Electric bicycles are an increasingly popular mode of transportation and recreation. However, their use is associated with a growing number of serious injuries, particularly among children and adolescents. The ACS recognizes the need to address this emerging public safety problem through evidence-based policy and injury prevention strategies.
We recognize the following facts:
- More than 1.1 million electric bicycles were sold in the United States in 2022 with a projected annual growth rate of 10%.1,2
- Over 20,000 people are injured while riding electric bicycles annually with approximately 3,000 individuals requiring hospitalization, and this is likely underreported.3
- The rate of electric bicycle injuries is increasing annually.4,5
- Electric bicycle injuries are more severe than their manual bicycle counterparts.6,7
- Head injuries occur most frequently, and only a third of injured patients are reported to wear helmets.3
- Helmets certified by the Consumer Product Safety Committee are intended for bicycle speeds 20 miles per hour (mph) and under, and the Department of Transportation-certified helmets are recommended for speeds above 20 mph.8
- There are three classes of electric bicycles. Each functions initially by pedaling and/or throttling, but ceases to provide assistance when the rider achieves 20 mph (Class 1 and 2) or 28 mph (Class 3).9
- Electric bicycles can be modified to bypass these maximum speed restrictions, increasing the risk of serious injuries.10
- Electric bicycles are not regulated as motor vehicles under federal law.11
- Legislation on electric bicycles varies significantly by state.12
As the popularity of electric bicycles surges, the burden of associated injuries is escalating. The ACS Committee on Trauma supports the development and enforcement of policies at the local, state, and federal levels to ensure the safe use of electric bicycles and prevent avoidable injuries.
Recommendations include:
- Electric bicycles should be clearly defined based on size and maximum obtainable speed on flat ground. Bicycles that exceed the defined size and speed for an electric bicycle should be classified as motorized bicycles with separate regulations.
- Each region (state, county, or municipality) should have specific policies that define age of use, helmet requirements, training, registration, and the rules of the road for use of electric bicycles in their communities.
- Universal helmet use is recommended, and the type of helmet should be determined by rate of speed of electric bicycle.
- Each region should have a mechanism to report crashes, injuries, and deaths involving electric bicycles, including those not treated at trauma centers.
- Efforts should be made to advocate for new ICD External Cause of Injury codes that identify electric bicycle injuries with sufficient specificity to capture device types, circumstances of the crash, and estimated speeds involved.
- Trauma centers that see high rates of electric bicycle injuries should consider implementation of targeted safety outreach programs.
- Each region should provide education on safe and appropriate electric bicycle usage including the laws of use for each region.
- Efforts should be made to provide safe, separated bicycle lanes that allow electric bicycle use with minimal car encounters.
- When electric bicycle safety laws are implemented, safeguards should be put in place to make certain their enforcement is fair and equitable.
