Injuries related to electric scooter and bicycle use in a Washington, DC, emergency department

Cicchino, Jessica B. / Kulie, Paige E. / McCarthy, Melissa L.
Insurance Institute for Highway Safety
October 2020

Objective: E-scooter use has grown rapidly in the United States. Its rise in popularity has coincided with the promotion of cycling in many cities, but more needs to be known about how these transportation modes compare to determine if cycling should serve as an appropriate benchmark for policy decisions and safety expectations regarding e-scooters.
Methods: We examined characteristics of adults seeking treatment in a Washington, DC, emergency department (ED) for injuries associated with riding e-scooters during 2019 (n = 103) or bicycles during 2015–2017 (n = 377).
Results: E-scooter incidents less frequently involved moving vehicles (12.6% vs. 39.5%) or occurred on roads (23.5% vs. 50.9%) than cycling incidents. Similar proportions were admitted to the hospital (8.7% vs. 8.5%) or received maximum Abbreviated Injury Scale (AIS) scores of 0–1 (62.1% vs. 59.1%) or 2 (35.9% vs. 36.0%). E-scooter riders less often sustained injuries with AIS >= 3 (1.9% vs. 4.8%; RR, 0.41; 95% CI, 0.10–1.41), indicating serious injury, but this difference was not statistically significant in regression controlling for age and sex. Distal lower extremity injuries were more common among e-scooter riders (14.6% vs. 4.5%; RR, 2.53; 95% CI, 1.66–3.35), and injuries to the proximal upper extremity (8.7% vs. 19.1%; RR, 0.50; 95% CI, 0.25–0.95) or chest, abdomen, and spine (2.9% vs. 13.0%; RR, 0.24; 95% CI, 0.08–0.71) were less common. Head injury rates were similar, but e-scooter riders more often experienced concussion with loss of consciousness (3.9% vs. 0.8%; RR, 2.84; 95% CI, 1.13–4.12) and were far less likely to wear helmets (1.9% vs. 66.0%). Estimated ED presentation rates per million miles traveled citywide were higher among e-scooter riders than cyclists (RR, 3.38; 95% CI, 2.77–4.13).
Conclusions: Injury severity was largely similar between cyclists and e-scooter riders despite the differences in circumstances leading to their injuries. E-scooter rider injury rates, though currently high, may decrease as they gain experience; however, if the number of new users continues to climb, they will persist in using the ED more often than cyclists per mile that they travel. Promotion of helmets among e-scooter riders could prevent serious head injury.