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The rising popularity of e-scooters in urban areas highlights the importance of understanding potential collision dynamics and consequences to enhance rider safety, especially since 80% of fatalities for these vulnerable road users result from incidents involving motor vehicles. This study aims to identify potential injury mechanisms of e-scooter riders involved in frontal impacts against Sports Utility Vehicles (SUVs) using Finite Element Analysis (FEA) and a Human Body Model (HBM). Six impact scenarios at 25 km/h were simulated: on the passenger's side door (1-SD), on the trunk door (2-TD), on the bonnet (3-FB), on the bonnet from the side (4-SB), on the windshield from the side (5-SW), and finally, on the bonnet with an offset (6-FO). A wide range of Injury Risk Criteria (IRCs) was analyzed, including A3MS, HIC15, BrIC, DAMAGE, Cmax and PC Score, and head contact forces were output. Injury Risk Curves were then used to calculate the probability and severity of the sustained injuries predicted by the mentioned IRCs. Overall, the results corresponding to the most injurious scenarios suggested serious (30% to 40% overall probability) and critical (45% probability for the 4-SB scenario) brain, moderate head (30% probability for scenarios 1-SD and 2-TD), and serious thoracic (26% to 78% overall probability) injuries. Additionally, in two scenarios (1-SD and 2-TD), the e-scooter rider's mandible impacted against the vehicle's roof side rail and rear spoiler, involving potential anterior-posterior serious mandible fractures. The conclusions reached in this study help to understand potential injury sources and provide valuable information for the design of specific safety systems or the creation or improvement of e-scooter legislation.

E-scooters as a mode of transportation is rapidly growing in popularity. This study evaluates head impact conditions and injury risk associated with E-scooter crashes. A multibody model of E-scooter falls induced by wheel-curb collision was built and compared with an experimental E-scooter crash test. A total of 162 crash scenarios were simulated to assess the effect of fall conditions (E-scooter initial speed and inclination, obstacle orientation, and user size) on the head impact kinematics. The forehead hit the ground first in 44% of simulations. The average tangential and normal impact speeds were 3.5 m/s and 4.8 m/s respectively. Nearly 100% of simulations identified a risk of concussion (linear acceleration peak >82 g and rotational acceleration peak >6383 rad/s2) and 90% of simulations suggested a risk of severe head injuries (HIC>700). This work provides preliminary data useful for the assessment and design of protective gears.

A 34-year-old female presented to the emergency department with neck pain, dysphonia and dysphagia ten days after a fall from an electric scooter. Subsequent computed tomography of the neck revealed bilateral vertebral artery and unilateral internal carotid artery non-occlusive dissections, which were managed with antiplatelet therapy. This case describes mechanisms of injury, clinical presentation, imaging appearances, and subsequent management of cervical artery dissection.

This study examines the spatio-temporal effects of the COVID-19 pandemic on shared e-scooter usage by leveraging two years (2019 and 2020) of daily shared micromobility data from Austin, Texas. We employed a series of random effects spatial-autoregressive model with a spatially autocorrelated error (SAC) to examine the differences and similarities in determinants of e-scooter usage during regular and pandemic periods and to identify factors contributing to the changes in e-scooter use during the Pandemic. Model results provided strong evidence of spatial autocorrelation in the e-scooter trip data and found a spatial negative spillover effect in the 2020 model. The key findings are: i) while the daily e-scooter trips reduced, the average trip distance and the average trip duration increased during the Pandemic; ii) the central part of Austin city experienced a major decrease in e-scooter usage during the Pandemic compared to other parts of Austin; iii) areas with low median income and higher number of available e-scooter devices experienced a smaller decrease in daily total e-scooter trips, trip distance, and trip duration during the Pandemic while the opposite result was found in areas with higher public transportation services. The results of this study provide policymakers with a timely understanding of the changes in shared e-scooter usage during the Pandemic, which can help redesign and revive the shared micromobility market in the post-pandemic era.

Resumen: Introducción: El uso de patinetes eléctricos se ha popularizado como medio de transporte en los últimos años, tanto por su versatilidad como por la practicidad en el uso de estos. Sin embargo, no dejan de ser una fuente de accidentes, muchas veces graves, generando nuevos problemas de salud pública y aumentando los costes de esta. Objetivo: Caracterizar la epidemiología de las lesiones producidas por accidentes en patinete eléctrico y estudiar el impacto económico indirecto en una mutua laboral. Materiales y métodos: Estudio descriptivo, donde se revisan retrospectivamente los pacientes atendidos en urgencias, del Hospital de Asepeyo en Sant Cugat, que han sufrido accidentes en patinete eléctrico en el periodo comprendido entre enero de 2018 y diciembre de 2020. Resultados: Se incluyeron 167 pacientes. El 55% (92) de los pacientes fueron hombres y el 45% (75) mujeres, con una edad media de 37,4 años. Se diagnosticaron 117 fracturas en el 63% (105) de los pacientes. Otras lesiones frecuentes documentadas fueron: 36 policontusiones, 16 TCE y 4 heridas que requirieron sutura. Las lesiones ligamentosas más comúnmente observadas fueron: 4 casos de rotura aguda de LCA, 3 casos de luxación acromioclavicular y 2 casos de rotura del LCC del pulgar. Un total de 105 pacientes requirieron ingreso hospitalario, 3 de ellos en UCI. El 51% (85) de los pacientes requirieron tratamiento quirúrgico. Durante ese periodo, el coste generado como consecuencia de las bajas laborales ascendió a 1.062.444 €. Conclusiones: El patinete eléctrico está comportando un incremento significativo de accidentes de tráfico en población adulta joven. Las lesiones que provocan pueden compararse con las vistas en accidentes de alta energía, generando un alto impacto socioeconómico debido a la naturaleza de las lesiones y sus potenciales complicaciones. Como mutua laboral, el impacto económico generado por las incapacidades laborales ha sido significantemente notable, ascendiendo a más de 1.000.000 € en el periodo revisado. Abstract: Introduction: During the last years, the use of e-scooter has become more and more popular due to the versatility as the practicality in intra-urban mobility. However, e-scooter has turned into a spring of accidents, lot of them, severe, causing new public health problems and significantly increasing the direct and indirect healthcare costs. Objective: To characterize the epidemiology of the injuries caused by e-scooter related accidents and to study their indirect economic impact in work-related accidents hospital. Materials and methods: Retrospective and descriptive study in which has been checked all the medical information about the patients attended in the ER (emergency room) of the Hospital Asepeyo Sant Cugat, who suffered e-scooter accident from January 2018 to December 2020. Results: 167 patients were included in the study. 55% (92) were male and 45% (75) were female. The average of age was 37.4 years-old. There were quantified 117 different fractures in 105 patients (63%). Other injuries documented were: 36 patients with multiple contusions, 16 head traumas and 4 wounds which required suture. The most frequent ligamentous injuries were 4 ACL ruptures, 3 ACJ dislocations and 2 patients with rupture of the UCL of the thumb. 105 patients required hospital admission, 3 of them in ICU. The 51% of the cases required surgical treatment of their injuries. In that period, as a consequence of the work inabilities generated by the total of the patients included in the study, the added cost for the hospital was around 1,062,444€. Conclusions: The popularization of e-scooters between the employed population has caused a high increased number of accidents in this range of age. Most of the injuries observed may be compared with those seen in high-energy traumas. These cause an important socio-economic impact due to the nature of the injuries and the potential complications that could appear. The work inabilities observed as a consequence of e-scooter related injuries in the employed population have caused a substantial economic impact, shooting up to more than 1,000,000€ the indirect cost of our hospital during the reviewed period.

This study aims to explore the spatial and temporal dynamics of e-scooter usage and its association with the built and social environmental attributes in Minneapolis, Minnesota. Using a 4-month long trip data from 2019, this street-segment-level (N=13,367) study deployed negative binomial regression to build trip generation and destination models. The extent of the impact of built and social environment-related attributes varies at different temporal dimensions of e-scooting. Regarding spatial pattern, university areas and areas close to downtown generated substantially higher trips than other Minneapolis areas. In terms of temporal pattern, trips are more diffused at night and morning, and more concentrated in midday and evening. The high percentage of residential, commercial, and institutional land uses, a higher land use mix, high-valued parcels, and more food-related Points of Interest are strongly associated with e-scooter usage. E-scooter is heavily used in areas with more bike-dependent commuter, less car-dependent commuter, and young-aged people. Further, the presence of a sidewalk, bike-share station, bus stop, and transit shelter on a street segment positively affect scooter usage. These findings will assist e-scooter operators and city planners to formulate policies. Further, by strengthening the literature, this study can serve as a foundation for cities new in e-scooter mobility.

With the introduction of mobile applications that allow short-term rentals, electric scooters (e-scooters) are gaining popularity as a means of micromobility in urban areas. The aim of the study was to assess the circumstances and causes of death in traffic accidents involving electric scooters in Poland. The inclusion criteria for the study were met by 9 cases (7 M,2F; mean age: 40.3 years). Accidents usually occur during working days during the warm months, especially during the morning traffic rush hour. Usually, these accidents involved another vehicle (4/9 cases). In addition, the victim was most often the driver (8/9 cases) and rarely uses a helmet (1/9 cases). In only two cases did the test reveal the presence of alcohol in the blood at the time of the accident. In studied cases, head injuries occurred in every case, and injuries to the limbs and chest occurred in more than half of the cases. Within the head, in addition to minor injuries like bruises and epidermal abrasions, skull fractures, and intracranial bleedings predominated. Similar minor injuries were also observed in the extremities, with significant fractures observed only in the lower extremities. Among chest injuries, lung contusions predominated. The most common cause of death was craniocerebral injury (6/9 cases), but there were two deaths each from chest injuries and polytrauma. To increase the safety of e-scooter users, it is recommended that measures be taken to educate users about the potential risks of using the vehicle and that measures be taken to increase the use of helmets, e.g. through legislative action. Further studies involving larger study groups are needed to assess the correlation between potential risk factors and the fatal outcome of the accident., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests., (Copyright © 2024. Published by Elsevier Ltd.)

It was the aim of the study to analyze the distribution and pattern of facial fractures following e-scooter trauma. Prospective audit data of facial fractures were retrospectively collected to investigate the impact of e-scooter hire, specifically in the form of facial fractures associated with their use. Data collected included patient demographics, mode of injury, date of injury, facial bones involved, presence of soft tissue injury, and factors associated with injury, including intoxication and helmet use. A total of 849 patients were treated for facial fractures during the study period, of which 34 were attributed to e-scooter use. One-half of those injured riding e-scooters were intoxicated, and one-quarter were wearing helmets. There have been an increasing number of facial fractures associated with e-scooter use following the start of the shared e-scooter trial. Zygomaticomaxillary complex fractures were the most common pattern of facial fracture seen. Most patients required surgical management of their injuries. Policymakers should consider how to improve the enforcement of current regulations, given the healthcare cost associated with the management of these preventable injuries., (Copyright © 2024 European Association for Cranio-Maxillo-Facial Surgery. All rights reserved.)

Comfort and safe-mobility are two aspects that should be provided to non-motorized users that are an increasing component of the urban micro-mobility (e.g. bikes and e-scooters). For these road users, road pavement unevenness, cracks, potholes and other surface defects can make riding uncomfortable and potentially hazardous. Traditionally, road managers use standardized surveys and Key Performance Indicators (KPIs) of pavement to make decision for maintenance programs and pavement management of road urban network poses challenges in the survey of pavement surface for International Roughness Index (IRI) and distress assessment both for operational and cost constrains. Moreover, there are theoretically limitations of IRI model for low speed urban roads and low-damped vehicles like bikes and e-scooters. In such framework aims of the paper is to investigate the use of smartphone sensors to collect data for the assessment of pavement conditions and definition of KPIs for bike and e-scooter users’ ride comfort and safety. A controlled experiment was performed with repeated runs of a bicycle and e-scooter equipped with a smartphone and an android application was used to collect acceleration and position data. Detailed pavement conditions have been identified with an advanced survey equipment. After data treatments for removing signal noise, adjustment for speed variability and outlier detection, root mean square (RMS) of vertical acceleration signal and weighted frequency content of the vibrations according to ISO 2631–1, have been confirmed suitable KPIs of pavement conditions and comfort rating that can be collected by bikes and e-scooter. Results confirmed the lack of correlation of vibrations in bikes and e-scooter with analogous parameters collected with car as probe vehicle and with IRI standard values, as well. Instead, pavement monitoring by bikes and e-scooter can provide effective detection of typologies and severities of distresses not detectable by similar approaches in damped vehicles. Good correlations have been identified between RMS and medium severity alligator, longitudinal and transversal cracks. High severity pavement distress and potholes have been identified by outliers in RMS.

Dockless electric scooters challenge cities seeking to regulate them amidst broader goals such as universal access. Cities are particularly concerned with improper scooter parking, which can impede access by other travelers. Despite an important role that scooter parking plays in both regulations and public discourse, no comprehensive view of current scooter parking regulations exists, nor is it clear how regulations align with broader city objectives. This research asks: how have U.S. cities regulated scooter parking to date and what issues do parking regulations aim to address? Data from 37 U.S. cities show that while areas of widespread agreement exist—nearly all (95%) cities allow scooters to park in the furniture zone—a wide range in scooter parking requirements exists. About three quarters of cities allow scooters to park at bike racks (78%) and against buildings (70%), while fewer than two-thirds allow scooters to park either on landscaping (62%) or against signs (60%). Even among cities with similar regulations, however, considerable nuance exists. Interviews with staff from six U.S. cities and existing research highlight motivations for scooter parking regulations. The regulations employed—and the high degree of variability across cities—yield implications for scooter parking policies, as well as scooters’ role in advancing broader city objectives. Scooter parking regulations play an important role in access, but cities should approach regulations as just one piece within a broader agenda of reclaiming streets for people and promoting mobility, sustainability, and access for all.

Purpose: Electric scooters (e-scooters) are an increasingly popular method of transportation worldwide. However, there are concerns regarding their safety, specifically with regards to orthopaedic injuries. We aimed to investigate the overall burden and financial impact on orthopaedic services as a result of e-scooter-related orthopaedic injuries., Methods: We retrospectively identified all e-scooter-related injuries requiring orthopaedic admission or surgical intervention in a large District General Hospital in England over a 16-month period between September 2020 and December 2021. Injuries sustained, surgical management, inpatient stay and resources used were calculated., Results: Seventy-nine patients presented with orthopaedic injuries as a result of e-scooter transportation with a mean age of 30.1 years (SD 11.6), of which 62 were males and 17 were females. A total of 86 individual orthopaedic injuries were sustained, with fractures being the most common type of injury. Of these, 23 patients required 28 individual surgical procedures. The combined theatre and recovery time of these procedures was 5500 min, while isolated operating time was 2088 min. The total cost of theatre running time for these patients was estimated at £77,000. A total of 17 patients required hospital admission under Trauma and Orthopaedics, which accounted for total combined stay of 99 days with a mean length of stay of 5.8 days., Conclusion: While there are potential environmental benefits to e-scooters, we demonstrate the risks of injury associated with their use and the associated increased burden to the healthcare system through additional emergency attendances, frequent outpatient clinic appointments, surgical procedures, and hospital inpatient admissions., Competing Interests: Declaration of competing interest The authors have no conflicts of interest to declare., (Copyright © 2024. Published by Elsevier Ltd.)

Many cities are grappling with how to regulate new shared mobility modes, including dockless e-scooters and bikes (i.e., “micromobility”). Transportation planners in these cities are particularly concerned about micromobility parking regulations, which have implications for the safety and mobility of riders and the general public. In this research, we investigate the parking practices as well as the frequency and types of parking violations of three types of vehicles operating on city sidewalks and streets: e-scooters, bikes, and motor vehicles. We collected original data on 3666 e-scooters, bikes, motor vehicles, and sidewalk objects in Austin, TX, Portland, OR, San Francisco, CA, Santa Monica, CA, and Washington, DC, to examine micromobility and motor vehicle parking practices. We find that motor vehicles impede access far more (24.7%) than bikes (0.3%) and e-scooters (1.7%). Ride-hail and food delivery drivers disproportionately impede access. Motor vehicles often impeded other travelers' access when dropping off or picking up people or food while double parking, parking in “No Parking” areas, or blocking driveways. Our findings suggest that micromobility companies are just one of several technology-enabled transportation services that should motivate cities to rethink parking policies.

Background: Since the introduction of electric-scooter (e-scooter) mobile applications, there has been a marked increase in e-scooter-related injury. On January 19, 2022, the City of Miami revoked permits to five major mobile applications for violation of safety protocols., Objectives: The purpose of our study was to assess the effects of this notice on the orthopedic patients seen at our corresponding Level I trauma center., Methods: Institutional Review Board approval was obtained for this study. A retrospective chart review was performed including all patients with orthopedic injuries at our Level I trauma center between July 19, 2021 and July 19, 2022. These dates include 6 months prior to and after the major e-scooter operators ceased use in Miami. SPSS statistical software version 28.0.0 (SPSS, IBM, Armonk, NY) was utilized for all statistical analysis., Results: There were 2558 patients in the prenotice cohort, and 2492 patients in the postnotice cohort. After the notice, there was a significant decrease in the number of patients that presented to our institution due to injuries caused by e-scooters (2.8% vs. 1.8% patients; p = 0.021). Patients with injuries caused by e-scooters had a significantly lower age (38 vs. 42, respectively; p = 0.034) and were more likely to be male (79.3% vs. 67.4% male, respectively; p = 0.007) than patients with other orthopedic injuries., Conclusion: This study demonstrates that the 2022 notice revoking the major mobile application operators from the City of Miami resulted in a significant decrease in the number of orthopedic cases due to e-scooter-related injury at the corresponding Level I trauma center., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Published by Elsevier Inc.)

Purpose: To perform an analysis of electric scooter (e-scooter)-related upper limb fractures (ULFs), which have increased dramatically in parallel with the rapid rise in the use of e-scooters and shared e-scooter services in recent years., Methods: We retrospectively reviewed the medical charts of e-scooter-related emergency department visits between January 2017 and January 2020 at a level I trauma center. All patients with ULFs were included in the study, and their data were analyzed for demographics, fracture diagnosis, associated injuries, and required surgical treatment., Results: This study included 356 patients (50% men) with 458 ULFs, of which 23 (5%) were open fractures. The mean age of the cohort was 32.9 years (standard deviation, 10.1 years). The most common mechanism of injury was rider fall (92.1%). The nondominant hand was injured in 53.1% of cases, and 32.1% of all fractures were treated with surgery. A total of 120 (33.7%) patients sustained more than 1 ipsilateral ULF, and 27 (7.6%) patients had a concomitant contralateral ULF. Radial head fracture was the most common fracture type (n = 123, 26.8%), of which 16 (13%) were bilateral. The fifth ray was injured most frequently among the metacarpal and phalangeal fractures (n = 33, 47.1%). Most of the nonextremity-associated injuries were those of the head and maxillofacial bones., Conclusions: The most common ULF associated with e-scooters was the radial head fracture. Physicians should be alert to and seek associated fractures during initial assessments of e-scooter-related upper limb injuries. Further investigation may be warranted to evaluate the effectiveness of protective measures in reducing the number of injuries., Type of Study/level of Evidence: Therapeutic IV., (Copyright © 2023 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.)

Objective: Electric scooters (e-scooters) are an increasingly popular form of transportation, but their use has also resulted in increased incidence of traumatic brain injury (TBI). Previous reports have predominantly described mild TBI with limited attention to other injury patterns. Our objective was to evaluate the impact of e-scooter use on rates of severe TBI., Methods: We performed a multicenter retrospective case review of patients who presented with severe TBI (Glasgow Coma Scale score 3-8) related to e-scooter use and undertook a systematic literature review to identify other reports of severe TBI related to e-scooter use., Results: Of the 19 patients (mean age, 38 ± 16 years; 73.7% male) included in the case series, 13 (68.4%) experienced a fall and 6 (31.6%) were involved in a collision. Various cerebral injury patterns, associated craniofacial fractures, and cervical spine injuries were also seen. Twelve patients (63.2%) underwent intracranial pressure monitor placement and 6 (31.6%) underwent a decompressive hemicraniectomy. Most patients (n = 12; 63.2%) were discharged to acute rehabilitation, with a median modified Rankin Scale score of 2 at 4.9 ± 7.7 months follow-up (52.6% had a good outcome of modified Rankin Scale score ≤2), but 4 patients died of primary injuries. The systematic review identified 18 studies with 77,069 patients between 2019 and 2021, with 37 patients who required intensive care and 6 patients who had neurosurgical intervention., Conclusions: Severe TBI after e-scooter use is associated with high morbidity and is likely underdiagnosed in the literature. Awareness and public policies may be helpful to reduce the impact of injury., (Published by Elsevier Inc.)

Purpose: Despite increased use of e-scooters globally, actionable data around injury incidence and patterns associated with e-scooter accidents are limited. This study aimed to determine the prevalence of imaging exams, injury incidence, and patterns related to e-scooter injuries, with the hope of guiding an appropriate policy response., Methods: This was a retrospective observational study of imaging exams ordered for injuries related to e-scooters seen in an Emergency Department (ED) setting within our health system from September 2018 through December 2019. Our institutional Radiology Information System (RIS) was searched for the presence of the word "scooter." Manual query of search results was conducted in the electronic medical record (EMR) and only studies confirmed to be related to e-scooters were included., Results: A total of 477 radiologic studies performed on 192 unique patients were confirmed to be performed for injuries related to e-scooters. The median patient age was 28 years and 58.3% were male. One hundred forty patients (72.9%) had injuries identified on imaging, with an overall exam positivity rate of 44.4%. The most common injuries were soft tissue and musculoskeletal in nature. Over half (51.9%) of the entries with the keyword "scooter" were excluded because of lack of EMR specificity regarding scooter type., Conclusion: While this study showed that injuries following e-scooter accidents are common and frequently involve the face and extremities, it is limited by lack of documentation in the EMR. Further research with a standardized documentation protocol will be needed to better understand injuries patterns following e-scooter accidents., (Copyright © 2021 Elsevier Inc. All rights reserved.)