Investigating severe e-bike and e-scooter injuries: Mechanisms and environmental considerations for public health action.

OBJECTIVES: To describe the patient, environmental, and injury characteristics of e-bike and e-scooter use and examine associations with injury severity to ultimately inform policy and safety measures. METHODS: We conducted a retrospective review of medical records, and prospectively collected data of the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) and Trauma Registry of patients who presented to the ED of our level 1 trauma centre with an injury related to e-bikes and e-scooters over 3 years (2020-2022). RESULTS: Of 169 injured persons (87 e-scooter, 82 e-bike), collisions with moving vehicles were the most common mechanism (e-scooter 22.9%, e-bike 24.7%), followed by unexplained falls (e-scooter 19.3%, e-bike 22.1%). E-scooter incidents more often stemmed from unfavourable road conditions (14.5%) and loss of control (18.1%) than e-bike incidents (5.2% and 6.5%); uneven or damaged pavement was the leading road hazard (e-scooter 31.3%, e-bike 75.0%). Most presentations involved riders (94.7%) and occurred on roads (78.0%). Injury severity did not differ significantly by vehicle type (p = 0.153). Injury severity was associated with male sex (p = 0.046) and presence of comorbidity (p = 0.023). 53.8% of all visits involved ≥ 1 fracture; 16 patients had an Injury Severity Score (ISS) > 12; and one died in the ED. Intoxication and high speed were commonly found in seriously injured people. CONCLUSION: E-scooter and e-bike injury patterns are influenced by rider demographics, injury mechanisms, and infrastructure and environmental factors. Strategies including infrastructure improvements, safe vehicle design, and addressing high-risk behaviours should be implemented to prevent micromobility injuries.