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Background: For an accurate estimation of health benefits and hazards of utilitarian cycling, a prospective collection of bicycle usage data (exposure) is fundamental. Individual and environmental correlates are necessary to guide health promotion and traffic safety issues. Firstly, this study aims to report on utilitarian bicycle usage in Belgium, using a prospective data collection in regular adult commuter cyclists. Secondly, the association is explored between the individual variation in bicycle usage and individual and environmental correlates., Methods: 1187 regular adult cyclists filled out travel diaries prospectively. Multivariate linear regression with Stepwise selection (SMLR) models studied the association between exposure and individual and environmental correlates., Results: Higher age and availability of cycle paths have a positive association with bicycle usage to work. Women cycle significant less compared with men, and so do cyclists with 'poor' or 'average' health. Living in an urban crown (opposed to city center) and living in Flanders (opposed to Brussels or Wallonia) is associated with significantly more cycling., Conclusions: Utilitarian cycling is related to regional differences, level of urbanization of the place of residence, availability of bicycle paths, and gender. These findings are useful in estimating health benefits and hazards of utilitarian cycling among regular Belgian cyclists.

This paper aims at predicting cycling accident risk for an entire network and identifying how road infrastructure influences cycling safety in the Brussels-Capital Region (Belgium). A spatial Bayesian modelling approach is proposed using a binary dependent variable (accident, no accident at location i) constructed from a case-control strategy. Control sites are sampled along the 'bikeable' road network in function of the potential bicycle traffic transiting in each ward. Risk factors are limited to infrastructure, traffic and environmental characteristics. Results suggest that a high risk is statistically associated with the presence of on-road tram tracks, bridges without cycling facility, complex intersections, proximity to shopping centres or garages, and busy van and truck traffic. Cycle facilities built at intersections and parked vehicles located next to separated cycle facilities are also associated with an increased risk, whereas contraflow cycling is associated with a reduced risk. The cycling accident risk is far from being negligible in points where there is actually no reported cycling accident but where they are yet expected to occur. Hence, mapping predicted accident risks provides planners and policy makers with a useful tool for accurately locating places with a high potential risk even before accidents actually happen. This also provides comprehensible information for orienting cyclists to the safest routes in Brussels., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

The purpose of this study is to gain insight into bicycle accidents. Bicycle accident data and weekly exposure data were prospectively collected for one year to calculate the incidence rate (IR) of bicycle accidents. An accident was included if it occurred during utilitarian cycling, resulting in an acute injury with corporal damage. If an accident occurred, a detailed questionnaire was filled out to collect detailed information about its circumstances and consequences. A sample of 1087 regular (≥2 cycling trips to work a week) adult (40±10 years) cyclists was analyzed. Over the 1-year follow-up period, 20,107 weeks were covered, accumulating 1,474,978 cycled kilometers. Sixty-two participants were involved in 70 bicycle accidents, of which 68 were classified as 'minor'. The overall IR for the 70 accidents was 0.324 per 1000 trips (95% CI 0.248-0.400), 0.896 per 1000 h (95% CI 0.686-1.106) and 0.047 per 1000 km (95% CI 0.036-0.059) of exposure. Brussels-capital region is the region with the highest IR (0.086; 95% CI 0.054-0.118), with a significantly (P<0.05) higher IR compared to Flanders (0.037; 95% CI 0.025-0.050). Injuries were mainly caused by 'slipping' (35%) or 'collision with a car' (19%). The accidents caused abrasions (42%) and bruises (27%) to the lower (45%) and upper limbs (41%). Police, hospital emergency department or insurance companies were involved in only 7%, 10% and 30% of the cases, respectively. It is noteworthy that 37% of the participants indicated that they could have avoided the accident. In order to decrease the number of accidents, measures should be taken to keep cycling surfaces clean and decrease the number of obstacles on bicycle infrastructure. Roads and intersections need to be built so that the collisions between cars and bicycles are decreased to a minimum. Car drivers and cyclists should pay more attention towards each other. Underreporting of minor bicycle accidents in Belgium is confirmed, and is higher than expected. Reliable accident statistics, taking into account exposure, are needed to decide which road safety measures are the most effective. The 'safety in numbers' principle is also applicable for minor bicycle accidents., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Minor bicycle accidents are defined as "bicycle accidents not involving death or heavily injured persons, implying that possible hospital visits last less than 24 hours". Statistics about these accidents and related injuries are very poor, because they are mostly not reported to police, hospitals or insurance companies. Yet, they form a major share of all bicycle accidents. Official registrations underestimate the number of minor accidents and do not provide cost data, nor the distance cycled. Therefore related policies are hampered by a lack of accurate data. This paper provides more insight into the importance of minor bicycle accidents and reports the frequency, risk and resulting costs of minor bicycle accidents. Direct costs, including the damage to bike and clothes as well as medical costs and indirect costs such as productivity loss and leisure time lost are calculated. We also estimate intangible costs of pain and psychological suffering and costs for other parties involved in the accident. Data were collected during the SHAPES project using several electronic surveys. The weekly prospective registration that lasted a year, covered 1187 persons that cycled 1,474,978 km. 219 minor bicycle accidents were reported. Resulting in a frequency of 148 minor bicycle accidents per million kilometres. We analyzed the economic costs related to 118 minor bicycle accidents in detail. The average total cost of these accidents is estimated at 841 euro (95% CI: 579-1205) per accident or 0.125 euro per kilometre cycled. Overall, productivity loss is the most important component accounting for 48% of the total cost. Intangible costs, which in past research were mostly neglected, are an important burden related to minor bicycle accidents (27% of the total cost). Even among minor accidents there are important differences in the total cost depending on the severity of the injury., (2010 Elsevier Ltd. All rights reserved.)