E-bikes can be a quick trip to the hospital

For people moving around Tucson, an electric bicycle can offer a fast, relatively inexpensive way to get across town, reach the University of Arizona campus or make a daily trip without a car. It can also bring riders to the emergency room with injuries that resemble those from a conventional bicycle crash, but can be more severe because of the higher speeds involved. At Banner University Medical Center, trauma surgeon Dr. Collin Stewart says he is seeing plenty of e-bike riders after crashes, and he has noticed those injuries becoming more common as e-bikes become more popular.

The appeal is easy to understand. E-bikes are available for as little as $400, according to the report, putting them within reach of many people who may not be able or willing to buy a car. Some of the higher-end models can travel 28 miles per hour straight out of the box. That speed puts an e-bike closer to the pace of motor traffic than to the speed many people associate with an ordinary bicycle. Some riders also modify their bikes to bypass built-in speed limits, allowing them to travel even faster.

For emergency doctors, the difference in speed can change the consequences of a mistake. Stewart said crashes can produce head injuries, broken arms and legs, and other broken bones. Riders can also suffer injuries to the torso when they are thrown from the bike and strike an object. The basic event may look familiar, such as a rider losing control or colliding with something, but the force of the impact can increase when the rider is traveling more quickly.

Head injuries are the most common type of injury reported in connection with e-bike crashes. The American College of Surgeons estimates that more than 20,000 people are injured while riding e-bikes each year, with about 3,000 hospitalized. The organization also believes many e-bike injuries are never reported, meaning the available figures may not capture the full scale of the problem. For Tucson residents, the numbers provide national context for what local trauma doctors are seeing at Banner University Medical Center.

Helmet use is another concern. Only about one-third of the riders included in the reported injury figures were wearing helmets. Even when riders do wear one, the equipment may not match the speed of the e-bike. Many use bicycle helmets designed for crashes at speeds of up to 20 miles per hour, while some e-bikes can reach 28 miles per hour or go faster after speed limiters are defeated. That gap does not mean a helmet has no value, but it does raise questions about whether the protective gear is suited to the conditions in which the bike is being used.

Stewart said many of the patients he treats are young. He compared giving a young child an e-bike to giving that child access to a motorcycle, pointing to the difficulty younger riders may have making decisions. His concern is that children can be operating a fast vehicle without the same expectations associated with a driver’s license. The comparison underscores why speed and judgment matter even when a vehicle has pedals and is marketed as a bicycle.

E-bikes are also being used by adults who depend on them for transportation. Stewart said some patients are in middle age and may have lost their driver’s licenses, making an e-bike their way to get around when they cannot drive a car. Unlike driving, e-bike use has not been accompanied by the same level of regulation, according to the report. That means riders may be relying largely on their own decisions about speed, protective equipment and how to share space with other people.

The result is a safety responsibility that falls heavily on the person operating the bike, as well as on anyone riding nearby. In Tucson, where e-bikes are visible on campus and on city streets, the convenience of a quick trip comes with the possibility of a high-impact crash. Doctors’ warnings do not suggest that every e-bike ride will end in injury, but they do make clear that an e-bike traveling 28 miles per hour is not behaving like a slow bicycle. Riders need to account for the speed, the limits of their equipment and their ability to make decisions before a routine trip turns into a hospital visit.