Recommendations for reducing cycling injuries and death
Prepared by:
W. J. Lucas, M.D., C.C.F.P.
Regional Coroner for Toronto
Recommendations
The following recommendations have been made with a view to improving
bicycle safety and reducing injury and death. Although several are specific
to the City of Toronto, many have broader potential application. Because
of the diverse backgrounds and experience levels of the committe participants,
opinions on these recommendations were variable. Some were strongly supported
by all members, while other recommendations received limited support. Rather
than totally reject the latter group, they have been included in this report
in the hope that they may provoke meaningful and useful discussion in another
forum at a later date. They are not ranked in any particular order of importance.

A. Bicycle collision reporting
Recommendation #1
That policing agencies be requested to complete the Motor Vehicle Accident
Report form in non-HTA reportable collisions.
Rationale:
Currently a bicycle collision is only reportable if a motor vehicle
is involved. Using the accident report form for recording bicycle collisions
which do not involve a motor vehicle will contribute to a more consistent,
accurate recording and analysis of bicycle collisions resulting in injury.
Development of a reporting system that captures all bicycle mishaps, both
on-road and off, will be of much greater assistance in planning more effective
prevention strategies for the future.
This recommendation will require the agreement of the Ministries
of Transportation, Solicitor General and Correctional Services, and Attorney
General, in co-operation with the Ontario Association of Chiefs of Police,
as there may be significant resource implications.
Recommendation #2
That Police Officers, cyclists, and drivers be reminded that reportable
bicycle collisions may be reported at any Police station. Cyclists should
not be requested to report their collisions at a Collision Reporting Centre
(CRC).
Rationale:
To facilitate the process of reporting bicycle collisions, education
will be required for Police Officers, cyclists and drivers about the collision
reporting procedure for cyclists. In the interest of collecting reliable
data for cycling collisions it is important that bicycle collisions be easily reportable. Since
CRC's were created to assist motorists in reporting motor vehicle collisions,
their remote locations are usually not conducive to reporting of bicycle
collisions. The information collected should be applicable across the entire
Province.

B. Collision data collection
Recommendation #3
That the following information be captured and coded by all Police Services
in the major urban areas of Ontario:
- type of involved person (regardless of injury)
- injury of involved person (eg. minimal, major, fatal)
- traffic control device (eg. stop sign, traffic signal)
- road surface condition (eg. dry, wet, ice)
- safety equipment (eg. helmet, lap belt only)
- location coordinate (eg. intersection, non-intersection)
- driver/pedestrian condition (eg. fatigue, ability impaired - over 80 mg.)
Rationale
Coding this information means this data will be available
in a computerized database for future analysis. When a collision occurs,
the Police have a legal obligation to report certain information, but it
is not necessarily coded within computerized accident management systems.
Only the coded information is easily accessible for analysis.
Many of the problems identified in this Coroner's Review may relate
to large urban centres, such as the Greater Toronto Area (GTA), and not
to the province as a whole. Establishment of databases designed to capture
bicycle related incidents in these urban centres, would facilitate the
development of locally focused solutions.

C. Expert review of bicycle collisions and collision data
Recommendation #4
That the City of Toronto, with the assistance of the Ontario Trauma
Registry, the Ministry of Transportation and other interested parties,
initiate a comprehensive study of bicycle usage and collisions within the
City. The study would include:
-
probable causes of collisions (behavioural, geometric design, road condition,
etc.)
-
high frequency collision locations
-
bicycle collision/injury trends
-
physical infrastructure improvements to prevent collisions
-
(site specific or systemic changes)
-
educational messages for drivers, cyclists and the media
-
any other relevant issues
Rationale:
The present study has generated more questions than answers, by focusing
primarily on fatalities (which represent only a small fraction of all collisions
involving cyclists). A new study, coordinated by the City of Toronto, the
main beneficiary of such work, would attempt to cross-reference police
reports with hospital emergency room and ambulance reports, to better understand
how and where bicycle collisions happen, to identify collision reduction
measures and to determine collision reporting rates. Bicycle traffic counts
should also be undertaken and analyzed to quantify exposure rates (the
relative risk of cycling on different types of facility) and to help put
trends in collision reports in context with trends in bicycle use.
The City already includes staff in most key areas (transportation,
planning, public health, ambulance and police) and the assistance of a
number of other parties would ensure that all key stakeholders are involved.
Recommendation #5
That a multi-disciplinary team involving municipal staff, including
traffic engineering, bicycle facility planning and bicycle safety training
staff, and police and ambulance personnel be established to conduct an
annual review of all cycling fatalities in the City of Toronto as well
as bicycle collision data.
Rationale:
A cooperative approach to bicycle collision review and analysis could
result in more effective preventative measures for reducing bicycle collisions
within the city. This will require interaction between Police Officers
and a wide variety of other municipal staff.

D. Collision prevention - education
Recommendation #6
That the City of Toronto identify on-going funding sources to expand
cycling collision/injury prevention programs. This could include, but not
be limited to:
- more widespread availability of CAN-BIKE Training for adults and youth;
- publishing regular road safety reports that highlight common collision
types and ways to prevent them; and
-
production of a bicycle safety video for use in driver training
-
programs, police training programs, in schools and other programs.
Rationale:
To ensure future cooperation between all road users, school age children
have been identified as an essential target learning group. The Canadian
Cycling Association has several educational programs available to this
age group. It is imperative that agencies responsible for public education
endorse the use of recognized educational programs.
One deficiency of adult bicycle education programs is the lack of
availability of a Canadian content bicycle video to accompany existing
training. To complement all road safety programs a priority should be placed
on the production of a video for training purposes with appropriate Canadian
content.
Recommendation #7
That the Ontario Ministries of Transportation and Health, in cooperation
with local municipalities, police forces and cycling groups, develop and fund
programs that would increase awareness of Ontario's bicycle helmet law
and encourage the use of helmets by all ages.
Rationale:
Bill 124 was adopted by the legislature and came into effect on October
1, 1995, requiring cyclists under the age of 18 years to wear
helmets. To date, it appears that helmet use promotion has been left to
local communities. Provincial funding and coordination would greatly enhance
efforts to increase compliance with the provincial helmet law and encourage
helmet use.
Adults are role models for young people and the age limit of mandatory
helmet use sends a mixed message. Numerous articles have been published
in recent years supporting the effectiveness of bicycle safety helmets.
Control studies have provided convincing evidence that riders not wearing
helmets are between two and three times as likely as a helmeted rider to suffer
a head injury in a crash. Other reports conclude that up to 80 per cent of deaths
among bicyclists are due to severe head injury. To be effective, however,
bicycle helmets must be worn properly with the proper retention device
to prevent them from coming off during a crash.
It must be recognized, however, that helmet use is not a panacea
for drastically reducing cycling related fatalities or serious head injuries.
Stricter bicycle helmet legislation and mass helmet usage in other countries
(U.S.A., Australia, and New Zealand) have failed to produce any statistically
significant reduction in the rates of fatalities and head injuries, despite
optimistic projections. In addition, compulsory helmet use may result in
reduced bicycle usage.
Recommendation #8
That additional cycling safety information be included in the Province
of Ontario's Official Bus Handbook and Official Truck Handbook when these handbooks
are reprinted.
Rationale:
The new Official Driver's Handbook (1995) includes more cycling content
than the previous edition, in response to a recommendation arising out
of a 1991 inquest. The two handbooks noted above have limited reference to
specific strategies for operators of these large vehicles directed towards
sharing the road with bicycles. In contrast, the Ministry of Transportation
Cycling Skills booklet includes two pages of text and diagrams providing
advice for cyclists on dealing with buses, trucks and streetcars.
Awareness and training for eliminating collisions must be the starting
point. Training has to establish the attitude that promotes safe interaction
between motorists and cyclists. Organizations which provide defensive driving
courses should increase their emphasis on vehicle/bicycle collisions. As
an example, the current Defensive Driver's Manual (1996) from the Canada
Safety Council has less than one page in its 88 page manual dedicated to
this issue. Those organizations which provide training and material for
all drivers should be encouraged to increase the information provided regarding
sharing of the road with cyclists.
Recommendation #9
That the Ontario Ministry of Transportation establish or enhance criteria
for cycling content to be included in driver training and driver instructor
training programs.
Rationale:
Incorporating CAN-BIKE training information into driver training
programs would provide information that is not currently available to new
drivers. MTO's Road Worthy, Ontario's standard in driver education and
training, has references to bicycles on pages 13, 34, 64, 70-72. These
references deal with bicycles as alternatives to cars, courtesy toward
bicyclists, dealing with bicycles at night or in inclement weather, intersection
behaviour, passing procedures, vehicle doors and bicycles, etc. A future
update of this text should review these references to ensure consistency
of content with existing bicycle training programs.

E. Collision prevention - enforcement
Recommendation #10
That the Toronto Police Service, in partnership with the municipal Cycling
Committee, expand targeted enforcement and education efforts towards specific
behaviours (cyclists and drivers) which cause collisions, and use the media
to raise awareness of these behaviours.
Rationale:
Programs such as the Cycling Ambassadors Program, which includes
S.P.A.C.E. (Safety, Prevention, Awareness, Courtesy, Enforcement) and O.A.S.I.S.
(Off-road Awareness, Safety, Information, Stop) have been, and continue
to be effective programs aimed at education and enforcement. Continued
support of existing programs and expansion of similar programs on a provincial
scale is an essential strategy in promoting awareness in these areas.
Recommendation #11
That the concept of diversion programs, in lieu of paying a fine for
cycling-related traffic infractions in the City of Toronto, be given further
study and consideration.
Rationale:
A CAN-BIKE training course, for example, would be a proactive and
effective approach to increasing skill and knowledge of road users and
to changing attitudes towards safety. Toronto Police and the Cycling Committee
could develop a strategy based on cost recovery to implement this program.

F. Legislative review
Recommendation #12
That the Ministry of Transportation establish an expert review process
(involving provincial and municipal representatives, cycling organizations and
police) to recommend changes to the Provincial Highway Traffic Act and
Municipal By-Laws so that they are more consistent and understandable with
respect to cycling and cyclists and therefore easier to promote and enforce.
Rationale:
Some Ontario Highway Traffic Act sections affecting cyclists are
not consistent with educational and enforcement priorities for reducing
collisions. Specific sections of the H.T.A. are submitted for consideration
along with recommended changes that would address concerns and questions
specific to the needs of cyclists, and are listed in Appendix "B".
Ontario's Highway Traffic act presently does little to clarify how
bicycles interact with other traffic on our roads. The concept of motorized
vehicles yielding to non-motorized vehicles, who in turn must yield to
pedestrians seems to be a common sense rule which should be accepted by
all road users. Entrenching this principle in the HTA would clarify the
situation, and likely significantly reduce risk of injury and death.

G. Road design/facilities
Recommendation #13
That The City of Toronto identify potentially dangerous locations for
cyclists including high frequency accident locations and cyclist-identified
problem areas where site specific improvements can be made to prevent bicycle collisions.
Rationale:
Making spot improvements at locations that are known to be hazardous
to cyclists, identified from accident data and by cyclists themselves,
will enhance cyclists' safety. The City of Toronto's hazardous catch basin
cover replacement program, in which catch basin covers are replaced systematically
(as part of annual reconstruction programs, on high priority cycling streets
and at locations identified by cyclists) is a good model of how a "bicycle
safety spot improvement program" could operate.
Recommendation #14
That The City of Toronto develop a comprehensive network of on-street
bicycle lanes and routes and off-street trails to enhance bicycle safety.
Rationale:
The former City of Toronto has installed about 50 kilometers of bicycle
lanes on its roads. In response to growing public concern about the safety
of cycling on City streets following the cycling fatalities in the summer
1996, Toronto City Council increased funding for the bicycle route program
and established a goal to install 15 km of new bicycle lanes and routes
annually. There has been very little development of on-street bicycle lanes
and routes on streets outside of the former city of Toronto.
There is a well developed system of multi-use trails in parks, ravines
and along the waterfront of the City. New sections of trail are added each
year. These off-street trails can provide an alternative for cyclists who
wish to travel for recreation or commuting purposes away from automobile
traffic. In order to expand the safe cycling opportunities for cyclists,
a comprehensive bicycle route network which integrates both off-street
and on-street facilities should be developed for the new City of Toronto.

H. Large vehicles and bicycles
Recommendation #15
That Transport Canada investigate the feasibility of requiring "side
guards" for large trucks, trailers and buses operated in urban areas to prevent
pedestrians and cyclists being run over by the rear wheels in collisions with these
large vehicles.
Rationale:
Side guards are a legal requirement in the U.K. and in Europe to
reduce injuries to pedestrians and cyclists. The mechanism of injuries for cyclists
and pedestrians involved in slow speed collisions appears to be a dragging
down motion of the victim caused by the large tire's slow rotation. In
at least 2 of the 1996 fatalities involving cyclists in the City of Toronto,
the cyclist was crushed under the rear wheels of a truck. Side guards are
designed to reduce the risk of a cyclist or pedestrian being dragged down
under the rear wheels.
Although side guards are costly and add weight to the vehicle, experience
in the U.K. and Europe would indicate there are several advantages. They
can provide a step for the driver wishing to climb up onto the vehicle,
and they can also provide protection for some in-board parts of the vehicle.
Most importantly however, they do appear to reduce the risk of injury to
pedestrians and cyclists.
The Federal Government (Transport Canada) sets vehicle standards
for all new vehicles which are manufactured in or imported into Canada.
The responsibility for mandating truck or bus safety equipment, including
retrofitting, would therefore fall under the jurisdiction of Transport
Canada. The responsibility of the Province would include prescribing that
side guard protection remain in place and be maintained if they were prescribed
by the Federal Agency.
