Health Officials Prepare to Track Electric Scooter Injuries

A hospital conference room is an unlikely place to assess a budding transportation revolution, but a team of San Francisco trauma specialists and researchers who gathered there sees its work as essential to ensuring the safety of residents in a city of high-tech guinea pigs.

“We don’t know what we don’t know,” Dr. Catherine Juillard, a trauma surgeon at Zuckerberg San Francisco General Hospital, said during the meeting in late June. After a brief absence, shared electric scooters will soon return to San Francisco, and the city and the doctors at the meeting want to track the injuries — from skinned knees to head trauma — that result from the scooters and other transportation options flooding the city.

“I can say that several years ago that I didn’t see these types of injuries happening, and now I do,” said Juillard, who is also a professor researching injury prevention at the University of California, San Francisco. “But we have to do the hard work of looking at the data to determine if there’s truly a trend.”

The concern began with the arrival of thousands of shared electric scooters this year. The pay-as-you-go vehicles — unlocked for $1 with a smartphone app, and then 15 cents per minute — turned pedestrians into urban adventurers whirring by at up 15 mph.

After nearly three months, the city issued cease-and-desist orders that temporarily took the scooters off the streets, but they’re poised to return as soon as this month, when the city issues permits to as many as five scooter companies.

The major scooter companies say they’re paying attention to injuries and doing what they can to encourage riders to be safe.

Bird, the segment’s biggest player, with scooters in more than a dozen cities and a value estimated at $2 billion, said Thursday it was forming a safety advisory council led by David Strickland, a former head of the National Highway Traffic Safety Administration. Strickland’s panel will “focus on increasing the safety of people riding slow-speed electric scooters in a car-centric world,” the company said.

Bird said it supported the collection of data on injuries, “in particular those caused by cars.”

It’s not just the scooters that Juillard and her colleagues are worried about. During their first meeting, the team called out the possible transportations options it might see: electric bikes, mopeds and scooters, and then hoverboards, Segways and even unicycles. (Given its proximity to Silicon Valley, San Francisco has become a real-world test bed for all manner of transportation.)

Juillard sees only the most banged up of accident victims, those who are rushed to the operating theater or admitted to the intensive-care unit. But Dr. Chris Colwell, the hospital’s chief of emergency medicine, sees everything from bumps and bruises to life-altering head injuries, and safety concerns popped up almost as soon as the scooters did.

“I’m quite confident that we were seeing five to 10 injuries from this a week, and I’m probably underestimating that,” Colwell said. “We saw one or zero a month before the increase in electric scooters.”

Bird and two other companies, Lime and Spin, put thousands of scooters on San Francisco’s streets this year in what Aaron Peskin, a member of the Board of Supervisors, called “a strategy of ask for forgiveness, not permission.”

The exact number of scooters that hit the streets is hard to know, but Bird told The Wall Street Journal that its customers totaled 90,000 miles in the first three weeks in San Francisco. A few weeks later, the San Francisco supervisors unanimously passed the ordinance and issued cease-and-desist letters. The wave hit Santa Monica, California, where Bird is based, before it arrived in San Francisco. Santa Monica sued Bird last year, but its scooters returned to the city’s streets after the company agreed to pay more than $300,000 in fines and secure proper licenses.

Lt. Saul Rodriguez, the public information officer of the Santa Monica Police Department, said he knew of three or four serious scooter injuries that he believed would require long-term treatment.

“That’s if they ever recover,” he said. “Knock on wood, nobody has died.”

The imminent return of the electric scooters to San Francisco, even in smaller numbers and in a limited one-year pilot, puts pressure on the doctors and public health professionals working on a taxonomy of e-vehicle types, sorting out shared and not shared, with or without a helmet, severity of the injury, and so on.

“The ideal is to be ready with standardized data-collection instruments when the pilot rolls out,” said Megan Wier, an epidemiologist with the San Francisco Department of Public Health.

With the clock ticking, Wier and her colleagues combed through months of police and hospital records to help inform the classifications. But she believes the most useful injury patterns will emerge only after a data schema is established and the scooters return to San Francisco.

In California’s Legislature, there is a movement afoot to loosen some regulations on the scooters. Assembly Bill 2989 would relax helmet requirements, stipulate that only riders under 18 need to wear protective headgear and allow electric scooters to be used freely on streets with speed limits up to 35 mph, rather than the current limit of 25 mph.

Bird, which has pushed hard for the bill, pointed out that adults riding electric bicycles are not required to wear a helmet. The company said it had passed out some 40,000 free helmets to its riders, but nonetheless felt the bill’s passage would provide riders with “more consistent ridership rules.”

Euwyn Poon, president of Spin, another scooter company, said it was “sensible” to allow electric scooter users to ride without a helmet, even on streets with higher speed limits.

“Our users prefer the convenience of riding a very short distance on a scooter without a helmet,” Poon said.

He acknowledged that the majority of riders disregarded safety guidance. “Our focus is on educating users as much as possible,” Poon said. “That’s the extent of what we can do.”

Peskin, the San Francisco supervisor, called the bill “terrible public policy” that would risk safety. Still, he said he understood that the city needed to do something about pollution and congestion.

“If used properly, electric scooters may very well be part of the transportation solution,” he said. “And if used wrongly, they’re a hazard.”

Peskin said he was impressed by new safety measures proposed in some of the permit applications. One company offered to include a helmet with each scooter, and another offered to require users to submit a selfie while wearing a helmet before the scooter could be unlocked.

Still, Juillard said she believed that hard data about safety risks was advisable as electric scooter companies expand into dozens more cities around the country. Bird alone wants to be in 50 cities by the end of the year.

“When technology enters transportation, people forget that it also becomes public health,” she said. “It becomes something where human lives are at stake.”