Risk Factors for Road-Traffic Injuries Associated with E-Bike: Case-Control and Case-Crossover Study

Abstract

The Electric Bike (EB) has become an ideal mode of transportation because of its simple operation, convenience, and because it is time saving, economical and environmentally friendly. However, electric bicycle road-traffic injuries (ERTIs) have become a road-traffic safety problem that needs to be solved urgently, bringing a huge burden to public health. In order to provide basic data and a theoretical basis for the prevention and control of ERTIs in Shantou, mixed research combining a case-control study and a case-crossover study was carried out to investigate the cycling behavior characteristics and injury status of EB riders in Shantou city, and to explore the influencing factors of ERTI. The case-control study selected the orthopedic inpatient departments of three general hospitals in Shantou. The case-crossover study was designed to assess the effect of brief exposure on the occurrence of ERTIs, in which each orthopedic inpatient serves as his or her own control. Univariable and multivariable logistic regressions were used to examine the associated factors of ERTIs. In the case-control study, multivariable analysis showed that chasing or playing when cycling, finding the vehicle breakdown but continuing cycling, not wearing the helmet, and retrograde cycling were risk factors of ERTIs. Compared with urban road sections, suburb and township road sections were more likely to result in ERTIs. Astigmatism was the protective factor of ERTI. The case-crossover study showed that answering the phone or making a call and not wearing a helmet while cycling increased the risk of ERTIs. Cycling in the motor-vehicle lane and cycling on the sidewalk were both protective factors. Therefore, the traffic management department should effectively implement the policy about wearing a helmet while cycling, increasing the helmet-wearing rate of EB cyclists, and resolutely eliminate illegal behaviors such as violating traffic lights and using mobile phones while cycling. Mixed lanes were high-incidence road sections of ERTIs. It was suggested that adding people-non-motor-vehicles/motor vehicles diversion and isolation facilities in the future to ensure smooth roads and safety would maximize the social economic and public health benefits of EB.

Analysis of road traffic injuries and casualties in China: a ten-year nationwide longitudinal study

“…Based on socio-demographic factors, geographical areas and different road types, epidemiological characteristics, the trends and main patterns of RTIs in China have been reported ( Wang et al, 2019 ; Zhang et al, 2011 ). Previous studies have shown that various economic factors, population size, road length, and car ownership have an impact on road traffic casualties and/or MVAs deaths ( Harper, Charters & Strumpf, 2015 ; Wang et al, 2012 ), while road type, cyclist behavior characteristics (including distraction driving, not wearing a helmet, riding in the wrong direction, violating traffic signals) have an effect on non-MVAs casualties ( Pai et al, 2018 ; Zhang et al, 2018 ; Zhong et al, 2022 ). To our knowledge, there were not sufficient researches on motor vehicle accident injuries in national road traffics in China, especially non-motor vehicle accidents and pedestrian injuries.…”

Analysis of Risky Riding Behavior Characteristics of the Related Road Traffic Injuries of Electric Bicycle Riders

“…Therefore, cyclists are prone to take a chance and engage in dangerous riding behaviors when riding. Risky riding behaviors, such as riding after drinking alcohol [ 31 , 32 , 33 ], riding without a safety helmet [ 34 , 35 , 36 , 37 ], riding with a passenger [ 25 , 35 ], riding in the opposite direction [ 25 , 36 ], not obeying traffic signals [ 25 , 33 , 38 ], using a cell phone or wearing headphones while riding [ 36 , 39 , 40 ], chasing and jostling with other vehicles or pedestrians [ 36 ], continuing to ride after discovering a vehicle malfunction [ 36 ], and riding on motor vehicle lanes [ 33 , 41 ] have been confirmed to be associated with the occurrence of ERTIs, consistent with the results of this study.…”

Investigating the Factors Affecting Rider’s Decision on Overtaking Behavior: A Naturalistic Riding Research in China

“…Nevertheless, the more frequent use of electric bicycles and bicycles is also detrimental to road safety. They are not protected by metal structures like motor vehicles, resulting in more severe injuries to non-motorized vehicle riders in the event of a traffic accident [5,6]. Data released by the World Health Organization in 2018 found that half of all deaths on roads globally are among the most unprotected, with nonmotorized vehicle riders being an important representation of unprotected road users [7].…”