New data reveals that e-scooter crashes are causing large numbers of young adults to require reconstructive plastic surgery, with the majority of incidents happening at night-time, and many of the injuries preventable.
A study, titled E-scooter Trauma: Injury Profiles and System Resource Demand, presented at the recent British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS - https://www.bapras.org.uk) Scientific Meeting, highlights not only the stress this trend places on the NHS, in particular plastic surgery departments, but also the worrying reality that patients involved are as young as 4 and as old as 80.
The statistics show that almost 3 in 5 (57%) of injuries occur between the hours of 6pm and 6am, with the mean age of patient 34.7 years old. Well over a quarter (27.3%) of patients presented with limb injuries, and a quarter (25.4%) with major head injuries, with the majority of these due to not wearing a helmet. One fatality occurred as a result of a head injury. The retrospective study, which covered all e-scooter injuries presented at a Major Trauma Centre within Imperial College Healthcare NHS Trust over a five-year period from September 2020 - August 2025, showed that 95% of patients required ambulance or air ambulance, and inpatient admission was required for 73% of patients, with an average hospital stay of 7-8 days in wards and intensive care settings. Plastic surgery was required for nearly one in seven (13%) of patients. Of the 161 patients, 118 were adult males, and only 28 were adult females, with the overall gender ratio M: F at 4:1.
Air ambulances cost thousands of pounds to dispatch, and there is unprecedented pressure on road ambulances,1 alongside critical care costing the NHS thousands of pounds per patient. The study’s lead author, Junior Clinical Fellow in Plastic & Reconstructive Surgery, Dr Manasweeta Borah, says:
“It is shocking that many of these e-scooter injuries could have been prevented, either through wearing a helmet, or exercising caution such as not riding on an e-scooter with another person. The statistics show that over half the injuries occur between the hours of 6pm and 6am, indicating that many are in the dark, compounding a need for improved rider education, alongside requiring those who rent e-scooters to wear helmets, enforced by the rental company. Speed limits also need to be reviewed and accident hotspots identified with a view to the enforcement of lower speed limits in these high-risk zones. We can see other countries implementing these changes and legislations and it’s time we followed suit.”
Risk management strategies have been implemented in the city centres of many countries, including Helsinki,2 where it has equated e-scooters with bicycles in the Road Traffic Act, banning riding on pavements and multiple riders, restricting speed limits to 20 km/h during the day and 15 km/h at night, with 10 km/h in busy pedestrian areas. In many other European countries, helmets are mandatory, either for all riders or specifically minors.
While the UK has banned the use of privately owned e-scooters on public pavements and roads, rented e-scooters are available in particular boroughs of London, as well as other areas participating in the rental e-scooter trials, and helmet use is only recommended, not mandatory.3
Dr. Borah continues: “Identifying whether a risk is rider-related or infrastructure-related is key to preventing so many accidents from happening in the future. If a system is put in place that would enable us to track all e-scooter related injuries and collect data about them, we can then make recommendations as to what needs to change. That could be mandatory rider education, a change in the law around helmet wear, or improved infrastructure. We are seeing far too many major trauma injuries to allow things to continue as they are.”
Consultant plastic surgeon and BAPRAS president, Paul McArthur, said: “This study presents us with a clear opportunity to reduce harm through evidence-based policy change, underlining the need for the implementation of new safeguards, education and regulation around e-scooters. In doing so, we can work together to mitigate the burden of preventable trauma on patients and costs to the NHS.”
The Department of Transport data shows that in 2024 there were 1312 e-scooter collisions, with 1390 causalities, of which 444 were seriously injured and 6 died.4
References
- https://nhsproviders.org/resources/nhs-activity-tracker-202425/august-2024/ambulance-sector
- https://www.hel.fi/en/urban-environment-and-traffic/electric-scooters-frequently-asked-questions
- https://www.gov.uk/guidance/e-scooter-trials-guidance-for-users
- https://www.gov.uk/government/statistics/reported-road-casualties-great-britain-e-scooter-factsheet-2024/reported-road-casualties-great-britain-e-scooter-factsheet-2024
