Background
Utilitarian cycling constitutes an important form of travel in Northern Ghana. Although cycling provides an indispensable way of reducing automobile pollution, traffic congestions and meeting the minimum daily physical activity recommended for healthy living, limited cycling infrastructure is available in Northern Ghana. This situation has fostered the mixture of cycles and, fast and robust motorized vehicles on the roadways, thus presenting an ominous road safety condition. The objective of this research is to establish the injury severity and pattern among bicyclists in Northern Ghana.
Methodology
A ten-year (2005 to 2014) accident data from Ghana was analyzed for the Tamale, Bolgatanga and Wa Municipalities in Northern Ghana. Analysis was basic descriptive.
Results
During the decade, 253 cyclists’ casualties occurred in the three cities out of which, 51% was fatal, 35% was serious and 13% was minor injuries. Ninety-three percent of cyclists’ accident victims were males. Cyclists were more likely to die when they collide with two or more vehicles, heavy goods vehicles or buses. Apparently, cyclists were not at fault in 58% of their casualty injuries while 25% and 7% were respectively attributable to carelessness and excessive speeding on the part of the cyclists. Also, of all the fatal cyclist’s casualties, 64% of the riders (n = 83) was not at fault while 23% and 6% were respectively attributable to cyclists’ carelessness and speeding.
Conclusion
Cycling has important health and environmental benefits to humanity. Nevertheless, more than 50% of cyclists involved in road crashes died through accidents, thus suggesting an important road safety concern. Improvement of cycle safety in Northern Ghana may be attained by building infrastructure such as cycle paths and demarcating lanes to physically separate cyclists from motorized transport. Explicit policies such as the minimum passing distance policy may give a further boost to cycling safety in Ghana.
1. Background
Bicycle is an important non-motorized transport which invention predated automobiles’. Therefore, cycling has been an indispensable mode of transportation over the years. Pedestrianism and cycling together constitute what is commonly referred to as active travel, active transport or active commuting ostensibly because of the direct physical activity involved. Cycling has played an important role as a mode of transport over the recent past and is still an inevitable mode of transport in contemporary times.
Internationally, cycling has attained an important acclamation for two major reasons. Firstly, it causes no noise or air pollution typically associated with automobiles. Secondly, cycling contributes substantially to the daily physical activity, aerobic fitness and cardiovascular health requirements. Currently, physical inactivity is a well-established risk factor for most chronic diseases such as coronary heart disease, stroke, diabetes, some cancers and depressions in the U.S., [cited in]. In fact, in 2009, physical inactivity was identified as the forth leading risk factor for non-communicable diseases which accounted for over 3 million preventable deaths worldwide [cited in]. This situation has arisen largely because of increased sedentary lifestyles in contemporary time. Being cognizant of this fact, many citizens in the advanced countries have consciously integrated cycling into their daily commuting to meet both their mobility needs as well as their minimum daily physical activity requirements. For instance, though being developed countries, cycling’s share of daily commuter trips is estimated to be about 26% in the Netherlands, 18% in Denmark, 10% in Germany, and 9% in Finland and Sweden. Ownership of a car is a status symbol in many advanced countries such as U.S. and Germany yet many car owners possess bicycles to enable them meet their routine daily physical activity requirements. Suffice to say that for residents in many developed countries, cycling is a matter of choice and not as a result of economic limitation.
Though countries have reported different association between socio-economic status (particularly income levels) and cycling, cycling in Ghana is predominantly utilitarian in nature and almost all the time undertaken by the poor. Over 2 and a half decades ago, it was reported that cycling was most common with people of lower socio-economic statuses in Northern Ghana.
Cycling has been common in Ghana particularly, in Northern Ghana. Until recently, bicycles constituted 60% of the traffic fleet in Northern Ghana. However, the improvement of economic situation of Ghana has increased the ownership of motorcycles in Northern Ghana. Between 2009 and 2013 for instance, over 90% of all registered vehicles in the Upper West, Upper East and Northern Region, (hereafter referred to as Northern Ghana) were motorcycles.
Although bicycles do not form part of the official vehicle register in Ghana, anecdotal evidence suggests that this vehicle type is equally predominant, perhaps the second most frequent in Northern Ghana after motorcycles. Notwithstanding their predominance in Northern Ghana, the safety situation of bicyclists has not been much investigated. Bicyclists are classified as vulnerable road users (VRUs). Therefore, to improve upon cyclists’ safety, provision of cycle infrastructure such as tracks, paths and clear demarcation of the roads (cycle lanes) for cyclists is imperative. Fast moving automobiles and high traffic densities hinder the safety of VRUs such as cyclists. Many developed countries where cycling is highly developed have explicit policies to protect VRUs. Such measures include the provision of infrastructure and enforceable laws to prevent road traffic injuries in general and the VRUs like cyclists in particular. For instance, in many European countries such as Sweden, Denmark, Germany and the Netherlands, infrastructure which clearly separate cyclists from fast and heavy traffic is always a road safety consideration.
Well-specific maintained cycle infrastructure is associated with bicycle safety. Between 2009 and 2012, the expansion of cycling facilities in Boston, U.S.A., led to a reduction in bicyclists’ injuries from 83 to 75%. In addition to cycling infrastructure such as paths and tracks, enforceable laws to increase cyclists’ safety are enacted. In Queensland, Australia, for instance, motorists are required by law to leave a one-meter gap when passing a cyclist in a low speed zone i.e., (a speed of 60 km/h or below) and 1.5-meter gap in a high speed zone i.e., (a speed of more than 60 km/h). In Ghana however, cycling facilities are limited in supply. Therefore, cyclists and motorists share the same roadways at the peril of the former.
The objective of this study was to establish the injury severity and pattern among bicyclists in Northern Ghana.
2. Methodology
2.1. Study sites
This research was conducted in Tamale, Bolgatanga and Wa Municipalities being the regional capitals of Northern, Upper East and Upper West Regions respectively. In terms of population size, the Tamale Municipal is the largest among the three cities with a population of 371, 351, followed by the Bolgatanga Municipal with a population of 131,550 while the Wa Municipality, the smallest among the three, has a population of 107, 218. In general, over 90% of all registered vehicles in Northern Ghana are motorcyclists. No formal data on bicycles exists in Ghana. However, anecdotal evidence suggest that there is a fairly large proportion of bicycles in Northern Ghana. For instance, over two decades ago, 60% of traffic volume in Tamale consisted of cycles.
2.2. Cycling infrastructure
Cycling infrastructure is poorly developed in Northern Ghana. Apart from Tamale, where there is limited cycling lanes, there is virtually no cycling infrastructure in the Wa and Bolgatanga Municipalities. Bicyclists therefore share the roadway with motorized traffic, a situation which appears to have aggravated the safety situation of bicyclists in these Municipalities. As indicated above, in countries where cycling safety is prioritized, ample infrastructure are provided. For instance, in Queensland Australia, over 11,000 km bicycle infrastructure have been provided to promote cycling.
2.3. Data source and quality
The data used in this research was obtained from the Building & Road Research Institute’s (BRRI) accident databank. The source of the data is the Ghana Police Service. A standard police accident form developed by the Transport Research Laboratory (TRL), UK is used to extract information from the police dockets and electronically entered into a Micro-Accident Analysis Package (MAAP) software also developed by TRL. There are plans to upload the accident data unto an internet-based database in the near future. The police work hand-in-hand with the surviving accident victims, eyewitnesses and hospitals to determine the severity and circumstances leading to the accidents. In cases where there are no surviving casualties and eyewitnesses of the accident, the police use their training and working experience to arrive at a potential error which led to the crash. The casualty injury severity is sub-divided into four levels, namely; property damage or no injury, minor, serious and fatal injuries. A damaged only accident is one which resulted in no injury but the vehicles involved sustained substantial destruction. A minor casualty injury is an accident victim whose injury did not require any hospitalization within 30 days of the accident and that the victim was treated and discharged the same day of the accident. A serious casualty injury is one whereby the accident victim was hospitalized for at least 24-h within 30 days following the accident while fatality relates to death of a casualty within 30 days of an accident.
Currently, there is some level of underreporting in the road accident statistics in Ghana. Nearly two-thirds (57%) of non-injury related crashes (property damaged only accidents), 8% of serious and 0% of fatal road injuries are not reported in Ghana [14]. It is important to stress that since the road users being investigated are vulnerable road users i.e., cyclists, the issue of underreporting or non-reporting may be minimal because their accidents may result in injuries or deaths. The police are always notified in the event of serious or fatal accidents.
2.4. Study period
Accident statistics involving at least one cyclists between 2005 and 2014 in the Tamale, Bolgatanga and Wa Municipalities were retrieved from the national accident database and analyzed.
2.5. Analysis
This research used predominantly basic descriptive statistical analysis.
3. Results
During the decade, i.e., 2005 to 2014, there were 297 bicycle related accident victims of which, 86% was cyclists, 9% was car occupants (drivers and passengers) while 3% was pedestrian in the three cities of Northern Ghana. The analysis was however based on cyclist victims (n = 253) and not cyclist-related casualties.
In terms of injury severity, 52% was fatal, 35% was serious and 13% was minor injuries. Nearly half (47%) of all cyclists’ casualties in the three cities occurred in Bolgatanga Municipal while 27% and 26% of bicycle injuries occurred in the Wa and Tamale Municipalities respectively. However, in terms of the proportion of cyclists’ who died, 56%, 55% and 47% was fatal in Wa, Tamale and Bolgatanga Municipalities respectively.
Among the bicycle casualties, 93% was males while 7% was females. Interestingly, the proportion of male cyclist who died (52%) was comparable to the proportion of female cyclists who died (48%) in the three cities of Northern Ghana. In contrast, the proportion of female cyclist who suffered serious accidents requiring hospitalization (50%) was about 1.5 times (34% of all male bicycle accident victims who suffered serious accidents), see Table 1.
Table 1. Distributions of cyclists’ accident severity by selected variables.
| Variable | Bicyclists injury severity | |||
|---|---|---|---|---|
| Minor (%) | Serious (%) | Fatal (%) | Total n (%) | |
| Age | ||||
| 1 to 9 | 0 | 50 | 50 | 2 (100) |
| 10 to 12 | 0 | 0 | 100 | 3 (100) |
| 13 to 19 | 11 | 30 | 59 | 37 (100) |
| 20 to 29 | 22 | 50 | 28 | 66 (100) |
| 30 to 59 | 10 | 36 | 54 | 113 (100) |
| 60 to 76 | 9 | 38 | 53 | 32 (100) |
| Gender | ||||
| Female | 6 | 50 | 44 | 18 (100) |
| Male | 14 | 34 | 52 | 234 (100) |
| Location (city) | ||||
| Bolgatanga | 15 | 38 | 47 | 119 (100) |
| Tamale | 12 | 33 | 55 | 66 (100) |
| Wa | 12 | 32 | 56 | 68 (100) |
| Time of day | ||||
| 06:00 to 11:59 | 17 | 28 | 55 | 60 (100) |
| 12:00 to 17:59 | 17 | 36 | 47 | 95 (100) |
| 18:00 to 23:59 | 7 | 40 | 53 | 95 (100) |
| 00:00 to 05:59 | 33 | 0 | 67 | 3 (100) |
| Riders’ errors | ||||
| None | 10 | 33 | 57 | 145 (100) |
| Carelessness | 20 | 33 | 47 | 64 (100) |
| Too fast | 11 | 44 | 44 | 18 (100) |
| Wrong overtaking | 17 | 67 | 17 | 6 (100) |
| Others | 21 | 37 | 42 | 19 (100) |
| Total | 13 | 35 | 52 | 253 (100) |
The modal age group which suffered bicycle accidents the most was the 30 to 59 year-olds constituting 45% of all cycle accident victims. Young adults (20 to 29 year-olds) also constitute 26% of cycle accident victims while teenagers and the aged (60 to 76 year-olds) respectively constitute 14% and 12% of cycle accident victims in Northern Ghana. However, children under 13 years constitute the minority (2%) of cycle accident victims. The data show that age distribution of bicycle casualties follow a pattern of transportation participation of the victims. In other words, riders within the active economic age group are more likely to own and ride cycles more frequently, and are thus exposed to bicycle injuries. In terms of accident severity, teenagers are more likely to suffer fatal bicycle accidents (59% of all teenage cyclist casualties). Similarly, 54% and 53% of the 30 to 59 year-olds and 60 to 76 year-olds respectively died as cycle accident victims. The proportion of young adults (20 to 29 year-olds) year group was however least likely to die as 28% of cycle accident victims in this age group died see Table 1.
Among cyclists’ accident victims in the three cities, no apparent fault was associated with 58% of all cyclists’ injuries and fatalities (n = 145) while 25% and 7% were respectively as a result of carelessness and being too fast on the part of the bicyclists. Also, of all the fatal cyclist’s accident victims, 64% of the riders (n = 83) was not at fault regarding their collisions while 23% and 6% were respectively as a result of carelessness and being too fast on the part of the cyclists. As illustrated in Table 1, among cyclists who were not at fault in their accidents, 57% died and 33% suffered serious injuries in their collisions.
Among the collision types in which at least a cyclist was involved, 44% was rear-end, 27% was side-swipe and 15% was right-angled collision.
With the exception of side-swipe collisions, at least 50% of cyclists’ in every collision type was fatal. This underscores the level of vulnerability of cyclists in road traffic crashes with other vehicles. In particular, the vast majority (82%) of casualties of head-on collisions was fatal while 71% apiece of rear-end and right-angled collisions were also fatal. See Fig. 1.
Apparently, cyclists were most likely to die when they were involved in a collision entailing more than two vehicles. As shown in Fig. 2, as high as 89% of cyclists died in accidents involving at least two vehicles and the cyclists (n = 19). Also, 76% of cyclists died when they collided with heavy goods vehicles (HGVs), (n = 33), while cycle-motorcycle collisions resulted in 57% deaths (n = 47). The accident circumstances in which only the cyclists crashed was rare n = 1. Nevertheless, this resulted in fatality. Hit and run incidents involving cyclist casualties also always resulted in fatalities (n = 3), Fig. 2.
4. Discussion
Road accident casualty injury severity among cyclists in Northern Ghana is very high as 52% of all cyclists died and 35% was involved in serious accidents requiring some hospitalization. The injury situation of the cyclists was aggravated when they collided with two or more vehicles, heavy goods vehicles and buses. The data showed that, 54% of all cyclists was blameless (not at fault) in the accidents which resulted in their injuries or deaths. This is largely due to the fact that as in Northern Ghana, cycling infrastructure is nearly nonexistent. Thus, cyclists share the same roadway with fast and robust automobiles. Separating cyclists from motorists may improve on cyclists’ safety. However, the cycling infrastructure should be exclusively kept for the intended purpose of cycling. This calls for enforcement to keep hawkers and motorized traffic out from invading the facilities. Tamale is a typical example where street hawkers, motorcycles and tricycles have nullified the protective effect of a limited cycling infrastructure.
As it were, numerous advantages exist in promoting cycling in Ghana namely, reduction of noise and auto emission pollutions, and meeting the minimum daily physical activity requirements for a healthy living. The World Health Organization (WHO) recommends that for adults between 18 and 64 years old, a minimum of 150 min of moderate-intensity aerobic physical activity throughout the week or at least 75 min of vigorous-intensity physical activity or an equivalent combination of moderate-and vigorous-intensity throughout the week is needed for a healthy living [15]. This works out to a daily requirement of about 30 min of moderate-intensity physical activity [cited in [2]]. This can easily be attained if one plans to introduce some active transportation activities such as cycling into their daily travels. Essentially, cyclists are already practicing healthy lifestyle in the area of transportation in Northern Ghana. Notwithstanding the fact that the ownership of a car is a status symbol in many advanced countries such as U.S. and Germany [5], many car owners possess bicycles to enable them meet their routine daily physical activity requirements. In Ghana, however, the status symbol of vehicle ownership supersedes the general and health benefits of bicycle use. Hardly will you see an individual who owns automobile cycling for health purposes. Bicycle infrastructure is limited in Ghana and in northern Ghana, the paucity of cycling infrastructure cannot be overemphasized. Cyclists are perceived to be poor and as such not considered in the road infrastructural construction in Ghana. They do not have advocates at the policy making and implementation levels. Consequently, cyclists’ voices are not adequately represented in policy and planning of road infrastructure to reflect their quest for requisite infrastructure for cycling. Among the three settlement, Tamale is the only city which has some rudimentary cycling lanes. These limited facilities have nevertheless been taken over by street hawkers and some motorized vehicles e.g., motor and tricycles and have therefore rendered them cycling unfriendly. Apparently, the limited cycling infrastructure in the Tamale Metropolis did not function to reduce accidents or fatality risk of cyclists in that city compared with Bolgatanga and Wa where there was no cycling infrastructure.
The data showed that 44% of the riders’ collision types were rear-end suggesting that no adequate gap was giving when motorists were trying to pass cyclists. In order to improve upon bicyclists’ safety, it is important to develop bicycle infrastructure such as cycle paths, and on shared roads, explicit demarcation of the roadway for cyclists from motorists should be provided and conspicuously marked. This will clearly separate cyclists from speeding motorists and improve on the former’s safety. In the developed countries where bicycle use is common, apart from provision of cycling infrastructure, explicit policies are promulgated to safeguard the cyclists. One of such policies is the minimum passing distance law in Queensland, Australia. In order to ensure that motorists do not infringe on this law, by intimidating or crushing cyclists, the minimum passing law is further enacted. According to this law, in Queensland, Australia, motorists are required by law to leave a one-meter gap when passing a cyclist in a low speed zone i.e., (a speed of 60 km/h or below) and 1.5-meter gap in a high speed zone i.e., (speed of 60 km/h or above) [12].
Promoting cycling in Ghana will also reduce the perennial traffic jams which has become a daily routine in many medium to large cities in the country.
4.1. Conclusion
Cycling is an important aspect of active transport and constitutes one surest way to attain the recommended public health physical activity requirement for healthy living in contemporary times, reduce traffic jams, and automobile pollutions. However, more than 1 in 2 cyclists die in cyclists’ related accidents in Northern Ghana. This is a serious road safety concern. In other to obtain safety for all cyclists, it is important to integrate cycling infrastructure such as lanes and paths into road constructions in urban centers in Northern Ghana. This means that cycling infrastructure should be conceptualized at the design stages of roads in urban environments and not an afterthought. Additionally, an awareness creation is necessary to educate motorists to have ample tolerance for cyclists in shared road environments. In other to ensure that this recommendation is adhered to by motorists, the minimum passing distance law may be very beneficial for Ghana.