Background Active transport (i.e. walking and cycling for transport) can provide substantial health benefits by increasing levels of physical activity (PA) and help reduce transport-associated emissions. Our aim was to conduct a health impact assessment (HIA) of cycling networks expansions in seven diverse European cities (Antwerp, Barcelona, London, Orebro, Rome, Vienna, Zurich) that form part of the Physical Activity through Sustainable Transport Approaches (PASTA) project. We modeled the association between cycling network distance (km) and cycling mode share (%) and estimated health impacts of the expansion of cycling networks. Methods Cycling network distances were computed for 168 European cities using OpenStreetMap data for designated cycling ways. Cycling mode share was available through the European Platform on Mobility Management. We performed a non-linear least square regression to assess the relationship between cycling network and cycling mode share. We performed a quantitative HIA for five different scenarios (S) (10% (S1); 50% (S2); 100% (S3), Go-Orebro (S4) and All-streets (S5)) assessing how an expansion of the cycling network would lead to an increase in cycling mode share and estimated associated mortality impacts thereof. We quantified mortality impacts in terms of changes to PA levels, exposure to air pollution and traffic incidents for the cyclist. Results Our results suggest that the cycling network may contribute to a cycling mode share of up to 25% in European cities. A cycling network as that of Orebro (S4; 255 km/100,000 persons) produced greatest health benefits through increases in cycling for London with 646 (95% CI: 397;1012) annual deaths avoided, followed by Rome (224; 95% CI: 133;359), Barcelona (162; 95% CI: 103;248), Vienna (82; 95% CI: 47;133), Zurich (27; 95% CI: 16;42) and Antwerp (3; 95% CI: 2;6). If all 168 European cities achieved a cycling mode share of 25% over 16,000 deaths (95% CI: 9,861;25,763) could be avoided each year. The largest cost-benefit ratios were found for the 10% increase in cycling network (S1) suggesting it to be most cost-effective (Rome € 40:1; Barcelona € 20:1; Zurich € 16:1; Vienna € 11:1, London € 3:1). Conclusions Especially in cities with a currently low cycling mode share, expansion of cycling networks may promote increases in cycling mode share. Increases in cycling mode share were estimated to provide considerable health benefits in European cities.
The different versions of the original document can be found in: