Alcohol and electric scooter injuries in an emergency department: a prospective observational study

Variable prevalences of alcohol use have been reported among injured electric scooter (e-scooter) riders in emergency departments (ED) worldwide. The studies indicate a relationship between alcohol and injuries, especially at nighttime. A better understanding would guide the prevention of these injuries. The study objectives were to investigate the relationship between alcohol and injury patterns as well as the impact of restriction policies on ED presentations.

A prospective observational study at an urban level 2 trauma centre ED, where all patients presenting with e-scooter injuries from April to September 2022 were eligible and asked for consent to participate and to take a breathalyser test. Pearson´s chi-squared test and Mann-Whitney U test were used for comparison between participants with/without alcohol involvement. In addition, the proportion of e-scooter injuries before and after restriction policies were introduced in 2022 was analysed together with city data on the number of rental e-scooters and trips 2021-2023.

One patient declined, and 133 injured riders consented. They were younger (mean age 34.1 years) and more often male (66.2%) compared to other ED patients. Alcohol was involved for 57/133 (42.9%) participants and data was missing for 25 (18.8%) participants. Alcohol use was more prevalent among participants arriving at night (22:00-05:59), 43/68 (63%; CI: 51-75) compared to 14/65 (22%; CI: 11-32) participants arriving between 06:00-21:59. Face and head injuries were more frequent with alcohol use, 44/57 (77%; CI: 66-88) compared to 29/51 (57%; CI: 43-71) without. However, the median injury severity score was lower with alcohol use. After the introduction of a city limit on the number of rental e-scooters, the number of trips in the city decreased by 35% and a 39% reduction of e-scooter injuries was found in the study ED.

Alcohol use was more prevalent among e-scooter riders presenting nighttime to the ED. Face and head injuries were more frequent with alcohol use. E-scooter city trips and injuries in the ED were reduced when the number of rental e-scooters had been limited. Future studies should evaluate interventions targeting intoxicated nighttime riding and helmet use.