Electric scooters are suddenly everywhere — buzzing up and down busy streets and weaving among pedestrians on congested sidewalks. Inevitably, the number of accidents is rising in lockstep with the number of e-scooters, resulting in injuries that are sometimes serious, including fractures, dislocated joints and head injuries.
“There are thousands of riders now using these scooters, so it’s more important than ever to understand their impact on public health,” said Dr. Tarak Trivedi, the study’s lead author, an emergency physician and scholar in the National Clinician Scholars Program at the David Geffen School of Medicine at UCLA.
Public health officials say the scooters are undoing much of the safety education that has been done over the last few decades, particularly efforts to get bicyclists and motorcyclists to use helmets.
“Shareable 2-wheeled devices turn all of this on its head,” said Frederick P. Rivara, MD, MPH, in an editorial accompanying Trivedi’s study. He called for development of helmets designed and tested for use by e-scooter riders.
Trivedi and his fellow researchers examined data from 249 people who were treated at the emergency departments of UCLA Medical Center, Santa Monica, and Ronald Reagan UCLA Medical Center between Sept. 1, 2017, and Aug. 31, 2018. The study found that about one-third of them arrived by ambulance, an indication of the severity of their injuries.
West Los Angeles is widely considered the epicenter of the electric scooter phenomenon — Santa Monica was one of the first U.S. cities in which the scooters were widely used — but the vehicles are now available in more than 60 cities nationwide and about a half dozen locations outside of the U.S.
Most common mishaps
The research, published Jan. 25 in JAMA Network Open, is the first published study on injuries caused by electric scooters. It reports that the most common mechanisms of injury among scooter riders were falls (80 percent), collisions with objects (11 percent), or being struck by a moving vehicle such as a car, bicycle or other scooter (9 percent).
Among the other findings:
- About 92 percent (228) of the injured people were riders, and 8 percent (21) were non-riders, including pedestrians who were struck by scooter riders or who stumbled over a discarded scooter.
- About 4 percent (10) were documented to be wearing a protective helmet while riding their e-scooter.
- About 5 percent of patients had either a blood alcohol content greater than 0.05 percent or were perceived by physicians to be intoxicated. (In California, a person with blood alcohol content of 0.08 percent is considered to be driving under the influence.)
- Patients fell into one of three injury categories: head injuries (40 percent), fractures (32 percent) and cuts, sprains or bruises without a fracture or head injury (28 percent).
- Fifteen people were admitted to the hospital, two of whom were treated in an intensive care unit.
The researchers also observed e-scooter riders at various Los Angeles intersections for a total of seven hours in September 2018. About 94 percent of the 193 people they saw riding scooters were not wearing helmets.
E-scooters can reach speeds of about 15 miles per hour, and it has become common to see them zipping along streets and sidewalks — even though they are intended to be used on streets only — often dodging pedestrians and motorists. Unused scooters are frequently left at the edge of curbs, but they sometimes are abandoned in places where they obstruct sidewalks or block building entrances.
Cities have adopted a hodgepodge of responses to the safety issues posed by the new phenomenon. For example, in August 2018, Santa Monica began a public safety campaign with Bird and Lime, two of the leading e-scooter suppliers. A month later, the city launched a pilot program intended to develop administrative regulations on shared scooters and bikes. (Santa Monica already has a longstanding rule prohibiting bikes and electric devices from sidewalks.)
Scooter companies typically recommend that riders be at least 18 years old and wear helmets, although riders often flout those guidelines. And in January 2019, a new California law eliminated the helmet requirement for e-scooter riders 18 and older.
Helmet standards needed
In his editorial, Rivara noted that use of helmets is required by motorcycle riders in 19 states and the District of Columbia, and is associated with a 37% reduction in fatalities. Bicycle helmets have been shown to reduce the risk of traumatic brain injury (TBI) by as much as 88% and are required in many cities and states.
But, he said, “None of the companies that rent these vehicles in the increasingly common hubless system provide helmets” and noted that there are no helmets specifically designed for e-scooters.
“The American Society for Testing and Materials standards for bicycle helmets do not cover uses on motorized vehicles, whether they be electric scooters, mopeds, or motorcycles. It is highly unlikely that an individual using a shareable electric scooter or electric bike would use a motorcycle helmet, even if one were provided,” he wrote.
“There are no data on whether bicycle helmets would provide adequate protection against serious TBI for these motorized devices, which can attain higher speeds than would be achieved by most bicyclists on flat roads. … The Consumer Product Safety Commission should test different helmets for these various devices and label them according to the vehicle in which their use is appropriate,” he said.
The authors wrote that the Segway, a two-wheeled personal transporter that was introduced in the early 2000s, and a precursor of the scooters, also carried a serious risk for orthopedic and neurologic injuries.
“We noted similar patterns of injury with the new standing electric scooters,” said Dr. Joann Elmore, professor of medicine in the division of general internal medicine and health services research at the Geffen School of Medicine, and the study’s senior author. “But unlike Segway transporters, standing electric scooters will have a substantial impact on public health given their low cost, popularity and broad accessibility.”