Do the Health Benefits of Cycling Outweigh the Risks?

By Hartog, Jeroen Johan de; Boogaard, Hanna et al. | Environmental Health Perspectives, August 2010 | Go to article overview

Do the Health Benefits of Cycling Outweigh the Risks?


Hartog, Jeroen Johan de, Boogaard, Hanna, Nijland, Hans, Hoek, Gerard, Environmental Health Perspectives


BACKGROUND: Although from a societal point of view a modal shift from car to bicycle may have beneficial health effects due to decreased air pollution emissions, decreased greenhouse gas emissions, and increased levels of physical activity, shifts in individual adverse health effects such as higher exposure to air pollution and risk of a traffic accident may prevail.

OBJECTIVE: We describe whether the health benefits from the increased physical activity of a modal shift for urban commutes outweigh the health risks.

DATA SOURCES AND EXTRACTION: We have summarized the literature for air pollution, traffic accidents, and physical activity using systematic reviews supplemented with recent key studies.

DATA SYNTHESIS: We quantified the impact on all-cause mortality when 500,000 people would make a transition from car to bicycle for short trips on a daily basis in the Netherlands. We have expressed mortality impacts in life-years gained or lost, using life table calculations. For individuals who shift from car to bicycle, we estimated that beneficial effects of increased physical activity are substantially larger (3-14 months gained) than the potential mortality effect of increased inhaled air pollution doses (0.8-40 days lost) and the increase in traffic accidents (5-9 days lost). Societal benefits are even larger because of a modest reduction in air pollution and greenhouse gas emissions and traffic accidents.

CONCLUSIONS: On average, the estimated health benefits of cycling were substantially larger than the risks relative to car driving for individuals shifting their mode of transport.

KEY WORDS: air pollution, biking, cycling, life table analysis, modal shift, physical activity, traffic accidents. Environ Health Perspect 118:1109-1116 (2010). doi:10.1289/ehp.0901747 [Online 30 June 2010]

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Recently, policy interest in promoting cycling as a mode of transport has increased substantially within Europe. Several capitals, such as Copenhagen, Denmark (in 1995), Helsinki, Finland (2000), Oslo, Norway (2002), Stockholm, Sweden (2006), Barcelona, Spain (2007), Paris, France (2007), and Brussels, Belgium (2009), have implemented low-cost rental systems aimed at stimulating commuters to use bicycles for the typically short urban trips. Motive for these policies is more often the reduction of traffic congestion than promotion of health. In 2005, the European Union formulated an important area of action: "addressing the obesogenic environment to stimulate physical activity" (Commission of the European Communities 2005). Attitudes and policies toward active commuting have recently been discussed (Lorenc et al. 2008; Ogilvie et al. 2004). The Transport, Health, and Environment Pan-European Programme (THE PEP) provides guidance to policy makers and local professionals on how to stimulate cycling and walking (THE PEP 2009). The promotion of walking and cycling is a promising way to increase physical activity across the population by integrating it into daily life.

Promoting cycling for health reasons implies that the health benefits of cycling should outweigh the risks of cycling. Although society may benefit from a shift from private car use to bicycle use (e.g., reduced air pollution emission), disadvantages to individuals may occur. Although individuals may benefit from increased physical activity, at the same time they inhale more pollutants because of increased breathing rates. The risks of being involved in traffic accidents may increase, as well as the severity of an accident. A study in Vancouver, Canada (Marshall et al. 2009), illustrated that, especially in the city center, high-walkability neighborhoods had high traffic density, leading to high air pollution concentrations for a traffic-related primary pollutant [nitric oxide (NO)] but not for a secondary pollutant (ozone). For cycling, similar issues may occur.

The aim of this review is to assess quantitatively whether the health benefits of the use of a bicycle instead of a private car for short trips outweigh the health risks. …

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