Transportation throughout Santa Monica and the Greater Los Angeles area has been taken for a ride over the past few years with the increased usage of scooters. The ease of access for the mobility unit, combined with its popularity among youth, has made the transportation mode quite common on sidewalks and streets alike.
With the rise in riding comes a tangential, and substantial, increase in scooter injuries. According to new UCLA-led research, scooter injuries nearly tripled across the United States from 2016 to 2020, along with a similar increase in severe injuries requiring orthopedic and plastic surgery over the same period. The study, published January 9 in the peer-reviewed Journal of the American College of Surgeons, compared national trends in scooter and bicycle industries as well as the implications of these injuries on the healthcare industry.
Lead author Nam Yong Cho, a third-year medical student at UCLA and a research associate at the UCLA Cardiovascular Outcomes Research Laboratories, said he became invested in the topic after encountering scooter-related injuries during his clerkship in emergency medicine services, as well as orthopedic surgery.
"Although [the patients] were pretty young, [freshman and sophomores] at UCLA, they had to undergo a surgery to fix their broken bones," Cho said. "Living in L.A., you see scooters all the time, so I was interested in how these injuries happen, and what is the implication in terms of healthcare resource use, and in terms of long-term outcomes [for] the patient."
Cho and researchers sought out the 2016-2020 National Inpatient Sample, a database from the Agency for Healthcare Research and Quality, to compare trends for scooter-related and bicycle-related injuries. Out of nearly 93,000 patients hospitalized in the sample, about 6,100 resulted from scooter injuries, but injury severity was skewed toward the scooter users.
Scooter-related injuries led to major operative interventions 56% of the time, compared to 48% for bike-related injuries. Scooter riders were also shown to have higher odds of experiencing long bone fractures and paralysis than bicycle-related injuries. Both groups were similarly likely to suffer traumatic brain injuries.
In doing his research, Cho noted he was surprised by the injury severity increasing over past years, and said that injury characteristics are influenced by factors like frequent lack of protective gear, mixed road usage among scooter riders, and a younger age range. Out of those hospitalized from scooter-related injuries, about 27% were under 18 years old, compared to 16% for bicycle-related injuries.
"I think what makes (scooters) popular for young people is that it is very expanded around urban centers, where young people are commuting, walking around," Cho said. "They can easily pick up a scooter to go from one place to another."
Among the study’s limitations were limited amounts of data on conditions like helmet use, the presence of multiple riders on scooters, as well as intoxication levels of those injured. Cho stated that during his emergency medicine shifts, he usually encountered intoxicated riders, which is distinct from bicycle use due to scooters being readily available outside of bars and restaurants.
The study could not differentiate between electric and non-electric scooters. It was also unable to account for objects and other vehicles that might have been involved in the injury incidents, or to determine the kind of terrain where they happened, and speed, time of day and total distance traveled when they occurred. The researchers also could not ascertain the type of scooter or bicycle models involved in the injuries.
Cho said that future studies should collect more data on accident hotspots or common injuries related to scooter use, in order to inform healthcare strategies and city planning. He added that future studies can also "investigate ways to reduce risk of collision" and incentivize riders to use protective gear.
The study touched on the burden that scooter-related injuries can have on the healthcare industry, as annual healthcare costs from the injuries increased from about $6.6 million in 2016 to $35.5 million in 2020. Researchers stated that increased costs and a "substantial proportion of patients necessitating surgical intervention" should be a "call to action" for the healthcare industry to promote scooter-related safety.
"I think they as healthcare leaders serve a critical role in health management and injury prevention in their communities [and] they should empower themselves to champion the prevention strategies for scooter-related injuries," Cho said. "And I also think they should strive to advocate for improved infrastructure, including enforced speed limits [and] dedicated lanes, which are vital to minimizing risk."
