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International Journal of
Environmental Research
and Public Health
Article
Considering the Potential Health Impacts of Electric
Scooters: An Analysis of User Reported Behaviors in
Provo, Utah
Jeffrey Glenn 1, * , Madeline Bluth 1, Mannon Christianson 1, Jaymie Pressley 1, Austin Taylor 2,
Gregory S. Macfarlane 3and Robert A. Chaney 1
1Department of Public Health, College of Life Sciences, Brigham Young University, Provo, UT 84602, USA;
mbluth13@byu.edu (M.B.); mannonlc@byu.edu (M.C.); jpressl3@byu.edu (J.P.); rchaney@byu.edu (R.A.C.)
2Community and Neighborhood Services Department, City of Provo, Provo, UT 84601, USA;
ataylor@provo.org
3
Department of Civil and Environmental Engineering, Ira A. Fulton College of Engineering, Brigham Young
University, Provo, UT 84602, USA; gregmacfarlane@byu.edu
*Correspondence: jeff_glenn@byu.edu; Tel.: +1-801-422-9754
Received: 17 July 2020; Accepted: 24 August 2020; Published: 31 August 2020
Abstract:
Electric scooters (e-scooters) are an increasingly popular form of transportation in urban
areas. While research on this topic has focused primarily on injuries, there are multiple mechanisms
by which e-scooter share programs may impact health. The aim of this study is to explore the
health-related behaviors of e-scooter users and to discuss their implications for public health.
Data were collected using an online survey emailed to registered e-scooter users. A total of 1070 users
completed the survey. Descriptive variable statistics and chi-squared analysis were performed
to determine variable dependent relationships and equality of proportions. The most common
destinations reported were “just riding around for fun”, home, and dining/shopping. The two most
common modes of transportation that would have been used if e-scooters were not available were
walking (43.5%) and using a personal vehicle (28.5%). Riding behavior was equally mixed between
on the street, on the sidewalk, and equal amounts of both. e-Scooters in Provo are likely having
both positive (e.g., air pollution) and negative impacts on health (e.g., injuries, physical inactivity).
Future research should further explore patterns of e-scooter use and explicitly examine the linkages
between e-scooters and areas of health beyond just injuries.
Keywords: electric scooters; urban transport; public health
1. Introduction
There is growing awareness in academic and policy circles of the close linkages between health and
urban transportation practices [
1
]. Stand-up electric scooters (e-scooters), two-wheeled vehicles with a
small electric motor and a thin deck on which a single rider stands, are a relatively new micro-mobility
option for urban areas and have the potential for both positive and negative health impacts [
2
–
4
].
Although research on the health impacts of e-scooters is sparse, the topic merits further exploration
given the rapid increase in e-scooter popularity over the past three years in the United States and
around the world [5–8].
Gaining a better understanding of the true positive and negative health impacts of e-scooters
must start with more fully understanding e-scooter users and patterns of use [
9
]. The potential health
impacts of e-scooters depend on answers to questions related to user behaviors—e.g., substituting
other forms of transit, commuting vs. recreational use, compliance with safety regulations. While some
information exists to help answer these and other key questions, important knowledge gaps remain.
Int. J. Environ. Res. Public Health 2020,17, 6344; doi:10.3390/ijerph17176344 www.mdpi.com/journal/ijerph
Int. J. Environ. Res. Public Health 2020,17, 6344 2 of 15
The aim of this study is to explore the health-related behaviors of e-scooter users in Provo,
Utah four months after an e-scooter share program was introduced. Among the many evidence gaps
that remain, this study focuses on four primary research questions: (1) What motivations do users have
for riding e-scooters?; (2) What are the primary destinations of e-scooter users?; (3) What alternative
travel mode would riders be using if not riding an e-scooter?; (4) To what degree are e-scooter users
aware of and complying with safety regulations? (5) What program or policy changes do e-scooter
users believe would improve Provo’s e-scooter share program? Based on this research, we identify
opportunities for policy change that will facilitate positive health impacts of e-scooter use in Provo and
other cities. We also hope to encourage researchers and policymakers to seek a deeper understanding
of patterns of use in diverse contexts as they consider the broad range of potential health impacts
of e-scooters.
1.1. Background: e-Scooter Share Programs
e-Scooter share programs were first introduced in the United States in Santa Monica, California in
September 2017 and are now present in over 80 cities and 26 states throughout the country [
5
,
10
–
13
].
In 2018, users took 38.5 million trips on shared e-scooters in the United States [
14
]. Two of the largest
e-scooter companies, Bird and Lime, were recently valued at over $2 billion each [
6
,
15
–
17
]. Multiple
other companies, including ride share giants Uber and Lyft, have entered the competitive e-scooter
market, which is predicted to become a $42 billion industry by 2030, although there is some evidence
that the COVID-19 pandemic has contributed to reduced ridership numbers in recent months [
18
–
20
].
While there are variations between programs, in a typical e-scooter share arrangement a private
company enters an agreement with local government officials to place e-scooters on city streets and
make them available to rent for short periods of time [
2
,
21
–
23
]. Potential users download a mobile
phone application that allows them to view the locations of available e-scooters in real time and to
begin, end, and pay for their rides. Users are typically charged a flat fee for the rental plus an additional
fee for each minute the e-scooter is used. Users leave their e-scooters at their final destinations where
the e-scooters then become available to other users. Within municipal share programs, e-scooters
typically have a range between 15 and 20 miles, and speeds are usually capped at 15 miles per hour [
10
].
e-Scooters are appealing for a variety of reasons. For users, e-scooters offer a convenient, affordable,
fun transportation option that serves as an alternative to motor vehicles, biking, and walking [
3
,
11
].
e-Scooters are frequently used for both commuting and recreational purposes [
6
]. For local governments,
e-scooters represent a new form of transportation that can help bridge the “last mile” gap, a common
obstacle for transit use, by connecting people with public transit nodes [
9
,
22
,
24
,
25
]. e-Scooters are
also seen as an environmentally friendly means for reducing traffic congestion in urban areas [
26
,
27
].
Moreover, e-scooter programs may be appealing to local officials because government funds are not
usually required to start or maintain them; rather, e-scooter companies pay fees that allow government
agencies to make infrastructure improvements for e-scooter riders [
14
]. e-Scooters may even be a
contributing factor to economic development because they facilitate easier access to businesses located
in urban centers where parking is scarce and motor vehicle travel is more difficult.
e-Scooters have been warmly welcomed by some municipalities and shunned by others as
state and local governments have struggled to enact appropriate regulations to manage the rapid
expansion of e-scooter share programs [
5
,
21
,
28
–
30
]. Significant variation in e-scooter laws exists
between states and cities—e.g., helmet use, sidewalk riding, hours of operation. [
6
,
10
,
21
,
28
,
31
,
32
].
Since many state legislatures have not specifically addressed e-scooter usage, local governments
have taken on the brunt of regulatory responsibility by attempting to manage e-scooter use with city
ordinances [
21
]. e-Scooters create complicated liability issues in which municipalities may become
liable for e-scooter injuries [10,21,31].
Int. J. Environ. Res. Public Health 2020,17, 6344 3 of 15
1.2. Background: e-Scooters and Health
There is a range of mechanisms through which e-scooters may affect health. In a recent evidence
review, Khreis et al. found multiple linkages between urban transport exposures or practices and
adverse health impacts [
1
]. While the research on e-scooters and health is limited, many of these
linkages have been shown or theorized to apply to e-scooters discussed below. Figure 1highlights
these linkages and illustrates that they are shaped by available transport options and features of the
built environment.
1.2. Background: e-Scooters and Health
There is a range of mechanisms through which e-scooters may affect health. In a recent evidence
review, Khreis et al. found multiple linkages between urban transport exposures or practices and
adverse health impacts [1]. While the research on e-scooters and health is limited, many of these
linkages have been shown or theorized to apply to e-scooters discussed below. Figure 1 highlights
these linkages and illustrates that they are shaped by available transport options and features of the
built environment.
Figure 1. Linkages between e-scooters and health. Adapted from Khreis et al., 2017 [1].
1.2.1. Injuries
A primary public health concern, and the focus of the vast majority of academic research on e-
scooters to date, is e-scooter-related injuries [10]. Several studies in the United States and elsewhere
have found a high incidence of injuries related to scooter usage, particularly head and limb trauma,
after the introduction of e-scooter share programs [5,12,24,28,33–35]. There is even some evidence
that the injury rate for e-scooters may be higher than that of motorcycles and personal vehicles [27,36].
Most injuries are due to falls or collisions with objects (not with motor vehicles) that occur due to
poor road conditions or excessive speeds [5,23,33,35,37]. There have also been reports of burns
resulting from explosions of batteries [35,38]. In the United States at least nine known deaths have
been linked with e-scooter use [10].
Various factors contribute to the prevalence of e-scooter injuries: Incompatible infrastructure
(e.g., lack of bike lanes), lack of directional tools on e-scooters (e.g., turn signals, headlights), rider
inexperience and noncompliance with age restrictions, failure of users to obey traffic rules, alcohol
use, and reluctance to wear helmets [5,7,24,28,33]. Recent studies have found helmet use among
injured e-scooter riders to be extremely low, ranging from 0% and 8% in most studies
[5,6,23,24,28,34,35,39]. Additionally, despite regulations prohibiting them from doing so, e-scooter
users commonly ride and park on sidewalks, which can lead to injuries to users as well as to
pedestrians [40,41]. One study found that 44% of collisions occurred on sidewalks where riding was
prohibited, and others have found that approximately 10% of all e-scooter related injuries involve
pedestrians [5,7,10,23,26,31,33,42]. Vulnerable populations such as the elderly, hearing impaired, and
young children have an increased risk for sidewalk-related injuries [31]. A sizeable proportion of e-
scooter injuries among users involve children under 18, despite most rental company agreements
prohibiting ridership for minors [5]. Many of these hazards relate to cultural norms and limited
regulation that may minimize users’ perception of potential dangers and therefore lead to unsafe
behaviors [28].
Figure 1. Linkages between e-scooters and health. Adapted from Khreis et al., 2017 [1].
1.2.1. Injuries
A primary public health concern, and the focus of the vast majority of academic research on
e-scooters to date, is e-scooter-related injuries [
10
]. Several studies in the United States and elsewhere
have found a high incidence of injuries related to scooter usage, particularly head and limb trauma,
after the introduction of e-scooter share programs [
5
,
12
,
24
,
28
,
33
–
35
]. There is even some evidence that
the injury rate for e-scooters may be higher than that of motorcycles and personal vehicles [
27
,
36
].
Most injuries are due to falls or collisions with objects (not with motor vehicles) that occur due to poor
road conditions or excessive speeds [
5
,
23
,
33
,
35
,
37
]. There have also been reports of burns resulting
from explosions of batteries [
35
,
38
]. In the United States at least nine known deaths have been linked
with e-scooter use [10].
Various factors contribute to the prevalence of e-scooter injuries: Incompatible infrastructure
(e.g., lack of bike lanes), lack of directional tools on e-scooters (e.g., turn signals, headlights),
rider inexperience and noncompliance with age restrictions, failure of users to obey traffic rules, alcohol
use, and reluctance to wear helmets [
5
,
7
,
24
,
28
,
33
]. Recent studies have found helmet use among injured
e-scooter riders to be extremely low, ranging from 0% and 8% in most studies [
5
,
6
,
23
,
24
,
28
,
34
,
35
,
39
].
Additionally, despite regulations prohibiting them from doing so, e-scooter users commonly ride and
park on sidewalks, which can lead to injuries to users as well as to pedestrians [
40
,
41
]. One study
found that 44% of collisions occurred on sidewalks where riding was prohibited, and others have
found that approximately 10% of all e-scooter related injuries involve pedestrians [
5
,
7
,
10
,
23
,
26
,
31
,
33
,
42
].
Vulnerable populations such as the elderly, hearing impaired, and young children have an increased
risk for sidewalk-related injuries [
31
]. A sizeable proportion of e-scooter injuries among users involve
children under 18, despite most rental company agreements prohibiting ridership for minors [
5
].
Many of these hazards relate to cultural norms and limited regulation that may minimize users’
perception of potential dangers and therefore lead to unsafe behaviors [28].
Int. J. Environ. Res. Public Health 2020,17, 6344 4 of 15
1.2.2. Environment (Air Pollution/Noise Exposure)
In providing an electric alternative to motor vehicles, e-scooters are typically perceived as an
environmentally friendly form of transportation that could lead to lower vehicle emissions and
cleaner air in cities where they are being used [
3
]. Since air pollution is responsible for premature
morbidity and mortality from a number of diseases—including, for example, respiratory infections,
cardiovascular disease, and premature birth—the potential positive impact of e-scooter use on health
is significant [
1
,
43
]. Exposure to noise from motor vehicle engines, which has been linked to increased
incidence of ischemic heart disease, cognitive impairment among children, and sleep disturbance, is also
inversely correlated with e-scooter use since the battery-operated engines are essentially silent [1,10].
Although e-scooters are commonly seen as a green alternative to gasoline-powered motor vehicles,
they present a number of environmental concerns—including greenhouse gas emissions, particulate
matter formation, and use of mineral and fossil resources—that often go overlooked [
44
–
47
]. Findings
from recent studies suggest that, overall, e-scooters have a more negative life cycle impact on the
environment than the transportation modes they are replacing [
2
,
47
]. One study found that e-scooters’
impact on climate change is better than that of personal automobiles but worse than that of buses with
higher ridership or electric bicycles [
2
]. With an average lifespan of about 2 years before often ending
up in landfills, e-scooters’ high level of disposability is a key driver of negative environmental impacts,
which means that this impact will likely lessen as technology improves, a goal e-scooter companies
are actively workings towards [
2
,
47
,
48
]. Another major issue is the vehicles used to collect e-scooters
each day for charging and relocating. One study found that the 43% of the emissions attributable to
e-scooters stem from collection vehicles [
2
]. More sparsely populated areas likely necessitate higher
collection miles driven and thus the e-scooters will likely lead to more air pollution than in densely
populated urban areas. Another environmental concern is the greenhouse gas emissions required
to manufacture and assemble e-scooters [
2
]. This process includes the extraction of raw materials,
including aluminum and lithium, for the e-scooter frames and batteries.
1.2.3. Physical Inactivity
Very little research exists on the linkage between e-scooters and physical activity. Insufficient
physical activity is responsible for over 2 million deaths each year as a key risk factor for multiple
chronic diseases [
49
]. Because the act of riding e-scooters in itself likely offers few physical activity
benefits, some health researchers have expressed concerns that e-scooters will replace active forms of
transportation such as walking and cycling [
50
–
52
]. On the other hand, some advocates have observed
a positive association between the increase in e-scooters and more active transportation as cities seeking
to accommodate e-scooters have improved infrastructure that indirectly creates an environment and
culture more conducive to cycling and walking [
53
,
54
]. Some e-scooter companies have argued that
e-scooters offer a low-intensity workout that can help users increase core strength and exercise their
legs, in addition to acting as a “gateway activity” to further exercise [
55
]. While these specific claims
have yet to be confirmed through research, some preliminary conclusions that e-scooters offer the
potential for at least minor physical activity benefits may be drawn from the literature about the
positive health benefits of standing compared to sitting [56–58].
1.2.4. Social Exclusion and Community Severance
Critical questions remain regarding the effects of e-scooters share programs on social life in
communities in which they operate. Community health and social interaction, which are influenced by
neighborhood design and transport infrastructure, have a significant impact on mental health and
well-being of community members [
1
,
59
,
60
]. Community severance occurs where transportation acts
as a physical or psychological barrier that separates built-up areas or open spaces [
1
]. There are reasons
to believe e-scooters may increase community connectedness by improving access to transit, recreation
facilities, and other public spaces where social interaction occurs. On the other hand, e-scooters may
Int. J. Environ. Res. Public Health 2020,17, 6344 5 of 15
also contribute to community severance, for example by increasing risks of pedestrian injuries or by
acting as a visual symbol of disorder in urban neighborhoods due to erratic placement of e-scooters after
use [
50
,
61
]. There are reports of frustrated city residents vandalizing e-scooters and even celebrating
their actions by posting evidence of that vandalism on social media [
62
]. Even if e-scooters do not
represent a new barrier to community connectedness, the benefits of e-scooter access may not be
available equitably to people of lower socioeconomic statuses while any negative health impacts may
disproportionately affect these same people, which could exacerbate existing inequalities [51].
2. Methods
2.1. Study Context
This study looked at e-scooter rider behavior in Provo, UT, a city of 116,000 people [
63
] located
approximately 40 miles south of Salt Lake City, UT. The close proximity of two large universities within
or near Provo City limits has contributed to a high concentration of residents and traffic. Provo’s mayor
was primarily interested in the e-scooter program to improve the air quality of the city by providing
zero emission alternatives to driving [
64
]. In partnership with the company Zagster, an e-scooter share
program was introduced in Provo in August 2019. The geographic area principally targeted in the
e-scooter program lies between downtown Provo and Brigham Young University (BYU), where there is
a high concentration of college-aged residents, relatively dense commercial and educational land use,
and a new Bus Rapid Transit (BRT) line. BYU does not permit e-scooters on campus. Figure 2shows the
geospatial distribution of e-scooter rides observed in October 2019. At the time of the survey, 500 total
e-scooters were available on city streets. Between August 19 and December 31, over 85,000 rides were
taken on Provo’s e-scooters [
65
]. Provo City Code 9.15.200 prohibits e-scooter use on sidewalks [
66
]
Helmet use is not required but is strongly encouraged. While Utah state law prohibits people under
eight years old from riding an e-scooter, Zagster policy requires users to be eighteen or older to rent
an e-scooter.
even celebrating their actions by posting evidence of that vandalism on social media [62]. Even if e-
scooters do not represent a new barrier to community connectedness, the benefits of e-scooter access
may not be available equitably to people of lower socioeconomic statuses while any negative health
impacts may disproportionately affect these same people, which could exacerbate existing
inequalities [51].
2. Methods
2.1. Study Context
This study looked at e-scooter rider behavior in Provo, UT, a city of 116,000 people [63] located
approximately 40 miles south of Salt Lake City, UT. The close proximity of two large universities
within or near Provo City limits has contributed to a high concentration of residents and traffic.
Provo’s mayor was primarily interested in the e-scooter program to improve the air quality of the
city by providing zero emission alternatives to driving [64]. In partnership with the company
Zagster, an e-scooter share program was introduced in Provo in August 2019. The geographic area
principally targeted in the e-scooter program lies between downtown Provo and Brigham Young
University (BYU), where there is a high concentration of college-aged residents, relatively dense
commercial and educational land use, and a new Bus Rapid Transit (BRT) line. BYU does not
permit e-scooters on campus. Figure 2 shows the geospatial distribution of e-scooter rides observed
in October 2019. At the time of the survey, 500 total e-scooters were available on city streets.
Between August 19 and December 31, over 85,000 rides were taken on Provo’s e-scooters [65].
Provo City Code 9.15.200 prohibits e-scooter use on sidewalks [66] Helmet use is not required but is
strongly encouraged. While Utah state law prohibits people under eight years old from riding an e-
scooter, Zagster policy requires users to be eighteen or older to rent an e-scooter.
Figure 2. Density of e-scooter trip points in October 2019. Data from Zagster via Provo City,
background streets supplied by OpenStreetMap.
Figure 2.
Density of e-scooter trip points in October 2019. Data from Zagster via Provo City, background
streets supplied by OpenStreetMap.
Int. J. Environ. Res. Public Health 2020,17, 6344 6 of 15
2.2. Study Design
This study was a cross sectional study designed to address the primary research questions.
Data were collected using a 13-item online questionnaire; three were demographic questions and
8 questions were about riding history, behavior, and knowledge (see Appendix Afor full question
list). Demographics included city residence, age, and gender. Riding behavior questions included
trip origin, trip destination, trip motivation, and street versus sidewalk riding on users’ most recent
e-scooter trip. Open-ended responses were solicited related to changes that would enable street versus
sidewalk riding and to e-scooter staging. The survey was emailed the week of 24 September 2019 to
all registered Zagster users (~15,000) in Provo City. A total of 1070 users completed the survey, for a
response rate of 7.1%. All research procedures were performed in compliance with relevant laws and
institutional guidelines.
2.3. Data Analysis
Participant demographic characteristics (age, gender, and place of residence) were first calculated,
and descriptive variable statistics were then conducted for each item in the questionnaire. After verifying
statistical assumptions, chi-squared analyses were performed to determine variable dependent
relationships and equality of proportions between demographic characteristics and motivations
for riding, destinations, travel mode alternatives, and safety behaviors. Quantitative analysis was
performed using the R statistical software (R Foundation for Statistical Computing, Vienna, Austria) [
67
].
Two researchers used NVivo qualitative data analysis software to thematically code responses to the
open-ended survey questions [
68
]. These coded responses were then analyzed collectively by the full
research team to identify the most prominent emergent themes.
3. Results
The majority of respondents were 18–24 years old (56.2%), and 5% were under 18 years old.
More men than women completed the survey (63% vs. 37%). Roughly 95% of participants were
residents of Utah County (Provo City—85.0%, Utah County—11.9%) (Table 1).
Table 1. Participant demographics from e-scooter survey.
Age (Years) Total Frequency (%) Male Female
Under 18 53 (5%) 33 (4.9%) 19 (4.9%)
18–24 601 (56.2%) 357 (53.0%) 242 (62.1%)
25–34 212 (19.8%) 141 (20.9%) 71 (18.2%)
35–44 114 (10.7%) 83 (12.3%) 29 (7.4%)
45–54 62 (5.8%) 40 (5.9%) 22 (5.6%)
55–64 24 (2.2%) 17 (2.5%) 7 (1.8%)
65+4 (0.04%) 3 (0.4%) 0 (0.0%)
Total participants 1070 674 (63.0%) 390 (37%)
3.1. Motivations for Riding e-Scooters
The most frequently mentioned reason for riding e-scooters was “to have fun” (42.2%) followed
by “to save time” (32.3%) (see Table 2). Though “having fun” was the top reason for riding e-scooters
for both men and women, significantly more women (48.3%) reported riding for this reason compared
to men (39.1%) (
χ2
=12.3, df =1, p<0.001). Similarly, men were more likely to ride “to avoid parking
hassles” (14.8%) compared to women (9.0%) (χ2=10.3, df =1, p=0.001).
Int. J. Environ. Res. Public Health 2020,17, 6344 7 of 15
Table 2. Motivations for riding e-scooters.
Reason Total Count (%) Male Female College-Age Non-College-Age
To have fun 669 (42.2%) 401 (39.1%) 268 (48.4%) 345 (37.6%) 324 (49.4%)
To save time 512 (32.3%) 338 (32.9%) 174 (31.4%) 360 (39.2%) 147 (22.4%)
To avoid parking hassles
205 (12.9%) 152 (14.8%) 50 (9.0%) 120 (13.1%) 80 (12.2%)
For environmental
reasons 86 (5.4%) 57 (5.6%) 26 (4.7%) 34 (3.7%) 48 (7.3%)
Other 58 (3.66%) 44 (4.3%) 16 (2.9%) 24 (2.6%) 38 (5.8%)
To save money 54 (3.4%) 34 (3.3%) 20 (3.6%) 35 (3.8%) 19 (2.9%)
Total n=1584 1026 554 918 656
Note: This was a select-all-that-apply question.
College-aged (CA) persons aged 18–24 years old comprise the largest portion of e-scooter ridership
in Provo City (56.2%). While more non-CA persons (49.4%) than CA persons (37.6%) reported a
motivation for riding e-scooters was to have fun (
χ2
=21.35, df =1, p<0.001), more CA than non-CA
persons reported a motivation was to save time (39.2% compared to 22.4%;
χ2
=48.73, df=1, p<0.001).
3.2. Destinations of e-Scooter Riders
The most common destinations to which e-scooters are reportedly being ridden are “just riding
around for fun” (25.3%), home (20.0%), and dinning/shopping locations (17.1%) (see Table 3, a full table
is presented in Appendix A). There were no statistical gender differences with respect to destination
with the exception of school; men tended to ride to school more (13.2%) than women (8.2%) (
χ2
=5.64,
df =1, p=0.02).
Table 3. Where e-scooters are being ridden by gender.
Destination Total Count (%) Male Female College-Age Non-College-Age
Rode for fun 269 (25.3%) 151 (22.4%) 118 (30.3%) 116 (19.4%) 153 (32.9%)
Home 213 (20.0%) 138 (20.5%) 75 (19.2%) 141 (23.5%) 72 (15.5%)
Dining/shopping 182 (17.1%) 112 (16.6%) 70 (17.9%) 92 (15.4%) 90 (19.4%)
Social gathering 170 (16.0%) 107 (15.9%) 63 (16.2%) 104 (17.4%) 66 (14.2%)
School 121 (11.4%) 89 (13.2%) 32 (8.2%) 102 (17.0% ) 19 (4.1%)
Work 84 (7.9%) 58 (12.9%) 26 (6.7)% 33 (5.5%) 51 (11.0%)
Public transit stop 25 (2.3%) 19 (2.8%) 6 (1.5%) 11 (1.8%) 14 (3.0%)
Total n =1064 n =674 n =390 599 465
The destinations of CA persons were different in many instances compared with non-college-aged persons. CA
persons were less likely to use the e-scooter when dining out/shopping (
χ2
=2.67, df =1, p=0.10; CA =15% vs.
non-CA =24%); to just ride around for fun (
χ2
=24.67, df =1, p<0.001; CA =19.4% vs. CA =32.9%); and, to work
(
χ2
=9.99, df =1, p=0.002; CA =5.51% vs. non-CA =10.97%). Conversely, they were more likely to ride home
(
χ2
=10.11, df =1, p=0.001; CA =24% vs. non-CA =18%); to school (
χ2
=42.23, df =1, p<0.001; CA =17.03% vs.
non-CA =4.09%); and to social gatherings (χ2=1.73, df =1, p=0.19; CA =17.4% vs. non-CA =14.2%).
3.3. Travel Mode Alternatives if Not Using an e-Scooter
The two most common modes of transportation that would have been used if e-scooters were not
available were walking (43.5%) and using a personal vehicle (28.5%) (see Table 4). The only statistical
difference by gender was for bicycling, where men were more likely to use a bicycle if an e-scooter
were unavailable (5.2% vs. 1.9%) (χ2=6.16, df =1, p=0.01).
Int. J. Environ. Res. Public Health 2020,17, 6344 8 of 15
Table 4. Reported travel mode alternative to e-scooters.
Alternative Mode Total Count (%) Male Female College-Age Non-College Age
Bicycle 41 (4.0%) 34 (5.2%) 7 (1.9%) 17 (2.8%) 24 (5.5%)
Not taken trip 113 (10.9%) 50 (7.6%) 63 (16.7%) 52 (8.7%) 61 (14.1%)
Personal vehicle 294 (28.5%) 196 (29.9%) 98 (25.9%) 149 (24.9%) 145 (33.4%)
Pick up/drop off32 (3.1%) 22 (3.4%) 10 (2.6%) 11 (1.8%) 21 (4.8%)
Public transit 88 (8.5%) 59 (9.0%) 29 (7.7%) 61 (10.2%) 27 (6.2%)
Rideshare 9 (0.9%) 4 (0.6%) 5 (1.3%) 4 (0.7%) 5 (1.2%)
Walking 449 (43.5%) 284 (43.4%) 165 (43.7%) 302 (50.4%) 147 (33.9%)
Other 7 (0.7%) 6 (0.9%) 1 (0.3%) 3 (0.5%) 4 (0.9%)
Total 1033 655 378 599 434
Similar to trip destination, there were significant differences between the 18–24-year-old CA and non-CA group.
As an alternative to e-scooters, CA persons were less likely to have used a bicycle (
χ2
=4.10, df =1, p=0.04;
CA =2.84% vs. non-CA =5.53%); to have not taken the trip (
χ2
=6.92, df =1, p=0.01; CA =8.68% vs.
non-CA =14.06%); to use a personal vehicle (
χ2
=8.59, df =1, p=0.003; CA =24.87% vs. non-CA =33.41%), and to
be picked up/dropped off(
χ2
=6.59, df =1, p=0.01; CA =1.84% vs. non-CA =4.84%). Conversely, CA persons
were more likely to use public transportation (
χ2
=4.57, df =1, p=0.01; CA =10.18% vs. non-CA =6.22%) and to
walk (χ2=27.37, df =1, p<0.01; CA =50.42% vs. non-CA =33.87%).
3.4. Awareness of and Compliance with Safety Regulations
Riding behavior was equally mixed between on the street (n =369, 34.6%), on the sidewalk
(n =357, 33.4%), and equal amounts of both (n =342, 32.0%). Sidewalk and street riding was associated
with gender in that men were more likely to ride on the street (
χ2
=11.01, df =1, p<0.001) and women
were more likely to ride on the sidewalk (
χ2
=3.01, df =1, p=0.08). There was no difference between
genders who reported to ride equally on the street and sidewalk. Likewise, CA persons were less
likely to ride on the street (30.2% vs. 40.2%;
χ2
=11.20, df =1, p<0.001) and more likely to ride on
the sidewalk (38.3% vs. 27.0%;
χ2
=14.6, df =1, p<0.001). There was no difference by age for those
who equally rode between sidewalk and street. The majority of respondents did not know that it is
illegal, according to Provo City code, to ride e-scooters on the sidewalk (n =691, 64.7%). There were
no differences between genders but there were by age. College-aged persons were less likely to know
about the sidewalk riding code (31.6% vs. 40.6%; χ2=9.06, df =1, p=0.002).
3.5. Changes to Enable Safer On-Street (vs. Sidewalk) Riding
When asked what program changes would make them ride on the street rather than the sidewalk,
some participants (12%) reported that they would have ridden in the street if they had known that
it was acceptable to do so and/or they could be sure drivers were aware that they were allowed to
do so. Overwhelmingly, most of the respondents (74%) asked for the addition of bike lanes and/or
better constructed bike lanes throughout Provo. There were very few mentions of where the bike lanes
should be added. Most respondents use the adjectives “good”, “wider”, “improved”, “clearly marked”,
and “painted” when describing what was meant by better bike lanes. The next highest response called
for better roads; 16% of respondents said that Provo streets had potholes, narrow roads, bumpy streets,
and a lack of lane divisions. Reckless drivers and curbside parking—which blocks bike lanes, takes up
room on the shoulders, and pushes scooter riders further into the center of the road—were cited as
deterrents to riding offthe sidewalk. When asked if there was anything else users wanted to mention
about the scooters, many of them (15%) simply stated that they enjoyed having scooters in the area.
4. Discussion
This study sought to consider the relationship between e-scooters and health by gaining a better
understanding of e-scooter users and their behaviors in Provo, UT. While e-scooters may affect health
in the various ways, whether they have a net positive or negative impact on health depends largely on
why and how people are riding them. Two-thirds of users who responded to the survey were men,
and over half were 18–24 years old. This age range is similar to what we would expect given the
age demographics of Provo where the median age is 23.6 and 44% of the population is between ages
Int. J. Environ. Res. Public Health 2020,17, 6344 9 of 15
20–29 [
63
]. While injury data from Provo has not yet been reported, previous studies in other cities
found that the majority of e-scooter injuries were among male millennials, the same demographic
group who make up the majority of e-scooter users in Provo [6,12,37,69].
User compliance with safety regulations is another important health-related factor addressed
by these data. Despite the Zagster policy requiring renters to be at least 18 years of age, 5% of all
respondents were under 18, which raises concerns about user safety and the ability of Zagster (and other
private e-scooter companies) to enforce its rider policies. Additionally, only 34.6% of users reported
complying with local law and riding exclusively on the street while the rest reported riding at least
partially on the sidewalk. While data from other cities is limited, a pilot e-scooter program in Portland,
OR found that the proportion of sidewalk riders varied greatly depending on street design—18% rode
on sidewalks with a 20 mph speed limit compared to 66% with a 35 mph speed limit, and 8% rode on
sidewalks if a protected bike lane existed compared to 39% where there were no bike facilities [
42
].
Riding on sidewalks is overall more dangerous for users and much more likely to lead to pedestrian
injuries as have been found in previous studies [
3
,
10
,
31
]. The finding that women were more likely
than men to avoid on-street riding is consistent with research on gender differences in cycling behavior
that finds safety perception is a major factor [
70
,
71
]. The majority of users (64.7%) reported being
unaware that e-scooters were not permitted on sidewalks, which represents a higher proportion
of riders compared to the 43% of users in Rosslyn, VA who were not familiar with e-scooter laws
concerning sidewalk riding [
40
]. While the difference between cities likely reflects that the e-scooter
program in Rosslyn had been active for a longer period of time, the lack of knowledge around laws
suggests that better educating users may be a first step in reducing unsafe riding behavior. Nearly 75%
of users in Provo mentioned in their open-ended responses that additional and improved bike lanes
would make it easier for them to ride on the street, which highlights another opportunity, albeit one
requiring a greater financial investment from the city, to create a safer environment for e-scooter users.
The data show that e-scooter users in Provo choose to ride for a variety of reasons. The top reason
given was to have fun (42.2%) and the top destination reported by users was “just riding around for fun”
(25.3%). However, a sizeable number of users also report riding e-scooters to commute to work (7.9%) or
school (11.4%) and for other purposes such as dining/shopping (17.1%) and traveling to social gatherings
(16%). These numbers are similar to those in Portland, OR where 28.6% of riders used e-scooters for
recreation or exercise while 71% used them to get to a destination [
42
]. Convenience appears to be an
important motivator as the second and third top reasons given for riding e-scooters in Provo were to
save time (32.3%) and to avoid parking hassles (12.9%). Interestingly, CA users were more likely to rent
e-scooters to save time than to have fun whereas non-CA users reported the opposite. CA users were also
more likely to ride to school and social gatherings while non-CA users were more likely to ride to dine
out/shop or commute to work. Our findings suggest that age is more influential on trip destination as
opposed to gender. A very small percentage of riders (2.3%) reported their destination as a public transit
stop, which may indicate that e-scooters in Provo are not necessarily delivering on the promise of solving
the “last mile” problem, although because the questionnaire asked specifically about the most recent trip it
is likely that some of the other riders were connecting from public transit. This is key question that should
be addressed through a different survey design in future research.
Given the variety of motivations cited for riding e-scooters, a critical question in terms of health
implications is: For which alternative modes of travel are e-scooters being substituted? The most common
response, given by 43.5% of users, was that they would have walked if an e-scooter had not been available;
among CA riders this percentage increased to 50.4%. Additionally, 4% of users reported riding e-scooters
instead of bicycling. Similarly, in Portland, OR 37% and 5% of e-scooter riders, respectively, would have
walked or biked instead of using an e-scooter, and in Raleigh, NC 49% of riders would have walked or
biked [
2
,
42
]. The most likely impact of these findings is an overall reduction in physical activity levels
because e-scooters are replacing more active forms of transportation. While this may be cause for concern
in terms of health, on the other hand, 29.4% of e-scooter users reported that they would have used a
personal vehicle or rideshare service (i.e., Uber, taxi) if an e-scooter had not been available. This number
Int. J. Environ. Res. Public Health 2020,17, 6344 10 of 15
is comparable to data from Rosslyn, VA (39%), Raleigh, NC (34%), and Portland, OR (34%) [
2
,
40
,
42
].
(In Portland, 6% of users even reported getting rid of a personal vehicle due to e-scooter availability [
42
].)
These rides represent fewer cars on the road and, in all likelihood, an overall reduction in local air pollution
and associated poor health. Additionally, the survey does not capture the possibility that the respondent
would have chosen a different destination entirely were an e-scooter not available. Given that e-scooters
are best designed for short trips in urban areas, it is possible that the avoided motor vehicle trips would
have been longer than their e-scooter substitutes. This finding is particularly relevant for Provo City,
a place with problematic winter air pollution and whose primary motivation for introducing e-scooters
was to provide a green alternative to motor vehicles; yet, considering disposability issues and emissions
due to collecting and placement of e-scooters, important questions remain about the full environmental
impact and its implications for health.
Based on the findings of this study, there are several policy change strategies that could help
optimize the heath impacts of e-scooter share programs in Provo and in other cities. First, to reduce the
probability of injuries, more training and strategically placed educational information (e.g., signs posted
in high traffic areas) should be provided to increase users’ knowledge about safety precautions
(e.g., avoiding sidewalks, safe parking) and users’ e-scooter operating skills. Considering the shared
road space, information should also be provided to help drivers, cyclists, and pedestrians be more
aware of e-scooter riders.
Second, as evidenced by ridership among children, there is an enforcement gap in Zagster’s ability
to enforce safety policies. Similarly, although this study did not explicitly explore helmet use, informal
observation on the streets of Provo suggest that helmet use is extremely rare among e-scooter users,
which is consistent with other studies [
7
,
10
,
33
]. To improve safety, cities should work with private
e-scooter companies to identify ways, which may include the passing of additional local ordinances, to
identify violations and enforce policies.
Third, for e-scooters to experience long term success it is clear that bike lines and other infrastructure
must continue to improve. When asked about possible improvements that would encourage them to
ride on the street, the vast majority stated designated lanes would be most helpful (n =787). Enhanced
education and training alone will likely be ineffective without a more conducive riding environment,
which should be a priority for city decision makers concerned with improving safety
Fourth, while a sizeable proportion of users are substituting e-scooters for personal vehicles,
there are still negative environmental impacts that should be considered and minimized. Zagster
recently introduced a new, more durable model of e-scooter to Provo City streets, and city policymakers
should continue to push for e-scooters that have longer durability. They should also work with Zagster
to ensure low-emissions vehicles are used for collecting and placing e-scooters, and that the routes
driven for these tasks are as short as possible.
Finally, cities should consult regularly with community members—those who use e-scooters
and those who do not—to understand the impacts of e-scooters on community severance and social
interactions, particularly among marginalized populations.
This study makes a significant contribution to the literature by applying an existing health impact
framework and proposing a range of linkages between health and e-scooters, a rapidly emerging
public health issue for which previous studies have focused almost exclusively on injuries. The study
also reports data from a relatively large sample of e-scooter users on their self-reported behavior,
which is scarce in the academic literature, that serve as starting point for understanding how population
health may be impacted by e-scooters. These data led to concrete, valuable recommendations for
policymakers in Provo and other places, especially mid-sized cities, which are currently grappling with
instituting appropriate policy responses for the variety of issues that come with e-scooter programs.
Some critical limitations should be noted. First and foremost, while this study considered linkages
between e-scooters and health, its findings do not directly address the health impact of e-scooters on
Provo residents. Even where it adds value in terms of providing a clearer picture of why and how
e-scooters are being used, it omits key demographic variables (e.g., race/ethnicity, income, etc.) that are
Int. J. Environ. Res. Public Health 2020,17, 6344 11 of 15
essential for understanding some of the connections between e-scooters and health (e.g., community
severance). Finally, the survey used is potentially problematic because it represents a single point
in time shortly after e-scooters were introduced in Provo. It also asks only about users’ most recent
trip and it relies on responses from a small, non-representative sample of registered Zagster users,
which may be a source of bias if those who elected to respond to the survey have different patterns of
behavior than those who did not respond. The use of an online survey may also lead to bias by selecting
for younger, internet-using adults; however, this is not a major concern because these respondents are
also the most likely to be e-scooter users.
5. Conclusions
e-Scooters are a nascent public health issue that positively and negatively affect health in a number
of ways, including through injuries, air pollution levels, physical activity levels, and community
severance. To understand the full impact of e-scooters on health we need to gain a thorough
understanding of e-scooter users and their patterns of use. This study found that in Provo, UT e-scooter
users are predominantly male, college-aged individuals who ride e-scooters for a variety of reasons,
the top being for recreational purposes. Most users were unaware of laws prohibiting e-scooters
from sidewalk riding, which led to two-thirds of users riding at least part of the time on sidewalks.
About half of users would be walking or riding bicycles if e-scooters were not an option, while about
one-third would be driving a personal vehicle. Thus, e-scooters in Provo are likely having both positive
and negative impacts on health. Future research, perhaps in the form of a health impact assessment,
should be designed explicitly to examine the linkages between e-scooters and areas of health beyond
just injuries, e.g., by focusing on community severance among marginalized communities or on users’
physical activity levels. Research is also needed to evaluate the impact of policies and interventions
designed to reduce e-scooter related injuries. Thoughtful, evidence-based implementation of e-scooter
programs is critical to ensuring a future net positive benefit to public and community health.
Author Contributions:
Conceptualization, J.G., G.S.M., and R.A.C.; methodology, A.T.; formal analysis, M.B.,
M.C., J.P., and R.A.C.; investigation, A.T.; writing—original draft preparation, J.G.; writing—review and editing,
J.G., M.B., M.C., J.P., A.T., G.S.M., and R.A.C.; visualization, G.S.M. and R.A.C.; supervision, J.G. and R.A.C.; project
administration, J.G. and R.A.C. All authors have read and agreed to the published version of the manuscript.
Funding: This research received no external funding.
Conflicts of Interest: The authors declare no conflict of interest.
Appendix A —Zagster Rider Survey Questions
1. On your last trip, why did you choose to ride a scooter?
2.
On your last trip, what mode of transportation would you have taken had a scooter not
been available?
3. On your last trip, where did you ride to?
4. On your last trip, where did you ride from?
5. On your last trip, where did you primarily ride?
6. If you rode on sidewalks, why did you choose to do so?
7.
Did you know that Provo City Code 9.15.200 prohibits riding on sidewalks? (Don’t worry, we
won’t tell on you.)
8. What changes would make you want to ride in the street instead of the sidewalk?
9. Where should scooters be staged in the morning that they aren’t currently?
10.
Anything else you’d like to tell us?
11.
What city do you live in?
12.
What is your age?
13.
What is your gender?
Int. J. Environ. Res. Public Health 2020,17, 6344 12 of 15
References
1.
Khreis, H.; May, A.D.; Nieuwenhuijsen, M.J. Health impacts of urban transport policy measures: A guidance
note for practice. J. Transp. Health 2017,6, 209–227. [CrossRef]
2.
Hollingsworth, J.; Copeland, B.; Johnson, J.X. Are e-scooters polluters? the environmental impacts of shared
dockless electric scooters. Environ. Res. Lett. 2019,14. [CrossRef]
3.
Zhu, R.; Zhang, X.; Kondor, D.; Santi, P.; Ratti, C. Understanding spatio-temporal heterogeneity of bike-sharing
and scooter-sharing mobility. Comput. Environ. Urban Syst. 2020,81, 101483. [CrossRef]
4.
van Boven, J.F.M.; An PLe Kirenga, B.J.; Chavannes, N. Electric scooters: Batteries in the battle against
ambient air pollution? Lancet Planet. Health 2017,1, e168–e169. [CrossRef]
5.
Trivedi, T.K.; Liu, C.; Antonio, A.L.M.; Wheaton, N.; Kreger, V.; Yap, A.; Schriger, D.; Elmore, J.G. Injuries
Associated With Standing Electric Scooter Use. JAMA Netw. Open 2019,2, e187381. [CrossRef]
6.
Kobayashi, L.M.; Williams, E.; Brown, C.V.; Emigh, B.J.; Bansal, V.; Badiee, J.; Checchi, K.D.; Castillo, E.M.;
Doucet, J. The e-merging e-pidemic of e-scooters. Trauma Surg. Acute Care Open
2019
,4, e000337. [CrossRef]
7.
Todd, J.; Krauss, D.; Zimmermann, J.; Dunning, A. Behavior of electric scooter operators in naturalistic
environments. SAE Tech. Pap. 2019. [CrossRef]
8.
Irfan, U. Electric Scooters: Why Bird, Lime, Skip, and Spin are Taking over Cities. Vox. 2018. Available online:
https://www.vox.com/2018/8/27/17676670/electric-scooter-rental-bird-lime-skip-spin-cities (accessed on
17 June 2020).
9.
Mathew, J.; Liu, M.; Li, H.; Seeder, S.; Bullock, D.M. Analysis of E-Scooter Trips and Their Temporal Usage
Patterns. ITE J. 2019,89, 44–49.
10.
Nisson, P.L.; Ley, E.; Chu, R. Electric scooters: Case reports indicate a growing public health concern. Am. J.
Public Health 2020,110, 177–179. [CrossRef]
11.
Choron, R.L.; Sakran, J.V. The Integration of Electric Scooters: Useful Technology or Public Health Problem?
Am. J. Public Health 2019,109, 555–556. [CrossRef]
12.
Puzio, T.J.; Murphy, P.B.; Gazzetta, J.; Dineen, H.A.; Savage, S.A.; Streib, E.W.; Zarzaur, B.L. The electric
scooter: A surging new mode of transportation that comes with risk to riders. Traffic Inj. Prev.
2020
,21,
175–178. [CrossRef]
13.
Dickey, M.R. Electric Scooters are Going Worldwide. Techcrunch. 2018. Available online: https://techcrunch.
com/2018/08/12/electric-scooters-all-over-the-world/(accessed on 17 June 2020).
14. NACTO. Shared Micromobility in the U.S.: 2018; NACTO: New York, NY, USA, 2019.
15.
Toll, M. Are Shared Electric Scooters Going Extinct? Lime’s Valuation Reportedly Tanks. Electrek. 2020.
Available online: https://electrek.co/2020/05/06/lime-valuation-drops-uber-investment-electric-scooters/
(accessed on 17 June 2020).
16.
Wiggers, K. Bird Raises $275 Million at a $2.5 Billion Valuation; Venturebeat: San Francisco, CA, USA, 2019;
Available online: https://venturebeat.com/2019/10/03/bird-raises-275-million-at-a-2-5- billion-valuation/
(accessed on 17 June 2020).
17.
O’Brien, C. Lime VP on Company’s Meteoric Rise to $1 Billion Valuation; Venturebeat: San Francisco, CA, USA,
2018; Available online: https://venturebeat.com/2018/07/02/lime-vp-on-companys-meteoric-rise-to- 1-billion-
valuation/(accessed on 17 June 2020).
18.
Grand View Research. Electric Scooters Market Size|E-scooters Industry Report, 2030. Available online:
https://www.grandviewresearch.com/industry-analysis/electric-scooters-market (accessed on 17 June 2020).
19.
McFarland, M. Lyft Launches a Scooter Service. Uber is Close Behind. CNN Bus. 2018. Available online:
https://money.cnn.com/2018/09/06/technology/lyft-scooters-denver-uber/index.html (accessed on 17 June
2020).
20.
Hawkins, A.J. Electric Scooter-Sharing Grinds to a Halt in Response to the COVID-19 Pandemic. The Verge.
2020. Available online: https://www.theverge.com/2020/3/20/21188119/electric-scooter-coronavirus-bird-
lime-spin-suspend-bikes (accessed on 17 June 2020).
21.
Williams, K. Trends in E-Scooter Litigation: An update on the still-evolving body of law. Bench Bar Minn.
2019,76, 26–29.
22.
Allem, J.P.; Majmundar, A. Are electric scooters promoted on social media with safety in mind? A case study
on Bird’s Instagram. Prev. Med. Rep. 2019,13, 62–63. [CrossRef]
Int. J. Environ. Res. Public Health 2020,17, 6344 13 of 15
23.
Blomberg, S.N.F.; Rosenkrantz, O.C.M.; Lippert, F.; Christensen, H.C. Injury from electric scooters in
Copenhagen: A retrospective cohort study. BMJ Open 2019,9, e033988. [CrossRef]
24.
Trivedi, B.; Kesterke, M.J.; Bhattacharjee, R.; Weber, W.; Mynar, K.; Reddy, L.V. Craniofacial Injuries Seen
With the Introduction of Bicycle-Share Electric Scooters in an Urban Setting. J. Oral Maxillofac. Surg.
2019
,77,
2292–2297. [CrossRef] [PubMed]
25.
Sipe, N.; Pojani, D. Can e-Scooters Solve the ‘Last Mile’ Problem? They’ll Need to Avoid the Fate of Dockless
Bikes. Conversat. 2018. Available online: https://theconversation.com/can- e-scooters-solve- the-last-mile-
problem-theyll-need-to-avoid-the-fate-of-dockless- bikes-102633 (accessed on 17 June 2020).
26.
Siman-Tov, M.; Radomislensky, I.; Peleg, K.; Israel Trauma Group. The casualties from electric bike and
motorized scooter road accidents. Traffic Inj. Prev. 2017,18, 318–323. [CrossRef]
27.
Schlaff, C.D.; Sack, K.D.; Elliott, R.J.; Rosner, M.K. Early Experience with Electric Scooter Injuries Requiring
Neurosurgical Evaluation in District of Columbia: A Case Series. World Neurosurg.
2019
,132, 202–207.
[CrossRef] [PubMed]
28.
Bresler, A.Y.; Hanba, C.; Svider, P.; Carron, M.A.; Hsueh, W.D.; Paskhover, B. Craniofacial injuries related
to motorized scooter use: A rising epidemic. Am. J. Otolaryngol. Head Neck Med. Surg.
2019
,40, 662–666.
[CrossRef] [PubMed]
29.
Burgoyne, J. The Case for Electric Scooters. US News World Rep. 2019. Available online: https://www.
usnews.com/news/cities/articles/2019-09-05/commentary-the- case-for-electric-scooters (accessed on 17 June
2020).
30.
Tapper, J. Invasion of the Electric Scooter: Can Our Cities Cope? Guard. 2019. Available online: https:
//www.theguardian.com/cities/2019/jul/15/invasion-electric-scooter-backlash (accessed on 17 June 2020).
31.
Sikka, N.; Vila, C.; Stratton, M.; Ghassemi, M.; Pourmand, A. Sharing the sidewalk: A case of E-scooter
related pedestrian injury. Am. J. Emerg. Med. 2019,37, 1807.e5–1807.e7. [CrossRef] [PubMed]
32.
Shaheen, S.A.; Cohen, A.P. Shared Micromoblity Policy Toolkit: Docked and Dockless Bike and Scooter Sharing; UC
Berkeley Transportation Sustainability Research Center: Richmond, CA, USA, 2019; pp. 1–9. [CrossRef]
33.
Badeau, A.; Carman, C.; Newman, M.; Steenblik, J.; Carlson, M.; Madsen, T. Emergency department visits for
electric scooter-related injuries after introduction of an urban rental program. Am. J. Emerg. Med.
2019
,37,
1531–1533. [CrossRef] [PubMed]
34.
Mitchell, G.; Tsao, H.; Randell, T.; Marks, J.; Mackay, P. Impact of electric scooters to a tertiary emergency
department: 8-week review after implementation of a scooter share scheme. EMA Emerg. Med. Australas.
2019,31, 930–934. [CrossRef] [PubMed]
35.
Liew, Y.K.; Wee, C.P.J.; Pek, J.H. New peril on our roads: A retrospective study of electric scooter-related
injuries. Singap. Med. J. 2020,61, 92–95. [CrossRef]
36.
Hamilton, I.A. Electric Scooters were to Blame for at Least 1500 Injuries and Deaths in the US Last Year. Bus.
Insid. 2019. Available online: https://www.businessinsider.com/minimum- of-1500-us- e-scooter-injuries-in-
2018-2019-2 (accessed on 17 June 2020).
37.
Allen, J.R.; English, K.C.; Rix, K.; Brown, C.V.R.; Ziebell, C.M.; Brown, L.H. 262 Epidemiology of Dockless
Electric Rental Scooter Injuries. Ann. Emerg. Med. 2019,74, S103. [CrossRef]
38.
Teoh, H. SCDF Received 40 Cases of E-Scooter Fires in 2017, Cautions against Overnight Charging. Yahoo!
News. 2018. Available online: https://sg.news.yahoo.com/scdf- received-40- cases-e-scooter-fires-2017-
cautions-overnight-charging-073308147.html (accessed on 17 June 2020).
39.
Meheus, F.; Rijal, S.; Lutumba, P.; Hendrickx, D.; Boelaert, M. NTD control and health system strengthening.
Lancet 2012,379, 2149–2150. [CrossRef]
40.
James, O.; Swiderski, J.; Hicks, J.; Teoman, D. Pedestrians and E-Scooters: An Initial Look at E-Scooter
Parking and Perceptions by Riders and Non-Riders. Sustainability 2019,11, 5591. [CrossRef]
41.
Fang, K.; Agrawal, A.W.; Steele, J.; Hunter, J.J.; Hooper, A.M. Where Do Riders Park Dockless, Shared Electric
Scooters? Findings from San Jose, California; Mineta Transportation Institute: San Jose, CA, USA, 2018; pp. 1–5.
Available online: https://scholarworks.sjsu.edu/mti_publications (accessed on 17 June 2020).
42.
Portland Bureau of Transportation. 2018 E-Scooter Findings Report; Portland Bureau of Transportation:
Portland, OR, USA, 2019. Available online: https://www.portlandoregon.gov/transportation/article/709719
(accessed on 17 June 2020).
Int. J. Environ. Res. Public Health 2020,17, 6344 14 of 15
43.
Bhalla, K.; Shotten, M.; Cohen, A.; Brauer, M.; Shahraz, S.; Burnett, R.; Leach-Kemon, K.; Freedman, G.;
Murray, C.J.L. Transport for health: The Global Burden of Disease from Motorized Road Transport; The World Bank:
Washington, DC, USA, 2014. [CrossRef]
44.
Ratinho, T. E-scooters, bikes and urban mobility: Lessons from the streets of Paris. Conversat. 2019. Available
online: https://theconversation.com/e-scooters-bikes-and-urban-mobility-lessons-from-the-streets-of-paris-
125619 (accessed on 17 June 2020).
45.
Hawkins, A.J. Electric Scooters Aren’t Quite as Climate-Friendly as We Thought. The Verge. 2019. Available
online: https://www.theverge.com/2019/8/2/20751610/scooters-electric-dockless-carbon- emissions-study-
life-cycle-analysis (accessed on 17 June 2020).
46.
Chester Energy and Policy. It’s a Bird
. . .
It’s a Lime
. . .
It’s Dockless Scooters! But Can These
Electric-Powered Mobility Options Be Considered Sustainable Using Life-Cycle Analysis? 2019. Available
online: https://chesterenergyandpolicy.com/2019/01/28/its- a-bird-its-a-lime- its-dockless-scooters-but-can-
these-electric-powered-mobility-options-be-considered-sustainable-using-life-cycle-analysis/(accessed on
17 June 2020).
47.
Moreau, H.; de Jamblinne de Meux, L.; Zeller, V.; D’Ans, P.; Ruwet, C.; Achten, W.M.J. Dockless E-Scooter:
A Green Solution for Mobility? Comparative Case Study between Dockless E-Scooters, Displaced Transport,
and Personal E-Scooters. Sustainability 2020,12, 1803. [CrossRef]
48. LINK. Available online: https://www.link.city/#scooter (accessed on 24 June 2020).
49.
Forouzanfar, M.H.; Alexander, L.; Anderson, H.R.; Bachman, V.F.; Biryukov, S.; Brauer, M.; Burnett, R.;
Casey, D.; Coates, M.M.; Cohen, A.; et al. Global, regional, and national comparative risk assessment of
79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries,
1990-2013: A systematic analysis for the Global Burden of Disease Study 2013. Lancet
2015
,386, 2287–2323.
[CrossRef]
50.
Sallis, J. Electric Scooters on Collision Course with Pedestrians and Lawmakers. Conversat. 2018. Available
online: https://theconversation.com/electric-scooters-on-collision-course-with-pedestrians-and-lawmakers-
99654 (accessed on 17 June 2020).
51.
Sustrans. Our Position on E-Scooters. 2019. Available online: https://www.sustrans.org.uk/our-blog/policy-
positions/all/all/our-position-on-e-scooters/(accessed on 17 June 2020).
52.
Kohl, H., III; Murray, T.; Salvo, D. Measuring Physical Activity. In Foundations of Physical Activity and Public
Health; Human Kinetics, Inc.: Windsor, ON, Canada, 2019; p. 72.
53.
Schmitt, A. Local Bike Advocates: E-Scooters Are Game-Changing. Streets Blog USA. 2019. Available
online: https://usa.streetsblog.org/2019/01/14/local-bike-advocates-e-scooters-are-game-changing/(accessed
on 17 June 2020).
54.
Urbanism Next. Micromobility. The Nexus. Available online: https://www.urbanismnext.org/technologies/
micromobility (accessed on 17 June 2020).
55.
Pure Electric. Does An Electric Scooter Keep You Fit? 2019. Available online: https://www.pureelectric.com/
blogs/news/does-an-electric-scooter-keep-you-fit (accessed on 17 June 2020).
56.
Healy, G.N.; Winkler, E.A.H.; Owen, N.; Anuradha, S.; Dunstan, D. Replacing sitting time with standing or
stepping: Associations with cardio-metabolic risk biomarkers. Eur. Heart J.
2015
,36, 2643–2649. [CrossRef]
57.
Pandey, A.; Salahuddin, U.; Garg, S.; Ayers, C. Continuous dose-response association between sedentary
time and risk for cardiovascular disease a meta-analysis. JAMA Cardiol. 2016,1, 573–583. [CrossRef]
58.
Dempsey, P.C.; Owen, N.; Yates, T.E.; Kingwell, B.A.; Dunstan, D.W. Sitting Less and Moving More:
Improved Glycaemic Control for Type 2 Diabetes Prevention and Management. Curr. Diab. Rep.
2016
,16,
114. [CrossRef]
59.
Markovich, J.; Lucas, K. The social and distributional impacts of transport: A literature review. Work Pap. Ser.
Transp. Stud. Unit. 2011.
60.
Schwanen, T.; Lucas, K.; Akyelken, N.; Solsona, D.C.; Carrasco, J.-A.; Neutens, T. Rethinking the links
between social exclusion and transport disadvantage through the lens of social capital. Transp. Res. Part A
Policy Pract. 2015,74, 123–135. [CrossRef]
61.
Zimmerman, H. As Electric Scooters Proliferate, So Do Minor Injuries And Blocked Sidewalks. NPR. 2019.
Available online: https://www.npr.org/2019/03/30/703102986/as-electric-scooters-proliferate-so-do-minor-
injuries-and-blocked-sidewalks (accessed on 17 June 2020).
Int. J. Environ. Res. Public Health 2020,17, 6344 15 of 15
62.
Newberry, L. Fed-up Locals are Setting Electric Scooters on Fire and Burying Them at Sea. Los Angeles Times.
2018. Available online: https://www.latimes.com/local/lanow/la-me-ln-bird-scooter-vandalism- 20180809-
story.html (accessed on 17 June 2020).
63.
United States Census Bureau. Quick Facts: Provo City, Utah. 2019. Available online: https://www.census.
gov/quickfacts/provocityutah (accessed on 17 June 2020).
64.
Pugmire, G. Provo Launches New Motorized Scooter Program. Dly. Her. 2019. Available
online: https://www.heraldextra.com/news/local/central/provo/provo-launches-new-motorized-scooter-
program/article_d7a19bfb-c57d-5046-93ad-5f0c8ca190b9.html (accessed on 17 June 2020).
65.
Pugmire, G. Ready to Roll: Shareable electric scooters return to Utah County. Dly. Her. 2020. Available
online: https://www.heraldextra.com/news/local/central/orem/ready-to-roll-shareable-electric-scooters-return-
to-utah-county/article_1f2b5fe4-1fb6-59b6-b53a-500f188b37d3.html (accessed on 17 June 2020).
66.
Provo City. Frequently Asked Questions Regarding Scooters. Available online: https://www.provo.org/
home/showdocument?id=15920 (accessed on 17 June 2020).
67.
R Core Team. R: A Language and Environment for Statistical Computing. 2020. Available online:
https://www.r-project.org/(accessed on 17 June 2020).
68.
QSR International Pty Ltd. (2018) NVivo (Version 12). Available online: https://www.qsrinternational.com/
nvivo-qualitative-data-analysis- software/home (accessed on 17 June 2020).
69.
Aizpuru, M.; Farley, K.X.; Rojas, J.C.; Crawford, R.S.; Moore, T.J., Jr.; Wagner, E.R. Motorized scooter injuries
in the era of scooter-shares: A review of the national electronic surveillance system. Am. J. Emerg. Med.
2019
,
37, 1133–1138. [CrossRef] [PubMed]
70.
Heesch, K.C.; Sahlqvist, S.; Garrard, J. Gender differences in recreational and transport cycling:
A cross-sectional mixed-methods comparison of cycling patterns, motivators, and constraints. Int. J.
Behav. Nutr. Phys. Act. 2012,9, 106. [CrossRef] [PubMed]
71.
Emond, C.R.; Tang, W.; Handy, S.L. Explaining gender difference in bicycling behavior. Transp. Res. Rec.
2009,2125, 16–25. [CrossRef]
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