Disparities in incidence and severity of electric scooter injuries in children.

Abstract

Pediatric electric scooter injuries are increasing alongside expanding availability. Although national data across all ages suggest racial and ethnic disparities, pediatric-specific analyses are limited. We aimed to quantify the burden of e-scooter injuries among pediatric patients, describe trends by age, sex, race/ethnicity, and injury characteristics, and assess disparities in incidence and severity. We conducted a retrospective cross-sectional study using 2020-2024 data from the National Electronic Injury Surveillance System, a nationally representative sample of U.S. emergency departments. We included patients < 18 years with e-scooter injuries. Injury characteristics were summarized by age, sex, and race/ethnicity. Chi-square tests compared injury patterns, and survey-weighted logistic regression evaluated associations between race/ethnicity and hospitalization or death (severity proxy), adjusting for age and sex. From 2020-2024, there were 2117 pediatric e-scooter injuries, with incidence increasing annually; 42.2% occurred in 2024. Males accounted for 70.1% of injuries, and children aged 11-14 years represented the largest age group (38.3%). Most injuries involved the musculoskeletal system (40.4% fractures, dislocations, strains, or sprains) or soft tissues (36.7%). The weighted hospitalization rate was 7.7%, and 0.3% of cases resulted in death. Black (16.0%) and Hispanic (15.7%) children accounted for a greater proportion of e-scooter injuries compared with their representation among all pediatric injuries. In adjusted analyses, race and ethnicity were not significantly associated with hospitalization (Black vs White: aOR 0.92, 95% CI 0.54-1.56; Non-Hispanic vs Hispanic: aOR 0.63, 95% CI 0.30-1.31). The incidence of electric scooter injuries is increasing, with younger adolescent males most often impacted. Black and Hispanic children account for a disproportionate share of pediatric e-scooter injuries, although adjusted analyses did not demonstrate significant racial or ethnic differences in hospitalization. Targeted prevention strategies combining educational, legislative, and environmental measures will be essential to curb rising incidence and address disparities.