In France, the overall share of cycling in travel remains low, at around 3%, with significant variations across urban areas (ranging from less than 1% in Saint-Étienne to 7.5% in La Rochelle, for example). However, cycling is increasingly being encouraged, and cities are being led to build bike lanes on their roadways and develop “cycle routes” and greenways that create inter-municipal, inter-departmental, inter-regional, and international connections as part of a European network, benefiting both recreational and utilitarian travel.

This resurgence of cycling is driven by economic factors (bicycles, including electric ones, available through self-service systems at moderate cost), ecological factors (a non-polluting mobility alternative), and behavioral factors (physical activity).

In the Netherlands, a country synonymous with cycling, 25% of commutes are made by bicycle, and this figure rises to 34% for trips under 7.5 km. The average distance traveled per year per capita is 2.5 km in the Netherlands (2000 data), compared to 0.2 km in other European Union countries—more than 100 times higher in the Netherlands. In France, in 2015, 2% of employed adults commuted to work by bicycle, and more than half of those aged 15–75 cycled at least once a year.

These trips sometimes result in accidents, and each year traffic safety authorities record traffic accidents involving cyclists, including approximately 160 fatalities in France.

Given the growing popularity of cycling, the issue of cyclist safety is critical, necessitating a thoughtful approach to propose effective solutions to prevent serious injuries, based on scientific assessments and risk-benefit analyses.

To better understand the circumstances surrounding bicycle accidents, their frequency, severity, and the profiles (sociodemographic characteristics) of those involved, Santé publique France commissioned a literature review of scientific publications on the subject in France and in countries with comparable levels of economic development since 1990.

This review covers prevention strategies to avoid these accidents, details their nature (individual or collective prevention), the actions implemented, and their outcomes. It identified the following points:

• Frequency of accidents and deaths

  • In France, the proportion of cyclist fatalities is low: approximately 2% of road deaths;

  • Cycling in dense urban areas is associated with a significant risk of accidents;

  • Young adults and people over 65 are more frequently involved in bicycle accidents;

• Circumstances and risk factors

  • The risk of an accident is higher when cycling is used daily for the commute between home and work, compared to all other cycling trips;

  • Risk factors for accidents include:

    • primarily behavioral: risk-taking, alcohol consumption, etc.; related to road infrastructure (bike lanes, speed limits, accident-prone roundabouts and intersections, lighting), or to equipment (poor bike maintenance, lack of lights);

    • Factors contributing to the severity of accidents are primarily the failure to wear a helmet, the size of the motor vehicles involved in the accident, or alcohol consumption;

• Prevention

  • Education and training programs have proven effective, particularly among younger children, in preventing accidents;

  • To prevent accidents, the optimal age to start cycling is 7 years old;

  • the presence of bike lanes appears to reduce the risk of collisions with other vehicles, but the complexity of road markings or certain intersections diminishes the potential benefits;

  • Wearing a helmet reduces the severity of head injuries in the event of an accident.