scootin’ around safety: the rise of electric scooters and the data … · 2020. 4. 24. ·...

Scootinrsquo Around Safety The Rise of Electric Scooters and the Data Behind Them

D AV I D Z A N E M S I N J U R Y E P I D E M I O LO G I S T F O R AU S T I N P U B L I C H E A LT H AU S T I N T E X A S

A N D

K E V I N R I X M P H I N J U R Y P R E V E N T I O N C O O R D I N ATO R F O R D E L L S E TO N M E D I C A L C E N T E R AT T H E U N I V E R S I T Y O F T E X A S

M A R C H 1 2 2 0 2 0

Visionto be the recognized leader and driving force

in understanding and preventing injuries and

violence

Mission to strengthen the practice of injury and

violence prevention

wwwsafestatesorg

Emerging Transportation Modalities

Credit Emerging Mobility Injury Monitoring in San Francisco CA Utilizing Hospital Trauma Records 12019

Click to edit footer style

4

E-Scootersbull Stand up

bull Rented

bull Speeds ~15 mph

bull Electric Power

bull Dockless

DOCKLESS ELECTRIC SCOOTER-RELATED INJURIES STUDY

Austin TexasS E P T E M B E R - N O V E M B E R 2 0 1 8

E P I D E M I O L O G Y A N D D I S E A S E S U R V E I L L A N C E U N I T E P I D E M I O L O G Y A N D P U B L I C H E A L T H P R E P A R E D N E S S D I V I S I O N

A U S T I N P U B L I C H E A L T H

Emerging Issue = E-Scooters

bull Arrived in Austin on April 5 2018

bull Local hospitals and EMS noticed injuries

bull Types of injuries Risk Factors


6

Methodology

bull Place City of Austin Texas

bull Timeframe September 5 ndash November 30 2018

bull Persons sustained injury related to e-scooter amp identified through

keyword searches

bull Austin-Travis County Emergency Medical Services

bull Hospital Emergency Department chief complaints from syndromic surveillance

Data Collection

bull Patient interviews through telephone questionnaire

bull Demographic

bull Clinical

bull User-specific

bull Environmental

bull Supplemented with

bull EMS call reports

bull Medical charts when available

bull Publicly available Fleet Data (Austin Transportation Department)

Data Sources Flow ChartEMS

198

165

93 70 108

33 screened out (medical mobility etc)

Syndromic (ED)

185

Since some patients appeared in both EMS and ED data sets or had multiple visits incidents were de-duplicated

EMS Only Both EMS and ED ED Only

271 patients injured potentially on e-scooters

Outreach Methods and Results

155

24588116

28

271

600+ calls

~200 letters mailed

69 text messages sent

130 Lexus Nexus Searches

contact rate 63

had contact information

271 injured persons

160 rented dockless electric scooter

associated injuries

32 electric scooter associated injuries

192 injured persons

190 riders 125 interviewed

65 medical chartsATCEMS reports reviewed

2 non-riders

1 person interviewed

1 medical chart reviewed

46 scooter associated injuries

32 not included in study

1 unknown

Outcomes of Classifying Persons

Epi-Curve for the 190 Confirmed amp Probable Riders

Injury Rate

From September 5 ndash November 30 2018bull 936110 e-scooter trips

bull 190 injured ridersbull Transported to hospital via EMS or reporting to a hospital ED

Approximately 20 persons injured per 100000 e-scooter trips

Letrsquos get to know the injured ridershellip

bull Over half (55) were males

bull Ranged in age from 9 to 79 years

bull Nearly half (48) were 18 to 29 years of age

bull Most (60) resided in Austin

bull Most (60) received training via scooter companiesrsquo phone application

bull Only one rider (lt1) was wearing a helmet

Scooter Rides Before Injury

0

5

10

15

20

25

30

35

0 rides (first time riders) 1-9 rides 10-29 rides ge30 rides

Perc

ent

of

Inte

rvie

wed

Rid

ers

Number of Rides Before Injury

33 - First time e-scooter rider

How serious were the injuries

bull 14 of injured riders were hospitalized

bull 42 of the 190 riders had a serious injurybull National Transportation Safety Boardrsquos definition includes a minimum of

bull fracture (excluding nasal finger toe)

bull nerve tendon or ligament injuries

bull 48+ hours in hospital

bull severe bleeding

bull andor organ damage

bull 7 sustained a traumatic brain injury

bull No deaths

Injury Body Locations

bull Head ndash 48

bull Face ndash 40

bull Upper Limbs ndash 70

bull Chestabdomen ndash 18

bull Lower limbs ndash 55

Bone Fracture Locations

78 persons (41) sustained at least one fracture

Geographic Characteristics

bull Downtown Austin ndash 31

bull University of Texas at Austin campus ndash 16

bull Injured while riding scooter

bull On street ndash 55

bull On sidewalk ndash 33

Map of Downtown AustinE-Scooter Injury Locations Based on Case Definitions

When were riders injured

0

5

10

15

20

25

30

35

40

45

Sunday Monday Tuesday Wednesday Thursday Friday Saturday

Nu

mb

er o

f In

jure

d R

ider

s

Day of the Week

bull About 2 injuries per day

bull Saturday or Sunday ndash 39

bull 600pm - 600am ndash 39

Higher injury rates observed starting at

9pm ndash 11pm

Circumstances of incidents

bull Motor vehicle ndash 16

bull Curb ndash 10

bull Inanimate object ndash 7

bull Collided with a motor vehicle ndash 10

Additional Information

bull Possible scooter malfunction ndash 19

bull Drinking alcohol beverages within 12 hours preceding injury ndash 29

bull Excessive speed ndash 37

bull Believed surface conditions contributed to the incident ndash 50

24

Acknowledgements

bull Austin-Travis County EMS

bull 9 area hospitals

bull Austin Transportation Department

bull Texas Department of State Health Services

bull Injured individuals that we interviewed

Acknowledging the Team

Austin Public Health Centers for Disease Control and Prevention

Jeff Taylor Laurel Harduar Morano

David Zane Talia Pindyck

Alice Tisdale Sara Blythe Ballard

Jessica Stradford Anjoli Anand

Ashley Hawes Alexis Peterson

Flor Hernandez-Ayala Erin Sauber-Schatz

Marissa Paz

Rachel Holder

So you just heard about the Austin Public Health Projectbull RECOMMENDATION

Why is it important to have consistent data with new technology

1 Patient Identification

2 Correct assignment of injury mechanisms

3 Consistency with language and verbiage

4 Epidemiological Research

5 Injury Pattern and Severity Research

6 Consistency across trauma registries and registrars

7 Injury Prevention Interventions

Dell Seton Medical Center-Austin TX Adult Level 1 Trauma Center(May 2018-January 2019)

22

19

11

23

34

Head

Face

Thoracic

Abdominal

Upper

Extremity

N=65

Admissions

1st Reported Death in

Austin February 2 2019

Similar mobility death

February 6 2019

ICD-10 CM Has the answers Or Does it

bullTypically the ICD-10CM codes are a hospitals best friend for datahellip Right

bullBut what happens when the thing want to code didnrsquot exist when the codes were created

How do we know we are telling the same story

bull 22 Trauma Service Areas in Texas

bull GETAC Injury Prevention and Public Education Committee allows launched state wide survey through Regional Advisory Councils (RACs)

bull RACs are composed of both hospital and pre-hospital community organizations

Who Responded (N=85)

Pre-

Hospital

46Hospital

53

Other

1

If you were interested are you currently able to abstract from a local database information on the patients your organization has cared for who have been injured in a scooter crash (in percent)

0

10

20

30

40

50

60

Yes No

Remember our first step to look at our data

When a person presents to your hospital as a result of a motorized dockless scooter related injury what ICD-10 code are you using to capture the injury

V0018

2 V0083

5V0089

5

I do not know

78

Other

10

Given this information What did we do

So what did we decided on

Accident on other rolling-type pedestrian conveyance

Falling from other rolling-type pedestrian conveyance

Pedestrian on other rolling-type pedestrian conveyance colliding

with stationary object

Other accident on other rolling-type pedestrian conveyance

Is this the right code

For Us

For You Probably But

Maybe No

Recommendations1 Make sure everyone is on the same page knowing what we are

talking about

2 Decide with other stakeholders on one coding system universally in your area

3 Ensure that this is taken to decision makers and people who can push the information out

4 Follow up to ensure

5 Support current national efforts for the adoption and implementation of new ICD-10-CM codes for these devices

Since this timebull ICD-10 CM codes for Dockless E-Scooters have been

presentedpromoted for the launch of the October 2020 ICD-10CM code update

httpswwwcdcgovnchsdataicdTopic-packet-Sept-2019-Part2pdf (pages 15-25)

Our work together

bullSince we actually work in the same city only made sense for us to continue our work together on this topic

So where did webull Unfortunately we cannot share a lot of information due to some

publications in the works But things we consider and things you may want to consider

How do scooter injuries compare with other types of transportation

Whatrsquos the new innovations coming to where you live and how will you keep track of injury risks

Questionsbull Thank you all very much

Contact Information

davidzaneaustintexasgov

KRixascensionorg

Visionto be the recognized leader and driving force

in understanding and preventing injuries and

violence

Mission to strengthen the practice of injury and

violence prevention

wwwsafestatesorg




4


bull Rented

bull Speeds ~15 mph

bull Electric Power

bull Dockless










6

Methodology




keyword searches



Data Collection


bull Demographic

bull Clinical

bull User-specific

bull Environmental






198

165

93 70 108


Syndromic (ED)

185





155

24588116

28

271

600+ calls

~200 letters mailed



contact rate 63


271 injured persons


associated injuries


192 injured persons



2 non-riders





1 unknown



Injury Rate












0

5

10

15

20

25

30

35


Perc

ent

of

Inte

rvie

wed

Rid

ers












bull No deaths


bull Head ndash 48

bull Face ndash 40














0

5

10

15

20

25

30

35

40

45


Nu

mb

er o

f In

jure

d R

ider

s

Day of the Week





9pm ndash 11pm



bull Curb ndash 10








24

Acknowledgements














Marissa Paz

Rachel Holder











22

19

11

23

34

Head

Face

Thoracic

Abdominal

Upper

Extremity

N=65

Admissions




February 6 2019









Pre-

Hospital

46Hospital

53

Other

1


0

10

20

30

40

50

60

Yes No



V0018

2 V0083

5V0089

5

I do not know

78

Other

10









For Us


Maybe No


talking about








Our work together







Contact Information


KRixascensionorg




4


bull Rented

bull Speeds ~15 mph

bull Electric Power

bull Dockless










6

Methodology




keyword searches



Data Collection


bull Demographic

bull Clinical

bull User-specific

bull Environmental






198

165

93 70 108


Syndromic (ED)

185





155

24588116

28

271

600+ calls

~200 letters mailed



contact rate 63


271 injured persons


associated injuries


192 injured persons



2 non-riders





1 unknown



Injury Rate












0

5

10

15

20

25

30

35


Perc

ent

of

Inte

rvie

wed

Rid

ers












bull No deaths


bull Head ndash 48

bull Face ndash 40














0

5

10

15

20

25

30

35

40

45


Nu

mb

er o

f In

jure

d R

ider

s

Day of the Week





9pm ndash 11pm



bull Curb ndash 10








24

Acknowledgements














Marissa Paz

Rachel Holder











22

19

11

23

34

Head

Face

Thoracic

Abdominal

Upper

Extremity

N=65

Admissions




February 6 2019









Pre-

Hospital

46Hospital

53

Other

1


0

10

20

30

40

50

60

Yes No



V0018

2 V0083

5V0089

5

I do not know

78

Other

10









For Us


Maybe No


talking about








Our work together







Contact Information


KRixascensionorg










6

Methodology




keyword searches



Data Collection


bull Demographic

bull Clinical

bull User-specific

bull Environmental






198

165

93 70 108


Syndromic (ED)

185





155

24588116

28

271

600+ calls

~200 letters mailed



contact rate 63


271 injured persons


associated injuries


192 injured persons



2 non-riders





1 unknown



Injury Rate












0

5

10

15

20

25

30

35


Perc

ent

of

Inte

rvie

wed

Rid

ers












bull No deaths


bull Head ndash 48

bull Face ndash 40














0

5

10

15

20

25

30

35

40

45


Nu

mb

er o

f In

jure

d R

ider

s

Day of the Week





9pm ndash 11pm



bull Curb ndash 10








24

Acknowledgements














Marissa Paz

Rachel Holder











22

19

11

23

34

Head

Face

Thoracic

Abdominal

Upper

Extremity

N=65

Admissions




February 6 2019









Pre-

Hospital

46Hospital

53

Other

1


0

10

20

30

40

50

60

Yes No



V0018

2 V0083

5V0089

5

I do not know

78

Other

10









For Us


Maybe No


talking about








Our work together







Contact Information


KRixascensionorg

Methodology




keyword searches



Data Collection


bull Demographic

bull Clinical

bull User-specific

bull Environmental






198

165

93 70 108


Syndromic (ED)

185





155

24588116

28

271

600+ calls

~200 letters mailed



contact rate 63


271 injured persons


associated injuries


192 injured persons



2 non-riders





1 unknown



Injury Rate












0

5

10

15

20

25

30

35


Perc

ent

of

Inte

rvie

wed

Rid

ers












bull No deaths


bull Head ndash 48

bull Face ndash 40














0

5

10

15

20

25

30

35

40

45


Nu

mb

er o

f In

jure

d R

ider

s

Day of the Week





9pm ndash 11pm



bull Curb ndash 10








24

Acknowledgements














Marissa Paz

Rachel Holder











22

19

11

23

34

Head

Face

Thoracic

Abdominal

Upper

Extremity

N=65

Admissions




February 6 2019









Pre-

Hospital

46Hospital

53

Other

1


0

10

20

30

40

50

60

Yes No



V0018

2 V0083

5V0089

5

I do not know

78

Other

10









For Us


Maybe No


talking about








Our work together







Contact Information


KRixascensionorg

Data Collection


bull Demographic

bull Clinical

bull User-specific

bull Environmental






198

165

93 70 108


Syndromic (ED)

185





155

24588116

28

271

600+ calls

~200 letters mailed



contact rate 63


271 injured persons


associated injuries


192 injured persons



2 non-riders





1 unknown



Injury Rate












0

5

10

15

20

25

30

35


Perc

ent

of

Inte

rvie

wed

Rid

ers












bull No deaths


bull Head ndash 48

bull Face ndash 40














0

5

10

15

20

25

30

35

40

45


Nu

mb

er o

f In

jure

d R

ider

s

Day of the Week





9pm ndash 11pm



bull Curb ndash 10








24

Acknowledgements














Marissa Paz

Rachel Holder











22

19

11

23

34

Head

Face

Thoracic

Abdominal

Upper

Extremity

N=65

Admissions




February 6 2019









Pre-

Hospital

46Hospital

53

Other

1


0

10

20

30

40

50

60

Yes No



V0018

2 V0083

5V0089

5

I do not know

78

Other

10









For Us


Maybe No


talking about








Our work together







Contact Information


KRixascensionorg


198

165

93 70 108


Syndromic (ED)

185





155

24588116

28

271

600+ calls

~200 letters mailed



contact rate 63


271 injured persons


associated injuries


192 injured persons



2 non-riders





1 unknown



Injury Rate












0

5

10

15

20

25

30

35


Perc

ent

of

Inte

rvie

wed

Rid

ers












bull No deaths


bull Head ndash 48

bull Face ndash 40














0

5

10

15

20

25

30

35

40

45


Nu

mb

er o

f In

jure

d R

ider

s

Day of the Week





9pm ndash 11pm



bull Curb ndash 10








24

Acknowledgements














Marissa Paz

Rachel Holder











22

19

11

23

34

Head

Face

Thoracic

Abdominal

Upper

Extremity

N=65

Admissions




February 6 2019









Pre-

Hospital

46Hospital

53

Other

1


0

10

20

30

40

50

60

Yes No



V0018

2 V0083

5V0089

5

I do not know

78

Other

10









For Us


Maybe No


talking about








Our work together







Contact Information


KRixascensionorg


155

24588116

28

271

600+ calls

~200 letters mailed



contact rate 63


271 injured persons


associated injuries


192 injured persons



2 non-riders





1 unknown



Injury Rate












0

5

10

15

20

25

30

35


Perc

ent

of

Inte

rvie

wed

Rid

ers












bull No deaths


bull Head ndash 48

bull Face ndash 40














0

5

10

15

20

25

30

35

40

45


Nu

mb

er o

f In

jure

d R

ider

s

Day of the Week





9pm ndash 11pm



bull Curb ndash 10








24

Acknowledgements














Marissa Paz

Rachel Holder











22

19

11

23

34

Head

Face

Thoracic

Abdominal

Upper

Extremity

N=65

Admissions




February 6 2019









Pre-

Hospital

46Hospital

53

Other

1


0

10

20

30

40

50

60

Yes No



V0018

2 V0083

5V0089

5

I do not know

78

Other

10









For Us


Maybe No


talking about








Our work together







Contact Information


KRixascensionorg

271 injured persons


associated injuries


192 injured persons



2 non-riders





1 unknown



Injury Rate












0

5

10

15

20

25

30

35


Perc

ent

of

Inte

rvie

wed

Rid

ers












bull No deaths


bull Head ndash 48

bull Face ndash 40














0

5

10

15

20

25

30

35

40

45


Nu

mb

er o

f In

jure

d R

ider

s

Day of the Week





9pm ndash 11pm



bull Curb ndash 10








24

Acknowledgements














Marissa Paz

Rachel Holder











22

19

11

23

34

Head

Face

Thoracic

Abdominal

Upper

Extremity

N=65

Admissions




February 6 2019









Pre-

Hospital

46Hospital

53

Other

1


0

10

20

30

40

50

60

Yes No



V0018

2 V0083

5V0089

5

I do not know

78

Other

10









For Us


Maybe No


talking about








Our work together







Contact Information


KRixascensionorg


Injury Rate












0

5

10

15

20

25

30

35


Perc

ent

of

Inte

rvie

wed

Rid

ers












bull No deaths


bull Head ndash 48

bull Face ndash 40














0

5

10

15

20

25

30

35

40

45


Nu

mb

er o

f In

jure

d R

ider

s

Day of the Week





9pm ndash 11pm



bull Curb ndash 10








24

Acknowledgements














Marissa Paz

Rachel Holder











22

19

11

23

34

Head

Face

Thoracic

Abdominal

Upper

Extremity

N=65

Admissions




February 6 2019









Pre-

Hospital

46Hospital

53

Other

1


0

10

20

30

40

50

60

Yes No



V0018

2 V0083

5V0089

5

I do not know

78

Other

10









For Us


Maybe No


talking about








Our work together







Contact Information


KRixascensionorg









0

5

10

15

20

25

30

35


Perc

ent

of

Inte

rvie

wed

Rid

ers












bull No deaths


bull Head ndash 48

bull Face ndash 40














0

5

10

15

20

25

30

35

40

45


Nu

mb

er o

f In

jure

d R

ider

s

Day of the Week





9pm ndash 11pm



bull Curb ndash 10








24

Acknowledgements














Marissa Paz

Rachel Holder











22

19

11

23

34

Head

Face

Thoracic

Abdominal

Upper

Extremity

N=65

Admissions




February 6 2019









Pre-

Hospital

46Hospital

53

Other

1


0

10

20

30

40

50

60

Yes No



V0018

2 V0083

5V0089

5

I do not know

78

Other

10









For Us


Maybe No


talking about








Our work together







Contact Information


KRixascensionorg










bull No deaths


bull Head ndash 48

bull Face ndash 40














0

5

10

15

20

25

30

35

40

45


Nu

mb

er o

f In

jure

d R

ider

s

Day of the Week





9pm ndash 11pm



bull Curb ndash 10








24

Acknowledgements














Marissa Paz

Rachel Holder











22

19

11

23

34

Head

Face

Thoracic

Abdominal

Upper

Extremity

N=65

Admissions




February 6 2019









Pre-

Hospital

46Hospital

53

Other

1


0

10

20

30

40

50

60

Yes No



V0018

2 V0083

5V0089

5

I do not know

78

Other

10









For Us


Maybe No


talking about








Our work together







Contact Information


KRixascensionorg


bull Head ndash 48

bull Face ndash 40














0

5

10

15

20

25

30

35

40

45


Nu

mb

er o

f In

jure

d R

ider

s

Day of the Week





9pm ndash 11pm



bull Curb ndash 10








24

Acknowledgements














Marissa Paz

Rachel Holder











22

19

11

23

34

Head

Face

Thoracic

Abdominal

Upper

Extremity

N=65

Admissions




February 6 2019









Pre-

Hospital

46Hospital

53

Other

1


0

10

20

30

40

50

60

Yes No



V0018

2 V0083

5V0089

5

I do not know

78

Other

10









For Us


Maybe No


talking about








Our work together







Contact Information


KRixascensionorg











0

5

10

15

20

25

30

35

40

45


Nu

mb

er o

f In

jure

d R

ider

s

Day of the Week





9pm ndash 11pm



bull Curb ndash 10








24

Acknowledgements














Marissa Paz

Rachel Holder











22

19

11

23

34

Head

Face

Thoracic

Abdominal

Upper

Extremity

N=65

Admissions




February 6 2019









Pre-

Hospital

46Hospital

53

Other

1


0

10

20

30

40

50

60

Yes No



V0018

2 V0083

5V0089

5

I do not know

78

Other

10









For Us


Maybe No


talking about








Our work together







Contact Information


KRixascensionorg


9pm ndash 11pm



bull Curb ndash 10








24

Acknowledgements














Marissa Paz

Rachel Holder











22

19

11

23

34

Head

Face

Thoracic

Abdominal

Upper

Extremity

N=65

Admissions




February 6 2019









Pre-

Hospital

46Hospital

53

Other

1


0

10

20

30

40

50

60

Yes No



V0018

2 V0083

5V0089

5

I do not know

78

Other

10









For Us


Maybe No


talking about








Our work together







Contact Information


KRixascensionorg



bull Curb ndash 10








24

Acknowledgements














Marissa Paz

Rachel Holder











22

19

11

23

34

Head

Face

Thoracic

Abdominal

Upper

Extremity

N=65

Admissions




February 6 2019









Pre-

Hospital

46Hospital

53

Other

1


0

10

20

30

40

50

60

Yes No



V0018

2 V0083

5V0089

5

I do not know

78

Other

10









For Us


Maybe No


talking about








Our work together







Contact Information


KRixascensionorg






24

Acknowledgements














Marissa Paz

Rachel Holder











22

19

11

23

34

Head

Face

Thoracic

Abdominal

Upper

Extremity

N=65

Admissions




February 6 2019









Pre-

Hospital

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Our work together







Contact Information


KRixascensionorg

Acknowledgements














Marissa Paz

Rachel Holder











22

19

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February 6 2019









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Marissa Paz

Rachel Holder











22

19

11

23

34

Head

Face

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Abdominal

Upper

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N=65

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February 6 2019









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Contact Information


KRixascensionorg











22

19

11

23

34

Head

Face

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Extremity

N=65

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February 6 2019









Pre-

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53

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0

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Our work together







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KRixascensionorg


talking about








Our work together







Contact Information


KRixascensionorg




Our work together







Contact Information


KRixascensionorg






Contact Information


KRixascensionorg

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