E-Bykes |
| In
barely a decade, electric bicycles have gone from a niche market
product to one of the fastest-growing modes of transport in the world.
Their ability to combine human effort with motorized assistance has
made them an attractive tool both for everyday mobility and for
physical activity, but this same growth has brought with it a growing
body of evidence on specific risks that deserves to be examined
together. One of the pioneering investigations on the subject, carried out through surveys of thousands of e-cyclists in a German-speaking European country, revealed that single-vehicle crashes—that is, falls or loss of control without a collision with another road user—constitute the most frequent type of incident among users of these bicycles. Practically one in six surveyed cyclists had experienced this type of accident since they began using their electric bicycle. The most common mechanisms included skidding on wet or icy surfaces, falling while crossing curbs or uneven surfaces, getting caught in tram tracks, and evasive maneuvers to avoid obstacles or other road users. Interestingly, the risk of this type of accident did not depend on age, but rather on factors such as being male, high exposure from frequent use, and using the bicycle mainly for commuting to work. However, when the severity of injuries was analyzed, the picture changed: women, older people, and those who perceived themselves as less physically fit had a higher risk of serious injury, a finding that suggests the factors determining the likelihood of an accident are not necessarily the same as those determining its severity. This distinction between accident risk and severe injury risk repeats itself, with interesting nuances, in a Scandinavian study based on three independent surveys with more than seven thousand participants. There it was found that, overall, electric bicycles showed a slightly higher accident risk than conventional bicycles, but this increase was almost entirely explained by women: among men there was no difference at all between the two types of vehicle. Part of this additional risk in women appeared to be related to unfamiliarity with the vehicle, given that electric bicycles tend to attract a newer cycling public, and prior experience with the bicycle proved to be a robust predictor of accident likelihood. Nevertheless, neither injury severity nor the proportion of accidents requiring medical attention differed significantly between conventional and electric bicycles, leading to the conclusion that the latter are not inherently more dangerous, but rather that their appeal to new users could explain much of the observed risk. A different picture emerges when examining the Asian context, where electric bicycles are not a recreational add-on but the primary urban transport mode for hundreds of millions of people. An extensive literature review on risky riding behaviors in that setting identified riding patterns markedly different from European ones: illegal occupation of motor vehicle lanes, speeding, running red lights, carrying passengers irregularly, and riding against traffic emerge as the most common infractions and those most associated with crashes. Psychological and demographic factors—age, gender, risk perception, safety attitude, and tolerated waiting time at a traffic light—proved decisive in the likelihood of committing these infractions. This analysis underscores that the electric bicycle phenomenon cannot be understood uniformly on a global scale, since regulation, infrastructure, and road culture in each region substantially shape behaviors and, therefore, risks. The pediatric population emerges as a group of particular concern in several recent analyses. A study based on a national injury surveillance system in a North American country documented that, while injuries associated with conventional bicycles declined steadily over the decade analyzed, those associated with electric bicycles increased consistently over the same period. Males accounted for the vast majority of these injuries, and the most affected age group corresponded to preteens and adolescents. Beyond frequency, severity proved especially concerning: electric bicycle injuries required hospitalization notably more often than conventional bicycle injuries or even light combustion-powered motorized vehicles, and showed higher rates of internal injuries and fractures. Added to this is an alarming finding on prevention: in cases where helmet use could be determined, the vast majority of children injured on electric bicycles were not wearing one, a proportion far higher than that observed among conventional cyclists. Another risk, less discussed but increasingly documented, stems not from riding itself but from the technology powering these vehicles. A review focused on burns associated with personal mobility devices, including electric bicycles, identified thermal runaway in lithium-ion batteries as a recurrent cause of fires and explosions. Hospital cohorts from various Asian cities showed patterns of severe burns, with extensive body surface areas affected and, in some pediatric cases, an injury pattern pointing to a problem of children's accessibility to defective or mishandled batteries. Combustion tends to occur during prolonged or unsupervised charging, and uncertified conversion kits—which transform conventional bicycles into electric ones through DIY methods—represent an additional risk factor repeatedly flagged. Against this set of risks, there is also a robust body of evidence on the benefits these bicycles bring to public health and the environment, particularly in the context of active commuting to work. A recent review focused on Europe synthesizes how these vehicles allow classic barriers to conventional cycling to be overcome, such as long distances, poor physical fitness, or steep terrain, thereby facilitating the adoption of physical activity among populations that would otherwise remain sedentary. The reviewed studies show improvements in cardiorespiratory capacity after just a few weeks of regular use, metabolic benefits comparable to some extent to those of traditional cycling, and a substantial reduction in carbon dioxide emissions when these vehicles replace trips previously made by car. However, the same review acknowledges that adoption remains low and uneven across the continent, constrained by the high purchase price, lack of charging and secure parking infrastructure, and a social perception that still associates the use of electric assistance with a form of cheating or insufficient effort. Considering these findings together, a nuanced picture emerges. The electric bicycle is not uniformly more dangerous than the conventional one, but it is not equivalent in every respect either: its higher average speed, additional weight, and capacity to attract inexperienced users—among them women new to cycling and minors—appear to concentrate much of the differential risk observed across studies. The most frequently cited accident mechanisms, such as skidding, loss of balance, and falls when crossing uneven surfaces or rail tracks, are not exclusive to electric propulsion, but the higher speed achieved with less effort could intensify their consequences. Added to this is a distinct technological risk, tied to battery safety, that requires regulatory attention independent of purely road-related aspects. Taken together, the available evidence suggests that maximizing the benefits of these bicycles—in terms of health, reduced pollution, and urban decongestion—without disproportionately shifting their risks onto the most vulnerable users will require simultaneous progress on several fronts: road infrastructure adapted to higher circulation speeds, effective policies to promote helmet use, stricter standards for batteries and chargers, and educational strategies specifically targeting new users and minors, without which the accelerated growth of this mode of transport could continue to be accompanied by a parallel increase in the burden of associated injuries. References: 1- Hertach P, Uhr A, Niemann S, Cavegn M. Characteristics of single-vehicle crashes with e-bikes in Switzerland. Accid Anal Prev. 117:232-238, 2018 2- Ma C, Yang D, Zhou J, Feng Z, Yuan Q. Risk Riding Behaviors of Urban E-Bikes: A Literature Review. Int J Environ Res Public Health. 16(13):2308, 2019 3- Fyhri A, Johansson O, Bjørnskau T. Gender differences in accident risk with e-bikes-Survey data from Norway. Accid Anal Prev. 132:105248, 2019 4- Goodman LF, Birnbaum Flyer Z, Schomberg J, Maginas M, Wallace E, Vukcevich O, Awan S, Gibbs D, Nahmias J, Guner YS. Electric bicycles (e-bikes) are an increasingly common pediatric public health problem. Surg Open Sci. 14:46-51, 2023 5- Warner-Levy J, Herieka M, Sheikh Z. Riding Toward Danger: A Scoping Review of Burns Associated With Personal Mobility Devices, Including Electric Bikes (E-Bikes) and Electric Scooters (E-Scooters). J Burn Care Res. 45(5):1154-1159, 2024 6- Sampieri A, Paoli A. Incorporating active commuting into daily life: a narrative review of e-bikes' impact on health and urban air quality. Front Sports Act Living. 7:1662076, 2025 |
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