enhance their safety when transporting child passengers. (Author/publisher)
Abstract