Teschke et al. BMC Public Health 2012, 12:765 http://www.biomedcentral.com/1471-2458/12/765 R E S E A R C H A R T I C L E Open Access Personal and trip characteristics associated with safety equipment use by injured adult bicyclists: a cross-sectional study Kay Teschke1*, Jeff R Brubacher2, Steven M Friedman3, Peter A Cripton4, M Anne Harris5, Conor CO Reynolds6, Hui Shen1, Melody Monro1, Garth Hunte2, Mary Chipman7, Michael D Cusimano7, Nancy Smith Lea8, Shelina Babul9 and Meghan Winters10 Abstract Background: The aim of this study was to estimate use of helmets, lights, and visible clothing among cyclists and to examine trip and personal characteristics associated with their use. Methods: Using data from a study of transportation infrastructure and injuries to 690 adult cyclists in Toronto and Vancouver, Canada, we examined the proportion who used bike lights, conspicuous clothing on the torso, and helmets on their injury trip. Multiple logistic regression was used to examine associations between personal and trip characteristics and each type of safety equipment. Results: Bike lights were the least frequently used (20% of all trips) although they were used on 77% of trips at night. Conspicuous clothing (white, yellow, orange, red) was worn on 33% of trips. Helmets were used on 69% of trips, 76% in Vancouver where adult helmet use is required by law and 59% in Toronto where it is not. Factors positively associated with bike light use included night, dawn and dusk trips, poor weather conditions, weekday trips, male sex, and helmet use. Factors positively associated with conspicuous clothing use included good weather conditions, older age, and more frequent cycling. Factors positively associated with helmet use included bike light use, longer trip distances, hybrid bike type, not using alcohol in the 6 hours prior to the trip, female sex, older age, higher income, and higher education. Conclusions: In two of Canada’s largest cities, helmets were the most widely used safety equipment. Measures to increase use of visibility aids on both daytime and night-time cycling trips may help prevent crashes. Keywords: Active transport, Bicycle safety, Visibility, Bicycle helmet Background Bicycling injuries are a concern both because of the dir- ect harm they cause individuals and because concerns about safety are a deterrent to use of this healthy mode of transportation, especially in North America [1-3]. In the United States, collisions with motor vehicles result in about 700 fatalities and 48,000 police-reported injur- ies per year among cyclists [4]. In Canada, with a popu- lation about one-tenth of the US, collisions with motor vehicles result in about 50 fatalities and 450 serious * Correspondence: kay.teschke@ubc.ca 1School of Population and Public Health, 2206 East Mall, University of British Columbia, Vancouver, BC, Canada Full list of author information is available at the end of the article injuries (requiring hospitalization) per year among cyclists [5]. These data do not account for all injuries to cyclists, since they do not tally crashes not involving motor vehicles, and they may also miss some that do [6]. As outlined in William Haddon’s original work on traf- fic injury epidemiology, there are many potential approaches to injury reduction. Measures can be direc- ted at the individual cyclist or the cycling environment, and can be focussed on pre-event prevention or post- event mitigation [7]. A number of authors have noted a difference in emphasis in bicycling safety between north- ern Europe and North America, with an environment focus dominant in the former and an individual focus dominant in the latter [8,9]. Within individual-based © 2012 Teschke et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.