What this study does show is that tram tracks as a part of the public road can lead to potentially dangerous situations for cyclists. Many injuries were severe and required an operative intervention. One patient died as a consequence of his injuries. Although this injury mechanism with on-road tram tracks is very dependent on the local traffic situation, the results of this study might be relevant for other international cities with on-road tram tracks or for cities considering trams as a part of their local transport infrastructure. Awareness of the potential danger of on-road tram tracks is essential for policy makers. To reduce the number of casualties and to increase the safety of bicyclists, roads for cyclists and trams should be segregated (
2). If this is cannot be realized, another possible intervention could be the placement of rubber linings within the tram gutter, making it difficult for bicycle wheels to get trapped in them (
14). Additionally, more attention could be given to education and warning of cyclists. Cameron et al. showed a sharp decline in the level of cycling injuries after a period of local media attention (
8). Finally, it is not obligated to wear helmets whilst cycling in the Netherlands. Though the mandatory use of helmets is still under debate, it is thought to reduce the incidence and the severity of brain injuries amongst cyclists (
2,
15). However, helmet use will have no effect on extremity injuries, which comprised a substantial amount of injuries in our population.
In conclusion, tram tracks on public roads are potentially dangerous and can lead to serious injuries and even mortality amongst cyclist. Extremity and neurological injuries are the most common injuries and frequently need an operation. Awareness of the potential danger of on-road tram tracks for cyclists is essential. Alteration of infrastructural situations or other preventive measures might decrease the incidence of these injuries and should therefore be considered.
This study was approved by the Medical Ethics Review Committee of the VU University Medical Center, Amsterdam, The Netherlands.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4310015/