SCOOTING PAINS: Early study results in from e-scooter injuries at La Jolla and San Diego-area hospitals
Both UC San Diego and Scripps Health are compiling their own studies of motorized scooter (e-scooter) emergency-room visits similar to a UCLA study that grabbed headlines last month.
In the first study to analyze the public-health impact of the exploding new transportation mode, UCLA researchers found that one in three people involved in e-scooter accidents required an ER visit. Analyzing data from two UCLA hospitals, the study blamed e-scooters for 249 ER visits between September 2017 and August 2018. Over the same 12-month period, 195 visits were caused by bicycle injuries and 181 by pedestrian injuries. (The study was published Jan. 25 in the medical journal JAMA Network Open.)
Preliminary data from the two upcoming San Diego studies, released exclusively to the Light, looks similar to UCLA’s.
UCSD Health reported 215 e-scooter-related visits to La Jolla’s Jacobs Medical Center and UCSD Medical Center in Hillcrest from Jan. 1 to Nov. 30, 2018.
“This is becoming an issue,” said Edward Castillo, UCSD School of Medicine adjunct professor of emergency medicine, who will either serve as lead or senior author of the study. “I don’t think there’s an awareness of what the rules are (for e-scooters) or how serious the accidents can be if you fall and hit your head without a helmet on.”
Scripps Memorial La Jolla reported 26 visits for e-scooter injuries in 2018. If that seems low, in 2017 — before e-scooters were brought by the hundreds to La Jolla by Bird and Lime users and freelance contractors — the number was six. And an even more alarming Scripps stat comes from the last quarter of 2018: e-scooter injuries represented 4 percent of all admitted trauma patients, up from a 0.1 percent in the same quarter of 2017.
“That’s a remarkable increase,” said Walter Biffl, Scripps Memorial’s trauma medical director, who estimates that e-scooters now comprise 10 percent of all transportation injuries his hospital sees — including from car, motorcycle, bicycle and pedestrian accidents.(Neither study had numbers available for total injuries, for injuries caused by other transportation modes, or for what percents of e-scooter accidents resulted in ER visits, since both were still being compiled at press time.)
Obviously, no e-scooter injuries would occur without e-scooters. However, both Castillo and Biffl perceive the greater issue as their lack of associated helmet use. According to UCSD’s data, only 5 percent of the injured e-scooter riders it saw wore helmets (similar to the UCLA study’s 4 percent finding). According to Scripps, none of its 26 injured e-scooter riders wore them.
“If there were stricter helmet laws, a lot of these injuries wouldn’t have happened at all,” Biffl said. (Indeed, studies show that helmets, of all types, provide substantial protection against head injuries. And a 2006 study found that helmet leglislation increases helmet use, particularly among younger age groups.)
To rent a scooter, both Lime and Bird make users promise to wear a helmet — and adhere to other policies including being over 18, riding only in bike lanes and not blocking public right-of-ways. However, these policies have no enforcement mechanism — not even, always, the law. (Although riding on sidewalks in the City of San Diego is still illegal, punishable by citations of up to $250, a bill signed by Gov. Jerry Brown last Sept. 20 requires helmets only of e-scooterers under age 18.)
“I think it would be hard to say that wearing a helmet isn’t a good idea when you’re riding a bike, so why not an e-scooter?” Castillo asked.
Biffl recalled the case of one 50-year-old male La Jollan, who presented, intoxicated, with a severe traumatic brain injury requiring two weeks of hospitalization, the effects of which may linger for the rest of his life. (Of the 22 e-scooter riders suspected of intoxication by Scripps Memorial, 17 tested positive for alcohol.)
“I’m not surprised by the severity of the injuries,” Biffl said, “but I think the victims are. It’s easy to think it’s harmless to ride a scooter. But we know that just standing in your kitchen and falling down, you can get a bad brain injury from that. So going 15-to-20 mph and tangling with traffic without a helmet, you can get all kinds of bad injuries.”
Other questions that need answering are whether these scooter rides replaced other modes of transportation, each of which is associated with some risk, and what those relative risks are. More than 40,000 Americans a year are killed by automobiles, for example, another 5,000 by motorcycles, and 840 by bicycles. (While hardly a consolation to the family of Esteban Galindo — the 26-year-old Chula Vista man killed when his Bird scooter was struck by a car at 4 a.m. last Dec. 22 — only three e-scooter deaths have been reported in the U.S. since the current craze began.)
And while the upcoming UCSD and Scripps Health studies will certainly be of some use, what is also needed — even Biffl and Castillo agree — is a more comprehensive study addressing the percentage of ER visits as a factor of total hours spent using e-scooters compared to other forms of transportation. (This information is not currently tracked by anyone in this form.)
Neither Bird nor Lime would provide any data for this article. Both companies responded to the Light’s inquiries by stating that they were “unable” to provide even city-specific user information, much less any injury or accident data, e-mailing only generalized statements about how committed they are to safety.
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