{
  "abstract": "Background Bicycling has many health benefits for children but can result in injuries. The built environment is associated with the risk of bicycling injury in adults, yet less is known about risks for children. This study sought to explore associations between built environment characteristics and child bicyclist injuries in three Canadian municipalities.Methods A case-crossover design where injured child bicyclists provided their injury site and two control sites along their route was used. Participants were recruited from three paediatric emergency departments in Vancouver, Calgary and Toronto. We recruited 333 injured child bicyclists (ages 5–17) from May 2018 to October 2021. Participants completed interviews that captured details concerning their injury location and route. We conducted built environment audits along the child’s bicycling route at the injury and two control sites. We compared the odds of injury across built environment characteristics of the injury and control sites using a mixed-effects logistic regression model.Results The median route distance to the injury location was 742 m. Most participants were injured while bicycling on local streets and on sidewalks/paths next to the road. Compared with sidewalks/paths next to the road, unpaved off-road locations (adjusted OR (aOR): 2.45; 95% CI 1.33 to 4.51) were associated with higher odds of injury. Other risk factors included locations with debris (aOR: 1.52; 95% CI 1.05 to 2.21), surfaces with bumps/holes (aOR 2.14, 95% CI 1.25 to 3.66) and construction (aOR: 2.31; 95% CI 1.37, 3.91).Conclusion This study adds to evidence suggesting built environment supports are important for increasing bicycling safety for Canadian children.",
  "authors": [
    {
      "affiliations": [
        "Department of Community Health Sciences, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada",
        "Department of Paediatrics, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada"
      ],
      "name": "Janet Aucoin"
    },
    {
      "affiliations": [
        "Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada"
      ],
      "name": "Moreno Zanotto"
    },
    {
      "affiliations": [
        "Department of Community Health Sciences, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada",
        "Department of Paediatrics, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada"
      ],
      "name": "Tate HubkaRao"
    },
    {
      "affiliations": [
        "Department of Paediatrics, University of British Columbia, Vancouver, British Columbia, Canada",
        "BC Children’s Hospital Research Institute, University of British Columbia, Vancouver, British Columbia, Canada"
      ],
      "name": "Quynh Doan"
    },
    {
      "affiliations": [
        "Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada",
        "Division of Emergency Medicine, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada"
      ],
      "name": "Suzanne Beno"
    },
    {
      "affiliations": [
        "Department of Paediatrics, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada",
        "Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada"
      ],
      "name": "Antonia Stang"
    },
    {
      "affiliations": [
        "Orthopaedic Surgery, Hospital for Sick Children, Toronto, Ontario, Canada",
        "Department of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada"
      ],
      "name": "Andrew William Howard"
    },
    {
      "affiliations": [
        "Department of Community Health Sciences, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada",
        "O’Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada"
      ],
      "name": "Gavin Robert McCormack"
    },
    {
      "affiliations": [
        "Department of Paediatrics, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada",
        "School of Social Sciences, University of Wollongong Faculty of the Arts Social Sciences and Humanities, Wollongong, New South Wales, Australia"
      ],
      "name": "Alberto Nettel-Aguirre"
    },
    {
      "affiliations": [
        "Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada"
      ],
      "name": "Meghan Winters"
    },
    {
      "affiliations": [
        "Department of Community Health Sciences, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada",
        "Department of Paediatrics, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada"
      ],
      "name": "Brent E Hagel"
    }
  ],
  "title": "Bicycling injuries in children and the role of the built environment: a case-crossover study",
  "uid": "d2b2511f-2ca9-5ce1-b363-0d58b244fa6d"
}