Background: Commercial bicycling has become a popular mode of transportation in Kenya, in both rural and urban areas since early 1990's. In Kisumu city, however, its related injuries cause significant morbidity and mortality. Many road users have viewed their presence in the roads as the cause of congestion, confusion, fear, and decreased safety in the roads in the road system. Bicyclists are at high risk of road traffic accidents and the attendant injuries, but are greatly neglected and few community-based studies have investigated the problem in Kenya.
Objectives: The primary objectives were; to determine demographic characteristics of the commercial bicyclists, factors associated with road traffic injuries and crashes involving commercial bicyclists. Other objectives were to determine the perception surrounding commercial bicycling, and to determine preferred road safety interventions for commercial bicyclists.
Study design and Methods: Population based, cross-sectional study involving Four hundred and twenty commercial bicyclists, five key informants, victims of road traffic crashes and injuries involving commercial bicyclists Cluster, systematic and simple random sampling methods were used to select bicyclists at sites. Questionnaires were administered to the commercial bicyclists; Interviews were also carried out with key informants.
Results: The majority of the respondent attained primary education (55.3%), 40.7% completed secondary level of education. The ages of the respondents were grouped as 21-25 years which accounted for 51%, 26-30 years (21.3%),. People prefer using bicycles because they are flexible (39%), and not time consuming (28.9%). Inadequate signals that cannot be understood easily by other users (28.9%) and, riders losing control (19.1%) are the major risk factors. There was significant relationship between drug taking, length of time at work and occurrence of crashes. (χ2 =7.745, p=0.001). A significant association between injury occurrence and condition of roads was also found, (χ2=10.226, p=0.001). Road signs were inadequate (74.5%) and those available were misunderstood. There was significant relationship between inadequate road signs (signals), their misunderstanding within the road and subsequent occurrence of accidents (χ2= 14.305; p= 0.002). Training for bicyclists (36.4%) and bicycle helmets were suggested as road safety intervention measures that could be adopted (34.5%).
Conclusion: Commercial bicyclists are men aged below 40years; they are highly exposed to crashes and injuries due to their interaction in the traffic system, since bicyclists riding in, traffic mix feel unsafe and fearful. Therefore, it is very dangerous to ride in a mixed system because there is increased risk of crashes or accident. There are poor traffic law enforcement mechanisms in Kenya. There is need to integrate this economic activity in the road system while minimizing risks to crashes and injuries.

Background: Commercial bicycling has become a popular mode of transportation in Kenya, in both rural and urban areas since early 1990's. In Kisumu city, however, its related injuries cause significant morbidity and mortality. Many road users have viewed their presence in the roads as the cause of congestion, confusion, fear, and decreased safety in the roads in the road system.
Objectives: The primary objectives were; to determine demographic characteristics of the commercial bicyclists, magnitude and characteristics of road traffic crashes and injuries involving commercial bicycling.
Methods: Cross-sectional descriptive study involving review of medical and traffic police records in New Nyanza Provincial General Hospital, Kisumu District hospital, and Traffic police station records departments respectively, was used to status of bicyclist crashes and injuries in Kisumu City. Hospital and police records were reviewed to determine road traffic crashes and injuries involving commercial bicyclist for a period of one year, 1st January 2008 to 31st December 2008. Information about injury disposition, severity, outcome of injuries were entered in designed forms.
Results: A total of 209 patients were treated for bicycle- related injuries in both hospitals and 64 cases were recorded in police records. The age group most affected in road trauma involving bicyclists was 21-30 years accounting for 32.1%. 45.9% were pedestrians hit by bicyclists, 46.9% of the bicycle related casualties reported by the traffic police were slightly injured, 28.1 % were seriously injured and 25% were fatal cases. Of the fatal cases 56.3% were passengers carried by bicyclists, 25% were pedestrians knocked by bicyclists and 18.7% were bicycle riders. 9.3% of injuries occurred in major roads within the city. The majority of casualties in police derived data were adults aged above 16 years (78.2%).
Conclusion: The high prevalence of bicycle related cases calls for a review of the local situation so that concerted efforts are made to design coordinated and effective interventions for commercial bicyclists. The age group most commonly affected in road trauma involving bicyclists was 21-30 years. Over three quarters of the patients who sustained bicycle related injuries were aged below 40 years and were mainly males.
Cut wounds were most commonly sustained followed by head injuries, dislocations, fractures while lacerations and contusions are sustained less. Most of those who died sustained head injuries.