1. No pain, no gain? Preventing cycling injuries in a world of expanding waist-lines. Rob Benington Injury Prevention Manager, Avonsafe Co-ordinator NHS Bristol

4. Cycling is good for you Physical activity is strongly associated with improvements in: Mental wellbeing Risk of cancer Weight management Cardiovascular health Reduced CO2 emissions/ urban liveability, etc. NHS Bristol wants more people to cycle more often and for longer.

5. Injury is not inevitable We can reduce risk of injury and increase health benefits at the same time. Injuries are bad for you

6. Non-Collision Cycling Incidents A road safety issue Caused c.95,000 cyclists to seek emergency treatment last year in England Caused 69% of cycling-injury admissions in England between (2006-11) On average, cause less serious injuries than collisions but can be fatal. (70% cause no injury that requires treatment). A cycle advocacy issue NCIs are preventable and removable and removing hazards makes cycling easier and more attractive.

7. “A total of 3,192 people were killed or seriously injured on UK roads while riding a bicycle last year”. The Times, 5-11-12 A total of 17,653 English cyclists were admitted to hospital with an injury during 2011-12, an increase of 1,611 (9%) on 2010-11. www.hesonline.nhs.uk c. 13% of all attendances at emergency departments are admitted. Ormel, 1999 c. 135,700 cyclists from England and c. 160,000 from the UK were admitted to hospital or treated in an emergency department during 2011-12. NHS Bristol, 2012

8. Cyclist injuries resulting in admission (England) 2011-12 Collision: Pedestrian / animal 117 Collision: Other cyclist 396 Collision: 2-3 wheeled motor vehicle 76 Collision: Car, pick up truck or van 2,450 Collision: Heavy transport vehicle or bus 180 Collision: Railway train or railway vehicle 2 Collision: Other non-motor vehicle 24 Collision: Fixed and stationary object 681 Non-collision incident 12,301 Other and unspecified 1,426 Total Cyclists17,653 (Total car occupants)14,573

9. Travel and transport injuries Non-collision injuries

10. Why are you here? Helping travellers prevent serious injury? Modal shift? Improving performance against NI047 and NI048 / KSI indicators? Reducing demand on acute healthcare services? Active travel = CHD, healthy weight, diabetes, depression? Low carbon travel?

11. What causes non- collisions? 1. Slippery road surfaces 2. Poor road surfaces 3. Kerbs and rail lines “An introduction to non-collision cycling incidents”, NHS Bristol 2012. www.tinyurl.com\avonsafecycling

12. Proposed strategy TrainingEngineeringPolicyOther ChildrenBikeability+ Just starting Bikeability Bikeability + Kerbs; rail lines; road maintenance Travel to Work, Inclement Weather Bike maintenance Commuter functional Bikeability+ Travel to Work, Inclement Weather Bike maintenance ExperiencedCommunication Travel to Work, Inclement Weather ?School travel Research ?

13. Engineering Engineering Other/Communication (re. Ice) Other/Communication (re. Ice) Training Training LSTF elements LSTF elements

14. Engineering

27. Ice risk management 1. Remove the risk 2. Avoid the risk 3.Mitigate the risk 4.Accept and adapt to the risk 5. Take the risk

28. 2. Avoidance

29. 3. Mitigation

30. 4. Adaptation www.icebikes.org

31. 5. Acceptance – Informed consent (Thanks to the Highways Agency who designed the poster)

32. Training (Bikeability +) Safe riding strategy Safe riding strategy (Explicit consideration of alternative mode of travel if weather conditions, personal health or bike maintenance require it). Spot Hazards – List of significant hazards could be included in L2 How to traverse kerbs and rail lines How to traverse kerbs and rail lines (While mentioned in L3 an observed demonstration should be required) Uneven road surfaces Uneven road surfaces (L3; Speed can be good) + Others? Blue Light runs, RRAGAR, + Others? Blue Light runs, RRAGAR,

33. Local Sustainable Transport Fund School and area travel plans School and area travel plans Awareness of staff working on LSTF Awareness of staff working on LSTF Employer travel plans Employer travel plans Bikeability + Bikeability + LSTF funded community projects LSTF funded community projects Engineering Engineering Communication Communication

34. Keeping cyclists safe, keeps cyclists cycling. www.tinyurl.com\avonsafecycling Rob.benington@bristol.nhs.uk