Randomized trials and self-reported accidents as a method to study safety-enhancing measures for cyclists-two case studies.

A large number of studies show that high visibility in traffic is important in the struggle of getting the attention from other road users and thus an important safety factor. Cyclists have a much higher risk of being killed or injured in a traffic accident than car drivers so for them high visibility is particularly important. A number of studies have examined the effect of high visibility, such as reflective clothing, but most studies have been primitive, the data limited and the results very uncertain. In this paper we describe the safety impact of increased visibility of cyclists through two randomised controlled trials: permanent running lights on bicycles and a yellow bicycle jacket, respectively. The effect of running lights was studied through a trial where the lights were mounted to 1,845 bicycles and 2,000 others comprised a control group. The bicycle accidents were recorded every two month in a year through self-reporting on the Internet. Participants were asked to report all cycling accidents independently of severity to avoid differences between participants as regards to which accidents were reported. They reported a total of 255 accidents i.e. 7 accidents per 100 cyclists. The results showed that the incidence rate for multiparty bicycle accidents with personal injury was 47% lower for cyclists with permanent running light. The difference is statistically significant at the 5% level. The effect of a yellow bicycle jacket was examined through a trial with 6,800 volunteer cyclists. The half of the group received a bicycle jacket and the other half comprised a control group. Both groups reported every month all their bicycle accidents independently of severity on the Internet. They reported a total of 694 accidents i.e. 10 accidents per 100 cyclists. The treatment group was asked each month if they carried the jacket on their last cycling trip. The results showed that on a random day the treatment group carried the jacket or other fluorescent cycling garment on 77% of their cycle trips. The incidence rate for multiparty accidents with personal injury was 38% lower than the control group. The difference is statistically significant at the 5% level. The trials were not blind and it seems that the lack of blinding has influenced the level of the groups accident reporting. To address this bias we used a correction factor formed by the difference in the number of single accidents of the two groups. The experiences with self-reporting of accidents via a web based questionnaire sent by e-mail with one respective two month intervals were very good; in both trials more than 80% answered all questionnaires whereas less than 2% did not answer, and the quality of the self-reported accident was considered high.