Marin trauma surgeons ask for more e-bike safeguards
Marin County has long been recognized as the birthplace of the modern mountain biking industry. Tourists travel to ride a bicycle across the Golden Gate Bridge and enjoy the Marin Headlands, Sausalito, Muir Woods and Mount Tamalpais.
Behind the beauty and adventure is a hidden danger. For decades, MarinHealth Medical Center has been the primary hospital treating bicyclists and motorcyclists injured across Marin, and borne witness to many accidents leading to lifelong disability and death.
In 2023, a new public health hazard is being recognized in electric-assist bikes. The closure of gyms and social distancing imposed by the COVID-19 pandemic led some to purchase ebikes as a healthy alternative for outdoor exercise.
But along with this innovation came new perils. Over the past three years, the medical center has witnessed a dramatic increase in e-bike incidents resulting in serious injuries, some of which have resulted in fatalities. As trauma surgeons, we believe it is time to raise public awareness about the special dangers associated with e-bikes, to protect adult and youth riders.
Our analysis of the trauma registry reveals that riders in ebike incidents were more likely to require hospital admission than regular bicyclists, with an order of magnitude higher risk of dying. The e-bike injury pattern includes pelvic fractures, which are more commonly seen in motorcycle riders than bicyclists. Our review revealed older patients were the most likely to die, as they may have been less skilled riding a bicycle. They were more likely to hit obstacles on bike paths and other fixed structures. One Sausalito pedestrian was killed after being struck by an e-bike rider.
Recently, the rapid proliferation of less-expensive, next-generation e-bikes increasingly being used by kids resulted in a dramatic rise in youth injuries. Seeing multiple unhelmeted kids on a single e-bike, traveling at a high rate of speed, is worrisome. We applaud the improved tracking of e-bike incidents by the Marin County Health and Human Services Department.
We believe that several steps can be taken to address the challenges posed by this new innovation.
A first step is to catalyze an educational safety campaign about the under-recognized risks of e-bikes. The public, especially parents, need to understand the importance of helmet use (mandatory for those under age 18), and that some e-bikes reach moped speeds that exceed state limits for youth under 16 years old.
Riders should beware of losing control while traveling downhill as the heavier weight of an e-bike can result in a rapid acceleration. Caution should be exercised when riding in traffic and on bike paths. Education about safety could be required at the point of sale.
We must strengthen and standardize local and state regulations to promote rider safety and assist law enforcement. Currently, there is confusion as rules differ across the three different categories of e-bikes, and across adjacent communities.
Mill Valley led the way earlier this year to ticket youth riding against traffic or without a helmet by requiring them to attend a safety course afterwards. Novato discussed banning e-bikes from trails and sidewalks, and setting speed limits. We believe multiple passengers on an e-bike should be banned.
The use of motorcycle helmets that protect both the skull and neck should be considered, and perhaps those using e-bikes which can obtain higher speeds should be licensed, like motorcyclists.
A third step at the federal level is to strengthen e-bike product safety standards and tighten e-bike manufacture to prevent disabling the speed limiter with a magnet. Across the nation, lithium-ion battery explosions in e-bikes leading to fires have been reported. Nevada's Incline Village and the Port of San Diego have banned the use of e-bikes in areas where pedestrians travel.
Our key advice for parents is to recognize that e-bikes are dangerous, and to think carefully before purchasing an ebike as a holiday gift for your children.
E-bikes are touted as an energy efficient method of transportation, but enormous injury and disability can result. Given Marin's history as a leader in the cycling industry, we believe it is our responsibility to raise awareness across California and the nation of the hazards of ebikes.