Pediatric experts urge e-bike safety as injuries rise

E-bikes are becoming a common sight in neighborhoods and on city streets, offering kids a faster and more convenient way to get around. But as their popularity continues to grow, so do concerns about the serious injuries they can cause.

“We're paying closer attention to e-bikes because of the increase in injuries we're seeing. I think they look similar enough to traditional bicycles or other vehicles kids are used to riding that many parents don't view them as a significant risk,” said first-year pediatric critical care fellow at MUSC Shawn Jenkins Children’s Hospital Taylor Allen. “But from what we've seen in the emergency department, the hospital and the ICU, these bikes can cause serious injuries.”

Allen and Jennifer Springer, a first-year pediatric hospital medicine fellow at MUSC Shawn Jenkins Children's Hospital, said they have seen a rise in severe e-bike injuries among children in the Charleston area. In the emergency department, intensive care unit and throughout the hospital children are being seen and treated for injuries ranging from head trauma and internal organ damage to severe abrasions and broken bones.

“As common as these bikes are in the Charleston area, their increased popularity is a pattern that's seen nationwide,” said Springer

According to a study published in JAMA Surgery, there were 4,578 e-bike-related injuries in the United States between 2017 and 2022. Injuries in children increased from 0% to 13% in total. The incidence of head trauma from e-bicycle accidents in 2022 was approximately 49 times higher than in 2017, increasing from approximately 163 to approximately 7922 head injuries.

Many families don’t realize e-bikes are heavier, faster, and behave differently than regular bikes, which means kids need different safety skills, equipment, and supervision. Due to the higher speed and weight of these bikes, there is a significant increase in impact force when they crash, leading to more significant injuries, specifically head and abdominal trauma. When compared with regular mechanical bicycles, e-bike related accidents have significantly more injuries per patient, increased severity of injuries and longer lengths of stay in the hospital.

When considering an e-bike for their child, the fellows recommend starting with the lowest-speed option. E-bikes are categorized into classes based on their speed and operation. Class 1 bikes are pedal-assisted and reach speeds of up to 20 mph. Class 2 bikes can reach 20 mph using a throttle, while Class 3 bikes can reach speeds of up to 28 mph.

Allen and Springer encourage every family to speak with their pediatrician to determine if their child is ready for an e-bike. Generally, e-bikes are not recommended for children younger than 12 years of age. Families should also check their state and local laws regarding e-bike use because some states require a driver’s license to operate one. Local laws can sometimes be more detailed or specific compared to state laws, so families should ideally be aware to check both. Helmets should be always worn on e-bikes, specifically helmets rated for the higher speeds that these bikes travel at.

“This is an area where I think everyone is still learning more about the best way to make these safe for kids. And everyone's goal is that kids can go outside, have fun and enjoy, but be safe. And there are ways to do that,” said Allen.