Improving Road Safety – World Health Organization

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Cyclist on Tight Road, Cropped, Dundas, Ontario KPThe World Health Organization (WHO) has released a new report on road safety, “The Global Status Report on Road Safety 2013“, which estimates that 1.24 million people die per year as a result of road traffic injuries.  The WHO report notes that road traffic fatalities are the leading cause of death, on a global scale, among people who are 15 to 29 years in age (WHO, 2013).

The report assesses 182 countries with a collective population of 6.8 billion people for policies that can be adopted and implemented to reduce road traffic deaths.  The policies are grouped under five headings: road safety management, safer roads and mobility, safer vehicles, safer road users, and post-crash response. The report includes a one-page summary for each one of the 182 countries assessed.

The report indicates that road traffic death rates have decreased in Canada from about 9.5 deaths per 100,000 people in 2000 to about 6.5 deaths per 100,000 in 2009.  While this is a healthy trend, the report also indicates that there were  2,227 road traffic fatalities in Canada in 2009, and that Canada lost approximately 5% of its GDP in 2009 because of road traffic crashes (WHO, 2013).  

When road traffic deaths are categorized by road users in Canada, the WHO reports that:

  • 69% occur among drivers and passengers of cars and light trucks;
  • 14% among pedestrians;
  • 9% among drivers of motorized 2- or 3-wheelers;
  • 3% among drivers and passengers in heavy trucks;
  • 2% among cyclists; and
  • 1% among drivers and passengers of buses (WHO, 2013).

Family Cycling, Dundas, Ontario KPWhile these numbers reflect the number of people killed in each road user category, they do not reflect the risk associated with each category of road user.  Analyses conducted for the United States indicate that the death rates per kilometre travelled are 23 and 12 times greater respectively among pedestrians and cyclists than among people who travel by car (Pucher and Dijkastra, 2003 as cited by the NCCEH, 2010).  It is expected that pedestrians and cyclists in Canada also have a much greater risk of dying from a road traffic crashes than their counterparts in vehicles.

From a road safety policy perspective, the WHO reports that Canada is doing well by having:

  • Regular inspections of existing road infrastructure;
  • National laws that require seat-belts in all new and imported cars;
  • Provincial laws that require child-restraints in vehicles;
  • Provincial maximum speed limits;
  • Provincial laws that require motor-cycle drivers and passengers to wear helmets;
  • A national law which regulates drinking and driving and allows random breath testing; and
  • Provincial laws that prohibit the use of mobile phones while driving (WHO, 2013).

However, the report also identifies several areas for improvement.  It notes that:

  • Canada does not have a road traffic fatality reduction target;
  • Canada does not require formal safety audits for new road construction;
  • 33% of all road traffic deaths in Canada involve alcohol and there is room for improvement in enforcement of drinking and driving laws; and
  • Canada has no law prohibiting the use of hands-free mobile phones while driving (WHO, 2013).

The WHO reports that 77% of the 182 countries assessed require a formal road safety audit for new road construction.  Canada is not among this group of countries.  The report explains that road safety audits can be used to assess, design and construct roads so they are safe for all road users including pedestrians and cyclists (WHO, 2013).

Bike Path, Dundas -DTThe WHO reports that 68 countries have national or sub-national policies to promote walking and cycling and 79 countries have national or sub-national policies to separate road users to protect vulnerable road users.  The report indicates that there are sub-national policies in Canada for both of these policies but it is not clear which jurisdictions within Canada do and do not have these policies (WHO, 2013).

The WHO report identifies New York City as an example of a jurisdiction that has made huge strides in reducing traffic fatalities by developing an Action Plan that seeks to reduce annual traffic fatalities by 50% by the year 2030.  The Plan includes:

  • The installation of 15,000 pedestrian countdown signal at intersections city-wide;
  • The implementation of 75 additional school speed zones where 20 mph (32 km/hour) is the maximum speed limit; and
  • The implementation of Neighbourhood Slow Zones in several neighbourhoods where the speed limit will be reduced to 20 mph (WHO, 2013).

References:

Traffic Congestion Costs More than Toll Roads

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Traffic-QEW-KPIn Ontario, there is finally an open debate among decision-makers about the policies that are needed to reduce traffic congestion in, and fund public transit for, the Greater Toronto and Hamilton Area (GTHA).  This is a discussion that has been needed for a long time because traffic congestion in the GTHA is costly in many ways.

A study prepared for the Toronto City Summit Alliance in 2010 reported that, between 1986 and 2006, in the GTHA:

  • The supply of roads in lane-kilometres increased by 56% while vehicle-kilometres travelled in personal vehicles increased by 106%;
  • The supply of transit grew by 18% while the demand in passenger-kilometres grew by 45%;
  • Traffic congestion reduced average peak period traffic speed by 25%;
  • Average time spent commuting increased by 52%;
  • Emissions of greenhouse gases from person vehicles increased by 56%; and
  • Direct annual costs of congestion (i.e. lost time to drivers) grew to more than $3 billion per year, while the drag on the economy grew to more than $2 billion per year (Toronto City Summit Alliance, 2010).

Traffic congestion is also costly to public health. Traffic congestion increases traffic-related air pollution in communities surrounding roadways; it increases exposure to air pollution among individuals in vehicles (Montreal, 2006); it decreases the time available to commuters for physical activity, family time, and socializing; and it increases the levels of stress among commuters (WHO, 2000; TPH, 2006).  The air pollution-related health impacts alone are significant.  In 2007, Toronto Public Health estimated that traffic-related air pollution produces approximately 440 deaths,1,700 hospital admissions and 200,000 restricted activity days per year in the City of Toronto alone (TPH, 2007).  The mortality-related costs alone were valued at about $2.2 billion per year (TPH, 2007).

While there are many policies that can and should be employed to reduce traffic congestion in urban and suburban areas within the GTHA, to deal with the issue on a regional scale one has to deal with the issue of public transit and the policies needed to encourage a shift from personal vehicles to public transit.  Metrolinx’s Regional Transportation Plan, “The Big Move“, has identified the need for $50 billion in capital investments for transit and transportation systems in the GTHA over the next 25 years (Toronto City Summit Alliance, 2010).  While it is widely recognized that this investment is needed, there is, as yet, no consensus about how to fund it.

GO Train, Union Station -KPThe Toronto City Summit Alliance report assesses 12 potential approached to this issue for: the funding they could provide; their potential impact on traffic congestion; and their unintended negative impacts.  The report considers: road tolls, a regional gas tax, a commercial parking levy, a regional sales tax, high occupancy toll (HOT) lanes, HST revenue from gas/diesel taxes, a central area congestion levy, a value capture levy, a utility bill levy, an employer payroll tax, and a national Federal-Provincial Transit Strategy.

HOT lanes, which allow lone drivers to drive on high occupancy lanes if they are willing to pay a toll, were identified as one approach that could generate significant funding for public transit and relieve traffic congestion, while avoiding some of the equity concerns presented by road tolls when applied to all lanes on a highway.  In 2011, the C.D. Howe Institute reported that, if all existing and planned high occupancy vehicle (HOV) lanes in the GTHA were converted to HOT lanes, $926 million per year could be generated in gross revenues for public transit (Dachis, 2011).

Provincial and municipal decision-makers have been reluctant to discuss road tolls as a source of transit funding because historically this approach has been unpopular among the citizens of the GTHA.  While road tolls are unlikely to provide all of the funding that is needed for The Big Move, they are an important tool in the box of tools needed to reduce traffic congestion and fund transit in the GTHA that should be seriously considered.  Perhaps we need to be clearer with the public that traffic congestion is already costing us much more than toll roads would?

References:

  • Toronto City Summit Alliance.  2010.  Time to Get Serious: Reliable Funding for GTHA Transit/Transportation Infrastructure.  Prepared by Neal Irwin, IBI Group and Andrew Bevan, Sustainable Prosperity.
  • Montreal Health and Social Service Agency.  2006.  Urban Transportation, A Question of Health. (63 pp)
  • World Health Organization. 2000.  Transportation, Environment and Health.
  • Toronto Public Health, 2006.  The Impacts of Traffic on Health.  Board of Health report. (19 pp)
  • Toronto Public Health, 2007.  Air Pollution Burden of Illness from Traffic in Toronto. Board of Health report.
  • Dachis, B.  2011.  Congestive Traffic Failure: The Case of High-Occupancy and Express Toll Lanes in Canadian Cities.  C.D. Howe Institute e-Brief. August 31, 2011.

Six Reasons to Support an Ambitious Cycling Strategy

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Bike Path, HamiltonOn November 30, 2012, the Ontario Ministry of Transportation released a Draft Cycling Strategy that is intended to replace the Ministry’s 1992 Bicycle Policy. The proposal has been posted for a 60 day public comment period which ends on January 29, 2013.  So, here are six reasons why decision-makers, public health professionals, and members of the public should support a well-funded and ambitious Cycling Strategy for Ontario.

An Ambitious Provincial Cycling Strategy can:

  1. Reduce the number of people who die from acute and chronic diseases associated with air pollution. 
  2. Reduce the number of people who develop chronic diseases by increasing levels of physical activity.
  3. Reduce emissions of greenhouse gases that contribute to climate change.

When researchers in the United States assessed the health benefits that would result from the elimination of all short automobile trips (i.e. round trips that are less than or equal to 8 kilometres) and the replacement of 50 per cent of these short trips with cycling trips, they found that improvements in air quality and increases in physical activity could produce health benefits worth more than $7 billion per year among the 31.3 million people in the areas examined.

These health benefits were equivalent to about 2.5% of the 2004 health care costs for the five midwestern states included in the study. The researchers estimated that the scenario would:

  • Prevent 433 deaths, 2,000 asthma attacks, 75 Chronic Obstructive Pulmonary Disease cases, 93,607 emergency room visits or hospital admissions, and 660 heart attacks and related hospital admissions each year by improving air quality; and
  • Prevent 700 deaths from chronic diseases each year by increasing physical activity.

The researchers also found that the 20% reduction in vehicle miles travelled would reduce greenhouse gas emissions from the region by 1.8 million tonnes or 20% per year (Grabow, 2011).

4.  Reduce the number of vehicle-related injuries and deaths among cyclists. 

Bike Lane, Burlington KPIn June 2012, the Chief Coroner of Ontario released the report, Cycling Death Review, which examined the deaths of 129 cyclists that occurred in Ontario over a 5 year period (2006-2011).  In that report, it is noted that more than 26,000 Ontario residents visit an emergency ward each year due to an injury sustained while riding a bicycle.  That report also indicates that while the 129 deaths were called “accidental deaths”, all of them were predictable and therefore preventable.

The Coroner’s report notes that: Denmark reduced deaths among cyclists by 35% by providing segregated bicycle tracks or lanes alongside urban roads; the state of Victoria in Australia reduced head injuries among cyclists by 51% within one year of implementing a new law requiring helmets in 1990; and the United Kingdom decreased fatalities among cyclists who collided with the sides of heavy trucks by 61% by requiring truck guards (Chief Coroner, 2012).

5.   Increase access to jobs, school, recreational facilities and other amenities among vulnerable populations.

A community that provides cycling facilities provides an alternate means of travel for those who do not own vehicles or cannot drive because of age, ability or income.  These facilities can give children, adolescents, and people living on low incomes, greater access to jobs, schools, recreational facilities and other amenities (WHO, 2011).

6.  Save money on transportation systems.

Cycling infrastructure is extremely cost-effective.  When the U.K. Sustainable Development Commission assessed the costs and benefits associated highways and cycling infrastructure using changes in travel time, travel costs, accidents, noise and greenhouse gas emissions as the costs and benefits considered, it found that major cycling infrastructure projects produce benefits that are worth 11 times as much as the costs, while local highway road schemes produce benefits that are worth 4 to 5 times as much as the costs (Sustainable Development Commission, 2011 as cited by TPH, 2012).  In Portland, Oregon, for example, where the 3 to 7% of travel is done on bicycles, only 1% of the capital expenditures for transportation are directed at cycling facilities (Wallasper 2010 as cited by TPH, 2012).

Policy Paper

For information on policies that could be incorporated into a provincial Cycling Strategy, see Share the Road Cycling Coalition’s Green Paper (2010).

References:

  • Grabow, Maggie, Scott Spak, Tracey Holloway, Brian Stone Jr., Adam Menick, Jonathan Patz. 2011.  “Air Quality and Exercise-Related Health Benefits from Reduced Car Travel in the Midwestern United States”, Environmental Health Perspectives.  November 2011 (38 pages) http://dx.doi.org/10.1289/ehp.1103440
  • Chief Coroner of Ontario. 2012.  Cycling Death Review.
  • World Health Organizations (WHO), 2011. Health co-benefits of climate change mitigation – Transport Sector.
  • Toronto Public Health (TPH), 2012. Road to Health: Improving Walking and Cycling in Toronto.  April 2012.

Hurricane Sandy – A Wake-up Call?

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In the wake of Hurricane Sandy, it seems an appropriate moment to re-examine the issue of climate change and its impacts on human health. For those who get their information on climate change from the news alone, it would be easy to assume that it is still unclear whether human activity is contributing to it.  One frequently sees newspaper columns that dismiss the science related to climate change and news articles which imply that there is still considerable debate around the contribution of humans to it.  But that debate is over and has been for years.  In 2007, the International Panel on Climate Change (IPCC) issued a report in which it confirmed, with 90 per cent certainty, that the world’s climate is warming and that human activity has had a discernible influence on many physical and biological systems (IPCC, 2007a; IPCC, 2007b).

The IPCC report on the physical sciences found that levels of carbon dioxide (CO2) in the atmosphere have increased from 280 parts per million (ppm) to 379 ppm over the last 200 years; an astounding increase when one considers that CO2 levels ranged between 180 and 300 ppm for the past 650,000 years.  The IPCC also concluded that, even if immediate and aggressive action were taken to freeze emissions at 2000 levels, a 2 degree Celsius increase in global temperatures is “locked in” for the next two decades because of “carbon feedback cycles” (IPCC, 2007a).

Climate change is expected to:

Reuters/Lucas Jackson

  • Increase the average temperature around the planet;
  • Increase the temperature of ocean waters;
  • Melt the polar ice cap and increase sea levels;
  • Change the ocean currents; and
  • Increase the frequency and/or severity of extreme weather events (IPCC, 2007a).

In Ontario, climate change is expected to affect human health by:

  • Increasing the frequency and severity of heat waves;
  • Increasing the frequency and severity of smog episodes;
  • Increasing the frequency of extreme weather events including snow storms, floods and tornadoes;
  • Increasing the risk of  insect-borne diseases such as Lyme’s Disease and West Nile Virus; and
  • Increasing the risk of water-borne diseases (Lemmen et al., 2008).

Reuters/Swoan Parker

At a global level, climate change is expected to have profound impacts on the health of whole populations in regions around the world.The IPCC concluded that projected climate change is likely to affect the health status of millions of people, particularly those who live in countries that have little adaptive capacity, through:

  • Increases in malnutrition and related disorders;
  • Increased deaths, disease and injury due to heat waves, floods, storms, fires and droughts;
  • The increased burden of diarraheal disease;
  • The increased frequency of cardio-respiratory diseases due to higher concentrations of ground-level ozone that result from climate change; and
  • The altered spatial distribution of some infectious disease vectors such as mosquitoes and ticks (IPCC, 2007b).

Africa is considered one of the most vulnerable continents because of multiple stresses and low adaptive capacity.  Most continents are expected to experience decreases in fresh water supplies.  Coastal areas around the world are at increased risk from flooding.  Malaria is expected to shrink in range in some areas of the world in response to droughts, while cholera is expected to increase in others in response to increasing water temperatures.  Europe and North America are expected to experience more flooding and more heat waves (IPCC, 2007b).

In 2006, Sir Nicholas Stern, former economist to the World Bank, led a study for the British Government which estimated that it would take about 1 per cent of the annual global Gross Domestic Product to fund the programs needed to stabilize greenhouse gas concentrations in the atmosphere below 550 ppm – the level required to limit global temperature increases between 2 and 3 degree Celsius.  The study also found that failure to make this investment could result in climate change impacts that would result in a 5 to 20 per cent loss in the global Gross Domestic Product (GDP).  The study concluded that these impacts could create economic and social disruptions on a scale similar to those experienced during the great wars or the depression (Stern, 2006).

Hurricane Sandy left a path of death, dislocation and destruction. The cost of repairs is estimated to be in the tens of billions of dollars.  Let us hope that it is seen as a wake-up call for those governments, politicians and journalists who have failed to take the science of climate change seriously.

References:

  • International Panel on Climate Change (IPCC), (2007a).  Climate Change 2007: The Physical Science Basis – Summary for Policy Makers.
  • Intergovernmental Panel on Climate Change (IPCC).  (2007b).  Summary for Policymakers.  Climate Change 2007: Impacts, Adaptation, and Vulnerability.   Contribution of Working Group II to the Fourth Assessment Report of the IPCC.  Prepared by ML Parr, OF Canziani, et al.  Cambridge University Press, Cambridge, UK: 2007. (22 pages)
  • Lemmen, Donald, Fiona Warren, Jacinthe Lacroix, Elizabeth Bush (editors).  (2008).  From Impacts to Adaptation: Canada in a Changing Climate 2007.  Ontario Chapter led by Quentin Chiotti and Beth Lavender.  Government of Canada, Ottawa, Ontario.  (448 pages)
  • Stern, Sir Nicholas. (2006).  Stern Review of Economics and Climate Change.  HM Treasury: October 2006.
  • Excerpts from: Perrotta, 2012. Public Health and Land Use Planning: How Ten Public Health Units are Working to Create Healthy and Sustainable Communities.  Prepared for the Clean Air Partnership (CAP).  230 pages.

Where do E-Bikes Belong?

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Over the last several months, I have seen scooter style e-bikes everywhere in down town Toronto; parked on side walks and travelling on roads, bike lanes, and the shoulders of roads.  I have become rather enamoured with them.  They are quiet, sleek and colourful.  I have seen them in pink, powder blue, red, grey, turquoise and white.  They are smaller than motorcycles; they appear to be light-weight and easy to maneuver; and they release no air pollutants along traffic corridors.

However, over the last few months, I have had five different cyclists tell me that they hate sharing bike lanes and road shoulders with e-bikes.  I have been told that: they are too bulky for cyclists to pass safely; they are too fast and quiet and can surprise cyclists from behind; and they can block the shoulder lanes for cyclists who are trying to get a jump on vehicles at traffic lights.  Last week, the Globe and Mail reported that separated bike lanes may not be wide enough to allow a cyclist to pass a scooter style e-bike.  So that raises the question: “Where do e-bikes belong?”

The Province permits e-bikes to be operated like bicycles without a licence or insurance as long as they are equipped with pedals.  The cyclists I spoke to had little concern about e-bikes that look like, and operate, mostly like bicycles.  These e-bikes are bicycles with batteries installed on them.  But these cyclists did have a concern about the scooter style e-bikes that look like, and operate, more like a motorized scooter than a bicycle.

According to Michael Vaughan of the Globe & Mail, these scooter style e-bikes can travel up to 32 km/hour and weigh up to 160 pounds.  While this speed may be perfect for roads in the inner core of large urban centres, it is too slow for most roads in southern Ontario.  From the few anecdotes that I have heard, it is not clear to me that all e-bikes belong on bike lanes, but given the health concerns associated with air pollution along traffic corridors, the greenhouse gases associated with most cars and trucks, and traffic congestion in many urban centres, it makes a lot of sense to encourage these scooter style e-bikes as an alternative to other motorized vehicles.  The question is: “How do we accomplish that?”

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