Bicycling-Related Mortality in Ecuador: A Nationwide Population-Based Analysis from 2004 to 2017

Abstract

Urban cycling is gaining popularity worldwide. Inadequate local and international guidelines on street cycling have contributed to a significant increase in road traffic/cycling collisions. Developing countries are the least safe for cyclists. In this sense, this is the first epidemiological study that seeks to determine the impact of street cycling-related mortality in Ecuador over the last 13 years. Methods: A descriptive ecological analysis of the epidemiology of bicycling-related mortality in Ecuador was conducted. All deaths identified as V10 to V19 according to the International Code of Diseases 10th edition (ICD-10) from 2004 to 2017 were retrieved from the National Institute of Statistics and Census in Ecuador (INEC) database. Results: From 2004 to 2017, a total of 300 deaths among street cyclists were officially reported in Ecuador. From this, 91% of the victims were men (n = 273) and 9% were women (n = 27). In relationship to other traffic accidents, bicycle-related deaths accounted for 0.68% of the overall car accident mortality. Bicycle-related deaths are more frequent in urban areas with 85% (n = 257), while rural areas accounted for 15% of the deaths (n = 43). In addition, lower educational attainment (75% did not reach secondary school) seems to be linked with higher mortality rates. Conclusions: In Ecuador, fatalities involving cyclists are an important part of the burden of disease attributed to traffic accidents. These preventable deaths are becoming a growing health problem, especially among those with poorer health determinants, such as lower educational attainment, ethnic minority status, and living in rural areas. The lack of public policy related to the prevention of this type of accident, as well as the irresponsibility of cars and transport vehicle drivers, might be associated with an increasingly high portion of the overall bicycle-related mortality in Ecuador.