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Globally, electric (e-) mobility has seen a rapid growth in recent years, as a cheap, convenient and environmentally sustainable form of travel, particularly for short trips. E-mobility encompasses a range of personal mobility devices, including e-scooters, e-skateboards, hoverboards, e-unicycles, and Segways. Other terms for this type of transport include personal mobility devices (PMDs), micromobility or e-micromobility, and rideables.
The e-mobility trend has seen an explosion of e-scooters on roads and paths in cities around the world through their availability via public hire schemes as well as private ownership for commuting, business operations, and recreational travel. Public e-scooters first became available in Australia and Aotearoa New Zealand in 2018, when e-scooter rental company Lime launched in Brisbane and across Auckland, Hutt Valley, Christchurch, and Dunedin. Since then, other competitors have also launched in locations around Australia and Aotearoa New Zealand. The introduction of e-scooters, however, has brought regulatory challenges and safety concerns.
Common injuries and impact on the health system
Since their introduction, e-scooter related trauma has increased substantially, with injuries and deaths in riders, passengers and pedestrians placing further pressure on first responders (ambulance and police) as well as hospital and health systems. Studies have documented injuries related to e-scooter use and report that both riders and other road and path users, such as pedestrians, are vulnerable to harm (1). Since their introduction in Australia there have been at least three fatalities from riding e-scooters, and data collected from three emergency departments in Brisbane found 952 related presentations (2). In Aotearoa New Zealand, the Accident Compensation Corporation (ACC) has paid out nearly $17M in e-scooter-related injuries in under three years, although this is now declining (3).
The most common injuries caused by e-scooter related traumas are primarily upper limb fractures and head and facial injuries. Whilst some of these injuries are minor and only require admission to an emergency department, or treatment by a General Practitioner (GP), there are many that require longer stays in hospital, with treatment from surgical teams and subsequent prolonged rehabilitation. In an Aotearoa New Zealand study, almost 40 per cent of cases required admission to a specialty service (3). This puts an increased burden on hospital resources and can profoundly affect the lives of the individual with loss of work and inability to care for themselves or others. Injuries and trauma have most occurred in males of the younger cohort and transpired in the afternoon and night times, most frequently later in the week (weekends) and in the city or city-fringe areas. This pattern is consistent across all jurisdictions and is also consistent with other international cities that have also introduced electric scooters (2,4,5, 6).
Individual risk-taking contributes to e-scooter related injuries and their severity. Although risk-taking behaviour is not well documented, current data suggests that drink riding is common with reports of alcohol being involved in 29 per cent of emergency department presentations according to one Australian study (2). While regulations stipulate maximum speed limits, exceeding the speed limit is also common, with one study finding that 34 per cent of individuals presenting to an emergency department with an e- scooter related injury were travelling over 20 kph at the time of the incident. The same study reported that 16 per cent of riders injured were not wearing a helmet at the time, despite the mandatory helmet use regulation (2). Riding is not the only way in which injuries can occur; parking of devices has also been problematic with reports of other bystanders, including those with vision impairment, falling over discarded PMDs on footpaths. In some cases, injuries have resulted from a fault with the device or device firmware, for example, causing braking problems (7). The devices can also be prone to risk-taking, with reports of product misuse and reports of hacking devices to override built-in speed limits allowing riders to greatly exceed speed limits.
In Aotearoa New Zealand, the New Zealand Transport Agency oversees regulates e-scooters use, while in Australia e-scooters and other e-mobility devices are subject to varying regulatory frameworks. Consequently speed limits, age limits and where people may legally ride their PMD (footpaths, roads, shared paths) vary across Australian states and territories andin some areas, only hired e-scooters are legal in public spaces whereas in other places, privately-owned e-scooters are also permitted. Safety concerns have prompted some jurisdictions in Australia to refuse to participate in e-scooter rental schemes, though electric mobility groups continue to lobby to expand the legalisation of private e-scooter use in every Australian state and territory. Implementing a consistent approach to PMD standards and legislation on a national level in Australia and in Aotearoa New Zealand would provide beneficial transparency for consumers and other stakeholders.
RACS recognises the impact that e-mobility devices are having on individuals and health systems when they are involved in a crash. To improve e-mobility safety RACS strongly advocates for:
- The prioritisation of safe active mobility
- To the extent possible, nationally consistent laws to support the safe use of PMDs
- Appropriate law enforcement measures to be implemented
- Nationally consistent data to be monitored so that the impact of e-mobility devices can be measured
RACS supports the following recommendations to improve e-mobility safety:
Greater provision of protected and connected infrastructure, and clear signage, for e-mobility device use, including non-shared paths that safely separate different transport modes.
- Mandatory helmets
Riders must always wear an Australian or Aotearoa New Zealand Standards approved helmet that is securely fitted to their head
- Single riders
There should only be one person riding an e-mobility device at any time. Riders must not carry passengers.
- Speed limits
E-mobility devices must be speed limited, recognising that more research is needed to establish safe and appropriate speed limits for various types of riding infrastructure (e.g., shared paths, bike lanes, roads).
- Areas of designated riding and parking
E-mobility device riding should be restricted to designated areas where there is adequate infrastructure and signage to support safe use. Mandated geofencing technology for all e-mobility hire schemes to restrict their use outside of designated areas. Provide appropriate and adequate infrastructure for designated device parking that does not impede the safety of others.
- Mandatory warning devices
All private and public e-mobility devices should be fitted with and required to use workingbells and lights (front and back) to alert pedestrians and others nearby of their presence.
- Reduce drink-riding and drugged-riding
Riders must adhere to the applicable state or territory alcohol and drug legislation.
- Restrictions on use of mobile phones whilst riding
Mobile phones must not be used whilst riding. If required, riders should pull over and stop before using their phone.
- Nationally recognised policy and regulatory framework
Nationally recognised injury surveillance approaches to facilitate accurate case capture in health systems and track e-mobility related traumas and associated costs.
- Mandatory crash reporting
National agreement on crash definitions and mandatory reporting of all crashes involving e-mobility devices to scheme operators and e-mobility riding and device regulators so that hazards and risks can more easily be identified and tracked.
- Funding to support e-mobility safety
A portion of the revenue raised through e-mobility share schemes is dedicated to supporting surveillance and safety initiatives.
Future Research Needs
RACS recommends that further research be prioritised to address current knowledge gaps and inform evidence-based injury prevention approaches:
- The relative risks of e-mobility comparative with other transport modes (e.g., public transport)
- The relative risk and usage patterns of shared scheme e-mobility devices compared with privately owned devices
- Coding, recording and reporting of e-mobility injury in relevant jurisdictions and nationally
- Risk-factors and contributions to injury type and severity
- Costs of e-mobility injury incidents to individuals and the health system
The introduction of electric personal mobility devices, especially electric scooters, have been rolled out ahead of surveillance, infrastructure and legislation that adequately addresses the safety of these devices. RACS supports a consistent approach that prioritises the safety of riders, pedestrians and other community members, and reduces the incidence of injury and impact on the health system.
Authors and Acknowledgements
This position paper was prepared by Professor Kirsten Vallmuur, Associate Professor Ben Beck, Dr Tanya Smyth and Ms Louise Pfrunder on behalf of the Royal Australasian College of Surgeons (RACS) and the Australasian Injury Prevention Network and approved by the RACS Trauma Committee.
1 M. Toofany, S. Mohsenian, L.K. Shum, H. Chan, J.R. Brubacher, “Injury patterns and circumstances associated with electric scooter collisions: a scoping review,” Injury Prevention, 27(5), pp. 490-499. Retrieved from: http://dx.doi.org/10.1136/injuryprev-2020-044085
2 Jamieson Trauma Institute, unpublished data, 2022. Brisbane, Australia.
3 Accident Compensation Corporation, “Three years of e-Scooters: the true cost of convenience”, 2021. Retrieved from: https://www.acc.co.nz/newsroom/stories/three-years-of-e-scooters-the-true-cost-of-convenience/
4 L.J. Mayhew and C. Bergin, “Impact of e-scooter injuries on Emergency Department imaging,” Journal of Medical Imaging and Radiation Oncology, 63(4), pp. 461-466, 2019.
5 M. Aizpuru, K.X. Farley, J.C. Rojas, R.S. Crawford, T.J. Moore, and E.R. Wagner, “Motorized scooter injuries in the era of scooter-shares: A review of the national electronic surveillance system,” American Journal of Emergency Medicine, 37(6), pp. 1133-1138, 2019.
6 Trivedi TK, Liu C, Antonio ALM, Wheaton N, Kreger V, Yap A, et al., “Injuries Associated With Standing Electric Scooter Use,” JAMA Network Open, 2(1), e187381, 2019.R. Barker, “Electric scooters”, Emergency Medicine Australasia, 31(6), pp. 914-915, 2019. Retrieved from: https://doi.org/10.1111/1742-6723.13424