Alcohol-related injuries from e-scooter and e-bike use in the US (2019-2022): A retrospective study

Abstract

Background: The use of electric-powered scooters and bikes (e-scooters/bikes) is rising, but little is known about associated injuries and substance use. This study analysed the trends and factors associated with e-scooter/bike-related injuries and alcohol/substance use emergency department (ED) visits from 2019 to 2022. Methods: A retrospective analysis of US ED visit data from the 2019-2022 National Electronic Injury Surveillance System (NEISS) identified visits for e-scooter/bike-related injuries. NEISS data were collected using stratified, multistage sampling, and the analysis accounted for this complex sampling design. Outcomes included yearly visits, patient demographics, injury details and alcohol/substance use associations. Multivariable logistic regression analysed factors associated with e-bike/scooter-related injury ED visits and alcohol/substance use. Results: Of 4020 e-scooter/bike injury ED visits, 3700 (weighted estimate 279 990) were e-scooters and 320 (weighted estimate 16 600) were e-bikes. Visits increased three-fold from 2019 (n=22 835) to 2022 (n=65 892). Most of the injuries involved males, with 79.6% of e-scooter injuries and 79.7% of e-bike injuries), aged 18-39 years (51.5% e-scooter, 48.5% e-bike) and non-Hispanic White (34.9% e-scooter, 38.8% e-bike). Alcohol use was reported in 8.6% of e-scooters and 2.5% of e-bike injury-related ED visits. Males had 2.6 times higher odds of alcohol use (OR: 2.61, 95% CI: 1.84 to 3.69) and 2.2 times higher odds of substance use (OR: 2.23, 95% CI: 1.19 to 4.16) associated ED visits, compared with females. Compared with the 18-39-year age group, those aged 10-17 years had 7.5 and 4.1 times higher odds of alcohol and substance use leading to e-scooter and e-bike injury-related ED visits, respectively. Conclusions: E-scooter injuries are increasing rapidly, especially among younger males, with a three-fold increase from 2019 to 2022. Alcohol and substance use both contribute significantly to morbidity. Strengthening policy and prevention approaches like the use of helmets are warranted to improve e-scooter/bike safety.