In recent years, electric bicycles or E-bikes have emerged as an increasingly common mode of transportation for older children and teens. They are faster, able to cover longer distances than traditional bicycles, and are cheaper than buying a car or a moped. However, behind the convenience and fun there is a growing pediatric public health crisis brewing. With summer quickly approaching, here are a few things that parents (and pediatricians) should know about E-bikes and how to keep their children safe.
E-bikes may look similar to traditional bicycles but they differ in one very important way: speed. E bikes can often reach speeds of over 25 miles per hour while traditional pedal bikes average about 10-15 miles per hour. E-bikes are currently categorized into three classes. Class 1, in which the motor will only provide assistance while you pedal and will stop assisting when you reach 20 mph. Class 2, which has a throttle that allows you to use the motor even when you are not pedaling but like class 1, tops out at 20 miles per hour. And class 3, which provides pedal assist up to 25-28 miles per hour. While an extra 10-15 miles per hour may not sound like much, the data shows that it can make all the difference.
Because of the speeds involved, the injuries seen in E-bike accidents often more closely resemble motorcycle crash injuries than those sustained in standard bicycle accidents. According to one study at a level 1 trauma center, 25% of patients in E-bike crashes required admission to the intensive care unit and 43.7% required surgery. In the same study, children under 18 years old had significantly higher rates of facial and head injuries (33% and 38%) than their adult counterparts. A different study conducted in Europe involving 722 kids/young adults between the ages 10-25 found that compared to standard bicyclers, E-bikers had significantly higher rates of traumatic brain injury (37.9 8% vs 19.4%), bleeding in the brain (4.9% vs 0.9%), and facial fractures (11% vs. 3.4%). This data shows E-bikers, in particular child and teenage E-bikers, are at extremely high risk for life-changing, deadly injuries.
E-bikes, while still less ubiquitous than standard bicycles, are becoming more and more popular. One study shows that nationally, E-bike injury rates increased by 293% between 2019 and 2022. In a large, pediatric-focused US study, it is estimated that there were 15,121 pediatric E-bike accidents between 2019-2023 with only 4.18% of those accidents occurring in 2019 and a whopping 49.8% occurring in 2023, heavily suggesting a massive surge in E-bike popularity. The population involved in pediatric E-bike accidents were overwhelmingly found to be male (79.7%) and adolescents aged 13-18 (71.4%). Clearly, kids and teens are riding E-bikes more than ever so here are some of the things we can do to help keep them safe.
Here in New York City, minors under the age of 16 are not allowed to ride E-bikes at all and those under 18, must do so with a helmet. Some states like Alaska, Rhode Island, Alabama and Hawaii have gone even further and require a driver’s license to legally operate an E-bike. Some things that parents can do to protect their children who operate electric bikes are 1) being educated about the differences between the E-bike classes and knowing that Class 3 bikes are not suitable for children and teens. Studies have found that above 20 mph, injuries tend to become much more severe. 2) Enforcing helmet use. No helmet, no ride. 3) When talking about E-bikes with your teen, treat it with the same respect and seriousness as driving a car. You may even consider requiring your teen to have their driver’s license before operating an E-bike so they have the road knowledge and judgment necessary to operate such powerful vehicles.
E-bikes are cost-effective, flexible, fast and can offer great independence to kids and teens. However they carry adult risks. Being educated on these risks is the first and most important step in keeping our pediatric E-bike riders safe. In order to increase awareness about this up and coming public health issue affecting our kids and teens, please discuss E-bike safety with your children and share this post with other parents to help spread the word.