A recent study examined how the growing use of electric bikes and scooters has caused a surge in brain injuries among riders and pedestrians. Such injuries account for a significant share of hospital admissions for head trauma, with one-third of patients suffering traumatic brain injury.

The same study showed that the most common cause of injury among riders were collisions with cars or trucks, accounting for about half of cases. Fewer than one-third of riders wore helmets, and not wearing one was linked to significantly higher rates of brain and facial injury. About one in five patients tested positive for alcohol, which was tied to worse brain injuries. Although the largest percentage of those injured were riders, pedestrians had the worst injuries.

“Our work shows that micromobility injuries are producing serious brain and spinal trauma that demands neurosurgical care at a scale we haven’t seen before,” said lead study author Hannah Weiss, MD, a resident in the Department of Neurosurgery at NYU Grossman School of Medicine. “In a busy urban setting, we are seeing more and more of these injuries firsthand, and pedestrians are sustaining on average more severe brain injuries than the riders themselves.” 

The following are easy, everyday things we can do to reduce the risk of injury.

For Riders

1. Wear a Helmet, Every Time.

Even for short trips, helmet use dramatically reduces the risk of traumatic brain injury.

2. Stay Alert at Day’s End.

The early evening is a high-risk period: lighting conditions are changing, roads are busier, and both riders and drivers may be fatigued and distracted. The most severe injuries occur at dusk or after dark.

3. Never Ride Under the Influence.

Alcohol significantly increases the risk of crashes and severe injury. Riding an e-bike or scooter under the influence carries many of the same dangers as driving a car under the influence.

For Pedestrians

4. Anticipate Speed and Silence.

E-bikes and scooters can travel much faster than traditional bicycles—up to 25 mph—and are often nearly silent. Never assume someone has enough time to cross in front of you. Adjust your judgment to this new, quiet speed.

5. Unplug and Look Up.

Distraction is a main cause of pedestrian injuries. Before stepping into the street or a bike lane, stow your phone and remove both headphones.

6. Be Careful at Intersections.

In dense urban environments like New York City about 75 percent of all pedestrian injuries occur at intersections. Pay particular attention when navigating large complex intersections, especially to left-turning vehicles. Before stepping off the curb, make a final check for traffic, including bikes and scooters that may not have stopped for the light or that are going the wrong direction.

7. Treat Bike Lanes Like Streets.

Bike lanes are traffic lanes. Never stand in a bike lane to wait for a cab, talk with a friend, or check your phone. Before you cross a bike lane, look both ways just as you would when crossing a street.

8. Make Eye Contact.

Don’t assume a rider sees you. Averting your gaze to a phone or looking away can be misinterpreted as you yielding the right-of-way. Whenever possible, make eye contact with an oncoming rider.

9. Be Visible and Predictable.

Avoid darting out from between parked cars. In the evening, when e-bike food delivery is at its peak, wear bright or reflective clothing, especially at dusk in poorly lit areas.

The Bigger Picture

Based on her team’s research, Dr. Weiss also calls for continued strengthening of regulatory measures to ensure safety.

Infrastructure Investment

Continue to expand the network of physically protected bike lanes. These lanes create clear, dedicated space for micromobility, separating riders from both pedestrians and traffic, which is the most effective way to reduce conflict.

Consistent Enforcement

Municipalities need to further standardize rules for various e-device classes and pair them with a consistent, more-visible enforcement strategy. This should target the most dangerous behaviors, such as riding on sidewalks, running red lights, and traveling the wrong way on one-way streets or bike lanes. The current lowered speed limit for these vehicles in New York City is 15 mph.

Rider Education and Public Awareness Campaigns

Continue to stress safety training for commercial delivery workers who use e-bikes, with a stress on safety during the dinner delivery rush. Continue city-wide public awareness campaigns like the New York City’s version of “Vision Zero”—which educates both riders and pedestrians on how to share our streets. The city reports that progress has been significant on that score, including in enforcement and engineering.

About NYU Langone Health

NYU Langone Health is a fully integrated health system that consistently achieves the best patient outcomes through a rigorous focus on quality that has resulted in some of the lowest mortality rates in the nation. Vizient Inc. has ranked NYU Langone No. 1 out of 118 comprehensive academic medical centers across the nation for four years in a row, and U.S. News & World Report recently ranked four of its clinical specialties number one in the nation. NYU Langone offers a comprehensive range of medical services with one high standard of care across seven inpatient locations, its Perlmutter Cancer Center, and more than 320 outpatient locations in the New York area and Florida. The system also includes two tuition-free medical schools, in Manhattan and on Long Island, and a vast research enterprise.

Media Inquiries

Greg Williams
Phone: 212-404-3500
Gregory.Williams@NYULangone.org