Cycling and Health


What the research shows

  • The most effective way to decrease injuries and deaths is to make streets safer for cyclists.

  • Almost all cycling fatalities and serious injuries are due to collisions with motor vehicles. Infrastructure changes such as bike lanes separated from traffic, lower speed limits for motor vehicles and safer intersections are necessary to protect cyclists from harm.

  • Good cycling infrastructure ( e.g. separated bike lanes) makes people feel safer and leads to increased numbers of cyclists. In addition, increased cycling volume leads to increased safety for individual cyclists.

  • Cycling is an excellent form of exercise.

  • Cycling is an effective way to reduce air pollution

What improved cycling infrastructure will do

  1. Make cycling safer for individuals

  2. Encourage more Torontonians to cycle

  3. Improve the health of Torontonians

  4. Make our communities healthier by decreasing air pollution

Policy documents summarizing the research

Canadian Association of Emergency Physicians Position Paper

In 2014 the Canadian Association of Emergency Physicians published a position paper on Improving bicycle safety in Canada

Ontario medical association Position Paper

In 2011 the Ontario Medical Association published a position paper on enhancing Cycling safety in Ontario

Active Transportation

Canadian Association of Physicians for the Environment has published an Active Transportation Toolkit

Toronto Public Health

The Toronto Public Health Department has published several excellent resources including Healthy Streets: Evidence Review and Road to Health: Improving Walking and Cycling in Toronto

Toronto Bicycle Infrastructure Projects

More Research and Studies

WHY CITIES with high bicycling rates are safer for all road users

Wesley et al. Journal of Transport & Health. In Press available 29, May 2019

Summary: Cities with high bicycling mode shares have surprisingly good road safety records. Via negative binomial regression, they assessed 13 years of data in 12 major US cities. Higher bicycling rates and ‘safety in numbers’ was not significant. Increased prevalence of protected bicycle facilities suggest safer cities for all.

Route Infrastructure and the Risk of Injuries to Bicyclists: A Case-Crossover Study

Teschke et al. Am J Public Health. December 2012 Vol 102
Summary:  This is a Canadian study.  Cycle tracks had 1/10th the risk of injury compared to major streets with parked cars. In  US, UK, Canada:  1-3% of trips are by bicycle; in Scandinavia, Holland, Germany  10-30% are by bicycle.
The more cyclists, the fewer injuries.  Helmets are rarely used in european countries with lower injury rates than here.

The impact of transportation infrastructure on bicycling injuries and crashes: a review of the literature.

Reynolds et al., Environmental Health. 2009 Oct 21;8:47
Results to date suggest that sidewalks and multi-use trails pose the highest risk, major roads are more hazardous than minor roads, and the presence of bicycle facilities (e.g. on-road bike routes, on-road marked bike lanes, and off-road bike paths) was associated with the lowest risk.

Bicycle Use and Cyclist Safety Following Boston’s Bicycle Infrastructure Expansion, 2009–2012

Pedroso et al., Am J Public Health   Dec 2016
 The expansion of Boston’s bicycle infrastructure was associated with increases in both bicycle use and cyclist safety.

Safer Cycling Through Improved Infrastructure

Pucher et al., Am J Public Health. 2016 December
Summary of the evidence, Lessons from Europe ( significantly lower bike fatalities/injuries than US) and from US cities
showing that with an increase in cycling network mileage, there was an increase in number of cyclists, and a decrease in number of crashes per 100,000 trips ( 25-70%), decrease in number of fatalities and severe injuries(50-80%).

All Cause Mortality Associated with Physical Activity During Leisure Time, Work, Sports and Cycling to Work.

Andersen et al. Archives of Internal Medicine   2000 160(11)
In this study done in Denmark,  cycling to work was found to decrease the risk of dying by over 25 per cent per year.

Do the Health Benefits of Cycling Outweigh the Risks?

de Hartog et al, 2010. Environmental Health Perspectives 118(8)
This study finds that the risks of cycling are greatly outweighed by the benefits of cycling.  It compares life expectancy lost ( due to accidents, exposure to air pollution) to life expectancy gained ( by exercise).  The health benefits outweigh the health risks by 9 times.  "The estimated gain in life expectancy per person from an increase in physical activity ranged from 3 to 14 months (Table 6). The estimated life expectancy lost because of air pollution (0.8–40 days) and traffic accidents (5–9 days) was much smaller."

Influence of Exercise, Walking, Cycling, and Overall Nonexercise Physical Activity on Mortality in Chinese Women              

C. Matthews et al., Am J Epidemiol (2007) 165 (12): 1343-1350
This study of women in China compared health outcomes of women who cycled for transportation with those who didn't.  Women  who cycled for transportation were 40% less likely to die of heart disease, stroke, cancer or any cause.

Association between active commuting and incident cardiovascular disease, cancer, and mortality

BMJ 2017; 357,  April 2017
This is a 5 year prospective cohort study done in Great Britain with 260,000 participants. The  findings are that people who cycle to work had lower chance of dying of any cause ( by 40 %), of getting cancer ( by 40%), or getting heart disease ( by 50%), and of dying of heart disease ( by 50 %).