John Austin, Louis Perkins, Laura N Haines, Leslie Kobayashi, Allison E Berndtson, Jessica L Weaver, Jarrett Santorelli, John Maa, Romeo C Ignacio, Sigrid Burruss, Amy E Liepert, Todd W Costantini, Jay J Doucet
{"title":"An exponential increase in e-bike injuries in California.","authors":"John Austin, Louis Perkins, Laura N Haines, Leslie Kobayashi, Allison E Berndtson, Jessica L Weaver, Jarrett Santorelli, John Maa, Romeo C Ignacio, Sigrid Burruss, Amy E Liepert, Todd W Costantini, Jay J Doucet","doi":"10.1136/tsaco-2025-002099","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Electric bicycle (e-bike) sales are growing exponentially worldwide. These vehicles are faster and heavier, with younger riders using e-bikes more frequently, reports of inconsistent helmet use, and increased deaths and injuries. We hypothesized that California has experienced significant annual increases in e-bike rider injuries and injury severity compared with injured traditional bicyclists, using a transportation injury registry and geospatial mapping system, including socioeconomic factors.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of the California Highway Patrol Statewide Integrated Traffic Records System (SWITRS) from 2018 to 2024, identifying e-bike collisions through reporter coding and vehicle brand names. We analyzed demographics, injury severity, fault status, traffic violations, and scene census tract Social Vulnerability Index (SVI). All non-e-bike traditional bicycle collisions served as the comparison group.</p><p><strong>Results: </strong>We identified 4035 e-bike and 58 332 bicycle collisions. E-bike injuries increased sharply over the study period, from two incidents in 2018 to 1566 in 2024 (p<0.001), while bicycle collisions remained stable. E-bike riders were younger (median 33 vs 36 years; p<0.001), with a significantly greater proportion aged ≤14 years (15.6% vs 10.2%). Moderate-to-severe injuries were more common among e-bike riders (15.8% vs 11.9%; p<0.001). Although overall mortality was similar (2.0% vs 1.7%), a significant divergence emerged in 2024, with higher e-bike mortality (p=0.027) and a significant interaction between year and vehicle type. E-bike collisions demonstrated more unsafe speed and improper turning violations and occurred in census tracts with lower social vulnerability. Spatial analysis showed tighter clustering of e-bike collisions relative to bicycles.</p><p><strong>Conclusions: </strong>E-bike injuries are rapidly increasing in California and are associated with a higher severity of injuries compared with traditional bicycles. Urgent efforts are needed for targeted prevention, regulatory alignment, and rider education.</p><p><strong>Level of evidence: </strong>Level III, retrospective case-control study.</p>","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"11 3","pages":"e002099"},"PeriodicalIF":2.5000,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13384186/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Trauma Surgery & Acute Care Open","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1136/tsaco-2025-002099","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Electric bicycle (e-bike) sales are growing exponentially worldwide. These vehicles are faster and heavier, with younger riders using e-bikes more frequently, reports of inconsistent helmet use, and increased deaths and injuries. We hypothesized that California has experienced significant annual increases in e-bike rider injuries and injury severity compared with injured traditional bicyclists, using a transportation injury registry and geospatial mapping system, including socioeconomic factors.
Methods: We conducted a retrospective analysis of the California Highway Patrol Statewide Integrated Traffic Records System (SWITRS) from 2018 to 2024, identifying e-bike collisions through reporter coding and vehicle brand names. We analyzed demographics, injury severity, fault status, traffic violations, and scene census tract Social Vulnerability Index (SVI). All non-e-bike traditional bicycle collisions served as the comparison group.
Results: We identified 4035 e-bike and 58 332 bicycle collisions. E-bike injuries increased sharply over the study period, from two incidents in 2018 to 1566 in 2024 (p<0.001), while bicycle collisions remained stable. E-bike riders were younger (median 33 vs 36 years; p<0.001), with a significantly greater proportion aged ≤14 years (15.6% vs 10.2%). Moderate-to-severe injuries were more common among e-bike riders (15.8% vs 11.9%; p<0.001). Although overall mortality was similar (2.0% vs 1.7%), a significant divergence emerged in 2024, with higher e-bike mortality (p=0.027) and a significant interaction between year and vehicle type. E-bike collisions demonstrated more unsafe speed and improper turning violations and occurred in census tracts with lower social vulnerability. Spatial analysis showed tighter clustering of e-bike collisions relative to bicycles.
Conclusions: E-bike injuries are rapidly increasing in California and are associated with a higher severity of injuries compared with traditional bicycles. Urgent efforts are needed for targeted prevention, regulatory alignment, and rider education.
Level of evidence: Level III, retrospective case-control study.
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