Increasing incidence of concussion and head injury due to electric biking: a 10-year sex- and age-specific analysis of national injury data

Objectives: Electric biking (e-biking) is a rapidly growing recreation, sport, and mode of transportation that often presents to emergency departments (EDs) with high-impact head injuries. This study aimed to evaluate the epidemiology of e-bike-related concussions and closed-head injuries (CHI) to inform more effective injury prevention strategies. Methods: The National Electronic Injury Surveillance (NEISS) was queried for e-bike related concussions and CHIs presented to national EDs from 1 January 2013-31 December 2022. Patient demographics, diagnoses, and dispositions were recorded, and injury narratives were reviewed to identify mechanisms of injury and motor vehicle (MV) involvement. Results: A total of 11,052 nationally estimated (NE) e-bike head injuries presented to US EDs from 2013 to 2022. E-bike head injuries increased significantly from 2013 to 2022 (p = .006, beta = 372.5), with 40.8% of all head injuries occurring in 2022. Nearly one-third of patients (31.0%) required hospital admission, with hospitalization occurring most frequently among ages 51 and older (44.5%). MV involvement accounted for 27.6% of head injuries, and caused a higher proportion of hospitalizations than mechanisms without MVs (35.6% vs. 29.4%, respectively; p < 0.001). High school age riders had the most MV incidents (53.2%), while the middle school age group had the highest proportion of concussions (26.5%) among all age groups. Relative to females, males were more likely to be involved in an MV incident (28.5% vs. 15.5%; p < 0.001) and were more likely to be hospitalized (33.0% vs. 25.4%; p < 0.001). Conclusion: The incidence of concussions and CHIs due to e-bikes increased significantly from 2013 to 2022, while high proportions of hospitalization indicate serious injury severity and large medical costs associated with these injuries. The prevalence of crashes involving MVs, especially among teenagers, calls for further research on commuter and recreational e-bike use along with new traffic legislation to protect young e-bikers.