Presenter Profile
Tanya Charyk Stewart, MSc
Adjunct Research Professor, Dept of Paediatrics; Dept of Pathology & Laboratory Medicine, Schulich School of Medicine & Dentistry
Associate Scientist, Lawson Health Research Institute
MOVES Research Team, Western University
tanya.charykstewart@lhsc.on.ca
Tanya Charyk Stewart is the Injury Epidemiologist & Data Specialist at London Health Sciences Centre and has appointments with both the Departments of Paediatrics and Pathology & Laboratory Medicine at Schulich School of Medicine & Dentistry at Western University. With over 50 peer-reviewed publications and several national and international research awards, Tanya’s research interests include injury prevention evaluations, road safety and injury research. Tanya is the Past-Chair of the Research Committee for the Pediatric Trauma Society and a founding member of the Trauma Registry Information Specialists of Canada (TRISC) and has served on the Executives of TRISC and the Interdisciplinary Trauma Network of Canada for many years. She was instrumental in making London the first international site of Injury Free in 2013 and is now an individual member of IFCK.
Presentations
Safe System Approach to Preventing Cyclist Fatalities: Safety by Design for Urban and Rural Environments
Tanya Charyk Stewart, MSc
Allison Pellar, MEng
Moheem Halari, PhD
Kevin McClafferty, BESc
Pascal Verville, PEng
Michael Pickup, MD
Douglas Fraser, MD
Jason Gilliland, PhD
Mike Shkrum, MD
Cyclists are a particularly vulnerable road user group, with the number of preventable deaths increasing by 37% over the past decade. The objective of this study was to review the epidemiology of cyclist fatalities to identify risk factors to target via a safe system approach.
Fatal cyclist motor vehicle collision (CMVC) and injury data were collected from the Office of the Chief Coroner (2013-19), with selected crash investigations and expert review by a multidisciplinary team of engineers, coroners, physicians, geographers and epidemiologist. Descriptive analyses were undertaken. Urban and rural CMVC were compared with Pearson chi square and Mann-Whitney U tests.
There were 83 unintentional cyclist fatalities (81% male), 5(6%) children, 11(13%) youth, 57(69%) adults and 10(12%) seniors, with median (IQR) age=48.0 (27.0-48.0) and ISS=75 (45-75). Head was the most severely injured body region (median MAIS=5), except in children [median MAIS thorax=4.5 (3.75-5)]. Nearly 2/3 of cyclists were not wearing a helmet and 24% were impaired at the time of the crash. Expert review found 60% of child cyclists were runover, all <6 years, and this was the only age group to be struck by a car or pickup truck. Distraction from cell phone (n=1;1%) or headphones (n=7;8%) may have contributed to CMVC. There were 49 (59%) cyclists killed in an urban environment. Comparing urban with rural CMVC, all child cyclist deaths were in the urban group, which also had a significantly (p<0.001) higher proportion of collisions involving an intersection (57%; 6%), very low speed (?15kmh) collisions (33%; 0%), bike lane (29%; 0% with 8/14, 57%, struck by a heavy truck), cyclists stopped/slowed (33%; 3%), crossing the street (31%; 0%), involving heavy vehicles (31%; 6%; p=0.006), resulting in more runovers (49%; 9%). Rural collisions were associated with significantly (p<0.001) more high speeds (>50 kmh) (94%; 49%), darkness/nighttime (44%; 10%), cyclist going ahead (97%; 65%), riding on roadway with traffic (65%; 18%). No rural CMVC had cycling infrastructure, bike lane/path or sidewalk, available (0% vs 33%; 0% vs 84%; p<0.001).
Riding a pedal cycle in traffic puts cyclists at risk for severe injury and death, in both urban and rural environments. A safe system approach recognizes that people are vulnerable and make mistakes. Incorporating engineering countermeasures into the design of roadways to separate cyclists from vehicles, lighting in rural areas, and traffic calming measures to reduce speeds. Vehicle safety features include guard rails, mirrors and cameras on heavy vehicles, higher rated vehicle headlight performance, and advanced driver assistance technologies to detect cyclist or automated emergency braking can play important roles in the prevention of CMVC. Policy and legislative action can also improve the safety of the transportation system. To be equitable, these countermeasure must be implemented in all areas of a region to protect all road users.
1. The epidemiology and risk factors associated with urban and rural fatal cyclist motor vehicle collisions.
2. Principles of a safe system approach to road safety for cyclists.
3. Engineering countermeasures including road and vehicle design, to help mitigate crash risk.