• Definitions of e-bikes vary across countries, complicating comparisons. • Most studies from China, U.S., Israel; publications surged after 2014. • E-bike riders face higher injury severity and hospitalization than bicycles. • E-bike riders sustain more head, face, neck injuries and TBIs than bicyclists. • Mixed findings on safety comparisons between e-bikes and e-scooters. The increasing popularity of e-bikes has prompted global concerns about their safety. This literature review synthesizes English-language literature on e-bike safety, focusing on publication trends, data sources, major themes, and comparisons with human-powered bicycles and e-scooters. In total, 197 studies published between 2009 and June 2024 were reviewed. Research activity has expanded rapidly in recent years, with China and the United States emerging as the leading countries. Most studies examined rider demographics, crash involvement, rider behaviors, and comparisons with other traffic modes. The most common data sources were medical records, surveys, and naturalistic designs. Among studies comparing e-bike safety with bicycles or e-scooters, consistent patterns emerged. E-bike crashes occurred far less frequently than bicycle crashes (often by a magnitude of 10 or more), but when medical attention was required, e-bike riders more often sustained severe injuries. Comparisons between e-bikes and e-scooters were less clear-cut, with mixed findings on both crash incidence and injury severity. The findings of this review highlight implications for engineering, enforcement, and education. The distinct injury patterns and higher operating speeds associated with e-bikes point to opportunities for engineering improvements, including clearer lane design and safer shared infrastructure for e-bikes. Faster and higher-powered models also introduce enforcement challenges related to speed compliance, lane access, and rider eligibility, underscoring the need for clear and consistent regulations. Finally, targeted education may help address unsafe behavior and support safe integration of e-bikes into multimodal transportation systems.
Ghanbari et al. (Sun,) studied this question.