E-scooters linked to 3.5 times more brain injuries than motorcycles, study finds

E-scooter riders are 3.5 times more likely to suffer a traumatic brain injury than motorcyclists when they end up in serious crashes, according to a new study comparing injury data from across England and Wales.

The research, published in Scientific Reports, looked at 15,247 patients admitted with moderate-to-severe trauma between 2020 and 2022. The group included 580 e-scooter riders, 7027 motorcyclists and 7640 pedal cyclists, with the surgeon, David Bodansky, at the head of the investigation.

The results make uncomfortable reading for anyone who sees an e-scooter as a relatively harmless alternative to a motorcycle or bicycle. Among adult riders suffering serious injuries, the risk of traumatic brain injury was 3.45 times higher for e-scooter riders than motorcyclists, while the risk was 1.74 times higher than for cyclists.

E-scooter riders were also more likely to suffer internal organ injuries, with a 46 per cent higher risk than motorcyclists, while vascular injuries involving arteries and veins were more than three times as common.

There is, however, an important distinction to be made regarding the figures. The study isn't saying that someone riding an e-scooter is 3.5 times more likely to crash or suffer a brain injury than someone riding a motorcycle. The comparison concerns the injury profile of people who had already sustained moderate-to-severe trauma and were recorded by the National Major Trauma Registry.

Even so, the researchers found a particularly stark difference regarding helmets. Just 5.9 per cent of e-scooter riders in the trauma data were recorded as wearing one, compared with 75.7 per cent of motorcyclists and 45 per cent of cyclists.

The researchers suggest the lack of helmet use could be one factor behind the higher incidence of head injuries, although they also point towards the design of e-scooters themselves. Their relatively small wheels, upright riding position and handlebar layout could contribute to riders being pitched head-first over the front of the machine during a crash.

There is some good news in the data, at least from a broken-bone perspective. Adult e-scooter riders had a 20 per cent lower risk of fractures than motorcyclists and a 10 per cent lower risk than cyclists. The researchers say this helps demonstrate that the injury profile of an e-scooter crash is different rather than simply being a more severe version of a motorcycle or bicycle crash.

The study also looked at a separate dataset of 23,193 self-reported e-scooter incidents from rental scooters operated across 18 cities between 2020 and 2024. Those records covered more than 33 million rides and more than 48 million miles travelled.

That data produced another interesting finding. Female riders were more than twice as likely as male riders to report a severe injury, despite having a 36 per cent lower collision rate. The researchers suggest vehicle design, riding environment and differences in where and how men and women ride could all play a part, although they stress that more research is needed.

The researchers are now calling for tougher safety measures around e-scooters, including mandatory helmet use, stricter speed limits and changes to scooter design. Suggested improvements include deformable handlebar grips and better braking systems.

There is also a wider issue here for the UK's ongoing argument over e-scooter regulation. Private e-scooters remain illegal to use on public roads, parks and pavements in the UK, while rental schemes operate under government-approved trials. The researchers note that privately owned machines vastly outnumber those used in rental schemes, meaning the available injury data doesn't necessarily capture the full picture.

For motorcyclists, the study isn't necessarily the slam dunk against e-scooters that the 3.5-times figure might initially suggest. Motorcycles are plainly capable of producing serious injuries, but riders tend to use considerably more protective equipment, particularly helmets.

What the research does highlight is that e-scooters aren't necessarily the low-risk form of urban transport they can sometimes appear to be. With small wheels, limited stability and virtually no protection between rider and road, coming off one can put the rider's head and upper body directly into the firing line. While motorcycles have spent decades developing safety equipment, training standards and crash protection to mitigate those risks, e-scooters have arrived on the streets with comparatively little of any of them.

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