Comparison of head-related injuries between standing electric scooter riders and pedestrians involved in motor vehicle collisions in Japan

OBJECTIVE: While previous research suggests that e-scooter riders and pedestrians may exhibit similar injury patterns due to a shared standing posture, direct comparisons using unified datasets are lacking. This study aims to identify the distinctive injury characteristics of e-scooter riders by comparing them directly with pedestrians in motor vehicle collisions, with a particular focus on head-related injury risk. METHODS: Using traffic accident statistics from the National Police Agency of Japan (January 2024-June 2025), I analyzed 165 injured e-scooter riders and 23,599 injured pedestrians ranging in age from 18 to 59 years. I statistically compared demographic, accident and injury characteristics (e.g., sex, injury source, primary injury region). To ensure a focused analysis, the primary injury region was collapsed into a binary outcome (Head/Face/Neck vs. Other). A logistic regression model was performed to estimate the adjusted odds ratio for head-related (Head/Face/Neck) injuries, adjusting for demographics and accident characteristics. RESULTS: < 0.001). Multivariable analysis revealed that unhelmeted e-scooter riders exhibited a significantly higher risk of head-related injuries compared with pedestrians (adjusted odds ratio 2.15, 95% confidence interval 1.53-3.00). CONCLUSIONS: This study suggests that a shared standing posture does not necessarily result in similar injury outcomes. The results indicate that e-scooter injury profiles, particularly for head-related injuries, differ from those of pedestrians. These findings suggest that it may be appropriate for traffic safety policies to consider e-scooter riders as a distinct category and prioritize the promotion of helmet use to mitigate head-related injury risks.