E-bike head injury frequency, severity, and hospitalization levels increased over the past decade

By Josh Wu. This article was initially published in the 1/23/25 edition of our Concussion Update newsletter; please consider subscribing.

A recent study published in The Physician and Sportsmedicine investigated the relationship between electric biking (e-biking) and high-impact head injuries. Niklas H Koehne et al. found that, in the past decade, the incidence of head injuries due to e-bike accidents has significantly increased, as did the severity of the injuries. 

E-bikes provide a fun, convenient way to commute and are becoming increasingly popular in society. However, as the use of these motorized bicycles increases, so does the potential risk and severity of injury. The study results show that E-bike head injuries increased significantly from 2013 to 2022, particularly in 2022, in which 40.8% of all observed cases occurred. Incidents involving another motor vehicle accounted for a fourth of the head injuries and were associated with increased levels of hospitalization. The rising incidence and severity of e-bike head injuries, particularly among teenagers, indicates a need for new preventative measures.

Using data from the National Electronic Injury Surveillance System (NEISS), the researchers searched for e-bike-related brain injuries presented to emergency departments from 2013 to 2022. They organized the data based on demographics and diagnosis while supplementing this information with injury narratives to identify the mechanism of injury and motor vehicle involvement. They identified an estimated 11,052 e-bike head injuries occured between 2013 to 2022.

Motor vehicle involvement accounted for 27.6% of head injuries and was associated with higher hospitalization rates compared to accidents with no motor vehicle involvement. Age and sex also affected results. High school-aged (14-18) riders had the highest rate of accidents involving motor vehicles (53.2%) and middle school-aged adolescents (11-14) had the highest rate of concussions (26.5%). Males were more likely to be hospitalized after e-bike accidents compared to females (33% vs 25.4%), although this may be due in part to males’ nearly 84% higher rate of incidents involving motor vehicles (28.5% vs 15.5%). 

Better traffic legislation and increasing awareness about sharing the road could help safeguard young e-bikers. E-bike riders can also take steps to be safer by always wearing a helmet and displaying bright or fluorescent colors so cars can see them. While this research article is a good step in identifying this problem, more research needs to be done to understand the public, health, and economic implications of e-bike-related head injuries.