Is the Use of Segways or E-Scooters in Urban Areas a Potential Health Risk? A Comparison of Trauma Consequences

A comprehensive review of current trends in e-scooter associated injuries, associated outcomes, and effective interventions: Towards establishing sustainable prevention interventions

INTRODUCTION

This review aims to provide a comprehensive overview of electric-scooter (E-Scooter) injuries by evaluating the incidence, common mechanisms of injury, clinical outcomes, associated costs, and effective interventions for injury prevention.

METHODS

A literature search using PubMed, Google Scholar, EMBASE, and ProQuest was performed to identify relevant articles published between July 10, 2014, and July 10, 2024. Outcomes of interest included epidemiologic trends of E-Scooter injuries, common mechanisms of injury, associated risk factors, clinical outcomes, and interventions to decrease E-Scooter injuries.

RESULTS

A total of 41 articles were included in this study, with 39 evaluating the epidemiologic trends of e-scooter injuries, 22 the most common mechanisms of injury, 21 assessed intoxication, 15 assessed helmet usage, 33 determined patient's clinical outcomes, and 3 assessed effective interventions for decreasing the incidence of e-scooter injuries. Falls were the most common mechanism of injury; however, collisions with motor vehicles caused more severe injuries. Additionally, studies showed that up to 74 % of all E-Scooter injuries included alcohol intoxication, and over 80 % did not use a helmet leading to severe head injuries.

CONCLUSION

The incidence of E-Scooter related injuries rose significantly in recent years. These injuries typically result from falls and MVAs and are compounded by factors including limited helmet usage and riding while intoxicated. These contribute to the poorer clinical outcomes seen with E-Scooter injuries. However, there remains a significant paucity of literature focused on the outcomes of policies and interventions designed to reduce these injuries. Further investigation must address these gaps and discrepancies to inform future policies.

Fatal traffic accidents involving electric scooters in Poland in 2019-2023

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.

The Impact of Standing Electric Scooters on Maxillofacial Fractures: An Italian Multi-Centric Epidemiological Study

Objectives: This study aimed to determine the impact of standing electric scooters on maxillofacial on the Italian territory. Methods: The authors analyzed the epidemiology of the injuries to define electric mobility's impact on maxillofacial surgery practice. For this retrospective cohort study, data were collected by unifying the standing e-scooter-related fractures database from 10 Italian maxillofacial surgery departments. The reference period considered was from January 2020 to December 2023. The main data considered included age, gender, type of access, time slot of admission, type of admission, alcohol level, helmet use, dynamics of the accident, and area of the fracture. Results: A total of 79 patients were enrolled. The average age of the participants was approximately 31 years. The blood alcohol level was found to be above the Italian norm in 15 cases (19%). Only one patient wore a helmet. The most affected facial third was the middle one with 36 cases (45.5%), followed by the lower one (31, 39.3%). The most recurrent patterns were fractures of the orbito-malar-zygomatic complex (15, 19%), followed by multifocal (bifocal, trifocal) fractures of the mandible (14, 17.5%). Conclusions: This study demonstrated how maxillofacial fractures related to the use of electric scooters are associated with complex patterns, associated with a high rate of post-surgical aftermaths.

New generation vehicles: the impact of electric scooter trauma on the severity of facial fractures assessed by FISS score. A multicentre study

With the increasing use of sustainable energy sources, the electric scooter has become a widely used vehicle. The aim of the study is to analyse the types of facial fracture related to road traffic accidents to outline the need for dedicated road rules. An observational, retrospective, multicentre study was carried out at the Maxillofacial Surgery Units of six Italian hospitals. Fifty patients (mean age was 34.76 years) from January 2020 to January 2024 were enrolled. The severity of trauma was evaluated by the Facial Injury Severity Scale (FISS) by Bagheri et al. Most of the accidents occurred during the day and the weekend in spring or summer; 24 drivers collided with infrastructures or pedestrians, while 26 involved other vehicles. A total of 33 vehicles were rented, and 17 were privately owned. A total of 43 subjects were not wearing helmets, five patients were drunk, and three patients took drugs. In order of frequency, the facial fractures involved: zygomatico-maxillary-orbital complex (ZMOC) (n = 16), mandibular condyle (n = 13), nasal bone (n = 11), orbit floor (n = 8), and mandibular body (n = 7). Fractures such as Le Fort I (n = 4), naso-orbito-ethmoidal NOE (n = 4) and mandibular ramus (n = 4) were less common. Other types of facial fracture were rare. Thirty patients reported multiple facial fractures. The vast majority of the cases showed a low severity grade FISS score. Fifteen patients suffered polytrauma. The mean hospitalisation time was 8.3 days. As accidents with electric scooters are increasing, it is important to characterise the most frequent facial fractures to improve patient management and encourage the introduction of new road rules.

Injury Patterns of Electric-Scooter Related Trauma: A Systematic Review With Proportion Meta-Analysis

Electric scooter (ES)-related injuries are increasing but poorly described. Clinicians need more information to be prepared for these patients. We supposed two prevalent patterns of patients: mildly injured (predominant upper-limb injuries) and severely injured (predominant head trauma). This study aims to understand the frequency of ES-related injuries and patients' characteristics despite the heterogeneity of data currently available. A systematic review with a proportion meta-analysis was conducted on studies with a multidisciplinary description of ES-related injuries in adult patients (PROSPERO-ID: CRD42022341241). Articles from inception to April 2023 were identified in MEDLINE, Embase, and Cochrane's databases. The risk of bias was evaluated using ROBINS-I. Twenty-five observational studies with 5387 patients were included in the meta-analysis, depending on reported data. Upper-limb (31.8%) and head (19.5%) injuries are the most frequent (25/25 studies included). When injured while riding, 19.5% of patients are intoxicated with drugs/alcohol, and only 3.9% use a helmet, increasing the possibility of severe injuries. About 80% of patients are victims of spontaneous falls. Half of the patients self-present to the ED, and 69.4% of cases are discharged directly from the ED. Studies' limitations include an overall moderate risk of bias and high heterogeneity. Electric scooter-related accidents are commonly associated with upper-limb injuries but often involve the head. Spontaneous falls are the most common mechanism of injury, probably related to frequent substance abuse and helmet misuse. This hot topic is not adequately investigated due to a lack of data. A prospective registry could fill this gap.

Characteristics of E-Scooter-Related Maxillofacial Injuries over 2019-2022-Retrospective Study from Poznan, Poland

Recently, there has been a considerable rise in the popularity and use of electric scooters. Because of this, the number of accidents involving them has also risen. Head and neck injuries are the most common. The aim of the study was to determine the most frequent craniofacial injuries resulting from accidents involving electric scooters, and to identify the risk factors directly related to their placement and severity. The study carried out a retrospective analysis of the medical records of patients of the Clinic of Maxillofacial Surgery over 2019-2022, in terms of craniofacial injuries suffered as a result of e-scooter-related accidents. In the study population (31 cases), of which 61.3% were men, the median age was 27 years. At the time of the accident, 32.3% patients were under the influence of alcohol. Accidents were most common in the 21-30 age group; more often than not, they occurred during warm months and on weekends. The study identified a total of 40 fractures in the patients. The most common craniofacial injuries were mandibular fractures (37.5%), zygomatic-orbital fractures (20%) and frontal bone fractures (10%). A multidimensional correspondence analysis was also performed, which showed that at an age of under 30, alcohol consumption and female gender were associated with a higher likelihood of mandibular fracture. Proper education on the risks associated with the use of e-scooters is essential, with particular emphasis on the impact of alcohol on the driver. It is important to develop diagnostic and therapeutic algorithms for doctors, both in ED and in specialised departments.