Dangers of e-mobility: A systematic review and meta-analysis of sustained injury patterns and injury severity

Background: Electric personal mobility devices (ePMDs) have conquered cityscapes, leading to increased reports of associated injuries. However, it remains elusive whether people who present to an emergency department (ED) after an accident are more severely injured when previously using non-electric personal mobility devices (PMDs) or ePMDs. Methods: PubMed Medline, Embase, and the Cochrane Library were searched until March 7, 2023 (PROSPERO: CRD42021257425). Following PRISMA guidelines, data were independently evaluated by two authors and pooled using a random-effects model. Primary outcomes were injury patterns and severity of PMD- and ePMDrelated injuries. Results: The systematic review included 24 studies reporting 843 scooter-, 3,000 e-scooter-, 15,482 bike-, and 5,694 e-bike-related injuries. E-scooter riders had higher odds of head and neck, thorax, and lower extremity injuries, lower odds of upper extremity injuries, and higher odds of surgery than bike riders. E-bike riders had higher odds of spine and lower extremity injuries, higher mean ISS, higher odds of ward and ICU admission, higher odds of surgery, and higher odds of death than bike riders. Conclusions: Riders injured severely enough to present to an ED are more severely injured when previously riding an ePMD. Thus far, legal regulations of ePMD usage vary between states, but mandatory protective gear use is rare. Our study's data supports previous suggestions to demand stricter ePMD usage regulations focusing on rider safety globally. However, it must be noted that age, gender, and driving behavior differed between devices. Observed outcome differences may, in part, be linked to these differences.