Traffic-related injuries are a serious health problem. Traffic safety is a priority reflected in the United Nations Sustainable Development Goals. Data on current hazards for bicycle-related injuries from the United Arab Emirates are lacking. The aim of our observational study was to assess the behavior of bicyclists on the roads in Al Ain City, United Arab Emirates and compare our current results with a previous study from 2004.We adapted and tested a structured data collection form. Different sectors of Al Ain were randomly selected to cover the whole city during different times. Bicyclists were observed without direct contact.Out of 1129 bicyclists, 97.6% were males and 13.2% children. 39.4% were cycling on main roads with high-density traffic, 33.1% were cycling against the traffic, 39.3% were cycling at night, and 96.8% of them were not using lights. Only 2.1% of the bicyclists used helmets. A higher proportion of female than male cyclists used helmets (25.9% vs 1.5%; P < .001, Fisher exact test). There was an increase in cycling with the traffic (P < .001) and in use of helmets (P < .025) compared with the previous study.Unsafe practices of bicyclists and low use of helmets despite legislation persist in Al Ain. There is a need to raise bicycle safety awareness and improve enforcement of bicycle helmet legislation. This should be directed toward expatriate workers, children, parents, and maids. Environmental changes, namely building separate bicycle lanes, can increase safety for cycling.
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