A Look at Cycling Safety in a Southern Municipality of the Netherlands.

Objectives Cycling is an important means of transportation in the Netherlands. Unfortunately, the number of cycling accidents and their adverse outcomes (injury and death) are on the rise. We set out to observe the nature of these accidents in Maastricht from 2001 to 2015 and analyzed the recommendations of stakeholders on ways to improve cycling safety. Methods An explanatory sequential mixed methodology was used for this population-based study. In the first phase, a retrospective quantitative analysis of the VIA® accident database for Maastricht was done. This was followed by a thematic analysis of data from five semi-structured interviews. Integration was at the Interpretation stage. Result The first phase showed males (54%) and under-25s (59.9%) had the most cycling accidents, while a larger percentage of females (50.7%) and people >65 years (67%) had adverse outcomes with accidents. More accidents occurred at intersections (52.6%), on shared roads (61.4%), and involved motorized vehicles (95.6%). Bivariate analysis and multivariable logistic regression showed that cycling accidents involving elderly people, women, wet weather or road surfaces, an innocent cyclist, the northeastern district, and morning hours had a higher chance of injury or death. Thematic analysis summarised stakeholder opinions under four themes: role in cycling safety; partners of cycling safety; the importance of accurate data; and investing in safety. Most of the respondents felt improvements in the city's accident database, cycling policy, and infrastructure were needed. Conclusion Our findings suggest that there has been a decrease in the overall number of cycling accidents in the 15-year period studied. However, differences in sociodemographic variables still determine the distribution and severity of accidents in Maastricht. The existing cycling database at the time of the study needed improvements with data collection and the city needs to involve more stakeholders in its policy-making process.