Discussion

Overall, substantial declines have been observed in cyclist mortality, ...Many factors likely contribute to trends in bicycling fatalities, including prevalence of bicycling, road design and engineering, traffic law enforcement, driver and bicyclist behavior, helmet use, and traffic volume.

...Future studies could explore recent cyclist mortality trends in greater detail by incorporating newer FARS data on crash location, road type, helmet use, distraction, or inebriation, as well as data from other sources on cycling trips and distance traveled among various age groups.

Public health goals of increased physical activity and population interest in alternatives to automobile transportation place additional focus on bicycle safety. ...Nonetheless, these shifts, combined with recent increases in the proportion of road deaths accounted for by cyclists (Figure 1), suggest an opportunity for expanding traditional road safety interventions in the United States (which have largely focused on vehicle passenger safety) with interventions designed to protect cyclists.

This report underscores the importance of improving bicycle safety in the United States with the aim of preventing fatalities. ...Several countries and some U.S. cities... have implemented multifaceted, integrated approaches to bicycling that address safety while also promoting cycling (1). Such approaches often include extensive bicycle infrastructure (e.g., physically separated bike lanes), traffic calming measures (e.g., speed humps), legal interventions (e.g., lowered speed limits), travel programs (e.g., safe routes to school), and education to encourage safe bicyclist and motorist behavior (1). Other strategies that can reduce fatalities include helmet laws and improved conspicuity of cyclists via lights and bright or reflective clothing.§ Overall, cyclist mortality has decreased in recent years, but adults remain at elevated risk. Multifaceted approaches to bicycle road safety are likely needed to ensure bicycling safety for all.