OA2088. Long-term head injury consequences and protection for cyclists and e-scooter riders

Abstract Background Addressing serious injuries with long-term consequences (LTCs) remains a key challenge for achieving Vision Zero. Cyclists and e-scooter riders represent a large share of road users involved in major injury accidents. In the context of EU-funded project ProtAct-Us data analysis shows that head and brain injuries (HBI) account for around 40% of all LTC-related outcomes among these groups, making them the most critical injuries. Methods This study assesses HBI risk for cyclists and e-scooter users through multibody accident reconstructions and finite element (FE) simulations to propose LTC-reducing countermeasures. The most common accident scenarios were identified using MHH Accident Research Unit and REHABIL-AID data, covering both single-vehicle and vehicle collisions. Multibody simulations recreated these scenarios to extract head kinematics before impact. These were then used in a predictive FE head model to assess HBI risk. Helmet effectiveness, with and without anti-rotational technology, was also evaluated under the same conditions. Results In total, 42 simulations were run to capture pre-impact head conditions. FE results revealed a high risk of skull fractures and brain injuries — over 90% — when no helmet was used. However, wearing a helmet significantly reduced the injury risk in all cases, regardless of anti-rotational features. This confirms the strong protective value of helmets in reducing LTC-related head trauma. Conclusions The study emphasizes the high risk of serious head injuries for unprotected cyclists and e-scooter users, including skull fractures and neurological damage. These findings offer insights for public authorities and aim to raise awareness among users about helmet use. They support discussions on mandatory helmet laws and the development of improved helmet designs and safety standards for modern urban mobility. Key messages • Risk of LTCs associated with skull fracture and neurological injuries for unprotected cyclists and e-scooter riders involved in accidents is high. • Wearing a helmet, whether it includes anti-rotational technology or not, significantly reduces the risk of head/brain injury in all accident scenarios. Topic Bicycle and e-scooter accidents, long-term head Injury consequences, head protective systems.