The rise in electric biking (E-Bike) injuries: a 10-year age and sex-specific analysis of national injury data

Electric biking (E-bike) is a growing recreation and transportation mode often linked to high-impact injuries. This study aimed to identify the age and sex-specific distribution and primary mechanisms of E-bike-related injuries in the US. The National Electronic Injury Surveillance System (NEISS) was queried for E-bike-related injuries present to US Emergency Department (Eds) from 1 January 2013-31 December 2022. Each narrative was reviewed to exclude injuries not sustained while directly operating an E-bike. Injuries that occurred while riding regular bikes, mopeds, or motorized vehicles that were not E-bikes were also excluded. Patient demographics, injured body part, diagnosis, and disposition were recorded. NEISS narratives were assessed to identify injury mechanisms. Annual injury trends were evaluated by exponential regression and case weighting was completed, all using SPSS statistical software. A total of 45,845 nationally estimated (NE) E-bike-related injuries (1,049 NEISS Cases) presented to US EDs from 2013-2022. Exponential regression revealed a significant increase in annual injuries across the study period (p = 0.047). The frequency of injuries remained steady prior to 2019, with a 90.9% increase from 2019 (NE: 2,171) to 2022 (NE: 23749) (p = 0.005). Hospitalization was required for 10.9% of patients following E-bike-related injury, with hospitalization most frequently occurring through fracture (51.2%) and concussion (29.9%). The most injured body part for the youth, middle school and high school age groups was the head, whereas the college, young adult and adult group was the finger. Lastly, 30% of injuries associated with E-biking had motor vehicle involvement. The rate of E-bike-related injuries has risen significantly over the last decade, including a large increase post-COVID. Falls causing fractures were the most frequent injury type for both sexes. Greater than 10% of patients required hospital admission. The high rate of vehicle-induced collisions emphasizes the need for additional regulations and legislation to protect E-bikers.