Officials in the nation’s capital are working quietly to improve the regulation of e-scooters, aiming to ensure the trendy devices are available across the District of Columbia and don’t pose hazards to pedestrians, especially those with disabilities.

But is it also time for politicians to grapple with a rising safety issue: Is it time to require their riders to wear a helmet?

Doctors from the Mayo Clinic and the Emory School of Medicine recently published their findings about scooters, based on scrutiny of the latest data that is coming from the U.S. Consumer Product Safety Commission’s National Electronic Injury Surveillance System. They looked at cases from 2014 to 2019, especially those treated in emergency departments (EDs) and reported:

“The estimated incidence of e-scooter injuries treated in EDs in the US nearly doubled between 2018 and 2019 despite various regulatory efforts and evidence highlighting this issue. Head injuries were the most common cause of visits to the ED, and traumatic brain injuries were prevalent among those injured. These results are troubling given that helmets are used by a minority of riders, helmet requirements have been eliminated in some areas, and riders often misunderstand road traffic laws that guide e-scooter use.”

Researchers, in examining 70,000 cases of emergency care for e-scooter injury, reported that the preponderance of patients were young men. As the doctors also found:

“The head was the most common site of injury (27.1% of all injuries). Approximately 50% of head injuries included diagnoses that suggested a traumatic brain injury (a head injury with a concomitant diagnosis of a concussion, internal organ injury, fracture, anoxia, or hemorrhage), constituting 14.5% of the total injury pool. Of patients presenting with a potential traumatic brain injury, 17.4% were admitted to the hospital compared with 7.7% of patients without this diagnosis.”

The DC City Council, the Washington Post reported, soon will be asked to begin considering a measure, shepherded by Mary M. Cheh (D-Ward 3) with more oversight of e-scooters, notably in requiring them to be locked in to poles or racks, so they are not casually dropped and left as sidewalk or curbside hazards.

Vendors have opposed the lock-in requirement and apparently were successful in getting the city to throw out an unpopular overnight ban on e-scooter use, the newspaper said. The companies contend the city lacks the street and sidewalk space or other facilities to support more stringent parking regulations, which also could be costly for the already coronavirus-strapped firms to retrofit their devices with.

E-scooter companies, including Lime, Bird, and Lyft, have seen their business shrink during the pandemic, and they have been forced to downsize to survive, the Washington Post reported. DC officials, at the same time, have sought to increase transportation options, knowing that, at some point, the crushing commute may resume, and residents will want help with it. The coronavirus has increased the region’s potential traffic nightmares, as fear of infection has hammered public transit, including buses and trains.

District officials’ reluctance to require helmets may not be a surprise, as these simple, familiar safety devices have faced resistance from bikers and motorcyclists. The National Transportation Safety Board, after studying the evidence, called for helmets to be required for bike riders in all 50 states, the District, and Puerto Rico, as the New York Times reported:

“The NTSB said research shows that less than half of bicyclists wear helmets, and that head injuries are the leading cause of bicycling fatalities … Researchers found that helmets reduced the likelihood of serious head injury by 60%, and that in cases where it was known whether cyclists were wearing helmets, 79% of those who were fatally injured between 2010 and 2017 were not wearing them. The National Highway Traffic Safety Administration said in a report last month that 857 cyclists were killed in traffic crashes last year, the highest number of fatalities since 1990.”

Alas, as has been the case with motorcyclists, a segment of bicyclists isn’t buying the idea of federally or state required helmets. Part of the joy of riding bikes or motorcycles, enthusiasts contend, is feeling free, with the wind whipping through the hair. Some object to head gear as ungainly or uncomfortable, as well as costly.

The District, by the way, requires bikers to wear a helmet. Children younger than 16 also wear one when “riding a scooter, skateboard, sled, coaster, toy vehicle, or any similar device,” district police advise. The firm’s web site offers a handy run-down of existing e-scooter laws.

In my practice, I see not only the harm that patients suffer while seeking medical services, but also the damage that can be inflicted on them and their loved ones by wrecks involving pedestrians, bikes, motorcycles, cars, and trucks. I’m all for allowing fans of walking or biking not only safety in their travels but also the aesthetic pleasures of tromping or zooming through the good, clean, fresh air. But my partners and I see and know just how serious back and spinal cord injuries can be — for a lifetime — and a few ounces of prevention from a helmet likely would be worth avoiding an ocean of tears from debilitating traffic injury. This issue also is taking on greater urgency with fatalities also occurring with scooters, including two deaths recently in Manhattan.

Photo credit: Chicago scooter rider turns an ankle @ Gabe Pierce, Unsplash