Pediatric e-bike and e-scooter injuries nearly quadruple at California hospital

Pediatric injuries involving electric bikes (e-bikes) and electric scooters (e-scooters) nearly quadrupled at a California pediatric hospital between 2019 and 2025, with e-bike injuries associated with greater severity despite accounting for fewer cases, according to research presented at the American Academy of Pediatrics (AAP) 2026 National Conference & Exhibition in San Diego, California.1,2

Investigators identified 379 patients with e-bike- or e-scooter-related injuries during the 7-year study period. Annual cases increased from 33 in 2019 to 124 in 2025. Although e-scooters accounted for 77% of injuries overall, the proportion involving e-bikes increased from 21% in 2019 to 31% in 2025.

"These recreational transportation devices are becoming increasingly common among children and teenagers, and the injuries we are seeing are rising just as quickly,” Bianca Edison, MD, MS, FAAP, FAMSSM, an attending physician in the Jackie and Gene Autry Orthopedic Center at Children’s Hospital Los Angeles, said in a press release.

E-bike injuries associated with greater severity

Investigators used medical records from a single quaternary pediatric hospital to identify patients injured while using e-bikes or e-scooters from 2019 through 2025. A large language model was used to identify potentially relevant cases.

The 379 patients had a mean age of 14.2 years, and 70% were male. An unprovoked fall or loss of control was the most common mechanism of injury, accounting for 71% of cases.

Upper extremity injuries occurred in 53% of patients, followed by lower extremity injuries in 46% and head injuries in 39%.

Despite accounting for fewer injuries overall, e-bike use was associated with significantly worse outcomes across the severity measures examined. Concussions occurred in 17% of e-bike riders compared with 8.6% of e-scooter riders (P = .030), and fractures occurred in 48% and 36%, respectively (P = .049).

Surgery was required for 26% of patients injured on e-bikes compared with 9.7% of those injured on e-scooters (P < .001). Hospital admission was required for 27% and 10%, respectively (P < .001).

Using the Pediatric Trauma Score, investigators also classified 8.8% of e-bike injuries as potentially life-threatening compared with 2.8% of e-scooter injuries (P = .027).

Legal compliance did not predict injury severity

Researchers classified riding as illegal when a patient operated an e-scooter before age 16 years or rode an e-bike before age 18 years without a helmet, based on the California laws applied in the study.

Overall, 53% of injured patients met this definition. Illegal riding was more common among e-scooter riders than e-bike riders, at 66% and 7.2%, respectively (P < .001). After adjustment for age, vehicle type, and helmet use, however, legal compliance was not associated with less severe injury outcomes (P = .849).

"Our data highlights that an intentional and nuanced approach to education, community awareness, and public safety measures around e-bike and e-scooter use is imperative, especially regarding our youth population," Edison said.

The findings do not establish population-level injury rates because they reflect patients treated at a single hospital rather than all children using e-bikes and e-scooters. However, the increase in cases and differences in severity demonstrate distinct injury patterns among patients presenting for care.

“It is imperative that youth, parents, and the community at large realize that preventing these injuries will require safety strategies that account for the different risks associated with each type of device and the implications of their use in public amongst other riders, pedestrians, and motor vehicle drivers, rather than a one-size-fits-all approach,” Edison said.

References

1. American Academy of Pediatrics. Study shows growing injuries from electronic bicycles, electronic scooters with differences in injuries, hospitalizations. Eurekalert. October 2, 2026. Accessed October 2, 2026. https://www.eurekalert.org/news-releases/1145266

2. Wyatt J. Patterns and severity of injuries following e-bike and e-scooter use. Abstract presented at: American Academy of Pediatrics 2026 National Conference & Exhibition; October 2-6, 2026; San Diego, CA.