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Alcohol, drugs and not wearing a helmet are frequent factors in e-scooter injuries

The researchers analyzed data collected from all patients admitted with e-scooter-related injuries to three Level 1 trauma centers between September 2017 and October 2018.

Scooter on Hennepin
For the study, the researchers analyzed data collected from all patients admitted with e-scooter-related injuries to three Level 1 trauma centers between September 2017 and October 2018.
MinnPost photo by Greta Kaul

A significant proportion of people who are seriously injured while riding electric scooters, or e-scooters, are under the influence of alcohol or drugs — and most are not wearing a helmet, according to a study published recently in the journal Trauma Surgery & Acute Care Open.

Men between the ages of 20 and 40 are at greatest risk, the study also found.

“E-scooters may look like fun and games, but it’s a vehicle. It’s a motor attached to wheels, and you need to have a healthy respect for it,” said Dr. Leslie Kobayashi, the study’s lead author and an associate professor of clinical surgery at the University of California, San Diego, in an interview with HealthDay reporter Serena Gordon.

“Anyone drinking or using any mind-altering substance should not be operating an e-scooter,” she added.

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A century-old mode of transport

Although motorized stand-up scooters were first manufactured over 100 years ago, they have gained mass popularity only within the past few years as various companies have made rentable, dockless e-scooters — with appealing names like Lime, Bird, Skip, Spin and Scoot — available in dozens of cities across the country, including Minneapolis, St. Paul, Rochester and Duluth.

Yet despite the public’s widespread adoption of e-scooters (an astounding 3.6 percent of American adults rode one within a year of their being introduced to U.S. cities in 2017, according to one report), little is known about the risks this mode of urban transportation poses to public health.

Kobayashi and her colleagues decided to address that research gap. They set about examining the types of injuries associated with e-scooters and the factors that might be influencing those injuries.

How the study was done

For the study, the researchers analyzed data collected from all patients admitted with e-scooter-related injuries to three Level 1 trauma centers between September 2017 and October 2018.

During that period, the three centers treated 103 e-scooter riders. Those injuries rose sharply across the 14 months of the study, with most occurring in the last five months — 43 in the last month alone.

The majority (62 percent) of the injured people were between the ages of 20 and 40, male (65 percent) and white (66 percent). Four out of 10 of them sustained moderate to severe injuries. One person was critically injured.

Most of the injuries were fractures involving the leg, the ankle, the collarbone, the shoulder blades and/or the forearm. Half of these patients had to undergo surgery to repair their injuries. The second-most common type of injury involved broken noses, cheekbones or other facial fractures. About a quarter of these patients required surgery.

Nineteen (18 percent) of the patients experienced an intracranial hemorrhage, or bleeding on the brain, as a result of their e-scooter injury. Fortunately, none required surgery. Another 17 patients (16.5 percent) sustained concussions.

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Overall, about a third of the 103 patients underwent surgery for their injuries. Although most (86 percent) of them were discharged to their homes, six of the patients had to be transferred to a nursing home or rehabilitation facility for long-term care. Two others required home health assistance.

Helmet-less and chemically impaired

Information on helmet use was missing from the medical records of five of the patients, but helmet use — or, rather, helmet non-use — among the rest of the injured e-scooter riders was remarkably consistent: Only two people were wearing protective head gear when they were injured.

“Helmet use has been shown to significantly decrease the risk of traumatic brain injury in motorcycle, bicycle, and skateboard accidents,” Kobayashi and her colleagues write in their paper, although they also add that “the effect of helmets in preventing head injury in eScooter riders are unknown, and we were unable to draw any meaningful conclusions in our study due to lack of helmet use.”

Intoxication, either from alcohol or drugs, was another common factor associated with the e-scooter injuries in the study. Of the 79 percent of the patients who were tested for alcohol, about half (48 percent) were well above the legal limit. Of the 60 percent also screened for drugs, about half tested positive — most commonly for tetrahydrocannabinol (THC), which is found in marijuana, followed by methamphetamine and amphetamines.

The rate of intoxicating substances found in the injured e-scooter riders is “notably higher” than that found in previous studies involving bicycle and skateboard injuries, the researchers point out.

Limitations and implications

The study comes with plenty of caveats. It’s observational, so can’t prove cause and effect. The study also involved a small number of patients, and all of them were seen at major trauma centers — a factor that may have biased the findings toward more severe injuries, the researchers acknowledge.

Still, the findings support other studies that have reported a high proportion of serious injuries among people who have accidents while riding e-scooters. Earlier this year, for example, a study done by Austin Public Health and the Centers for Disease Control and Prevention found that of 190 e-scooter riders injured during a three-month period in Austin, Texas, half experienced a “severe” injury, including 15 percent who sustained a traumatic brain injury.

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A third of those riders acknowledged drinking alcohol in the hours before their e-scooter accident. Only one was wearing a helmet.

FMI: You can read the new study on Trauma Surgery & Acute Care Open’s website.