Contents lists available at ScienceDirect Journal of Transport & Health journal homepage: www.elsevier.com/locate/jth Alookatelectricbikecasualties:Dotheydifferfromthe mechanical bicycle? Maya Siman-Tov a, ⁎ , Irina Radomislensky a ,KobiPeleg a,b , Israel Trauma Group(H.Bahouth,A.Becker,I.Jeroukhimov,I.Karawani,B.Kessel,Y.Klein,G.Lin, O.Merin,M.Bala,Y.Mnouskin,A.Rivkind,G.Shaked,G.Sivak,D.Soffer,M.Stein, M. Weiss) a Israel National Center for Trauma and Emergency Medicine, Gertner Institute for Epidemiology and Public Health Policy, Tel-Hashomer, Israel b Department of Disaster Medicine, School of Public Health, Tel Aviv University, Israel ARTICLEINFO Keywords: Electric bicycle Mechanical bicycle Injury Trauma Hospitalized patients Head injury ABSTRACT Objective: Toevaluateandcompare,atthenationallevel,injurytrendsand,characteristicsand to identify high risk groups of electric bike (E-bike) and mechanical bicycle (M-bike) related hospitalizations as a key message for public policy. Methods: Historic prospective study based on data from the Israel National Trauma Registry (INTR), between 1.1.2013 and 31.12.2017. All hospitalized casualties were E-bikers and M-bi- kers. Results: During the study period, 1733 E-bikers and 7259 M-bikers were hospitalized. Arab children (age 0–15) and young adults (age 16–29) were at higher risk for E-bike and M-bike casualties respectively. The hospitalization rate per 1000 vehicles was lower for E-bikers in comparison to M-biker. However, during the five year period a dramatic increase in E-bike re- lated hospitalizations was reported coinciding with a decrease of M-bike related casualties. Among M-bikers, the decrease in hospitalization rate was for accidents on both inter and intra- city roads, but not on unpaved roads, which remained stationary, suggesting that the transpor- tationmodeischanging.IncomparisontotheM-bikers,E-bikerswereatgreaterriskforenduring head injuries (OR 1.16 95% CI 1.00–1.25) and lower extremity injuries (OR 1.37 95% CI 1.23–1.52),toundergonesurgery(OR1.1395%CI1.00–1.26),havinglongerhospitalstays(OR 1.44 95% CI 1.23–1.68) and being discharged to rehabilitation center (OR 1.43 95% CI 1.09–1.86). Conclusion: During the last five years in Israel there is a dramatic increase in E-bike related hospitalizedcasualtiescorrespondingtoasubstantialincreaseinE-bikeusage.Incomparisonto M-bikers,thereisalowercasualtyratebutthesecasualtiesaremoreseverelyinjuredandutilize morehospitalresources.Itisofutmostimportancetoidentifythesehighriskgroupsinaneffort to develop culturally appropriate interventions for these road users, including training, aware- ness and helmet enforcement. Policy change recommendations are discussed. https://doi.org/10.1016/j.jth.2018.10.013 Received6May2018;Receivedinrevisedform28October2018;Accepted31October2018 * Correspondenceto:IsraelNationalCenterforTraumaandEmergencyMedicineResearch,GertnerInstituteforEpidemiologyandHealthPolicy Research, Sheba Medical Center, Tel Hashomer 52621, Israel. E-mail address: mayasi@gertner.health.gov.il (M. Siman-Tov). Journal of Transport & Health 11 (2018) 176–182 2214-1405/ © 2018 Elsevier Ltd. All rights reserved. T