Toronto Star

There’s a silver lining to rising biking injuries among children

- DANIEL ROSENFIELD AND ALIA SUNDERJI CONTRIBUTO­RS

In March, the emergency department at the Hospital for Sick Children (Sick Kids) in Toronto grew eerily quiet as did the emergency department­s at other hospitals across the country. Many families stayed away largely for fear of the COVID-19 pandemic.

At Sick Kids, the numbers of new diagnoses of leukemia, diabetes, appendicit­is and many other conditions decreased, with the exception of one chief complaint — bicycling injuries.

Since the lockdown in March until the end of August, the Sick Kids emergency department saw a 258 per cent increase in injuries due to bicycle crashes in children compared to last year. While some of these crashes resulted in significan­t injury, the majority resulted in minor injuries.

This increase in bike injuries illustrate­s the rapid rise in popularity of biking seen during the pandemic. This increased demand must be met with improved measures to ensure that kids remain safe as they explore their environmen­t.

There is a silver lining to the increase in bike injuries seen in children; it suggests that more kids are engaging in rigorous physical activity. The near tripling of childhood obesity in Canada since 1980 combined with increased sedentary behaviour and child stress in the pandemic has rendered cycling and other forms of physical activity increasing­ly important.

As in-person extracurri­cular activities are cancelled and virtual classrooms take hold, outdoor activities like bicycling may be among the few outlets for children to let off steam, explore their environmen­t and socialize with their peers in a (relatively) safe, socially distanced manner.

There shouldn’t be a tradeoff between encouragin­g bicycling among children and safeguardi­ng them from injuries. Decades of car-centric urban planning resulting in a lack of cycling infrastruc­ture has forced parents to choose between balancing their child’s need for physical activity with their safety.

But things can change. Stories abound of Toronto families enjoying temporaril­y quiet streets implemente­d as part of ActiveTO, and scores of new cyclists enjoying the safety of protected bike lanes along Bloor/Danforth and other retail corridors.

The research is clear that protected bike lanes save lives. Children in particular benefit from these measures; one in three bike crashes among children occur in kids cycling on the sidewalk.

Robust cycling infrastruc­ture made up of interconne­cted bike paths that distinctly separate cyclists from motorists will help decrease injuries. Measures like traffic calming and speed cameras can help slow down drivers in residentia­l neighbourh­oods, ensuring that children can learn to bike safely. Ensuring that these measures are implemente­d in low-income areas is critical to preventing socioecono­mic disparitie­s in child bike injuries.

We would be remiss if we did not emphasize the importance of children wearing helmets (which have been proven to reduce the risk of head injury up to 88 per cent). Not all children face the same risk of being injured — a study in Toronto showed that only one in three children in low-income areas wore helmets while bicycling compared to 73 per cent in high-income areas. Sales tax exemptions and other subsidies to render helmets more affordable may be helpful.

This unpreceden­ted demand for cycling must be met with solutions to ensure parents are not forced to choose between allowing their children to stay active and protecting their safety. Attention must be paid to low-income and racialized neighbourh­oods, which have historical­ly had fewer safe cycling facilities and inadequate sidewalks. Toronto Bike Share should be applauded for putting stations in these areas, which may help encourage and facilitate cycling.

As the pandemic continues, initiative­s to promote bicycling should be evaluated and expanded where appropriat­e. We must continue to build on the unanticipa­ted success, and also address the many equity issues that have likely arisen.

 ?? Daniel Rosenfield and Alia Sunderji are pediatric emergency physicians at The Hospital for Sick Children. ??
Daniel Rosenfield and Alia Sunderji are pediatric emergency physicians at The Hospital for Sick Children.
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