The safety of electrically assisted bicycles compared to classic bicycles

•Use of electrically assisted bicycles is rapidly increasing.•Use of electric bicycles is associated with an increased risk to be treated at an emergency department due to a crash.•Crashes with electric bicycles are about equally severe as crashes with classic bicycles. Use of electrically assisted bicycles with a maximum speed of 25km/h is rapidly increasing. This growth has been particularly rapid in the Netherlands, yet very little research has been conducted to assess the road safety implications. This case–control study compares the likelihood of crashes for which treatment at an emergency department is needed and injury consequences for electric bicycles to classic bicycles in the Netherlands among users of 16 years and older. Data were gathered through a survey of victims treated at emergency departments. Additionally, a survey of cyclists without any known crash experience, drawn from a panel of the Dutch population acted as a control sample. Logistic regression analysis is used to compare the risk of crashes with electric and classical bicycles requiring treatment at an emergency department. Among the victims treated at an emergency department we compared those being hospitalized to those being send home after the treatment at the emergency department to compare the injury consequences between electric and classical bicycle victims. The results suggest that, after controlling for age, gender and amount of bicycle use, electric bicycle users are more likely to be involved in a crash that requires treatment at an emergency department due to a crash. Crashes with electric bicycles are about equally severe as crashes with classic bicycles. We advise further research to develop policies to minimize the risk and maximize the health benefits for users of electric bicycles.