Cycle fatalities in Delhi and their risk factors.

There is a lack of research that investigates the risk factors of cycling in low- and middle-income countries. We present descriptive epidemiology of crashes that involved at least one fatal cyclist, over a three-year period (2016-2018) in Delhi, India. Next, we used an unmatched case-control approach to identify road design risk factors of cycle fatalities. Cases were road segments with at least one cycle fatality, and controls were those with none. We developed logistic regression models with cases and controls as binary outcomes to estimate the odds ratio of site characteristics. There were 167 crashes involving at least one cyclist fatality over the study period. Fatal cyclists were almost all males. They were less likely to be children or young adults and less likely to be residents of high-income localities, compared to the general population. One in ten crashes included more than one occupant on a cycle and 5% of fatal victims were pillion riders. Seventy percent crashes occurred at midblock, and majority were backend collisions. Regression shows that road width, traffic speed, and volume of heavy vehicles have strong positive effects on the fatality risk of cyclists. These results can inform strategies to design interventions for safety of cyclists.