Recent observations by pediatric health professionals highlight a troubling trend: the rising incidence of severe injuries among children and teens using e-bikes and e-scooters. These motorized devices pose new risks that surpass those associated with traditional bicycles and scooters, and the increase in usage has led to significant public health concerns.
Historically, childhood injuries from biking or skating were typically minor, resulting in scrapes or broken bones that usually healed without long-term consequences. However, with the prevalence of e-bikes and e-scooters, the situation has substantially changed. E-bikes can reach speeds of up to 28 mph, while personal e-scooters can go between 15 mph and 50 mph. This acceleration leaves less reaction time for riders, contributing to accidents that often lead to life-threatening injuries.
Emergency departments across the United States have reported alarming increases in serious injuries tied to these devices. For instance, data from the National Electronic Injury Surveillance System reveals that from 2020 to 2021, there were 13,557 injuries among children from e-scooter use, marking a 71% increase from previous years (from 5,012 injuries in 2020 to 8,545 in 2021).
One worrisome aspect of these injuries is that they often encompass multiple traumas rather than singular incidents. Traditionally, life-threatening injuries associated with biking typically occurred through collisions with vehicles. With e-bikes and e-scooters, the high speeds have led to more crashes and isolated incidents generating severe injuries that mirror those seen in car accidents, including complex fractures, concussions, and even amputations.
The risk factors associated with teenage usage of e-bikes and e-scooters are further complicated by developmental aspects. Young individuals often lack the neurological maturity to manage high-stakes decision-making, leading to increased susceptibility to impulsive behavior. This developmental mismatch is particularly pronounced during adolescence, a time when the brain's reward systems develop faster than areas responsible for impulse control.
Marketing strategies directed at youth exacerbate this situation. Many social media platforms feature enticing content that encourages young people to seek out these motorized vehicles without adequately conveying the associated risks. Messaging that emphasizes independence and ease of commuting overlooks the severe consequences that can stem from merely one miscalculated moment.
In light of these increases in injuries and the associated risks, there is a pressing need for regulations that would govern the use of e-bikes and e-scooters by minors. Some states, including New Jersey, have begun implementing measures requiring riders to have a license, registration, and insurance similar to motorcycle regulations. These policies signal an acknowledgment of the significant risks these devices pose to younger riders.
For families, promoting safe riding practices is equally important. Parents and guardians should establish strict guidelines if their children are permitted to use these vehicles. Recommendations include:
In addition to parental guidance, broader societal measures could further enhance safety, including:
The rapid advancement of technology often outpaces public policy and safety guidelines, and the increase in injuries from e-bikes and e-scooters underscores this gap. There is an urgent need for collaborative efforts among legislators, healthcare professionals, and families to address these risks effectively. If timely interventions and regulations are established, society can benefit from the legitimate mobility advantages these devices offer while ensuring pediatric safety.
The balance of preserving freedom and ensuring safety for young riders is critical going forward, and proactive measures can mitigate the risks that currently plague this rapidly evolving mode of transportation.
J. Todd R. Lawrence, M.D., Ph.D., is an attending pediatric orthopedic surgeon, and Madison A. Kesler is a research associate at Children’s Hospital of Philadelphia.
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