Introduction Pedestrian and bicycling injuries may be less likely to be captured by traffic injury surveillance relying on police reports. Non-collision injuries, including pedestrian falls and single bicycle crashes, may be more likely than motor vehicle collisions to be missed. This study uses healthcare records to expand the ascertainment of active transportation injuries and evaluate their demographic and clinical features. Methods We identified pedestrian and bicyclist injuries in records of deaths, hospitalisations and emergency department visits in Ontario, Canada, between 2002 and 2017. We described the most common types of clinical injury codes among these records and assessed overall counts and proportions of injury types captured by each ascertainment definition. We also ascertained relevant fall injuries where the location was indicated as ‘street or highway’. Results Pedestrian falls represented over 50% of all pedestrian injuries and affected all age groups, particularly non-fatal falls. Emergency department records indicating in-traffic bicycle injuries not involving a collision with motor vehicles increased from 14% of all bicycling injury records in 2003 to 34% in 2017. The overall number of injuries indicated by these ascertainment methods was substantially higher than official counts derived from police reports. Conclusion The use of healthcare system records to ascertain bicyclist and pedestrian injuries, particularly to include non-collision falls, can more fully capture the burden of injury associated with these transportation modes.
Official sources of cyclist safety data suffer from underreporting and bias. Crowdsourced safety data have the potential to supplement official sources and to provide new data on near-miss incidents. BikeMaps.org is a global online mapping tool that allows cyclists to record the location and details of near misses and collisions they experience. However, little is known about how the characteristics of near-miss and collision events compare. Further, the question remains whether the characteristics of crowdsourced collision data are similar to those of collision data captured by official insurance reports. The objectives of this study were twofold: ( a) to assess similarities and differences in near misses and collisions reported to BikeMaps.org and ( b) to assess similarities and differences in collisions reported to BikeMaps.org and to an official insurance data set. Logistic regression was used first to model the odds of crowdsourced near-miss reports as opposed to collision reports and then to model the odds of crowdsourced as opposed to official insurance collision reports, as a function of incident circumstances. The results indicated higher odds of crowdsourced reports of near misses than of crowdsourced collision reports for commute trips, interactions with motor vehicles, and in locations without bicycle-specific facilities. In addition, relative to insurance reports, crowdsourced collision reports were associated with peak traffic hours, nonintersection locations, and locations where bicycle facilities were present. These analyses indicated that crowdsourced collision data have potential to fill in gaps in reports to official collision sources and that crowdsourced near-miss reporting may be influenced by perceptions of risk.
Globally, alcohol consumption has considerable public health, social, and economic costs. Per capita alcohol sales data are the most accurate means of quantifying consumption, but can overestimate local consumption in areas of high tourism. The goal of this research was to investigate a method for adjusting estimates of per capita alcohol consumption for tourist influence in 26 census divisions (CD) in British Columbia, Canada. Modifying estimates involved calculating temporally weighted annual tourist populations for each CD, enumerating the proportion of tourists to local populations, and using this proportion to derive local per capita consumption modified for tourist alcohol consumption. The adjustments for tourist influence decreased consumption estimates by approximately 2% provincially and between 1% and 16%, regionally. This research provides a foundational model for estimating temporally weighted regional tourist populations and applying them to adjust alcohol consumption estimates.
Objectives: Bicycling is a form of active transportation with a number of health benefits but carries a high risk of injury compared to other transportation modes. Safety intervention evaluations often produce results in the form of ratios, which can be difficult to communicate to policy-makers. The primary objective of this study was to estimate the number of bicycling injuries on an urban corridor preventable by separated bicycling infrastructure.
Methods: Stakeholders identified a key corridor with multiple segments having bicycling infrastructure but most of the corridor lacking similar infrastructure. We counted bicyclist volume along this route and used secondary data to supplement counts missing due to COVID-19. We used two reference studies including local bicycling population to estimate benefit of separated bicycling infrastructure and applied this to a city-wide estimate of baseline risk of injury per kilometre bicycled, which used a combination of secondary data sources including police, health care and travel survey data. Finally, we adjusted baseline risk to account for increased bicyclist volume during and following the COVID-19 pandemic.
Results: We estimated installation of fully separated cycle tracks along one Toronto corridor would prevent approximately 152.9 injuries and 0.9 fatalities over a 10-year period.
Discussion: Our results underscore the benefits of separated bicycling infrastructure. We identify several caveats for our results, including the limitations of studies used to estimate relative risk of infrastructure. Our method could be adapted for use in other cities or along other corridors. Finally, we discuss the role of preventable burden estimates as a knowledge translation tool.
Transportation shifts in Canada precipitated by COVID-19 may persist into recovery. We examined commuters in a national survey (Canadian Perspectives Survey Series 3) and commute changes attributed to COVID-19 risk. We modeled associations of changing commute with pre-COVID-19 mode, adjusting for coarse socio-demographic covariates. We found that all out-of-home commute modes declined during COVID-19, with increases in telework. Commuting by public transit was most strongly associated with change in commute mode to avoid COVID-19 risk. Among pre-COVID-19 transit commuters, 18.2% continue to rely on transit, and personal motor vehicle use is more common (13.0%) than walking (3.4%) or cycling (2.9%).
There is no safe concentration of radon gas, but guideline values provide threshold concentrations that are used to map areas at higher risk. These values vary between different regions, countries, and organizations, which can lead to differential classification of risk. For example the World Health Organization suggests a 100 Bq m−3value, while Health Canada recommends 200 Bq m−3. Our objective was to describe how different thresholds characterized ecological radon risk and their visual association with lung cancer mortality trends in British Columbia, Canada. Eight threshold values between 50 and 600 Bq m−3 were identified, and classes of radon vulnerability were defined based on whether the observed 95th percentile radon concentration was above or below each value. A balanced random forest algorithm was used to model vulnerability, and the results were mapped. We compared high vulnerability areas, their estimated populations, and differences in lung cancer mortality trends stratified by smoking prevalence and sex. Classification accuracy improved as the threshold concentrations decreased and the area classified as high vulnerability increased. Majority of the population lived within areas of lower vulnerability regardless of the threshold value. Thresholds as low as 50 Bq m−3 were associated with higher lung cancer mortality, even in areas with low smoking prevalence. Temporal trends in lung cancer mortality were increasing for women, while decreasing for men. Radon contributes to lung cancer in British Columbia. The results of the study contribute evidence supporting the use of a reference level lower than the current guideline of 200 Bq m−3 for the province.
We used 2013/2014 Canadian Community Health Survey to describe who bicycles for leisure, commuting, or both leisure and commuting. Nearly one-quarter of Canadians bicycled in the 3 months prior to the survey: 7 Canadians bicycled for leisure for every 1 person who bicycled for commuting purposes. People bicycling for leisure were more likely to be younger, male, higher income, and identify as white. Commute bicycling captured a very small proportion of the bicycling population; men were nearly twice as likely to commute compared to women and there was little difference in bike commuting across racial identity.