Injury patterns and safety implications for electric bikes compared to mopeds in the United States

Injury counts for e-bikes increased significantly greater than moped injury counts and increasingly involved younger riders. Alcohol involvement was significantly lower in e-bike injuries compared to moped injuries. Low reported rates of drug or pedestrian involvement were observed. Helmet use was poorly documented, despite head injuries being the most common injury type. Given the high prevalence of internal head trauma, universal helmet laws for e-bike and moped users should be considered. While fatalities remain rare for e-bikes compared to mopeds, the consistent role of motor vehicle interactions in the most severe cases points to a systemic issue in roadway safety. These findings suggest that e-bikes are comparatively under regulated compared to mopeds. Policies, such as universal helmet laws, geofencing, pedestrian airbags, and infrastructure improvements could help mitigate both e-bike and moped injuries.