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Health Impact Assessment of increased cycling to place of work or education in Copenhagen
  1. Astrid Ledgaard Holm1,
  2. Charlotte Glümer2,
  3. Finn Diderichsen1
  1. 1Department of Public Health, Faculty of Health Sciences, Section of Social Medicine, University of Copenhagen, CSS, Copenhagen, Denmark
  2. 2Research Centre for Prevention and Health, Glostrup University Hospital, Glostrup, Denmark
  1. Correspondence to Dr Astrid Ledgaard Holm; asho{at}


Objective To quantify the effects of increased cycling on both mortality and morbidity.

Design Health Impact Assessment.

Setting Cycling to place of work or education in Copenhagen, Denmark.

Population Effects were calculated based on the working-age population of Copenhagen.

Main outcome measures The primary outcome measure was change in burden of disease (measured as disability-adjusted life years (DALY)) due to changed exposure to the health determinants physical inactivity, air pollution (particulate matter <2.5 μm) and traffic accidents.

Results Obtainment of the proposed increase in cycling could reduce the burden of disease in the study population by 19.5 DALY annually. This overall effect comprised a reduction in the burden of disease from health outcomes associated with physical inactivity (76.0 DALY) and an increase in the burden of disease from outcomes associated with air pollution and traffic accidents (5.4 and 51.2 DALY, respectively).

Conclusion This study illustrates how quantitative Health Impact Assessment can help clarify potential effects of policies: increased cycling involves opposing effects from different outcomes but with the overall health effect being positive. This result illustrates the importance of designing policies that promote the health benefits and minimise the health risks related to cycling.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: and

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  • To cite: Holm AL, Glümer C, Diderichsen F. Health Impact Assessment of increased cycling to place of work or education in Copenhagen. BMJ Open 2012;2:e001135. doi:10.1136/bmjopen-2012-001135

  • Contributors ALH was the main contributor to data analysis and writing of the article. FD contributed to the design of the study, interpretation of data and drafting of the article. CG supplied parts of the data material and contributed with important revisions of article drafts. All authors approved the final version of the article.

  • Funding This research received no specific grant from any funding agency in public, commercial or not-for-profit sectors.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Study data are available from the corresponding author upon request (e-mail: asho{at}