Cyclists injured in traffic crashes in Hong Kong: A call for action

BACKGROUND: Perceived as a minor transportation mode mainly for recreation, cycling and its related safety issues have not been treated as a citywide concern in Hong Kong and have thus received inadequate research efforts. Our study aimed to illuminate the safety challenges faced by cyclists in Hong Kong. METHODS: We examined the police crash records from 1998 to 2017 and developed a Bayesian Poisson state space model to evaluate the longitudinal change in traffic injuries to cyclists. We then used quasi-induced exposure to measure the annual relative risk of crash involvement for cycling. Based on an officially published travel characteristics survey, we further measured the risk of injury for cycling per minutes cycled. RESULTS: Between 1998 and 2017, Hong Kong witnessed a more than twofold increase in the number of cyclist injuries, with an average annual increase rate of 5.18% (95% CI: 0.53%–12.77%). By 2017, cyclists were 2.21 (1.82–2.69) times more likely to be involved in traffic crashes than in 1998. Per 10 million minutes, the injury rates for cycling were 28.64 (27.43–29.70) and 42.54 (41.07–44.02) on weekdays during 2001–2003 and 2010–2012. After adjusting for sex and age groups, cyclists were 1.95 (1.43–2.61) times more likely to be injured in 2010–2012 than in 2001–2003. Per minutes traveled, cyclists also sustained significantly higher risks of fatality and injury than pedestrians, private car drivers and passengers, taxi passengers, public bus passengers, and minibus passengers. A comparison of Hong Kong with other regions suggests that Hong Kong is among the most dangerous areas for cycling in terms of fatality rate per minutes cycled. CONCLUSIONS: Cyclist injuries have become a substantial public health burden in Hong Kong. A range of countermeasures with proven effectiveness should be promptly implemented to improve the safety of these vulnerable road users.