Bicycle Helmet Safety Institute

Cycling Deaths in British Columbia

Summary: A study of bicycle rider deaths in 1986 to 1995 and recommended measures by the British Columbia Coroner.

Deaths Of Cyclists in British Columbia
A Composite View of Cyclist Death Commonalities,
Prevention Strategies and
Collective Recommendations

Compiled and written by
Robert P. Francis and Peggy Justason
Office of the Chief Coroner
British Columbia, Canada

Table of Contents

I. Introduction

II. Nathan: A Case in Point

III. The Human Cost

V - Conclusion and Recommendations

Vl - Appendix A

Vll - Reference Material

Acknowledgements

This report, in large, highlights and encourages the work of many dedicated agencies and individuals who are committed to reducing injuries and deaths of cyclists in British Columbia. Although it is not possible to name all individuals who have contributed to the current provincial initiatives and recommendations contained in this report, special thanks is extended to those who are not directly acknowledged below but whose contributions have helped shape our current laws and future safety programs.

Our sincere appreciation is extended to June Wick and staff at the Office for Injury Prevention, Janice Schmidt of the Motor Vehicle Branch, the Bicycle Safety (Advisory) Committee and, the Cycling Education Committee for their forward-looking reports and ongoing guidance and assistance.

We would also like to acknowledge Ms. Tej Sidhu's assistance in data collection and background research for this report.

Transmittal Letter

- (British Columbia Letterhead)


Re: Coroner's Report on Deaths of Cyclists in British Columbia

We are pleased to provide you with a copy of the report, Deaths of Cyclists in British Columbia, prepared by the office of the Chief Coroner.

The report reviews coroners' reports on cycling deaths between 1986 and 1995 and summarizes their recommendations. It was requested by the Attorney General in response to the death of Nathan Gemiano in a cycling accident in Oak Bay.

The B.C. Ministry of Transportation and Highways which is responsible for road safety in B.C., has already addressed many of the report's recommendations through recent legislation, education and awareness programs.

The report's first and perhaps most important recommendation was for legislation requiring cyclists to wear helmets. As you know, that legislation came into effect September 1996. Several of the report's other ten recommendations are also in place. They include:

• conducting a comprehensive awareness campaign to accompany the introduction of the helmet legislation;
  
  
• establishing an ongoing cycling education program, Bike Smarts, designed to provide the basics of safe cycling, including traffic safety, proper equipment, bike handling skills and hazard management, for children in grades three to seven;
  
  
• promoting skills development, wearing properly fitted helmets and other protective gear, and learning respect for the rules of the road through the Safe Cycling program;
  
  
• ensuring the visibility of cyclists during night-time hours by requiring the use of visibility equipment such as reflectors, rear lights or flashing red lights;
  
  
• whenever possible, providing wider shoulders or cycling paths for cyclists when constructing or rehabilitating highways.
  
  

We want to thank the Chief Coroner's office for producing this useful report. It provides a context to other research into ways to reduce the number of cycling deaths in the province.

Sincerely.

Ujjal Dosanjh Minister of Attorney General

Lois Boone Minister of Transportation and Highways

I. Introduction

"Brain injury can cause epilepsy, intellectual and memory impairment and personality changes. They can cost $1,000 per person a day to treat and lifetime extended care costs can be as much as $200,000 a year. "

Royal Commission on Health Care and Costs (1991)

Personal tragedies and individual suffering resulting from cycling accidents are not factored into the statistics nor are the costs of these preventable deaths.

When a young child dies in a tragic but preventable accident, the entire community grieves. In British Columbia preventable injuries alone number in the thousands, and perhaps scores of children's deaths may be preventable each year. Indeed, such needless death causes all involved to reflect on what could have been done differently. The "What if's" and "If only's" echo through our minds ... sometimes forever. Such is the case of the tragic death of Nathan Geminiano.

In Victoria, Nathan's death sparked an outcry among drivers and cyclists alike. Concern and discussion followed in the local media about bicycle safety (or the lack of it) and about the dangers of cyclists sharing roadways with motorized vehicles. Since Nathan's death, his family has been asking the questions "why?" and "what are we doing about reducing these types of tragic consequences?"

In response, the Attorney General requested that the Coroners Service review their record of deaths in this matter and provide a written summary of their collective recommendations. The thought was that this could, perhaps, assist the current studies and initiatives before the province and play a role in the ongoing and collective efforts for public education.

Pressure and congestion within major cities in British Columbia is causing all levels of government to review strategies and planning to encourage alternate travel. Cycling is and will continue to be on the increase. Unfortunately, we fear that along with the increased volumes therein lies a potential for increased injuries and fatalities, as bicycles and vehicles inevitably collide.

Clearly, however, government action and review is already underway. Mandatory helmet legislation was introduced and passed in June, 1995. This legislation is scheduled to be effective September 3, 1996 and would apply to all persons operating a cycle or riding as a passenger on a cycle. It will be an offence for parents or guardians to knowingly permit a person under the age of 16 to operate or ride a bicycle without a helmet. The legislation provides for a maximum penalty of $100 and permits municipalities to enact bylaws requiring the wearing of bicycle helmets on pathways not covered under the definition of a highway in the Motor Vehicle Act. For many of us working the front lines, at the accident scenes and dealing with families of deceased. this action is applauded. We can only say, thank you-it is necessary.

The overall purpose of this discussion, therefore, is to strengthen support for the promulgation of the legislation and further advocate the need for educational programs in conjunction with this legislation. Undoubtedly, the key to successful implementation will be public education.

Our report presents a number of historic and more current coroners'/juries' recommendations which endorse and support the many current initiatives underway in the province of British Columbia. Prevailing research and collective recommendations are also presented in order that readers may understand the direction of current injury prevention strategies in the province of British Columbia.

The following review is, therefore, dedicated to the memory of Nathan Geminiano and to the scores of other youngsters, like Nathan, who have lost their lives as a result of a bicycle accident.

II - Nathan: A Case in Point

The death of Nathan Geminiano was tragic, not only for his family, but also the larger community. His family hope that something positive can come of these tragic events.

Nathan Geminiano was only 14 years old; bright, healthy and active. According to his friends, he was an excellent cyclist. The accident happened in the blink of an eye. No one saw it coming not even Nathan.

Nathan was riding his bike on Oak Bay Avenue in Victoria, just east of Foul Bay Road when he approached a segment of the road under reconstruction. He was wearing a helmet. There were a number of clearly marked 'sawhorse' shaped caution signs whose presence in effect served to narrow the travelled portion of the roadway. It was in this narrowed roadway where the truck and bicycle collided. The flatbed truck had been travelling in the same direction as Nathan. For the truck driver there were a number of obstructions to manoeuvre the rig around. The truck was moving somewhat to its right as there was a caution sign in the centre of the roadway up ahead. Also, prior to this sign was a vehicle waiting to turn left and which, in fact, did turn left. It is unclear just how far the truck had to move to its right to avoid these obstructions. As there were no witnesses to the actual contact between the truck and the cyclist and as the exact location of the truck at the time the contact took place cannot be precisely determined, it is impossible to ascertain exactly what occurred. However, investigators believe that Nathan's left bicycle handlebar came into contact with a 4" X 4" piece of wood being carried under the truck bed. This undoubtedly would force the handlebar into a hard right turn, overturning the bike and thrusting Nathan under the wheels of the truck. Nathan was fatally injured.

Although the use of helmets is critical in reducing the number and severity of head injuries, the public must also have an understanding of other common risk factors if we are to address some of the root causes of these accidents. Nathan's case illustrates the importance of "sharing the road" education and the unfortunate results when both cyclists and drivers fail to recognize clearly dangerous scenarios, where even a helmet will not provide enough protection to prevent death.

III - The Human Cost

Unfortunately, statistics relating to bicycle accidents bring a very disturbing picture into focus.

B.C. Facts (Source: Motor vehicle Branch)

• In 1993 there were 2,039 reportable bicycle accidents; 2,068 in 1994, 29 more than in 1993; (A bicycle accident is reportable in British Columbia if it results in injury or death or aggregate property damage of $25 or more. At least one motor vehicle must be involved.)
  
  
• In 1993 there were 1,916 cyclists injured and 10 fatalities; in 1994 there were 1,926 injured with 9 fatalities;
  
  
• Males represented 74% (1993) and 76% (1994) of those injured; and
  
  
• Males represented 90% (1993) and 80% (1994) of cyclist fatalities.
  
  

1993 Major contributing Factors:

Historically, most fatal accidents have occurred in clear, dry, and daylight conditions in the spring or summer months. Most notably, 80% of the 10 cyclists killed in 1993 were not wearing bicycle helmets. In 1994 the figure was 66% of fatal bicycle accidents where the cyclist was not wearing a helmet. Many of these accidents occurred in driveways, on bike paths, as well as on our roadways. Indeed, bicycle accidents are one of the most common causes of head injuries in children

Five Top Contributing Factors Assigned to Cyclists

(Source: Motor Vehicle Branch)

(1994)

• Driving without due care: 13.0%
  
  
• Failing to yield the right of way: 10.1%
  
  
• Driving on wrong side of road: 7.2%
  
  
• Ignoring traffic control device: 4.5%
  
  
• Driver inexperience: 3.4%
  
  

Five Top Contributing Factors Assigned to Motor Vehicle Drivers

(Source: Motor Vehicle Branch)

(1994)

• Failing to yield to right of way: 16.44%
  
  
• Driving without due care: 9.67%
  
  
• Improper turning 2.27%
  
  
• Visibility impaired 2.22%
  
  
• Weather conditions 2.03%
  
  

As coroners we can play a significant role in prevention of injury and death if we bear in mind our potential role to assist in the prevention of severe injury or death should we have occasion to investigate a bicycle-related death. The Coroners' records in British Columbia as in other provinces catalogue death after death that was preventable. Several of these, taken from the Coroners' records, serve to emphasize the nature and seriousness of the problem.

Case #1

A 12-year-old boy was riding his bike on the shoulder of the Fraser Highway against traffic in the late afternoon of a mid-January day. It was reasonably dark. A truck pulled over onto that shoulder of the road to pass a vehicle turning left and stuck the cyclist. The bike was not equipped with a light or reflector on the front. The cyclist was not wearing a helmet. The youth suffered multiple traumatic injuries, the most severe being head injuries. Death was instantaneous.

Case #2

The death resulting from this cyclist/motorist collision involved a 4-year-old girl riding her bike into a "T" intersection when a motorist, observing her approach, nevertheless, thinking he had time, turned in front of her and she ran into the right front of this vehicle. There were no mechanical or environmental factors affecting this accident. The little girl had just recently learned to ride without training wheels and was practising stops and starts. She died immediately of massive head injuries.

Case #3

This car/bicycle collision occurred in midsized town B.C. at a "T" intersection. Road conditions were good but it was dark. The cyclist was wearing dark clothing, was operating his bicycle without a light, was not wearing a helmet and was seriously visually impaired. He died of head injuries. The coroner recommended mandatory use of helmets by cyclists and that the Motor Vehicle Act be amended to require that a red light be mounted on the rear of bicycles.

Case #4

A man in his mid-sixties was riding his bike on the shoulder of the Pat Bay Highway near Beacon Avenue (a controlled intersection) heading towards Victoria when he turned on to the slow lane of traffic without signalling and causing the van in that lane to brake abruptly to avoid hitting him. The cyclist then continued over to the fast lane and was struck from behind by another vehicle. Road and weather conditions were excellent. The cyclist died of massive injuries, in particular, head injuries. He was not wearing a helmet.

Case #5

A cyclist in his early twenties was riding his bike on Highway 19 in Courtenay in a northerly direction when struck by a vehicle travelling in the same direction. Road conditions were good but it was dark and the bicycle was neither equipped with headlight, tail light or any type of reflector. The speed limit was 60 KM/H. The vehicle was travelling at about 100 KM/H. Both the cyclist and the vehicle operator were intoxicated by alcohol at the time. Death resulted from breakage of the spinal cord.

Case #6

A cyclist in his early sixties was travelling on the shoulder of a four lane highway facing oncoming traffic when he turned into the path of an approaching car. The driver of this vehicle tried to avoid him but was unable to do so. The autopsy report attributed death to multiple injuries consistent with blunt impact The deceased was a known diabetic who was known on occasion to be non-compliant in taking his insulin. Testing done following his death indicated that the loss of control of his bicycle could have been related to this disease.

Case #7

A teenage boy was riding his bike just south of the Quesnel city limits on Highway 97. He had left home a little earlier and was believed to be headed to a local recreation complex. A motorist was travelling south on Highway 97 travelling in the slow lane and was leaving the highway in the exit lane to access Dragon Hill Road. Road conditions were good but it was dark. Suddenly the car driver saw the cyclist coming directly at her and she was unable to avoid him, the left front headlight area of her truck came in contact with the cyclist. His bike had no reflectors or headlight. He died from severe head injuries. He was not wearing a helmet at the time of the impact.

Appendix A to this paper provides several more examples of such deaths in British Columbia in the last few years.

IV - Past and Present Research

Clearly bicycle safety has, in recent times, been on the minds and agenda of a number of agencies in British Columbia. 1987 was a turning point. Agencies such as the B.C. Medical Association, the Registered Nurses' Association of B.C., the Insurance Corporation of B.C., the Bicycling Association of B.C., and the Home and School Federation collaborated in an effort to effect change. These agencies, among others, have been actively involved and instrumental in past and ongoing efforts for public education. Indeed, in 1987 the B.C. Medical Association advocated the mandatory use of hard-shelled bicycle helmets by all B.C. cyclists, as well as their infant passengers. The Registered Nurse's Association followed suit as did other agencies and some local governments.

Also, in 1987, the provincial government commissioned a significant review of bicycle/ motor vehicle traffic accidents. William Mercer, Ph.D prepared the report for the provincial Counter Attack Program. Dr. Mercer's conclusions are repeated here as they provide historical continuity to the current statistics and support the development of recommendations included in this report.

(for accidents occurring between 1980-1986):

• 14% -17% of the accidents occurred in July/August;
  
  
• accidents tended to occur in urban areas, at intersections, between Spring and Fall, in good weather, on weekdays, and in day light;
  
  
• no traffic control device in most accidents;
  
  
• 20% of accidents there was a stop sign;
  
  
• 13% there was a traffic light;
  
  
• 10% were hit-and-runs.
  
  

Turning to the primary factors contributing to these accidents (as determined by the investigating police officers), there were no contributing factors assigned to about 50% of the cyclists and about 60% of the motorists

Where contributing factors were indicated, Dr. Mercer's findings also included the following common contributing factors:

For motorists:

• Failure to yield right of way (37%)
  
  
• Driving without due care and attention (24%)
  
  
• Visibility impaired (7%)
  
  

For cyclists:

• Driving without due care and attention (26%)
  
  
• Failure to yield right of way (15%)
  
  
• Wrong side of the road (12%)
  
  

Typically, these accidents involved both the motor vehicle and the cyclist "going straight" and colliding at 90 degrees at an intersection. The next most frequent accident configuration involved the motor vehicle making a right or left turn and colliding with the cyclist who was "going straight". The third most frequent bicycle/motor vehicle collision occurred when the motor vehicle was passing or "overtaking" the cyclist.

Cyclists involved in these bicycle/motor vehicle casualty accidents were three times as likely to be male as female, and had an average age of 22 years, with about 70% being over 16 years of age and half falling between 16 and 30 years. Head injuries or lower leg injuries were the most frequent outcomes for cyclists (27% each), followed by arm/shoulder injuries (22%). Of the 2,096 casualties, 17 or 0.8% were fatalities.

These results suggest two directions for countermeasures that might reduce bicycle/motor vehicle casualty accidents: public education on the legitimacy of cyclists as road users and public education emphasizing improvements in bicycle conspicuousness. Argument for the latter stems from the fact that for motorists in bicycle/motor vehicle collisions 'Visibility impaired' and for cyclists 'defective headlights' are both contributing factors that could be reduced if the cyclist was more visible. However, it would appear that the larger (although perhaps less soluble) problem has to do with neither cyclists nor motorists recognizing that cyclists have similar rights and responsibilities on the public roads as do any other users.

In more detail, for motorists in these accidents, Driving Without Due Care and Attention (24%) and Failure to Yield Right of Way (37%) suggest that the driver is not treating the bicycle in the same way that another motor vehicle would be treated. For cyclists, the contributing factors of Due Care (26%), Failure to Yield (15%), Wrong Side of Road (12%) and Signal Ignored (8%) suggest that they are not riding the bicycle with the same respect for other road users or for the laws that they would have if they were driving a motor vehicle. Indeed, the fact that about 70% of these cyclists are 16 years of age or older and probably have driver's licences, opens up possible driver's licence-related as well as public education responses to this situation.

Bicycle Study --Ontario

A 1991 study conducted by the Department of Surgery, The Hospital For Sick Children, Toronto Fatal Bicycle Accidents in Children: A Plea For Prevention, produces some very interesting facts and, in our view, reaches some pertinent conclusions. The purpose of the study was to document the number of cycling deaths occurring among Ontario children and to determine how many could have been prevented by optimal treatment after the injury event. All fatal bicycle accidents for children (age 0 - 15) over the five year period 1985 to 1989 were studied with a view to determining the cause and circumstances of death. 81 deaths resulted from bicycle accidents of which 74 (91%) were deemed unsurvivable, 89% of these being from head injuries. None of the 81 victims were wearing a helmet at the time of the injury. Most of the accidents occurred during the summer months and during daylight hours. 96% of the deaths resulted from collisions with a motor vehicle.

The conclusions that were arrived at as to who was primarily responsible for the accidents were enlightening. Police investigations concluded that the cyclist caused the collision in 70% of the cases, either by violation of the road traffic law or because of poor road sense. The most common errors occurred when the cyclist veered in front of a vehicle (36%), entered from a minor road or from behind a parked car (13%), and made a left turn (7%). Other causes included failing to stop at a red light, racing a train, and alcoholic intoxication. Charges were laid in ten cases for careless driving and three for speeding. The police were unable to ascertain a cause in eight cases. The authors point out that although the police must assign blame for the accidents, the outcome of this practice may not in fact reflect the real source of the problem. This could well be that it is beyond a child's psychomotor skills to ride safely in traffic and that it might be wiser to prevent children (e.g. those < 12 years) from riding on busy streets. Although various authors have recommended educational programs for various age groups, and this approach is receiving a great deal of emphasis in British Columbia, several researchers nevertheless indicate that a child's poor comprehension of safety rules may limit the effectiveness of safety education programs because young children do not perceive the traffic environment as adults do.

The authors certainly did not discourage the continuation and development of education programs targeting cyclists but argued that emphasis should also be placed on defensive driving programs that would make motor vehicle drivers more aware of cyclists on residential streets.

The authors, pointing out that 89% of the deaths and serious injuries recorded in their study were due to head trauma, suggested the most effective means of automatic protection was in the wearing of a bicycle helmet. Here they relied on an Australian study (Rivara, 1989 N Eng J Med) that found that riders wearing helmets had 85% less risk of head injury and 88% less risk of brain injury compared to those not wearing helmets. They advanced the view that the introduction of legislation requiring the use of protective helmets should be considered.

Bicycle Helmet use

It can readily be seen that as the number of cyclists in British Columbia continues to grow, it follows that the number, severity and costs of incidents will increase.

Several years ago the Motor Vehicle Branch, consulting with a network of concerned people and agencies, began a careful investigation into the use of bicycle helmets. In order to ensure that key issues such as enforcement, safety standards, helmet cost and public education were considered, and to develop the most promising approaches to implementation of possible legislation, the Motor Vehicle Branch established an Advisory Committee on Bicycle Helmets consisting of wide representation from such diverse groups as the Medical and Nursing Associations, B.C. Sports Medicine Council, Local Governments, various ministries of the provincial government, police organizations and others.

The Advisory Committee was given a specific mandate: to identify key issues involved with bicycle helmets and mandatory bicycle helmet legislation; to develop strategies that resolve or address these issues effectively; and to develop a set of options and recommendations to be incorporated into a Discussion Paper.

In July of 1993 a discussion paper on Mandatory Bicycle Helmet Legislation was published by the Bicycle Helmet Advisory Committee. It provided recommendations on the key issues which may effect the public's acceptance of, and compliance with, mandatory bicycle helmet legislation. The bottom line was that mandatory legislation was an end to work towards but much education and research was required along the way.

According to the Report of the Bicycle Helmet Advisory Committee in July of 1993, 13 bicyclists were killed (eight due to head injuries) and 1,846 others injured in 1991 due to collisions with motor vehicles in British Columbia. Of those injured, 363 were hospitalized for head or brain injuries. Provincial hospital statistics indicate that head injuries account for almost half of all acute cases resulting from cycling incidents. Studies have indicated that the risk of head injury could be reduced by 85% with the use of a bicycle helmet, yet helmet usage is reported to be anywhere between 5%-50% depending on the geographic location. The Motor Vehicle Branch completed a survey in July/August 1995 where the overall average helmet use was 38%. There were, however, considerable variations in use between metropolitan and smaller communities and between school-aged (6-15 years) and older cyclists. This survey will be repeated after the helmet legislation is in effect.

The B.C. Coroner's fatality statistics below also illustrate the importance of continued efforts in encouraging the public's acceptance and use of bicycle helmets. Head injuries are still the cause of death in over half of the cycling deaths in the province.

                                 % of Head
               Number of        Injuries as
 Year       Cycling Deaths     Cause of Death

 1992          14                    78%

 1993          13                    62%

 1994           9                    66%

 1995          12                    58%

One recommendation of this Advisory Committee which turned out to be exceedingly important was that a comprehensive education and communication campaign be developed to address the broader issues of safe bicycle handling and operation. This program was to form the basis of the government's response to bicycle safety in British Columbia and the introduction of mandatory helmet legislation was to be incorporated into this larger initiative. As a result of this recommendation the Bicycle Safety Education and Awareness Program (Safe Cycling Program) was established, a program that commenced in 1994 and which is discussed in some detail later in this study. It is now the primary vehicle for safe cycling education in this province.

Key Prevention and Safety organizations in B.C.

The primary objective of this paper is to review and formulate recommendations which, when properly implemented, could well improve the safety of cyclists in varying traffic conditions in this province. In making these recommendations it must be remembered that a great deal of positive action is already taking place in British Columbia both with respect to injury prevention in general and cycling safety in particular. Having a good understanding about what is now happening should assist us to focus on to whom the recommendations Fshould be presented as well as the terms in which they are made and the suggested mode of their implementation where this is feasible.

Two government initiatives of prime importance in this field are the Office for Injury Prevention and Safe Cycling Program. A brief review of the work of each follows.

The Office for Injury Prevention (OIP) was established in August 1992 under the Ministry of Health. The agency's primary objective is to assist in the reduction of unintentional injuries in British Columbia with the first phase of operation focused on children and youth. The office points out that unintentional injuries are the single leading cause of death for children and youth in British Columbia; that most injuries are predictable and up to 90% are preventable. When one considers, for example, that the Coroners Service investigations in 1993 found that 414 or 18% of all unnatural deaths were of children or youth, 72% of which were accidental, one can readily see that an intensive coordinated attack against accidental deaths is essential. The OIP is beginning to play a very key role in this attack.

The OIP facilitates a planned and coordinated approach to prevent injuries amongst over 150 voluntary, professional, private sector and government organizations presently involved in a wide range of injury prevention activities for children and youth. The OIP continues to develop an Injury Prevention Data and Surveillance System and provides injury data at both the provincial and local levels thus promoting research and program evaluation. Particularly in this respect, OIP encourages program evaluations to determine which injury strategies are most effective.

The Office of Injury Prevention came into being following the recommendation of the British Columbia Royal Commission on Health Care Costs, which called for a reduction of 25% by the year 2000 in fatalities and injuries from motor vehicle accidents, drowning and fires. The Office set an initial goal of reducing all injuries in children and youth (ages 0 - 24) by the same year. Although OIP came into being partly for economic reasons (accidents were causing taxpayers too much money), the agency's approach to accident prevention is most encouraging.

With the agency in place, British Columbia looked to Sweden for a model. Sweden had a 35 year history of injury prevention programs and in that time has reduced injury deaths to half the Canadian rate. The Swedish model is based on a three-pronged approach: injury surveillance and prevention research; providing a safer environment for children through legislation and regulation; and (coalitions to promote) a broad-based safety awareness and education campaign.

Sweden is now the world leader in injury prevention. British Columbia builds on its model by encouraging community involvement, and also by urging organizations and communities to form new partnerships with agencies and individuals not traditionally involved with injury prevention. Whereas there has been cooperation and communication between groups in the past there has never been a single agency taking an overall lead role in injury prevention. Coordinated leadership will enable organizations and communities to identify 'gaps' and reduce unplanned duplication in the services provided as well as stimulating more effective implementation of the various strategies. In this respect, program evaluation will help determine which injury prevention strategies are the most effective.

Some very pertinent information provided by the OIP tells us about the cost of injury in Canada. In 1986 the total cost of illness was $79.1 billion. That estimate includes two components: 'direct' and 'indirect' costs. Direct costs include the costs of hospital care, care provided by physicians and other health care professions, the cost of medical drugs, research and pensions. Indirect costs are calculated by estimating the long term social cost of illness, such as loss of future earnings from people who suffer disabling disease or who die prematurely.

Injuries represent 13.9% or approximately $11 billion of the total cost of illness in Canada. About $1 billion of this can be attributed to British Columbia and of this amount, about $250 million is spent on hospital care. In Canada generally, the cost of illness due to injuries for all ages is second only to the cost of cardiovascular disease!

In that same year, 1986, some $382 million was spent on health science research. Only $1 million or less than 0.3% of this funding was allocated to injury research. Even though injuries are one of the most expensive illness categories, funding allocated to injury research is hardly noticeable when compared to funding for treatment. This issue is further addressed in the recommendations contained at the end of our report.

Preventing Injuries

For most types of injuries there are proven effective measures to prevent them or, at least mitigate their seriousness. Seat belts for drivers, steel-toed boots for workers, helmets for cyclists are some obvious measures. Yet, in spite of a helmet's proven ability to reduce injuries, actual use of such preventative measures can be quite low. For example, The Adolescent Health Survey, a Recent survey of British Columbia adolescents in grades 7-2, showed that only 2-11% of bicycle riders always wear a bicycle helmet. Yet data published by the OIP demonstrates that there are preventative measures which are highly efficacious at reducing injuries, but cannot be effective unless they are used. In this respect, the risk of bicycle-related brain injury can be reduced by 88% with the use of bicycle helmets. (Thompson et al, N. Eng J MED; 320:1361-7.)

Action Planning For Injury Prevention

The Office for Injury Prevention has developed a set of guidelines for planning action which should lead to injury prevention. In that our current study makes a series of recommendations that require action planning for injury prevention, some insight into the OIP guidelines is of value.

Their guidelines are as follows:

So often a great idea gets nowhere because the avenues of communication are not opened. We have all seen, for example, some excellent brochures explaining by diagram and example what to do or what not to do and yet we wonder how well these brochures have been circulated and, even then, whether or not they have been read. The message is vitally important but so is its delivery to the right persons.

Participation is key

The OIP stresses the ongoing need for participation and cooperation. In this respect, and commencing with the words "Never doubt that a small group of thoughtful, committed citizens can change the world: Indeed, it is the only thing that ever has", the OIP stresses participation in the following manner:



It only takes one person to affect change. Individuals wishing to become involved with injury prevention can initiate programs, join with other individuals or groups, or support local injury prevention initiatives. Parents, ethnic or interest groups, neighbourhoods, or entire communities can band together to improve their school yards, play areas, and neighbourhoods. Any individual or group has the ability to target specific injury problems based on their specific neighbourhood or community priorities. Individuals and groups wishing to become involved in injury prevention are not "starting from scratch".

The injury prevention campaign has already begun, and a wide variety of individuals, groups, and agencies, including OIP, are involved. So far, over 150 organizations are participating in injury prevention activities and programs for children and youth throughout B.C..

The OIP has published a Directory (The British Columbia Directory: Unintentional Injury Programs for Children and Youth (Ages 0 - 24)) listing agencies already involved in injury prevention and names of contacts who can be reached to supply further information. This directory is available, on request, at no charge.

Bicycle Safety Education and Awareness Program

From the general to the particular. Discussion concerning the OIP and its approach to accident prevention leads us directly to a program that has been developed on the basis of the principles enunciated by the OIP. Whereas there is very serious ongoing concern about the safety of cyclists, it must at the same time be recognized that major steps are now being taken to reduce accidents, such injuries and deaths. The Motor Vehicle Branch (MVB) of the Ministry of Transportation and Highways initiated its Bicycle Safety Education and Awareness Program in the Spring of 1994.

The MVB is now into its third year in the development and operation of a multi-year, province-wide education and awareness program to promote safe cycling within the province. Its primary objectives are as follows: 1. Improve cycling skills, knowledge level and attitude of young B.C. cyclists; 2. Promote the use of proper safety equipment among cyclists of all ages; and 3. Improve the road sharing relationship between cyclists and motorists.

The education and awareness campaign is being implemented by an advisory group to the MVB called the Cycling Education Committee (CEC). Represented on this committee are a number of organizations from the fields of cycling, health, education, government and injury prevention medicine who have a vested interest in the promotion of safe cycling in B.C. Membership includes the coordinating manager for the Office of Injury Prevention.

With the guidance of the committee, the MVB will pursue three streams in its goal to reduce the frequency and seriousness of cycling related incidents and fatalities in B.C.: education programs; public awareness campaigns; and stakeholder involvement

Safe Cycling Education Programs

While most safe cycling programs target people of all ages, young cyclists have been identified as a very important group. By reaching the eight to 16-year-olds and their parents, there is a real opportunity to instill safe cycling practices such as wearing bicycle helmets and handling a bicycle safely and competently for life.

Therefore, one of the CEC's primary activities is the development of a standardized cycling education program for schools and communities. An educational program design consultant was contracted to develop the 'Bike Smarts' cycling skills instruction program. Modular in design and geared to elementary school students in Grades 3 to 7, this program covers rules of the road, the importance of protective equipment such as bicycle helmets, bicycle handling skills, understanding traffic signals and hands-on practice in group bicycle riding sessions.

The initial Bike Smarts cycling skills instruction course was conducted in two schools in Fall 1994. An expanded pilot program was conducted in the Spring 1995. It included conducting one to two courses in each of the MVB's four regions throughout the province and a "Train the Trainer" pilot instruction program to develop Bike Smarts course instructors for each community. Members of the Advisory Committee and the educational community will be consulted on an ongoing basis to ensure the program meets technical and educational standards. Currently, the program is available to teachers and instructors for children ages 7-13, to teach skills on safe handling of bicycles. The Bike Smarts Handbook outlines five bicycle safety sessions with a sixth road component given by a certified instructor.

As the educational program grows and community demand for consistent cycling instruction increases, the Committee will begin the process of transferring stewardship to one or more organizations committed to safe cycling education to ensure long-term, community-based program delivery and further development.

It is the Advisory Committee's long term education goal to provide fundamental safe cycling skills instruction to all B.C. elementary school children.

Based on the success of Bike Smarts program, partnerships with like-minded organizations, the Committee and the MVB hope to establish community cycling resource centres throughout the Province by 1997.

Public Awareness campaign

The second key activity in the overall program is a public awareness campaign mounted in the media, schools, public forums and through stakeholder groups. There will be two to three campaign windows per year: Spring (when schools are focused on cycling training), Summer (to reach young and recreational cyclists through community channels) and Fall (back to school traffic safety and/or motorist and cyclist interactions).

The MVB launched its first safe cycling public awareness campaign in March 1994. Its first spring theme focused on the importance of bicycle helmets. The radio and newspaper campaign targeted parents with the message of head protection while an activity panel in the weekend colour comics reinforced the importance of wearing appropriate cycling gear for children. The MVB and the CEC next launched a 1994 fall campaign. Aimed at cyclists and motorists, the radio spots and transit signs promoted sharing the road and respecting other road users, using the theme, «It's a two-way street".

Spring 1995 saw the launch of a community and school campaign which focused on preparation for the new cycling season in terms of attitude and equipment. Spring school presentations and program presence in community and school cycling and injury prevention events moved into community and youth programs over the summer. The Fall 1995 campaign focused on another aspect of the cyclist/motorist share the road issue. Clearly, education is ongoing regarding sharing the road, with the annual campaign on sharing the road commencing in June, 1996. However, still more effort is required to improve the knowledge and experience of car and large truck drivers relating to sharing the roads with bicycles.

Stakeholder Involvement

The Committee's third key activity will be the establishment of stakeholder relations, particularly among organizations currently providing cycling related education programs. By consulting with these groups and obtaining their input, the MVB and the CEC hope to establish a standardized and consistent safe cycling program across B.C. which is supported and/or implemented by these groups. The Committee has developed a preliminary stakeholder directory which includes all B.C. organizations who are involved in cycling as part of their recreational, skills improvement or injury prevention programs. Plans are in place to establish contact with these groups to introduce the MVB's safe cycling education and awareness program and the CEC. Thereafter the CEC will regularly update these stakeholders on the program's progress and solicit feedback and involvement for future campaigns and partnership opportunities. By forming partnerships in each community, the legacy of both the MVB and the CEC will be the establishment of a strong safe cycling skills and educational program throughout B.C. which can be sustained by communities and organizations who are committed to safe cycling.

Cycling Network Program

British Columbia is also encouraging cycling as an alternative form of transportation. In support of that concept the government, through the B.C. Transportation Financing Authority, allocated $2 million for the fiscal year 1995/96 to encourage additional cycling infrastructure. The Cycling Network Program now provides funding for the construction of bicycle lanes/paths on provincial and local roads 50/50 cost shared with local governments. However, future grants will require municipalities to have a comprehensive cycling network plan in order to qualify. This program has been very well received with many municipalities already in progress with upgrading infrastructures.

V. Conclusion and Recommendations

The recommendations made here are derived primarily from a review of the coroners' records over the last ten years regarding cycling deaths and a review of current literature in this regard. Discussions have taken place with many who are interested in preventing the injury or death of cyclists and generally promoting a safety conscious attitude and atmosphere for cyclists and motorists alike.

In making recommendations we recognize that the Bicycle Safety and Awareness Program operated by the MVB and the many agencies, clubs and institutions working with it, will have considered many of our recommendations and already put some into practice. In support of their work we will be sending this report to its Cycling Education Committee because it is the primary force for seeing that cycling becomes a much safer activity in this province. A copy will also be sent to all groups, agencies and institutions which are in any way involved in safe cycling and the prevention of injuries. This will include ministries of government where action may be required to put a recommendation into affect. In this way we hope that we can assist those who are putting ideas into action in the cycling safely community.

Recommendations

Recommendations are directed to the following agencies for their consideration:

Subject: Mandatory Use of Bicycle Helmets

#1

Background

Background information supporting this incentive is reviewed at pages 12 and 13 of this study. It should be noted that Ontario has taken the lead in this area of cycling safety in Canada, having enacted legislation for the mandatory use of bicycle helmets. Their law to came into force in the fall of 1995.

Recommendation

The Coroners Service strongly supports BC legislation making mandatory the wearing of approved bicycle helmets by anyone operating a bicycle. This legislation comes into force in the fall of 1996

Subject: Education and Awareness Programs in Conjunction with Helmet Legislation.

#2

Background

Education and Awareness programs should be developed to complement and persuade observation of this new law. Unfortunately, just because something is passed into law does not mean its observance is automatic. It is more important that people observe the law because they believe in it, not simply because it is the law.

Recommendation

The Coroners Service advocates and encourages implementation of MVB's Cycling Education Committee recommendations and specifically that bicycle helmet legislation be accompanied by education awareness programs to foster and promote the use of helmets.

#3

Background

Not only are serious injuries caused by cyclists colliding with pedestrians but deaths have occurred as well. Education programs in B.C. should foster cyclists' respect of and responsibilities toward pedestrians.

Recommendation That the Cycling Education Committee support the implementation of education programs that include some focus on the safety and protection of pedestrians.

#4

Background A review of coroners' records over a ten year period (1985-1995) clearly supports the proposition that most bicycle motor vehicle collisions are due to the simple negligence of the vehicle driver, the cyclist, or both. Common examples of such negligence include going through stop signs, changing lanes without looking and riding at night without reflective equipment or clothing.

Recommendation Ongoing revision of cycling education programs should stress the fact that most accidents and injuries are due simply to inattention or negligence. Course structures should stress the importance of driving alertly at all times.

#5

Background

Several deaths of cyclists have been reported in Ontario that were linked directly to the use of stereo headphones. We have all seen people riding bikes or driving cars seemingly completely in their own space and little aware of what is going on about them. Cyclist users of headphones, indeed any users who are engaged in an activity that may pose dangers to themselves or others through inattention to what they are doing, should be made aware of the dangers inherent in the use of these headsets in certain situations.

Recommendation

A study should be conducted into the incidence of stereo headphone use in conjunction with bicycle accidents with a view to supplementing bicycle education programs about the dangers of such use and, depending on the outcome of the study, consider recommendations for the prohibition of such use in certain circumstances.

#6

Background

Time and time again a coroners report will indicate with respect to a night time accident that the cyclist was dressed in dark clothes, his bike did not have a headlight nor did it have a tail light or reflector. There are many devices on the market, some of them ingenious such as a flashing red light on the back of a helmet, that make the cyclist readily seen in the dark. This problem can be addressed through educational programs and guidelines for "being seen" that can be developed through rules of the road requiring that mandatory requirements such as front headlight and rear reflectors for night-time riding be established.

Recommendation

Examine ways and means for ensuring the visibility of cyclists during night-time hours and to make recommendations, where appropriate, for amendments to the Motor Vehicle Act requiring the mandatory use of visibility equipment such as vests, reflectors, lights and flashing lights.

#7

Background

Collisions between cyclists and trucks are, unfortunately a common occurrence. Frequently it appears that the truck driver is not even aware of the collision. In many cases, where death is a result, the exact cause of the accident cannot be determined. The truck driver just didn't notice. Perhaps the cyclist inadvertently got too close, or the driver moved in on the cyclist. Do drivers in BC respect the right of cyclists to share the roadways? Are there roadways now open to cyclists that, because of heavy traffic or roadway conditions - narrowness, configuration - should not be open to bicycle traffic? These are complex problems calling for in-depth evaluations.

Recommendation

#8

Background

The intent of this recommendation is to keep the public informed through a coordinated approach. Examples abound of the constant reminders needed to maintain levels of public education, e.g. Every purchase of a bicycle or motor vehicle should be accompanied by a copy of the pamphlet "DRIVE RIGHT - CYCLE RIGHT"

Recommendation

That public awareness campaigns be funded and implemented through all forms of media presentations, but particularly radio, television and retail cycle shops.

#9

Background

This recommendation is supportive of current planning initiatives already in place in some communities. Development of such plans in other communities is encouraged. A recent Coroners Report recommended the provision for "bicycle lanes on all major roadways and bridges."

Recommendation

Reserved lanes for cyclists should be provided for cyclists where motor traffic density is determined to be high and cycling paths be constructed in conjunction with the development of new highways.

#10

Background

We all can think of examples where we have seen motor vehicles coming out of private driveways onto the roadway where their vision is impaired by trees and shrubbery. Due to extremely fast growth in many areas of this province, what may be clear vision one year may well have turned into obscured vision the following year. Many coroners cases make reference to this situation and several 'obscured vision' have contributed to cyclists deaths.

Recommendation

Develop and enforce laws requiring property owners to maintain clear sight lines at sidewalks and driveways on private property.

#11

Background

It is one thing for a child to ride a bicycle in a cul de sac. It is another to ride it in thoroughfares busy with myriad types of motor vehicles, varying road conditions (including those under repair) and where there are a variety of signs and signals that are confusing to most of us. When do children's psychomotor skills develop to the extent that they can ride safely in busy traffic? Some researchers indicate that a child's poor comprehension of safety rules may limit the effectiveness of safety education programs because young children do not perceive the traffic environment as do adults. Findings of a study into these matters could have a profound impact on bicycle safety education as well as providing guidelines as to the time when children may 'graduate' to riding on shared roadways.

Recommendation

Conduct a study to determine at what age children become sufficiently mature to understand and follow the rules of the road and, at the same time have the requisite psychomotor skills to do so.

#12

Background

A search of coroners records as well as a review of current literature often leaves the reader in a dilemma as to really knowing why an accident occurred. Knowing the 'why' will assist teachers, riders and drivers in better understanding the dynamics of vehicular traffic on shared motorways and, therefore, how better to conduct the operation of their vehicle in a safety conscious manner.

Recommendation

Conduct a pilot study to take place over a period of several years to investigate all motor vehicle bicycle related accidents with a view to developing a better understanding of their causation so as to be in a better position to develop safe driving and safe cycling programs and educational materials.

VI. Appendix A

Cyclist/Motorist Collisions Resulting in Death
A Study of Coroner's Files for 1986-93

Note: The information outlined below has been taken from coroners Judgements of Inquiries or from findings at inquest. It is not intended to make a comprehensive report of each case but rather to provide a nutshell of the basic situation that gave rise to each accident so that, in the eyes of experienced observers, recommendations may be made to avoid these types of tragedies.

86-128-0171 A fifteen year old cyclist was riding his bike in a southerly direction on Highway #1 south of Duncan next to the sidewalk in the curb lane. Traffic going south was stopped at lights at a controlled intersection. Included in this traffic was a logging truck and trailer which was signalling for a right turn. As the cyclist was catching up to it the lights changed and the truck began its turn thus cutting off the oncoming cyclist. The cyclist hit the truck, fell and was crushed under the right rear tires. It was recommended that convex mirrors be used and required by regulation for a greater number of vehicle users so as to give a better view of the right side of their vehicle.

86- 137 -0007 This three year old was playing on a construction site when he followed on his tricycle behind a truck which was moving from the site of one house to the next. He was directly behind the truck when it stopped but because of the child's size and his location behind the truck, the driver could not see him in any of his mirrors. He commenced to back up over the child.

86-210-3126 Cyclist hit and killed by hit and ran car driver. Driver who eventually confessed was impaired. General negligence and alcohol.

86-221 -2454 A 22 year old male cyclist dressed in dark clothing and with no lights or reflectors on his bike entered an intersection on a yellow light and was struck by a half-ton truck. The cyclist had his feet on the handlebars at the time. He died of head injuries.

86-222-1090 A truck crossed centre line and hit cyclist in oncoming lane. Driver charged. General negligence.

87-110-0214 Charges laid against driver who hit cyclist from behind. Cyclist was riding on the shoulder of the highway. General negligence.

87-210-1757 Cyclist tried to jump curb to get onto pedestrian crosswalk going over a bridge. In doing so he hit a passing truck with his arm and fell under it and was crushed. He was not wearing a helmet.

87-222 -2912 An 18 year old female was riding a men's one speed bicycle down Nordell Way in Delta with her left hand on the handlebar and her right hand holding a guitar case. The vehicle following her was unable to stop when she fell from her bike and was run over. The vehicle did not strike her bike. It was determined that the guitar had been stolen and that the cyclist was impaired.

87 -660-0023 A six year old was riding his bike on the sidewalk towards the corner as a large tractor trailer unit was travelling in the same direction and signalling a right turn. It stopped and began to make the turn. An independent witness saw the youth come to a stop and then start up again as the truck was making the turn. He looked as though he was trying to ride under the truck. He was crushed by the wheels.

87-536-0016 An accident on Highway #97 occurred when a cyclist pulled from the shoulder lane (to pass another cyclist) to the driving lane at about the same time a vehicle travelling in the same direction was about to pass both cyclists. The bicycle was about one foot into the driving lane when it was struck directly from behind. The cyclist was wearing earphones and listening to a radio. The driver of the oncoming vehicle had been driving for about 12 hours and was drowsy. The cyclist was wearing a helmet. It was recommended that cyclists not be allowed to use radios etc. with ear pieces as listening devices.

88-007-2524 A youth was operating his bike on sidewalk adjacent to a busy roadway with his brother on the handlebars and was among a group of pedestrians. Apparently his bike slid on some gravel on a driveway and he fell onto the roadway into the path of an oncoming truck. The driver did not see the incident as it would have occurred after his position in the truck had passed the cyclist. Recommendations were made to the police about enforcing cycling bylaws against riding double and riding on the sidewalk.

88-431-0014 An elderly cyclist made an unsafe move in front of vehicular traffic catching up to him and leaving no opportunity for the driver to avoid hitting him

88-660-0110 A nine year old youth hit in an intersection due to negligence of driver coming into the intersection from the cyclist's left. Cyclist may have left the curb before it was safe to do so. General negligence.

89-160-0362 A 12 year old cyclist waited until it was safe to proceed and then rode his bike across the crosswalk. A vehicle in the centre lane stopped and waited for him but a vehicle driven by a 16 year old in the inside lane passed the stopped vehicle on the inside and hit the cyclist. Death was due to head injuries. General negligence.

89-221-0015 White Rock - Death occurred as a result of two cars colliding and one of those vehicles then striking the cyclist. General negligence.

89-240-0709 Cyclist went through a stop sign and broadsided another vehicle. General negligence.

89-110-0008 Nanaimo - cyclist on his way to work apparently slipped on icy roadway and truck following was unable to avoid him. Truck did not observe him fall but first noticed him on the roadway. General negligence.

89-160-0227 Victoria - Cyclist went through stop sign coming off a sidewalk and was hit by oncoming vehicle. General negligence.

89-570-0054 Kelowna - Two cyclists were heading northward and crossed a small wooden bridge, the deceased in the traffic lane, the other cyclist on the walkway. As the deceased turned left while exiting the bridge a truck hit him on the left side. He did not have a helmet and died of head injuries. General negligence.

89-160-0306 The deceased cyclist was travelling easterly along the west side of Sooke Road when he went out of control and fell into the travelled portion of the road and was ran over by an oncoming vehicle. The cyclist was impaired at the time.

89-242-1608 An elderly cyclist was making a left turn at a "T" intersection on West Marine Dr in Vancouver when he was hit by an oncoming car. The actions of both parties contributed to the accident. General negligence.

89-104-0036 Comox - A well known racing cyclist made a swinging left turn through a stop sign and into the path of a motor vehicle. The cyclist made no attempt to stop or slow down before making the turn. General negligence.

89-224-0807 Two young teen aged cyclists were travelling in a westerly direction on a gravel road a vehicle driven by an 18 year old caught up to them from behind. He thought one cyclist was going to go to one side of the road and the other to the other side of the roadway so he sped up and was in collision with one cyclist. General negligence.

90-125-0002 A cyclist in his thirties was travelling northbound around a curve in the roadway. Without looking up he crossed the centre line and an oncoming motorist tried to avoid him but was unable to do so. It was dark and the cyclist had no illumination and only one reflector which was on the back of his bike. The cyclist was impaired by alcohol at the time and was not wearing a helmet. Recommendations were made for the mandatory use of helmets and for cycling lanes to be incorporated in the planning of new highways. Recommendations also included specifics about lighting of the roadway in that location and the curve design.

91-221-0103 A 12 year old boy was riding his bike on the shoulder of the Fraser Highway against traffic in the late afternoon of a mid-January day. It was reasonably dark. A truck pulled over onto that shoulder of the road to pass a vehicle turning left and stuck the cyclist. The bike was not equipped with a light or reflector on the front. The cyclist was not wearing a helmet. The youth suffered multiple traumatic injuries, the most severe being head injuries. Death was instantaneous. General negligence.

91-306-0004 A woman in her mid-thirties was riding her bicycle on a May evening about 7:00 p.m. when she rode onto a railroad crossing as a train was moving by and struck the front corner of a rail car. Conditions were clear, dry and light. The train had whistled prior to the crossing and its head lamps were on. The cyclist was impaired by alcohol at the time. The cyclist died immediately of massive intrathoracic haemorrhage.

91-225-1434 The death resulting form this cyclist/motorist collision involved a 4 year old girl riding her bike into a "T" intersection when a motorist, observing her approach, nevertheless, thinking he had time, turned in front of her and she ran into the right front of his vehicle. There were no mechanical or environmental factors affecting this accident. The little girl had just recently learned to ride without training wheels and was practising stops and starts.

91-242-0137 A male in his early twenties was riding his bicycle downhill at a speed of about 60 kilometres in city traffic and collided broadside with a vehicle that passed in front of him. It was dark and the cyclist had no headlights or reflectors on his bicycle. He died within the hour of massive injuries.

91-302-0026 This elderly man (in his eighties) was riding his bicycle along the right hand shoulder of the highway in small town British Columbia being followed by a truck who was partially in the right hand shoulder as well and struck the cyclist from behind. The contact point was completely off the travelled portion of the highway. Alcohol consumption by the driver of the vehicle was a factor in the accident. The cyclist died at the scene

91-242-1548 A motorist making a left hand turn at a Vancouver intersection stuck the right front of a vehicle travelling across her path. This vehicle swerved to avoid the collision and moved into the lane of oncoming traffic where a cyclist was travelling. The cyclist was thrown under this vehicle. Environmental and mechanical conditions did not affect this accident. The cyclist, who was not wearing protective head gear, received serious head injuries resulting in death.

91-573-0053 This car/bicycle collision occurred in mid-sized town B.C. at a "T" intersection. Road conditions were good but it was dark. The cyclist was wearing dark clothing, was operating his bicycle without a light, was not wearing a helmet and was seriously visually impaired. He died of head injuries. The coroner recommended mandatory use of helmets by cyclists and that the Motor Vehicle Act be amended to require that a red light be mounted on the rear of bicycles.

91-226-1455 This motor vehicle/cyclist collision occurred on the Lougheed Highway in Port Coquitlam. The complexities of the circumstances giving rise to the accident are too extensive for review here but, the cyclist was killed as a result of the collision. No scene, environmental or vehicle factors contributed to the accident. The coroner found that both the cyclist and vehicle driver were not paying adequate attention to where they were going. Alcohol consumption by the vehicle driver was a factor. General negligence.

91-200-0657 A teenage cyclist was riding her bicycle near the fog line on a roadway in Surrey when she made a left turn onto another street on which a motor vehicle was approaching at a high rate of speed. Driving conditions were excellent. A collision occurred and the cyclist died of multiple injuries. Although the cyclist may not have met all her responsibilities as a bicycle operator, the coroner found that the excessive speed of the motor vehicle was the prime cause of the accident. General negligence.

91-426-0005 This accident occurred on Highway 95 north of Radium, B.C. A middle aged woman was cycling with a group when her handlebar was hit by a vehicle passing her. The operator of that vehicle had been startled by another vehicle passing him and had moved to its right. The cyclist died of traumatic head injuries on the way to hospital. The coroner made the following recommendation to the Minister of Highways, namely: As bicycle touring is becoming a large tourist related industry in the province and because of increased traffic flow on our highways, the Minister of Highways should place signs on touring routes notifying motorists. Future highways should be designed with bicycle touring in mind.

91-597-0054 Two young children (age six) were riding their bikes on a street that had a 8% downgrade. They approached an intersection which was controlled by a stop sign in their direction, the road being a "through" street. One girl went into the intersection and was narrowly missed by oncoming traffic. The second girl then entered the intersection and was stuck and killed

91-170-0039 A car was travelling downhill at about 40 km/h (10 km/h over the speed limit) when it slowed and turned into a driveway, at which point it struck a cyclist who was travelling in the same direction on that roadway. The driver had checked her rear-view mirror but had not done a shoulder check. The cyclist was not wearing a helmet. He died of severe head injuries. Weather and driving conditions were not a factor. General negligence.

91-222-1965 The cyclist in this accident was rid on the travelled portion of Bridgeport Road in Richmond in an easterly direction when he was struck from behind by a flatbed truck. The right front fender of the truck hit the deceased, then the passenger mirror and finally the bulkhead thus projecting him to the ground. The road is flat and straight but visibility was poor because of heavy rain. The truck driver did not stop at the scene. The bicycle was not equipped with reflectors or tail light. The cyclist died of multiple injuries.

91-245-1729 An elderly man (early 80s) was riding his bike in Vancouver. He stopped at an intersection and then proceeded to go through it in a northerly direction. A vehicle was travelling towards him from the east in the curb lane and although the cyclist appeared to see it, he accelerated across the roadway. The driver of the vehicle swerved to avoid him but was unsuccessful. The cyclist died of brain injuries. Road conditions were good but a low bright sun was shining in the car driver's eyes.

92-167-0124 A man in his mid-sixties was riding his bike on the shoulder of the Pat Bay Highway near Beacon Avenue (a controlled intersection) heading towards Victoria when he turned into the slow lane of traffic without signal and caused the van in that lane to brake abruptly to avoid hitting him. The cyclist then continued over to the fast lane and was struck from behind by another vehicle. Road and weather conditions were excellent. The cyclist died of massive injuries, in particular, head injuries. He was not wearing a helmet.

92-678-004 A ten year old youth was struck from behind by an impaired driver who did not stop at the scene of the accident. Observers of his erratic driving had tried to warn the youth by blowing their horn. The cause of death was severe head injuries.

92-166-0122 An experienced male cyclist in his sixties was riding his bike on a busy road in Victoria when, apparently without signalling or shoulder checking, he proceeded to change across three lanes. A vehicle travelling in the left centre lane struck him as he swerved in front of her. He was thrown from his bicycle and his helmet came off on impact with the roadway. Road and weather conditions were excellent. Death was as a result of head injuries resulting from a fractured skull.

92-225-1666 A young teen age cyclist approaching a "through" street at a "T" intersection went through a stop sign and made a wide right hand turn into oncoming traffic. A van travelling on the "through" street tried to stop but to no avail and the youth was struck, thrown and suffered severe head injuries from which he died.

92-241-0982 A lady in her mid-twenties who was approaching a "T" intersection, apparently went through a stop sign and, in an effort to avoid being hit by an oncoming vehicle, fell to the roadway but was struck by the car she was trying to avoid. She was not wearing a helmet and suffered severe head injuries from which she died. The cyclist's view of oncoming traffic on the roadway on which she was proceeding onto would have been somewhat obstructed by parked vehicles and a hedge. It was raining quite heavily at the time.

92-225-1207 Two young boys were riding their bikes near a construction site in Surrey where large trucks were operating. There was a flag person in the area to control traffic. He had stopped all traffic movement for a truck and when the truck completed its job it backed up. At this time the two boys started riding towards the back of the truck at which the flag person called to them getting the attention of one but not the other who continued to ride past the rear of the truck and was struck by it. The cyclist died of multiple injuries.

92-125-0028 A cyclist in his early twenties was riding his bike on Highway 19 in Courtenay in a northerly direction when struck by a vehicle travelling in the same direction. Road conditions were good but it was dark and the bicycle was neither equipped with head light, tail light or any type of reflector. The speed limit was 60 km/h. The vehicle was travelling at about l00 km/h. Both the cyclist and the vehicle operator were intoxicated by alcohol at the time. Death resulted from breakage of the spinal cord.

92-634-0010 The bicycle rider, a man in his eighties, was sitting on his bike in a roadway across the lane of travel. It was dark and the cyclist had on dark clothing. He was in a dip in the road which caused a bit of a blind spot and an oncoming vehicle had to swerve to miss him. A following vehicle collided with the cyclist without seeing him at all. Death was immediate from massive injuries including head injuries. The cyclist had been in a previous serious accident in the area and various complaints had been made to authorities about his riding habits.

92-417-0013 A city bus was passing a young male cyclist when part of the bicycle touched the bus and the cyclist was thrown under the rear tires of the bus causing his immediate death. The bus driver was aware of the cyclist and gave him sufficient space to pass safely by him. The cyclist was experienced and rode his bike in this area frequently. The coroner was unable to determine what caused the bus and cyclist to come into contact but speculated that rough pavement might have been responsible.

93-222-1577 A young man in his early twenties was riding his bike late at night and collided with a vehicle in an intersection. He was thrown from his bike and suffered head injuries from which he died. Road conditions at the time were good but the roadway itself was very dark. The bicycle had no headlights or reflectors. The coroner found that the cyclist was travelling at a high rate of speed. A toxicology report indicated that the cyclist was impaired by alcohol.

93-175-0036 A cyclist in his mid-twenties was riding his mountain bike south on a main thoroughfare. He was wearing a baseball peaked hat and was pedalling hard with his head down when he crashed into a stationary vehicle. The force of the collision caused the cyclist to penetrate the rear window of the car and, in doing so he received severe lacerations to his neck from which he died. The coroner recommended to the Motor Vehicle Branch that legislation be passed making helmets mandatory for cyclists.

93-110-0134 A middle aged man from Europe was cycling with his wife in the Qualicum Beach area on Highway 19. Two semi-trailers were parked along the side of the highway leaving about 2 metres between their vehicles and the fog line on the highway. The cyclists were travelling in this 2 metre ribbon when they were struck from behind, the oncoming vehicle in fact touched the trucks on their tires and wheels. The deceased was thrown into the back of the second semi-trailer and suffered severe head injuries from which he died immediately.

93-202-1344 A male in his early thirties was riding his bicycle downhill on a city street following a motor vehicle. The cyclist was travelling at about 50 km/h. At an intersection and while rounding a curve, the bicycle skidded out of control into the oncoming lane of traffic and collided with a truck. The cyclist suffered a massive right occipital skull fracture and died as a result.

93-635-0009 A cyclist in his early sixties was travelling on the shoulder of a four lane highway facing oncoming traffic when he turned into the path of an approaching car. The driver of this vehicle tried to avoid him but was unable to do so. The autopsy report attributed death to multiple injuries consistent with blunt impact. The deceased was a diabetic who, on occasion, was known to be non compliant in taking his insulin. Testing done following his death indicated that the loss of control of his bicycle could have been related to this disease

93-243-1727 This mid-thirties male cyclist was riding to work in Vancouver. He was considered to be a good cyclist and was wearing a helmet. Road conditions and visibility were good. There was light to moderate traffic in the direction the cyclist was going. He was following a truck and keeping pace in a safe manner. The truck driver made a right turn signal as he approached an intersection and then made the turn. The cyclist collided with the right rear wheels of the truck and was knocked to the pavement. He died of massive head injuries as a result of a skull fracture.

93-600-0078 A teen age boy was riding his bike just south of the Quesnel city limits on Highway 97. He had left home a little earlier and was believed to be headed to a local recreation complex. A motorist was travelling south on Highway 97 travelling in the slow lane and was leaving the highway in the exit lane to access Dragon Hill Road. Road conditions were good but it was dark. Suddenly the car driver saw the cyclist coming directly at her and she was unable to avoid him, the left front headlight area of her truck came in contact with the cyclist. His bike had no reflectors or headlight. He died from severe head injuries. He was not wearing a helmet at the time of the impact.

94-245-1122 At about 11:30 p.m. on a July evening a middle aged cyclist was travelling north on a major thoroughfare in Vancouver when he was struck by an automobile travelling in the same direction. He died within a few days of massive injuries to his abdomen and head. The cyclist had been drinking heavily as his subsequent blood alcohol reading of .4 was to attest. He was wearing dark clothing and had no illumination on his bicycle. The accident occurred when he suddenly swerved into the lane of the oncoming vehicle.

94-230-0024 This accident involved a five year old on a First Nation Reserve near Agassiz. She was in the intersection of the lane to her house and the roadway that went by it. The driver, a local resident, had not seen the child until almost upon her, a grove of wild shrubs and trees obscuring the driver's view until about 50 meters from the lane. The child was hit broadside and carried some distance. No brake marks were found on the pavement, nor was there other evidence of the point of impact. Dusk was rapidly approaching and there was a fine but steady rain. The motor vehicle involved, a truck, was in good mechanical condition at the time of impact. The young girl was described as being healthy and alert. She was able to ride her bike but had received no formal training in safety.

94-165-0036 At approximately 23:30 hours on a late April evening in Langford, B.C. a half ton truck travelling in an easterly direction on Kelly Road near Langford struck a cyclist travelling in a westward direction on the roadway. The bicycle, driven by a male in his mid thirties, was not lighted although it had orange reflectors on the pedals. The cyclist was wearing dark clothing that included a black jacket with white bands on the sleeves. The principal cause of death was a massive head injury. The cyclist was severely impaired by alcohol.

94-228-0641 In early April at approximately 11:40 in the evening a cyclist and a dump truck were travelling in a southerly direction in the curb lane on Pinetree Way in Coquitlam. While passing through the intersection of Lincoln Street, the truck began to overtake the cyclist and as it cleared that intersection its driver became aware that the cyclist had fallen under its trailer wheels. He stopped immediately and Emergency Health Services were summoned. The cyclist, a man in his sixties, died immediately from multiple blunt force injuries particularly to the head and abdomen. Traffic was light at the time, skies were overcast with light rain and wet pavement. The deceased was in good health at the time of the accident and was not on any medications. The death is one in a category of deaths in which a bicycle and, usually, a truck somehow come together as one is passing the other but no satisfactory explanation or reason can be found to describe just what occurred.

94-203-1926 A 12 year old girl was riding her bicycle in a southerly direction on the east sidewalk of No.4 Road in Richmond at about 5:00 p.m. on a wet mid November day. She was run over by a large pickup truck coming out of a driveway (front first) and turning right to go in a northerly direction on No.4 Road. Lighting conditions were such that headlights were appropriate for safe driving. The bicycle was not equipped with a bell or a light although there were reflectors front and rear. The cyclist was wearing dark clothing but not a helmet. The cyclist ended up on the inside lane of No.4 Road and the driver continued on later advising that he did not know he had struck anyone or anything. Trees and shrubs along the sidewalk obscured vision north and south on the sidewalk until the driver's cab was over the sidewalk area. Various recommendations were made by the jury including the use of equipment, clothing etc. that makes the cycle or cyclist readily seen in dark conditions; enforcement of bylaws requiring property owners to maintain adequate sight lines at driveways; mandatory testing of blood for alcohol and drugs of drivers involved in fatal accidents; mandatory completion of a defensive driving course for drivers involved in fatal accidents; public education programs to reinforce driver awareness of cyclists and pedestrians; and the provision for bicycle lanes on all major roadways and bridges.

94-500-0032 Canyon - A nine year old glided down a 6% incline on 43d street, probably went through a stop sign and collided with a large truck. The driver as he was passing through the intersection noted an object to his right on 43d street and on checking his side mirror observed the cyclist collide with his rear wheel. The cyclist's skull was fractured.

95-170-0257 A teenaged cyclist was riding her bicycle over an overpass on highway 17 near Sidney contrary to large signs directing cyclists to disembark and walk over overpass. She was holding a bottle in her right hand and exited very quickly off the steep ramp. She moved quickly to avoid a wheel chair on the sidewalk and as she moved back onto the sidewalk she lost control of her bike, the front wheel locking to the application of the front brake but no apparent application of the back brake. As the bike's front tire scraped along the curb the teenager was propelled off her bicycle landing hard on the pavement hitting her head. She was not wearing a helmet. She died of brain injuries.

95-167-0137 An experienced cyclist in his mid-forties was cycling on the paved shoulder towards Victoria in the 6100 block of the Pat Bay Highway when he was struck from behind by a automobile which had been weaving in and out of traffic and drove onto the shoulder of the road. Observers said this vehicle was going slightly over the speed limit, was not keeping a proper lookout and the driver had consumed alcoholic beverages. The cyclist died instantly of damage to the brain stem. Road conditions were good and the accident occurred in daylight hours.

95-219-1205 A cyclist in his mid-forties was cycling in a westerly direction on 104th Avenue in Surrey. He was travelling in the curb lane next to the edge of the roadway. It was about 5:00 p.m. and road and weather conditions were good. A van travelling in an easterly direction on the same roadway proceeded across the median into the oncoming lane and struck the cyclist head on. The driver of this vehicle indicated that she either had a blackout or fell asleep.

95-221-1345 A cyclist in his late fifties was riding his bicycle westbound on 8th Ave. in Surrey at about 2:30 p.m. on a late August afternoon. He was travelling on the shoulder of the road and wearing a helmet. Weather conditions were clear and dry and the roadway was in good repair. A van travelling in the same direction as the cyclist moved partially into the shoulder and clipped the cyclist throwing him into a six foot ditch where he landed on his head. He died of cerebral trauma.

VII. Reference Material

Bicycle Helmet Advisory Committee, Discussion Paper on Mandatory Bicycle Helmet Legislation. 1993.

Bicycle Safety What Even Parent Should Know. (1991) Bicycle Forum Magazine, Missoula, MT.

British Columbia, Report of the British Columbia Royal Commission on Health Care and Costs, Closer to Home. Victoria: Crown Publications, 1991.

-, Ministry of Attorney General, Bicycle / Motor Vehicle Casualty Traffic Accidents: Trends Characteristics Persons Involved and Consequences (1986). Counter Attack Research Papers 1987, February 1988, pp. 74 - 94.

-, Ministry of Health, Office for Injury Prevention, Injury Prevention Stakeholder's News. 1995. Issue No.4; March / April '96 Issue No.2.

-, Ministry of Transportation and Highways, Bike Smarts. Victoria: Motor Vehicle Branch.

-, Ministry of Transportation and Highways, British Columbia 1994 Traffic Collision Statistics. Victoria Motor Vehicle Branch.

-, Ministry of Transportation and Highways, British Columbia 1993 Traffic Collision Statistics. Victoria: Motor Vehicle Branch.

Hospital for Sick Children, Toronto, Ontario, Fatal Bicycle Accidents in Children: A Plea for Prevention. 1991

Share the Road '95, Cycling B.C.

Thompson, Robert S., Rivara, Frederick P. and Thompson, Diane C., "A Case Control Study of the Effectiveness of Bicycle Safety Helmets". The New England Journal of Medicine. Vol. 320, May 25, 1989.

BHSI note: In 2000 the University of North Carolina conducted an evaluation project for the BC helmet law. It showed substantial increases in helmet use after the law was passed.