Declining helmet use and emerging electric vehicle injuries among pediatric patients presenting with micromobility accidents: A single-center analysis.

Abstract

Each year, hundreds of thousands of children are treated for injuries related to micromobility use. Helmet use is a proven preventive measure, yet use remains low. Recently, the rise in electric vehicles (EVs) has introduced new risks. The study aimed to characterize pediatric micromobility accidents from motorized and nonmotorized bicycle, scooter, and skateboard accidents, with a focus on helmet use and its impact on injury severity. We conducted a retrospective study at a Level 1 adult and Level 2 pediatric trauma center, analyzing 285 cases of pediatric injury from motorized and nonmotorized bicycle, scooter, and skateboard accidents between January 1, 2020, and December 31, 2024. Data from the trauma registry and electronic health records were reviewed. Helmet use and its association with demographic factors, injury severity score, and clinical outcomes were analyzed. On average, there were 57 cases of micromobility injuries each year, with cases increasing from 45 to 77 between 2020 and 2024. Overall, helmet use was 23.5%. Helmet use declined from 31.1% in 2020 to 23.4% in 2024. Lower helmet use was significantly associated with lower socioeconomic status and non-White riders. From 2020 to 2024, EV-related injuries increased from 0% to 37.7%. Increased EV use was significantly associated with older age and male gender. Despite a helmet mandate in New Jersey, helmet use in our cohort was lower than national estimates, and the issue is getting worse in recent years, especially among non-White individuals from low-opportunity neighborhoods. While helmet use among patients presenting for trauma care did not correlate with lower injury severity, this likely reflects injuries prevented or lessened by helmets, reducing the need for trauma care. EVs constitute an increasingly large percentage of injury mechanisms in our cohort, especially among young males. Our work highlights the need for targeted interventions among the most vulnerable populations. (J Trauma Acute Care Surg. 2026;00: 000-000. Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved.). Prognostic/Epidemiology; Level III.