San Diego County routinely issues public health advisories to warn local doctors of emerging threats, but Thursday was the first time in recent memory that a mode of transportation made the list.
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The county health department issued a formal warning physicians of the dangers related to e-bikes, noting that injuries related to these increasingly popular electric-powered rides have recently been on the rise. It is a message that Rady Children’s Health, which operates the region’s only children’s hospital, has been warning about for several years now, providing data in March that document a rapid rise in traumatic injuries among young riders.
To date, explained Dr. Sayone Thihalolipavan, San Diego County’s public health officer, information on e-bike injuries has been fragmented. A health care tracking code for e-bike injuries appeared in 2023, and 2024 was the first full year in which this label was in widespread use. Given that it takes the state about 14 months to collate and error-check reports from hospitals across California, comprehensive county-by-county e-bike injury counts were only recently published.
Data show that there were 865 e-bike-related emergency department visits and 186 hospitalizations across San Diego County in 2024. While a single year of information is not enough to show a trend, the county’s emergency medical system has tracked e-bike codes at local trauma hospitals.
While it’s not as comprehensive as countywide data, as only half of the region’s 12 acute-care hospitals are trauma centers, monitoring shows a striking increase in the most severe e-bike injuries.
Traumatic e-bike-related injuries, according to county tracking, have risen from 191 in 2023 to a preliminary count of 377 in 2025.
While e-bike trauma is on the rise, motor vehicle mayhem remains much more common. According to the county’s trauma dashboard, local hospitals handled 1,633 motor vehicle injuries in 2024. Falls were the main cause of traumatic injury, with more than 5,700 incidents in 2024.
This trend, taken together with the first year of countywide reporting, and the fact that May is National Bike Safety Awareness Month, prompted Thursday’s warning to doctors. Thihalolipavan said it is important to make sure that all local physicians understand that not all e-bikes are alike.
“Especially for the docs who are working with the younger population, we want to make sure there is some education on what e-bikes are, how they are different and what you should be advising from an injury prevention perspective,” Thihalolipavan said.
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E-bikes, the advisory notes, break down into three broad classes, with the most-advanced models including handlebar-mounted throttles that allow riders to accelerate without pedaling. Those with motors of a certain size are legally classified as mopeds or motorcycles and cannot legally be ridden by anyone younger than age 16.
Kids ages 9 through 12, the advisory notes, should not operate any e-bike faster than 10 mph.
And, the general edict that all e-bike riders should wear a helmet also comes with a speed-based proviso.
“It’s not just wearing a regular bike helmet,” Thihalolipavan said. “You need a special type of helmet that’s rated for that speed.
“It’s things like that that we want to make sure doctors are equipped to handle, knowing that this has not generally been a topic that has been discussed in the medical community.”
San Diego County Supervisor and board chair Terra Lawson-Remer cited Thursday’s e-bike public health advisory as proof that more must be done to combat increasing injury rates. She promoted a series of upcoming three-hour e-bike safety classes at YMCA branches in her district.
“We can keep e-bikes as a fun, healthy way to get around — but only if we treat safety like it matters,” Lawson-Remer said in a statement.
As has previously been observed, more affluent coastal communities, likely because they have a greater ability to buy e-bikes, have seen the highest rates of injury. According to the county’s research, 246 of the 865 e-bike emergency visits in 2024 were in coastal North County. Fifty-six of those visits were for children younger than age 12. Seven kids in that youngest age bracket were seriously injured enough to require a hospital stay.
