Injury Rate From E-scooters May Exceed That of Motorcycles

NEW YORK (Reuters Health) – Data from Los Angeles suggest that the injury rate from electric scooters may exceed the national rate for motorcycles.

A review of medical notes on patients presenting to 180 clinics and two hospitals in greater Los Angeles between 2014 and 2020 shows that e-scooter riders sustained injuries at a rate of 115 per million trips, researchers report in PLoS ONE.

“Riding a shareable e-scooter is probably more dangerous than riding a bicycle, and potentially more dangerous than riding a motorcycle,” lead author Dr. Kimon L.H. Ioannides of UCSF Fresno told Reuters Health by email.

“Our study showed that arm injuries were most common, often from falls, so it is possible that the design of e-scooters offers less stability and protection for the upper body compared with a bicycle,” said Dr. Ioannides, who was a fellow with the National Clinician Scholars Program at the University of California, Los Angeles, when the research began. “However, their ease of use may also lead to more casual, unhelmeted use by inexperienced riders in unfamiliar areas and situations. As with motorcycles, their motors may be leading to higher speeds that make injuries more likely to require medical care.”

Other common injuries ranged in severity from scrapes, bruises, broken bones and concussions to collapsed lungs and internal bleeding, the researcher said.

To take a closer look at injuries from e-scooters, he and his colleagues used a natural-language processing (NLP) algorithm to search for e-scooter injuries among 36 million injuries described in medical records. After the injuries were identified by the software, the researchers examined them manually. They combined the injury tallies with municipal data on scooter use and calculated a monthly utilization-corrected rate of e-scooter injuries.

Overall, the researchers identified 1,354 people injured by e-scooters, with 30% seen in more than one clinical setting, for example the emergency room with a follow-up outpatient visit, 29% requiring advanced imaging, 6% requiring inpatient admission, and two dying.

The estimated injury rate of 115 per million trips “is substantially higher than prior national estimates of 104 injuries per million motorcycle trips, 15 injuries per million bicycle trips, 8 injuries per million passenger car trips, and 2 injuries per million walking trips, although these established statistics are drawn from public safety records that may capture only a more severe subset of injuries,” the researchers write.

“In contrast, our fatality rate of 19 per 100 million e-scooter trips is closer to prior national estimates of 21 per 100 million bicycle trips than 537 per 100 million motorcycle trips,” they add.

The increase in e-scooter injuries did not surprise Dr. Christopher Morrison, an assistant professor of epidemiology at the Columbia University Mailman School of Public Health in New York City.

“This work is important,” Dr. Morrison told Reuters Health by phone. “One of the first steps in understanding an emerging public-health problem is to describe it and to try to understand how many events there are and how to deal with them.”

There are many possible interventions to help prevent the problem, said Dr. Morrison, who was not involved in the study. For example developing roadways so that pedestrians, bicycles, e-scooters and motor vehicles can safely share them, he added.

While the findings are valuable, it’s a mistake to compare e-scooter injuries to those from other modes of transportation, said Dr. Jonathon Ehsani, an assistant professor in the department of health policy and management and research director for the Center for Injury Research and Policy at the Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland.

“It’s like comparing apples to oranges,” Dr. Ehsani, who also was not involved in the research, told Reuters Health by phone. “Motorcycles go extremely fast and the force involved in a collision is an order of magnitude higher than it would be for an e-scooter.”

That said, the authors should be commended for doing a “tremendous job” extracting injury events, Dr. Ehsani said. “The message from this study is that we need to do a better job of surveillance of e-scooters and more broadly micro-mobility and the authors have offered an innovative way to do it.”

There are many ways to make e-scooters safer, Dr. Ehsani added. For example, some e-scooter designs allow their speed to be adapted to the environment.

“One of the greatest things I’ve seen with these e-scooter companies is the speed can be toggled depending on where you are riding,” he said. “So, if you are riding an e-scooter and you enter a busy area with lots of pedestrians, the maximum speed can be dropped from 15 mph to 7 mph and the rider has no control.”

SOURCE: PLoS ONE, online April 6, 2022.

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