Youth e-bike, e-scooter injuries rising in U.S., says Stanford Medicine-led study

Rates of electric bike and electric scooter injuries are rising in children and teens across the country, a new Stanford Medicine-led study has found.

Young people are also more likely to be severely injured on e-bikes or e-scooters than on nonmotorized vehicles, the study showed.

The research, publishing Nov. 2 in JAMA, drew on medical records from more than 13,000 young people treated for bike, scooter and skateboard injuries at six large U.S. pediatric hospitals between Jan. 1, 2023, and March 31, 2026.

“Over that period, e-bike injuries increased by 33% per quarter, and e-scooter injuries increased by 15% per quarter,” said lead author Alan Schroeder, MD, clinical professor of pediatrics. “Those increases were substantially higher than comparable increases in injuries from nonmotorized bikes and scooters.” Schroeder treats children in the intensive care unit at Lucile Packard Children’s Hospital Stanford.

“We’ve been seeing more and more kids on e-bikes, both on the street and in the hospital,” said pediatric trauma surgeon Stephanie Chao, MD, an associate professor of surgery and of pediatrics, and a coauthor of the study. “These kids are coming in with increasingly severe injuries,” added Chao, who is also the trauma medical director at Packard Children’s.

For example, she noted, brain injuries were about twice as common among kids injured on e-bikes and e-scooters as on nonmotorized vehicles, and the proportion of injured patients who needed hospitalization was higher among e-bike riders than any other group studied.

Schroeder and Chao suggest several policies to prevent injuries, including a cutoff age for electric vehicle riding as well as e-bikes that cannot exceed certain speeds. About one-quarter of e-bike injuries and almost half of e-scooter injuries occurred in children under 12, they noted.

“We’ve uncovered a serious public health emergency that needs a public health solution,” Schroeder said.

A broken femur

Fifteen-year-old David Zapien knows firsthand that electric bicycle injuries can be severe. On Sept. 15, a friend said, “Want to ride my e-bike?”

“Sure, why not?” David said. He doesn’t have an e-bike of his own, so he was curious to try it. He rode a short distance, did a U-turn and prepared to ride back. He cranked the e-bike’s throttle, not realizing how powerful it was.

“I pressed the throttle too much, and the bike popped up,” David said, miming a wheelie motion. The uplift and the acceleration sent him flying.

He’s an agile kid, an avid baseball player, and he reacted better than many people could.

“I landed on my feet, but my leg bent sideways,” David said. The impact snapped his left femur and dislocated his left knee.

From the emergency department of a hospital near his family’s home in Merced, California, David was taken by ambulance to Packard Children’s. The following day, Stephanie Kha, MD, clinical assistant professor of orthopaedic surgery, repaired his femur, anchoring a rod in his bone with four screws, two in his knee and two near his hip.

Although he was able to walk soon after the surgery, his doctors think it’ll be several months before he can run. Baseball is also out of the picture for now.

Rising injury rates

From their roles on the front lines of treating patients like David, Schroeder and Chao had suspected that e-bike and e-scooter injuries were rising. Not to mention the rapid spike in media reports. But the scientific literature lacked reporting on the topic.

Medical codes specific to e-bike and e-scooter injuries were introduced in 2022. Stanford Medicine researchers participate in PEDSNet, a database housed at the Children’s Hospital of Philadelphia that aggregates data from electronic medical records at multiple leading U.S. pediatric hospitals. When Schroeder suggested that the PEDSNet researchers study trends in e-bike injuries, his colleagues across the network were enthusiastic. One advantage of PEDSnet is the availability of near real-time electronic health record data (the study included data through March 2026). Although national registries for injuries do exist, there are often lags of one to two years in compiling their data.

The researchers examined medical records from 13,307 patients younger than 18 who had injuries from e-bikes, nonmotorized bikes, e-scooters, nonmotorized scooters and nonmotorized skateboards. They analyzed patients’ ages, the severity of their injuries and where patients received care: urgent care, the emergency department and/or in a hospital.

Although rates of all types of injuries were rising, the most dramatic increases were observed in e-bike and e-scooter injuries, which increased exponentially during the period studied.

High-severity injuries affected 8% of patients with e-bike injuries versus 4% of patients injured on nonmotorized bikes, as well as 5% of patients injured on e-scooters and 2% of those riding nonmotorized scooters. Severe injuries were those that required hospitalization in an intensive care unit; major neurologic, vascular, thoracic, abdominal, pelvic or neck injuries; traumatic amputations; severe crush injuries; and bone fractures that required surgical repair. Brain injuries — not all of which were classified as severe — were also twice as common, affecting 10% of those injured on e-bikes and 9% of those injured on e-scooters, compared with 5% and 4% of patients injured on the nonmotorized vehicles. Seventeen percent of e-bike injuries resulted in hospitalizations.

“It’s crazy to me that a quarter of our e-bike injuries and almost half of our e-scooter injuries are happening in kids who are so young,” Schroeder said. “I honestly think that kids under 12 should not be riding any form of motorized vehicle.”

Improving safety

Several measures could help make e-bikes and e-scooters safer for young riders. “We have evidence-based solutions,” Chao said.

A few California counties are passing local ordinances to restrict e-bikes and e-scooters to older riders. San Diego and Marin counties require riders of faster e-bikes to be at least 16, and San Mateo County is running a pilot program to restrict certain e-bikes to those over age 12. “I think we should be putting forth common-sense laws such as these statewide,” Chao said.

Riders also need proper helmets.

“Many parents have no idea that e-bike riders might need different helmets than regular bike helmets,” Chao said. “Because of the high speeds that certain types of e-bikes can reach, the helmets need to provide more full face and head protection. We need to teach that to parents and kids, and we need laws to enforce these basic safety principles.”

At present, some e-bikes can be easily tampered with to increase their top speed, raising the chances that riders will be severely injured in an accident.

“We should not build bikes where kids can do a little adjustment and up the speed to 40 miles per hour,” Schroeder said. “There should be safety guards you cannot undo.”

Teaching all young riders that they must obey traffic rules may also reduce the number of accidents.

“Kids know a red light means ‘Stop,’ but they may not realize that, on an e-bike, they have to obey the same road rules as other vehicles,” Schroeder said. The Stanford Health Care Trauma and Injury Prevention program recently collaborated with the Santa Clara County Sheriff’s Office to revive its Juvenile Traffic Diversion Program, which offers a two-hour safety class that educates young people about traffic rules, safe riding behaviors and helmet use.

David Zapien also has some safety advice for other young e-bike riders, including getting proper instruction about an e-bike before you try it.

“Be safe and wear a helmet,” he said. “It isn’t worth trying to do a stunt. One mistake and it’s just over: You break something or hit your head.”

Researchers from Nemours Children’s Health in Wilmington, Delaware; Children’s Hospital of Philadelphia; University of Washington and Seattle Children’s Research Institute; University of Colorado Anschutz Medical Campus and Children’s Hospital Colorado; Ann & Robert H. Lurie Children’s Hospital of Chicago and Northwestern University Feinberg School of Medicine; and Baylor College of Medicine in Houston contributed to the study.

The analysis of PEDSnet data was conducted by data scientists from Children’s Hospital of Philadelphia. The infrastructure for PEDSnet is funded by the Patient-Centered Outcomes Research Institute.

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