The Decibel - A pediatric emergency physician on the risks of e-scooters

Episode Date: September 3, 2026

The popularity of e-scooters on Canadian roads has exploded in recent years. But new data from health officials and the Canadian Paediatric Society shows that the risks of e-scooters can lead to hospitalization and death. Has policy and regulation kept up with how readily available the transportation has become? Dr. Daniel Rosenfield, pediatric emergency physician at SickKids Hospital in Toronto and chair of the Injury Prevention Committee for the Canadian Paediatric Society, joins The Decibel to talk about the trauma cases he’s seen first-hand, why e-scooters can be deadly and how to balance regulation with medical safety. Questions? Comments? Ideas? E-mail us at [e-mail] Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

You've probably seen them around on sidewalks, in bike lanes, and winding through traffic. E- scooters seem to be everywhere, even when they're not allowed to be everywhere. And new data in Canada is highlighting how dangerous they can be, especially for children. I now get texts from my colleagues almost every few days to say another e-scooter crash, or sometimes back-to-back or even three or four moderate to severe injuries in a given shift. And to me, that is a huge change from years past where these were anomalies. That's Dr. Daniel Rosenfield. I'm a pediatric emergency physician at Sick Kids Hospital in Toronto

and the chair of the Injury Prevention Committee for the Canadian Pediatric Society. He says there's been an exponential growth of e-scooter injuries and fatalities, and doctors across the country are concerned. So today, he's here to explain what makes e-scooters especially risky for children, the patchwork of rules and regulations that exist in Canada, and what parents and really everyone should know to stay safe. I'm Cheryl Sutherland, and this is the decibel from the Globe and Mail. Dr. Daniel Rosenfield, thanks so much for joining me today.

Pleasure to be here. So Dr. Rosenfield, I think many of us have seen e-vehicles on the road. I mean, they're very familiar to many people. But let's start with defining what we're talking about. What exactly is an e-scooter? So, I mean, I think it's always fun to have these discussions, and the data is actually really important because up until a couple years ago,

nobody really knew what these devices were. So a lot of us remember the push scooters that became or pedal scooters that became popular, kind of the early 2000s, 2010s. I think the big brand at the time was Razor, and they were these foldable little metal things, had two little wheels, and kids could have a lot of fun on them. And even some older kids would be on them at school, and that would be that. So imagine that with a large electric motor.

So these are devices that have a small platform, a high center gravity, very high handlebars, and motors that can produce significant power, and have significant size batteries to contribute to long distances and long range. Yeah, like how fast are we talking? How fast can they go? Yeah, so the short answer is it depends.

Anywhere between in Ontario and other provinces, the typical legislated max speed is about 24 to 25 kilometers an hour. If you look in the box of most of these devices, they're advertising speeds of 30, 40, 50 kilometers an hour and up. That's so fast. It's incredibly fast. And up the upper tiers, we're talking like 70, 80, 90 kilometers an hour. The other addendum to that is that some of them have programmed speed maxes.

30-40 or hopefully 24 or 25, but you'll go on YouTube, you can find videos of how you can change that. And teenagers being teenagers, that's a task they have. So, you know, the speeds are incredible. And, you know, while they're kind of marketed as toys, we really think of them as motor vehicles

because the speeds you can attain. The other thing I'll add is that not only can you get to high top speed, you get to that top speed really quickly. So I don't know if you've ever driven an electric car. But the big thing in electric cars is their acceleration is tremendous. A Tesla will beat a Ferrari off of the mark every time, because of that instant torque from the electric motor. E-scooter is the exact same.

So you go from zero to 20, 30, 40 kilometers an hour in a matter of seconds, whereas a kid with a pedal scooter or even a traditional pedal bike would need a downhill slope and would need 10 seconds to attain the same speed. Right. And of course, we have to remember they were on this, like I said, a small platform. And it's unstable, right? It's exceedingly unstable. There's two little wheels.

Their centers of gravity make no sense. And the other thing we see is people put passengers on them. Parents put their kids, kids put their siblings. So you take this inherently unstable device with a tiny, platform and add two people to it and it's incredibly unstable. Right. Okay. What makes them so dangerous compared to, say, a bicycle?

Yeah. So we've actually done even comparative studies and those papers will be coming out hopefully in the fall, comparing traditional push scooters to e-scooters, bicycles, to e-bikes. And they're not on the same planet. It's really comparing apples to oranges. The key is what we were talking about is the speed you can attain and the speed at which you could obtain said speed. At the end of the day, trauma in general is just an equation of how much energy the object

has against the object it's hitting. So in most of the cases we're seeing are falls. So you're going 30 kilometers an hour. You have a bunch of energy stored in your body and then you go to zero when you hit the ground. Or you get hit by a car who's going 60 and now you've got all of that combined energy. Bicycling, sure, if you're cycling at 25 or 30, you're going to have the same injury pattern.

But reality is it's much harder, especially for kids and young kids to attain those speeds. So at the end of the day, this is in some ways it's a very simple equation is speed and energy equals tissue damage, and you're able to obtain such a higher speed and so much more energy on these electric devices without even knowing it. This sounds concerning, and of course you are an expert in injury prevention. So one more context question here. How do e-skirters compare to other things that are considered dangerous?

So, you know, I always look back at kind of the history of kind of dangerous toys and pediatrics. So there are some classic examples. There's one out of the 70s and 80s, which is just comical that they exist. existed, there was a toy developed called lawn darts. Lawn darts were a toy that you'd throw in the lawn and you'd hit it into a target, and they had metal spikes on the end. Okay. You can probably envision where this was going, but kids would get these spikes in their head or

their abdomen and would need surgery. And I believe there might have been a fatality or two associated with these. So the obvious answer in that case was we need to get rid of these products, which we did, or make them safer by putting foam on the end. And so the main difference, of course, with e-scooters is that e-scooters have a use. You know, we can't just simply wish our way out of this and say, get rid of all e-s scooters. I don't think that's a reasonable answer to this. And I'm sure we're going to get into that a little bit later.

But, you know, other examples of places and injury, you know, we used to have baby walkers. Baby walkers were a thing where babies and toddlers would learn how to walk by holding these little devices with wheels on them. I was mentioning this to my producers about the baby walkers and all the kids going down the stairs, right? Exactly. So there was a rash of kids falling down the stairs due to these baby walkers. So they were also banned. Again, I think the last one was produced in like 2004. And, you know, another work I was involved with were mini magnet toys in the early 2010s.

So we saw a bunch of kids ingesting these mini magnets and they kind of fuse across the bowel and kids would need surgery and there were a couple of fatalities in the United States. So again, we worked with regulators to get rid of those because they had no other utility. They were just a desk toy. So there's a long storied history in the injury prevention space of identifying these kind of novel threats to kids. But this is a really unique one and I think we'll take a more nuanced conversation because simply get a. getting rid of them I don't think is a feasible solution, nor do I think it's the right one in this case. Okay, so let's get into the numbers. How many kids are getting injured or killed while riding an e-scooter?

So, you know, the data is very incomplete currently. So we're really at the beginning of the discovery phase, I'll say, in the academic world and the literature. The main reason for that, of course, is that these were hard to quantify. People weren't documenting on their charts that it was a scooter or even knowing it was an e-scooter because we didn't know these existed a couple years ago. So even the international classification for diseases is creating new code so that we can actually get a better idea at the highest level of how much this is happening. The follow-up, though, to what we do know, we have small center studies.

So, you know, my center at Sick Kids, I've been able to look at our specific data using the Canadian Hospital Injury Reporting and Prevention Program data, which I'm the medical director for at Sick Kids. And I've been able to look at the numbers for the last kind of five years. They've just been going up exponentially. So, you know, the last three years, I'll give you the numbers. In 2023, we saw 26, 2024, we saw 46, 2025. we saw 107 and this past year 2026, just until August 1st, we've seen 92, which is well on track to

surpass last year's number. These numbers are mimicked across the country with my colleagues I have chatted with from coast to coast to coast. They're all seeing kind of exponential rises in the presentation of these. And we recently completed this Canadian pediatric surveillance program study from 2025, where we pulled the pediatricians across the country for specifically severe injuries and fatalities. Because, you know, as much as I care about kids.

scraping, I really care about how many of them are in intensive care, permanently disabled, or dying. And those numbers, we only have one snapshot in time, but those numbers, I think, are quite sobering. We were able to capture 10 fatalities, and I have to double-check the exact number for ICU admissions, but a solid number for 2025, for kids who shouldn't be there. Yeah, yeah, absolutely. That's concerning to hear that there are 10 fatalities on that. So it is very dangerous, and these are concerning numbers.

And is this all from e-scooters, or are these also e-bikes and other? devices? Great question. So we did look at that last survey study, we did ask about all electric micro-mobility, so we included e-hoverboards and e-unicycles and e-bikes. The vast majority, I think 90% of our cases were e- scooters. The interesting thing, though, is we're going to have to keep a close eye on e-bikes. My colleagues in the United States, who I'm working with on some other projects, have seen massive spikes in e-bike numbers. And, you know, one thing I've learned in the injury space is none of these things stay geographic. They often will spread. So we're keeping an eye out for e-bikes, and I certainly when I walk around the streets of Toronto or visit other cities, I see a lot of them now, too.

And so I do wonder if we're going to see spikes in those as well. But right now I'm really focused on these scooters because that's what we're seeing. Okay. What do these accidents look like? Like, are these mostly collisions on the road? Yeah. So all the data and across our local data, national data, and some recently published studies out of the United Kingdom and Australia have all kind of said the same thing. In the pediatric space, three quarters of injuries are typically falls and just kind of isolated fall. So hit a bump in the road and fell. and about a quarter of them, or slightly less than a quarter, 20 to 22 percent are collisions with other motor vehicles. Okay. And how old are the kids typically ending up in the hospital? Yes. So the vast majority, the archetype of the e-scooter crash is between 10 and 12-year-old boy. So pretty young.

Pretty young. Certainly, you know, you wouldn't want a 10-year-old drama in a car. And, you know, we've been saying that these things should be kind of treated as such. But those are the kids we're seeing on it. There is a little blip in the younger groups, too, like age 3 to 5. are typically children on the back of their parents or their sibling scooter as well. And those obviously are very unfortunate as well because they were just kind of following instructions. So if e-scooter collisions are this severe and getting more common, why are so many kids using them? So it's a really interesting question.

And I won't pretend to say I have a definitive answer. This is the answer that I've aggregated after talking to parents and family members and colleagues and scouring the academic literature. The short answer is availability. So these devices, you know, over the past since they've been created, have come down in price and come up with features as the technology has just improved. I do think there's a likely a social contagion effect going on where, you know, kids, one has one, then the other wants one, and now you've got a gaggle of preteens around the neighborhood. And caregivers thinking this is a cool toy, there's likely a marketing component here. I don't know if you've walked through your

big box retailer lately, but often that Black Friday or other big sale days, these are marketed and sold ridiculously cheap for what they are and really advertised as kind of this fun toy that your kid will love. I've spoken with colleagues who, after they've heard my messaging, said they were going to buy their child or their niece or nephew and e-scooter because they thought it was such a cool toy and then realized they shouldn't. So I'll say, you know, sometimes the messaging is helping. But I think those are kind of part of and parcel of the reasons why these have become more popular. But we're still digging into it. We have to really do a little bit more research as to what's driving the optic. Okay. Cheapish. I looked up the price and I think they're like around

$700, give or take. Oh, you can get much less than that. Oh, really? Yeah. There's so, again, And if you look them up anywhere from, you can go as low as like $200. Okay. Well, that's very accessible then. Yeah. And it's really interesting because we haven't, and where this is an ongoing area of research is to actually who is buying these and who's using them. Because to me, there's an interesting equity discussion here as to which populations of kids

and teens is this uniformly distributed across Toronto or across the country? Or are there certain pockets that are just using them more because of whatever reason? And so we're really trying to look to that as well because that's how we're going to inform kind of, again, targeted interventions if we notice that a certain community or group is using them more for whatever reason, we need to know that. Yeah. We don't have answers to that just yet. We'll be right back.

What do the rules for East Scooters look like across Canada? Oh, where do I start? Patchwork would be generous. They are exceedingly convoluted, complicated, and very Canadian in that sense, actually. You know, we have a federation of 10 provinces in three territories, and the rules are different across each one. What I will say is, I do think most provincial governments where most of this likely falls jurisdictionally have done a pretty good job.

I'm not going to sit here and pretend government's been completely sitting on their hands on this file. But they're very variable. And it's a little hard to keep them all straight. So, firstly, most provinces regulate them at the provincial level. So they do that by creating, you know, age limits. So, for example, in Ontario, you have to be at least 16. British Columbia, the same thing, 16. Quebec has made it 14.

Nova Scotia just passed the law that says 14. There are a couple provinces like Newfoundland doesn't have any law with any rules on the books right now. So you have laws to typically talk about age limits. safety standards of like, you know, you can't jailbreak the device. You have to have one passenger on it. You have to be wearing a helmet if you're under 18. But it's really a patchwork. And the interesting thing is some of these provinces have rules whereby they create the

overarching framework, but the local municipality is the one that has to buy in. So Toronto is a great example of that because officially Toronto has not opted in and they are illegal on public property in all of Toronto. Yes. And you may have seen some of the advertisements from the city saying these are illegal here. But in neighboring Mississauga or in neighboring York region, they have opted into the pilot. So each place is going to, jurisdiction is going to do what it's going to do, but it is a very complicated level of understanding for the average user purchaser and user.

Especially if you know you're going from, take the GTA as an example, like from Toronto to Mississauga, which is just like 40 minutes away, that rules change, right? And yeah, so it's illegal in Toronto, but not illegal in Mississauga technically. And we're seeing this play out across the country. So in Alberta, they have the same kind of opt-in model for different pilot programs. I think BC has the same kind of opt-in for pilots. But I think what's interesting what we're seeing in these numbers is we've, I think we've moved beyond pilots at this stage in terms of just how they've kind of exploded in overall use. Are we seeing higher rates of injury in places where e-scoaters are permitted and more readily available? Like, for example,

in Toronto, are we seeing less injuries because they're not legal? So I can't answer that definitively. I will tell you my hunch, my strong, strong hunch is that the laws don't matter in terms of predicting injury because we're absolutely seeing. seeing a ton of injuries that happen in Toronto, despite it being illegal in Toronto, but legal elsewhere. What I will say is what's interesting is primarily people are injuring themselves on private devices. So there are publicly available kind of scooter share programs in different municipalities and absolutely people are crashing on them. But the private scooter share programs are much more incentivized to follow the provincial rules. And it's much harder. You're not going

to typically bring home a shared scooter to jail break it to max out its top speed. So the injuries in those contexts actually typically happen more in adults, mostly because kids can't get them. So they do have, you know, most of them require apps and credit cards, and most 10-year-olds don't have an app or a credit card. And so in some ways, for kids at least, the sharing devices are actually safer because they're harder to access. And so it's hard to say if what we're seeing across all the jurisdictions is going to be kind of consistent throughout or if we're just going to see more kids who are injured where it is legal or not. I think the answer will be no to that. I think it like as we've seen to date, nobody really knows the rules, nobody follows them,

and it's kind of a free for all. That's really interesting. It's kind of counterintuitive to think that, you know, these shared scooters, if they exist in whatever jurisdiction, that those are safer than these private scooters because you can kind of fiddle with them, I guess. Yeah, I think that's the short version. Again, I don't have, the data is really hard to come by on that. And they have their own, I'm not going to sit there and pretend they don't have their own issues. I know people, you know, leave them in the middle of the road and they have, they have their own issues with people with disabilities who, trip on them in the middle of sidewalk. There's a huge, there are huge problems there too, but strictly from the device perspective and how they're, you know, maintained in standards that

they hold, they are likely better than some of the private ones that we've seen. You talked about how people don't pay attention to the rules. So I'm wondering, is, is this partly an enforcement issue? So, you know, it's a really great question. And whenever I get asked about the enforcement, the first thing is I will defer to this, again, not my area of expertise, but I have spoken with numerous law enforcement agencies. And the first thing they'll tell you is, you know, what are we going to go ticket a bunch of 10-year-olds. Like, there's a practical reality in terms of enforcement, like in the classic sense of the word enforcement that's just not remotely pragmatic when we're dealing with kids and teens.

The last thing we want to do is create an antagonistic relationship with kids, teens, and law enforcement. I think that is a hugely problematic. I do think educational blitzes are always a good idea. But, you know, in the injury prevention world, we talk about the three E's, like the letter E, in education, enforcement and engineering. Education, which is an enforcement, are much less effective at fixing the problem than engineering. But certainly, enforcement is a part of the strategy, but is not going to be the solution.

A lot of this also comes down to marketing and availability, right? So what role, if any, should private companies play in addressing this issue? So in areas where these are going to be legal and ride sharing programs or scooter sharing programs exist, they need to follow the provincial rules as they've been laid out and maintain a safe. product that follows the rules. I think, you know, if we have data suggesting otherwise, then that needs to be addressed. But I think if they are following those rules and regulations, then I think that's the best that we can hope for. So some people listening may already have one of these or their kids do. So what do you recommend for people to ride safer?

So the first thing is following the rules as they are currently laid out provincially, which is that if you're under 16, you should not be on one period. So I appreciate that, you know, if you're listening and you have one at you didn't realize this, I think that's often actually, to be fair, what we often learn in the emergency department is that a parent or caregiver just have no idea how dangerous these could be. That is the, again, we don't typically ask them in real time, like what's going on here. But afterwards, after they've been admitted or stabilized or, you know, are in rehabilitation, sometimes these questions come up. And it repeatedly, the answer is, I just didn't know. So in this context, I would say, now that you know, either get rid of the device

or lock it up until the child is old enough. The other thing I always tell, this is an aside, but kids don't know the rules of the road. They're not intuitive. People forget that one of the reasons 16 has been chosen is because that's when you can get your driver's license. And as much as you want to talk about the value of driver's licenses, you have to pass a test to learn what lights mean

and where you can go in the lane. Different signs. And 10-year-olds don't have that natural knowledge because it's not natural. We all learned it at some point. And so that's a huge element of this as well. So I would certainly not encourage or have anyone be using these scooters if they're under 16 or understand the rules of the road, etc. That being said, I'm a realist.

I know this podcast is unfortunately not going to make the big difference to get them all off. If they are going to use them, the one thing you can add the easiest thing to do is wear a helmet. Head injuries are by far the most devastating injury we see. You can have massive trauma on the rest of you and have very complex fractures requiring surgery, etc. But the head injury is the one you won't come back from. You might be completely neurologically devastated. You might need to be in a rehabilitation hospital for months, and you may never be the same.

And the vast majority, almost 90% of the data that we see, says the boys, again, mostly boys, are not wearing helmets. People ask, well, what type of helmet? I say the one they will wear, because right now something is better than nothing. I think we'll do more research and we'll figure out maybe it should be a motorcycle helmet. But honestly, I'm not going to, beggars, can't be choosers,

bicycle, hockey, polo, motorcycle. I don't care what the helmet is as long as you wear and it's not wrapped around the handlebars, that's what I'm going for. Protect your head, wear a helmet. Absolutely. A few other tips and tricks, don't have any passengers. As we've seen, the second you throw on another kid or a smaller child, your balancing is totally off.

Don't jailbreak your devices because not only does that make them more unsafe, but it also predisposes them to battery fires, which have become a big issue of late. Don't use them while altered on any substances, alcohol, marijuana, or anything else like that. And those are going to be your best chances of riding safely. And, of course, ride only in designated areas, bike lanes or, you know, low, speed roads. I think where there was an Instagram video going around the other day, but someone on a 401 on a scooter. It wasn't a kid. But obviously, yes. Don't go on the highway. Don't go on the highway. Okay. Dr. Rosenfield, thank you so much for coming in. I really appreciate it. Thank you.

That was Dr. Daniel Rosenfield, a pediatric emergency physician at Sick Kids Hospital in Toronto and the chair of the Injury Prevention Committee for the Canadian Pediatric Society. That's all for today. I'm Cheryl Sutherland. Ali Graham produced this episode. Our producers are Madeline White, Rachel Levy McGoughlin, and Mahal Stein. Our editor is David Crosby. Adrian Chung is our senior producer, and Angela Pichenza is our executive editor. Thanks so much for listening.