Rapid Responses to:

EDUCATION AND DEBATE: R E Williams De futuro urbanorum BMJ 1998; 317: 1713 [Full text]

Rapid Responses: Submit a response to this article

Rapid Responses published:

Homo se propellens requiem

Elizabeth Michel   (21 December 1998)

Avelopia: the disease of not having a bicycle

Douglas Carnall   (7 January 1999)

Homo se propellens requiem 21 December 1998
Elizabeth Michel, Technical Editor ( Health and Safety) London Send response to journal: Re: Homo se propellens requiem	How refreshing it is to read about the environmental effect of cyclists on London's traffic. The missing link is whether the price they have to pay for the privilege of cycling in the traffic jungle is too great: asthma, fume poisoning and the dreaded accident. I bet the survival rate of cyclist is far shorter than a car, a black cab or the other unhealthy and definitely not green Homo urbanus vehiculo constrictus.
Avelopia: the disease of not having a bicycle 7 January 1999
Douglas Carnall, Research Fellow School of Public Policy, UCL Send response to journal: Re: Avelopia: the disease of not having a bicycle	RE Williams is correct to point out the superiority of the cycle for urban transport, and while bogus Latin is not generally the best way to get a message over these days, perhaps Homo urbanus vehiculo constrictus conveys the limited vision of unthinking adherents to car culture rather well to a medical audience. I would like to introduce another term that we have found useful in our work as cycle activists: avelopia, or the disease of not having a bicycle. The diagnosis is generally made on the history: the symptoms include shortness of breath on mild physical exertion, low mood and self esteem, physical isolation, and poverty brought on by vehicle running costs and excessive public transport fares. On examination the legs are generally thin, yet flabby, the pulse quickened, the cheek sallow, the posture weak. Varying degrees of overweight are common. These unfortunates, as well as being frustrated in their day to day transport needs, lack the wellbeing that comes from physical fitness, and face the prospect of an earlier death from cardiovascular disease. Avelopics may delude themselves that in their cars they are safe from pollution (though collectively causing more than 90% of it), but in fact they are wrong to do so. Cabin air intakes are at road level, and the levels of particulates are higher inside it than outside. Patients with avelopia are therefore at higher risk of an adverse event as a result of air pollution. Intense anxiety about physical hazard is often a prominent feature of the disease. While the level of deaths and injuries on Britain's roads is unacceptably high, the risk of fatal trauma comes, not from cycling, but from badly driven motor vehicles. 75% of British drivers admit to speeding regularly; 90% of British drivers make serious errors of judgement on every trip. It doesn't have to be like this: Denmark has a cycle casualty rate ten times less than in the UK (and higher car ownership), a fact that possibly reflects that drivers cycle, and cyclists drive, and avelopia is almost unknown. Avelopia is entirely preventable and cheap to treat if it occurs. Doctors should certainly "wheel themselves," for how else will they be able to help their avelopic patients?