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Comparative Study
. 2011 Aug 4:343:d4521.
doi: 10.1136/bmj.d4521.

The health risks and benefits of cycling in urban environments compared with car use: health impact assessment study

David Rojas-Rueda  1 , Audrey de Nazelle, Marko Tainio, Mark J Nieuwenhuijsen
Affiliations
Comparative Study

The health risks and benefits of cycling in urban environments compared with car use: health impact assessment study

David Rojas-Rueda et al. BMJ. .

Abstract

Objective: To estimate the risks and benefits to health of travel by bicycle, using a bicycle sharing scheme, compared with travel by car in an urban environment.

Design: Health impact assessment study.

Setting: Public bicycle sharing initiative, Bicing, in Barcelona, Spain.

Participants: 181,982 Bicing subscribers. Main outcomes measures The primary outcome measure was all cause mortality for the three domains of physical activity, air pollution (exposure to particulate matter <2.5 µm), and road traffic incidents. The secondary outcome was change in levels of carbon dioxide emissions.

Results: Compared with car users the estimated annual change in mortality of the Barcelona residents using Bicing (n = 181,982) was 0.03 deaths from road traffic incidents and 0.13 deaths from air pollution. As a result of physical activity, 12.46 deaths were avoided (benefit:risk ratio 77). The annual number of deaths avoided was 12.28. As a result of journeys by Bicing, annual carbon dioxide emissions were reduced by an estimated 9,062,344 kg.

Conclusions: Public bicycle sharing initiatives such as Bicing in Barcelona have greater benefits than risks to health and reduce carbon dioxide emissions.

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Conflict of interest statement

Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.

Figures

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Sensitivity analysis tornado plot. Centiles for relative risk (RR) for all cause mortality associated with physical activity refer to arithmetic increase of confidence intervals
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Comment in

References

    1. Midgley P. Bicycle-sharing schemes: enhancing sustainable mobility in urban areas. United Nations, Department of Economic and Social Affairs, 2011.
    1. World Health Organization. Global strategy on diet, physical activity and health. WHO, 2004.
    1. Centers for Disease Control and Prevention. Obesity: halting the epidemic by making health easier. CDC, 2010.
    1. Commission of the European Communities. Promoting healthy diets and physical activity: a European dimension for the prevention of overweight, obesity and chronic diseases. EU, 2005.
    1. Intergovernmental Panel on Climate Change. IPCC fourth assessment report: climate change. Synthesis report. IPCC, 2007.

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