E-scooters present a growing public-health challenge

E-scooters present a growing public-health challenge
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All over America and around the world, municipal officials are considering transportation alternatives that move large numbers of people while cutting pollution — especially greenhouse gases — and easing traffic congestion. 

Over the last decade, bike sharing became ubiquitous in U.S. cities from Boston to Bakersfield, but small, electric e-scooters are heralded by some as the next phase in the greening of our towns and cities.  

Fast-growing e-scooter firms Bird and Lime — and the larger more established firms Uber and Lyft — are aggressively pushing scooter-sharing. It’s promoted in cities as widespread as Washington, D.C.; Buenos Aires; Tel Aviv and Paris as clean, cost-effective commuting, short distance travel and even sightseeing options. 

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This movement may be good for clearing the air, easing automobile congestion and building valuation (Bird and Lime are worth about $2B each), but municipalities, manufacturers and sharing companies need to address pressing safety, health and environmental problems already taking root.

That need becomes urgent as e-scooter popularity skyrockets. In 2018, shared e-scooter and bicycle trips in the U.S. more than doubled over 2017’s baseline to reach 84 million; rentable e- scooters alone accounted for more than 38.5 million trips. 

They're touted as convenient and cheap — only about $1 to unlock with a smartphone app and about 15-20 cents per-minute to ride in cities globally (however, as companies lose money, their per-minute fees in some cities are as high as 39 cents). 

E-scooters can be dropped off on the sidewalk after riders reach their destination, and a recent survey of 7,000 people in 10 U.S. cities found them extremely popular with those making between $25,000 to $50,000 a year, and with women (72 percent) more than men (67 percent). E-scooter sharing is popular with younger riders; Lime reports an average user age of 31 and that 75 percent of its riders are under 36.

Growing injuries match the growing popularity. Many emergency rooms have reported leaps in e-scooter injuries, causing several municipalities to ban their use. There’s an increased acknowledgement that safety concerns present a major barrier to mass adoption, as companies face fresh regulatory pushback and litigation risk amid reports of vehicle malfunctions and deaths.

The Associated Press recently reported that since the beginning of 2018, at least 11 scooter deaths have been recorded in the U.S., nine of which occurred on rented vehicles. YouTube Star Emily Hartridge’s death on an e-scooter last summer underscored to many that rider-safety programs are inadequate.

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A Centers for Disease Control and Prevention (CDC) study found that for every 100,000 e-scooter trips taken, 20 individuals were injured — for comparative purposes, nationally there is less than one injury (.75) for every 100,000 car trips.

Researchers in Santa Monica California found that scooter injuries landed people in the hospital about 50 times more than bike injuries in the same year-long period. 

A Rutgers University study released in June found the number of nationwide injuries involving e-scooters climbed from 2,325 in 2008, to 6,957 in 2018; 66 percent of those treated were not wearing helmets. 

Mandating helmet use should be a requirement; indications are that it makes riding e-scooters significantly safer. In Austin, Texas, public health officials working with the CDC produced a landmark study that counted 192 scooter-related injuries in just three months during a 2018 scooter pilot program. Nearly half were head injuries, including 15 percent that were traumatic brain injuries. Less than 1 percent of the injured riders wore a helmet. 

Clearly, e-scooters present a growing public-health challenge. To ensure that their transition into the fabric of urban life is accomplished as safely as possible, the following steps can be taken by e-scooter companies — including better design and cooperation with policymakers, and by municipalities — including passing laws and working to change rider behavior:

Design improvement

Even at 15 mph, at which Bird caps their scooters, e-scooters’ small wheels and high center of gravity cause many designers to call them unsafe on roadways in disrepair; “…they need really really flat smooth pavement. We don’t maintain that…” says Arizona State University Professor David King. E-scooters also suffer from low side visibility, making them difficult to see for drivers, cyclists and pedestrians. Safety advocates urge decreasing speed caps and changing scooter designs, lowering the center of gravity to make them more stable — and visible — by adding a seat.

Shared scooters block sidewalks

As riders can drop them anywhere when they’re done with them, scooters create fall hazards, especially for the blind and visually impaired, as well as those using wheelchairs or similar mobility devices. Geofenced drop-off corrals near known user destinations — easily sited by using scooter GPS data — can make pedestrians safer.

Laws treating scooters as motor vehicles are necessary as reports of rider misbehavior become widespread.

Riding on sidewalks is illegal in most American cities, but, anecdotally, a large number of scooter collisions with pedestrians take place on sidewalks. Impaired riding is a worldwide issue and should be treated as drunk driving; out of 103 patients treated at three U.S. trauma centers for e-scooter-related injuries, 79 percent were tested for alcohol; 48 percent of that group were found to have a blood-alcohol level of more than 0.08, the legal limit for drivers in most states. Sixty percent of the study’s 103 patients were also screened for drugs; 52 percent of them tested positive.

The need for laws and education programs is urgent

E-scooter regulation is catching up with their use. There are few US federal laws, like the UK’s total ban on e-scooters and France’s prohibition of riding on sidewalks,. Therefore state and local regulations are needed.

After a total ban, San Francisco passed regulations that require scooter companies to present safety and parking plans before being allowed to operate. Washington, D.C. is reviewing a bill that regulates e-scooter speed limits, parking, riding hours and safe practices; Nashville has already passed a similar law. 

Santa Monica pioneered a model safety program with teeth; regulations focus on helmet use; keeping off sidewalks; having a valid driver’s license; riding one person to a scooter, and more.

Santa Monica Police ticket violators and the public safety campaign is subsidized by legal and impound fees collected from e-scooter operators. Programs like these are springing up in other municipalities; Montgomery County, Maryland is expanding its scooter safety program, including free rider training.

Rising e-scooter share adoption means that local governments will be increasingly challenged with safety concerns; one Washington, D.C. transportation official recently complained to the Washington Post that e-scooters are vastly under-regulated. 

Only by treating e-scooters as serious modes of transportation — requiring laws, safety programs and user training like any motor vehicle — are towns and cities going to be able to ensure that riders operate them in the safest way possible, not only for themselves, but for other e-scooter and bike riders, motor vehicle operators and pedestrians. 

Jonathan Fielding, M.D., is a professor of public health and pediatrics at University of California, Los Angeles.