SAN DIEGO —Children and teens who ride electric- or gas-powered bikes are at higher risk of trauma or death when involved in collisions as compared to those riding pedal-assisted bicycles, according to research presented during the American Academy of Pediatrics 2026 National Conference & Exhibition in San Diego Oct. 2-6.
In the abstract, “Comparison of Bikes, E-Bikes, and Gas-Powered Cycle Injuries in the United States: A National Review from 2005–2024,” researchers analyzed data from the National Electronic Injury Surveillance System (NEISS) to investigate injuries and deaths in the pediatric population.
The authors analyzed incidents involving patients age 17 and younger, following a total 134,426 cases involving pedal-assist bicycles, 305 e-bikes, and 1,721 gas-powered cycle-related injuries over the 20-year span. Gas-powered bikes led to the most hospital admissions followed closely by e-bikes.
“In the pediatric trauma setting, electronic bicycles are becoming increasingly common,” said abstract author Seth Weir, DO, a third-year general surgery resident. “The goal of this research was to better inform parents when buying electric assist powered bicycles and adequately portray the risk of injury in each type.”
Most patients were white males who were treated and released from the hospital. The most common type of injury for pedal-assisted bikes was contusion or abrasion, as opposed to e-bikes in which fractures were more common. In all three types of bike incidents, patients most often reported injuries to the head as opposed to other parts of the body, with a breakdown of e-bikes 20%, gas-powered cycles 16.6%, and pedal-assist bicycles 15.8%.
The highest percentage of trauma-related deaths were related to electric bicycles, according to the research. E-bikes also led to the second-highest trauma-related admission rate when comparing the three bicycle types.
The researchers suggest that although hospital admission and fatalities are rare, there is a need for regulation to prevent harm. They recommend strategies such as requiring a driver’s license or regulating the speed at which bikes are able to go for pediatric age groups.
Funding organizations: Stony Brook University Hospital, Prisma Health
Contact: Seth Weir, DO resident physician, Prisma Health, at Seth.Weir@prismahealth.org
Dr. Weir is scheduled to present his research, which is below, from 5:15 to 7 PM PDT on Saturday, Oct. 3 at the Marriott.
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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org . Reporters can access the meeting program and other relevant meeting information through the AAP meeting website at http://www.aapexperience.org/
ABSTRACT
Program Name: Call for Abstracts
Submission Type: Section on Surgery
Abstract Title: Comparison of Bikes, E-Bikes, and Gas-Powered Cycle Injuries in the United States: A National Review from 2005–2024
Seth Weir
PORT JEFF STA, NY, United States
10/02/2026 5:15 PM - 7:00 PM
Electronic bikes, or E-bikes, are becoming increasingly common throughout the United States (U.S.). In comparison to normal peddle powered bikes, their ability to accelerate quickly and reach high speeds increases the chance for injury. Recently studies have described E-bike related injuries, but comparisons to normal bicycles and gas-powered cycles injuries and disposition have not been studied yet. The purpose of this study was to characterize and compare pediatric E-bike vs bike vs gas-powered cycle-related injuries in the United States injury patterns.
A retrospective cross-sectional analysis was performed using the National Electronic Injury Surveillance System (NEISS), a stratified probability sample of U.S. hospitals with emergency departments, from 2005 to 2024. Cases involving patients ≤17 years with injuries related to E-bikes, bikes, and gas-powered cycles. Standard NEISS variables were analyzed, including patient demographics, injury characteristics, anatomical location, diagnosis, and emergency department disposition. National estimates were generated using sampling weights provided by the Consumer Product Safety Commission.
A total of 134,426 cases met criteria for bicycles, 305 for E-bikes, and 1721 gas-powered cycle related injuries in the study period. Most documented cases occurred in males across all subgroups. White patients were the most affected across all races in all 3 subgroups. The most common type of injury for bikes was contusion/abrasion (24%) and gas-powered cycles (27%), E-bikes was fracture (27%), shown in figure 1. Injury to the head was the most frequent anatomic location to sustain injury among all three groups (E-bikes 20%, Gas-powered cycles 16.6%, Bicycles 15.8%). The mean age for patients with E-bike related injuries 12.43 +/- standard deviation (SD) of 3.71, bicycles was 9.67 +/- 3.96, and gas-powered 13.13 +/- 3.69. Overwhelmingly patients were treated and released (92%), (90%), (87%) for bikes, E-bikes and gas-powered cycles respectively. Gas-powered cycles had the highest percentage of patients that required admission (10%), with the next highest being E-bikes (6.6%), while the bicycle group had the lowest percentage of patient’s admitted (5%). All subgroups had documented cases of fatalities; E-bikes had 1 reported fatality (0.32% of all cases), 2 fatalities in the gas-powered cycles group (0.12%), and bikes with 37 (0.03%).
E-bikes have a high potential for injury in the pediatric population and most commonly present with fractures. This study is the largest national database study and is the first to compare to both bikes and gas-powered cycles. Although hospital admission and fatalities are rare, the fact that E-bikes have the highest percentage of fatalities and the second highest for admission indicates there is a need for further regulation of this transportation modality. Strategies such as requiring a driver’s license or regulating the speed at which they are able to go for pediatric age groups could prevent the number of injuries associated with E-bikes.
Mechanism of Injury
Types of injury related to percentage of injury by subgroup.
People
Comparison of Bikes, E-Bikes, and Gas-Powered Cycle Injuries in the United States: A National Review from 2005–2024
2-Oct-2026