Coal-powered economic growth linked to rising urban air pollution and deaths in India

University of Oxford

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Dr Basudev Swain (left) and Dr Rui Song  (right) by the Radcliffe Camera, University of Oxford.

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Credit: Basudev Swain / Rui Song

Research led by the University of Oxford has found that rapid economic growth brought major gains in access to electricity and cleaner cooking in India, but growing reliance on coal-fired power has contributed to worsening outdoor air pollution and a sharp rise in urban air-pollution-related deaths. The study has been published today (25 Sept) in Nature Cities.

Rapid economic growth in India since 2000 has enabled millions of people to move towards cleaner cooking fuels and technologies, reducing exposure to household air pollution. But this growth has also driven a near-fourfold increase in electricity demand. According to the new study, over three quarters (76%) of this demand was supplied by coal, accompanied by a sharp rise in sulphur dioxide (SO₂) emissions. This has increased concentrations of sulphate aerosols and fine particulate matter (PM2.5), leading to a rise in the number of deaths caused by urban air pollution.

The findings reveal contrasting public-health consequences of India’s economic and energy transition: declining risks from pollution inside homes alongside increasing exposure to polluted outdoor air.

Study lead Dr Basudev Swain (Department of Physics, University of Oxford at the time of the study, now Goethe University Frankfurt, Germany) said: “This is not simply a story of development making pollution worse. Rising incomes have enabled a major transition towards cleaner household energy, with important health benefits. The challenge is to ensure that the electricity supporting those gains is itself generated more cleanly.”

The researchers combined satellite observations, atmospheric analysis, chemical transport modelling, socioeconomic and energy data, and population and mortality data to trace the connections between economic growth, electricity demand, power generation, air pollution and health.

Between 2000 and 2020, India’s GDP per capita increased from around US $600–$700 to more than US $2,000, while electricity demand rose from approximately 450 terawatt-hours (TWh) to almost 2,000 TWh. The analysis found that a 1% increase in GDP per capita was associated with an approximately 1.14% increase in electricity demand.

This was accompanied by a significant increase in the number of coal-fired power plants in India, with 71 being commissioned before 2000, and another 182 commissioned between 2001 and 2024.

Urban aerosol pollution increased markedly during this period. Sulphate – which can form in the atmosphere from SO₂ released by coal combustion – increased from approximately 35.5% of total urban airborne particle pollution in 2000 to 46.4% in 2020.

Atmospheric modelling indicated that the power sector’s contribution to total urban aerosol loading increased from around 16% in 2000 to 36% in 2020, making it the largest anthropogenic contributor in the analysis. The largest increases were concentrated across northern and eastern India, including the Indo-Gangetic Plain, where dense populations overlap with extensive coal-fired power infrastructure.

The study estimated that urban deaths attributable to PM2.5 exposure increased from approximately 670,000 in 2000 to 870,000 in 2020 – an increase of around 30%.

The increase associated with power-sector emissions was particularly pronounced. The modelling estimated that urban PM2.5-attributable deaths associated with power-sector emissions rose from approximately 15,000 in 2000 to nearly 300,000 in 2020.

The study also highlights a very different trend inside Indian homes. Access to clean fuels and technologies for cooking increased from approximately 25% of the population in 2000 to nearly 75% by 2023. Over a similar period, independent health datasets show a decline in deaths attributable to household air pollution, falling from approximately 1.25–1.30 million a year around 2010 to approximately 1 million a year by 2023.

Study co-author Dr Rui Song (Department of Physics, University of Oxford) said: “Our findings have implications well beyond India. They show how difficult it can be to break the link between economic development and coal dependence when rapidly rising electricity demand and energy-security concerns prolong reliance on existing coal infrastructure. Coal-fired power not only worsens air quality and harms public health; its aerosol emissions can also reduce solar power output, directly weakening the clean energy transition.”

The researchers note that coal-fired electricity generation is not the sole cause of India’s urban air pollution, and that industrial emissions also made an important contribution to worsening air pollution. According to the study’s models, by 2020 the power sector accounted for an estimated 36% of total urban airborne particle pollution, while industry accounted for about 32%. However, power-sector PM2.5 increased by around 400% between 2000 and 2020, compared with around 90% for industrial emissions.

Notes to editors:

For media enquiries and interview requests, contact: caroline.wood@admin.ox.ac.uk

The study ‘Economic boom-driven electricity demand linked to urban air pollution and health in India’ will be published in Nature Cities at 10:00 am BST / 5:00 am ET Friday 25 September 2026 at https://www.nature.com/articles/s44284-026-00518-9 To view a copy of the study before this under embargo, contact caroline.wood@admin.ox.ac.uk

About the University of Oxford

Oxford University has been placed number 1 in the Times Higher Education World University Rankings for the tenth year running, and ​number 3 in the QS World Rankings 2024. At the heart of this success are the twin-pillars of our ground-breaking research and innovation and our distinctive educational offer.

Oxford is world-famous for research and teaching excellence and home to some of the most talented people from across the globe. Our work helps the lives of millions, solving real-world problems through a huge network of partnerships and collaborations. The breadth and interdisciplinary nature of our research alongside our personalised approach to teaching sparks imaginative and inventive insights and solutions.

Through its research commercialisation arm, Oxford University Innovation, Oxford is the highest university patent filer in the UK and is ranked first in the UK for university spinouts, having created more than 300 new companies since 1988. Over a third of these companies have been created in the past five years. The university is a catalyst for prosperity in Oxfordshire and the United Kingdom, contributing around £16.9 billion to the UK economy in 2021/22, and supports more than 90,400 full time jobs.

Journal

Nature Cities

DOI

10.1038/s44284-026-00518-9

Article Title

Economic boom-driven electricity demand linked to urban air pollution and health in India

Article Publication Date

25-Sep-2026

 

US will face a shortage of nearly 28,000 surgeons by 2038, first nationwide study finds

Vascular surgery, ophthalmology, thoracic surgery, and plastic surgery face the greatest shortfalls, with shortages especially severe in rural areas

American College of Surgeons

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Key Takeaways

• The U.S. is projected to be short nearly 28,000 surgeons by 2038, with the workforce meeting just 84.3% of national need.
• Gaps between surgeon supply and demand are projected to be worse in rural areas.
• The greatest shortfalls are projected in vascular surgery, ophthalmology, thoracic surgery, and plastic surgery. 
• Expanding the number of residencies available can help train more doctors to meet future critical needs.
• The findings will be presented at the American College of Surgeons Clinical Congress 2026 in Washington, Sept. 26-29.

WASHINGTON (September 25, 2026) — The United States will be short nearly 28,000 surgeons by 2038, according to the first unified assessment of the country’s surgical workforce.

The analysis found the surgeon workforce will meet just 84.3% of the country’s need, with the greatest shortfalls in vascular surgery, ophthalmology, thoracic surgery, and plastic surgery, and gaps projected to be worse in rural areas. Concerns about a physician shortage aren’t new, but previous estimates have focused on one or a handful of specialties, leaving no unified picture of how many surgeons the country will need, or where.

The research will be presented at the American College of Surgeons (ACS) Clinical Congress 2026 in Washington, Sept. 26-29, where thousands of surgeons will convene to advance surgical quality, patient safety, and access to care.

“Studies usually look at one specialty at a time, so a shortage looks like that specialty’s problem,” said Fernando Ribeiro Duraes, BA, a medical student at Case Western Reserve University School of Medicine, and lead author on the study. “When you put all 10 specialties together, you can see supply is projected to fall while demand keeps rising, and that the gaps are worse in rural areas. The fixes have to be targeted by specialty and by geography, not incremental.”

In this study, researchers used the Health Workforce Simulation Model (HWSM), a federal model from the U.S. Department of Health and Human Services, and analyzed supply and demand across 10 surgical specialties from 2023 to 2038. They included ophthalmology, plastic surgery, vascular surgery, urology, orthopedics, otolaryngology, neurosurgery, thoracic surgery, general surgery, and colorectal surgery. To create demand projections, they analyzed demographics, health utilization patterns, and physician-to-population ratios.

Study Results

Researchers found that overall, surgeon supply is projected to decline 4.2% from 2023 to 2038, while demand for surgeons will increase by 12.8%. Researchers anticipate this will result in a shortfall of 27,940 surgeons nationally. Across the U.S., the workforce is projected to meet 84.3% of need. Four specialties face critical shortages: vascular surgery (65.8% of need met), ophthalmology (71.8%), thoracic surgery (73.1%), and plastic surgery (74.1%).

Four more specialties face moderate shortages: urology (84.4%), otolaryngology (87.5%), orthopedics (87.9%), and neurosurgery (88.7%). General surgery (91.3%) and colorectal surgery (98.3%) are projected to stay near equilibrium.

These gaps between surgeon supply and demand are also projected to be worse in rural areas. 

The study began close to home. Eliana Ferreira Ribeiro Duraes, MD, PhD, MBA, a plastic surgeon at the Cleveland Clinic, and Fernando Ribeiro Duraes’ mother, started the work by looking at shortages in her own specialty. “I saw [Fernando Ribeiro Duraes] and his colleagues trying to figure out what specialty they wanted,” she said, which prompted a study into wider projections so they can “understand the future and what’s expected to be the landscape in different surgical specialties.” 

For patients, surgical shortages mean longer waits for procedures. Patients may also need to travel longer distances for medical care, especially for people in rural areas who may have to drive hours to be treated.

The findings, researchers say, point to the urgent need to address future surgeon shortages through targeted workforce policies and geography-focused strategies beyond incremental changes. Fernando Ribeiro Duraes specifically points to the proposed bill H.R. 3890, the Resident Physician Shortage Reduction Act, which would raise the number of residency positions, a figure that has not changed since 1997; undoing recent caps placed on federal loan borrowing; and expanding loan forgiveness programs for public service, which can help “encourage physicians to go to these rural areas,” he said. 

Co-authors are Victor F. A. Almeida, MD; John Y. Ha, BA, BS; Emanuella M. Brito, BS; Manoela Dantas, MD; Leonardo De Castro Duraes, MD, PhD; Risal S. Djohan, MD; and Eliana Ferreira Ribeiro Duraes, MD, PhD, MBA.

Disclosures: Authors have no disclosures to report. 

Citation: Ribeiro Duraes F, et al. Projected Surgical Workforce Shortages in the United States: A National Workforce Analysis to 2038. Scientific Forum, American College of Surgeons (ACS) Clinical Congress 2026.

Note: Research abstracts presented at the ACS Clinical Congress Scientific Forum are reviewed and selected by a program committee but are not yet peer reviewed.

# # #

About the American College of Surgeons

The American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and improve the quality of care for all surgical patients. The College is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has approximately 95,000 members and is the largest organization of surgeons in the world. "FACS" designates that a surgeon is a Fellow of the American College of Surgeons.

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Urban heat islands linked to worse recovery after major surgery

Air conditioning, hydration, and access to cooling centers may need to become part of discharge planning, researchers say

American College of Surgeons

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Key Takeaways 

• Among 697,552 patients undergoing major surgery, each additional 1°C (1.8°F) of urban heat island intensity above a 2.19°C (3.9°F) threshold was associated with 8% higher odds of failing to achieve a “textbook outcome” after surgery. 

• The association was stronger among Black patients and people living in areas with high social vulnerability. In an analysis limited to heat island intensity above the 2.19°C threshold, it was particularly pronounced after cancer-related, emergency, and high cardiac-risk procedures. 

• Researchers say surgical teams may need to ask about home cooling and hydration and connect high-risk patients with community resources before discharge during hot weather. 

• The findings will be presented at the American College of Surgeons Clinical Congress 2026 in Washington, Sept. 26-29. 

• 
  

WASHINGTON — Patients living in areas with more intense urban heat were less likely to have an optimal recovery after major surgery, according to new research on nearly 700,000 patients.  

The research will be presented at the American College of Surgeons (ACS) Clinical Congress 2026 in Washington, Sept. 26-29, where thousands of surgeons will convene to advance surgical quality, patient safety, and access to care. 

Above an urban heat island intensity threshold of 2.19°C, or about 3.9°F, each additional 1°C (1.8°F) was associated with 8% higher odds of not achieving a “textbook outcome.” In this study, a textbook outcome required no complications, no readmission, no prolonged hospital stay, and survival for at least 30 days. 

An urban heat island is a developed area that is warmer than its surroundings. Roads, buildings, and other infrastructure absorb and re-emit more heat than natural landscapes, while limited trees and vegetation reduce shade and natural cooling. The temperature difference can vary substantially across neighborhoods within the same city. 

“Heat isn’t only uncomfortable; these data suggest it can have a real impact on surgical recovery,” said Timothy M. Pawlik, MD, PhD, MPH, MTS, MBA, FSSO, FACS, senior author of the study and professor and chair of the Department of Surgery at The Ohio State University Wexner Medical Center in Columbus, Ohio. “It’s something health care providers need to be aware of. We need to screen for heat exposure and connect at-risk patients with resources.” 

Satellite Data Linked Neighborhood Heat to Surgical Recovery 

The research team developed the Adaptive Spatiotemporal Environmental Thermal Health Exposure Resolution framework, a method for estimating heat exposure in the areas where patients live. The framework used satellite-derived temperature data to link patients’ residential areas with urban heat island intensity, postoperative outcomes, and community characteristics. 

The study included 697,552 patients who underwent major surgery across 3,144 U.S. counties. Their average age was 76 years old. 

Overall, 50.2% of patients achieved a textbook outcome. Across the cohort: 

• 25.2% experienced complications 

• 22.9% had a prolonged hospital stay 

• 14.8% were readmitted 

• 7.1% died within 30 days 

The relationship between heat and suboptimal surgical recovery was stronger among Black patients and residents of communities with high Social Vulnerability Index scores, a composite measure of community-level social and economic vulnerability. 

When the researchers restricted the analysis to urban heat island exposure above 2.19°C, the association was particularly pronounced among patients undergoing cancer-related, emergency, or high cardiac-risk procedures. 

Dr. Pawlik said dehydration and changes in the body’s fluid balance during high heat may be one possible explanation for the stronger association among cardiac patients, who may have less ability to tolerate those stresses.  

Heat Risk May Need to Be Part of Discharge Planning 

The findings suggest that surgical teams may need to consider not only whether a patient is medically ready to leave the hospital, but also whether the patient can recover safely in the environment to which they are returning. 

“Do you have air conditioning in your house? Do you have a fan? Are you going to be able to stay hydrated?” Dr. Pawlik said. He added that questions about heat exposure may need to be increasingly incorporated into discharge planning.  

Access to cooling is not equal. People at higher risk during extreme heat include older adults, people with chronic health conditions or disabilities, people with limited incomes, people experiencing homelessness, and those who do not have access to safe, adequately cooled housing. 

Many communities open cooling centers during periods of extreme heat. Hospitals, patients, and caregivers can use a state-by-state directory of cooling center resources to identify potential local assistance. 

Because the study was observational, it identifies an association and does not establish that residential heat exposure caused the worse outcomes. 

Co-authors are Jethro Z. S. Wang, DMD, MS; Abdulaziz Elemosho, MD; Zheheng Huang, MS; Peng Chen, PhD; Odysseas P. Chatzipanagiotou, MD; Rabia Bega, MBBS, MPH; Yanping Xu, MD, PhD; Lorenza Arena, MD; and Sebastian O. Ekenze, MD, MPH. The authors are affiliated with The Ohio State University in Columbus, Ohio. 

Disclosures: Authors have no disclosures to report.  

Citation: Wang, J, et al. Heat Island-Related Surgical Outcome Burden under Global Warming, Demographic and Adaptation in 3,144 Counties across the United States. Scientific Forum, American College of Surgeons (ACS) Clinical Congress 2026. 

Note: Research abstracts presented at the ACS Clinical Congress Scientific Forum are reviewed and selected by a program committee but are not yet peer reviewed.  

# # # 

About the American College of Surgeons   

The American College of Surgeons (ACS) is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and improve the quality of care for all surgical patients. The ACS is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has approximately 95,000 members and is the largest organization of surgeons in the world. “FACS” designates that a surgeon is a Fellow of the ACS.   

Follow the ACS on social media: X | Instagram | YouTube | LinkedIn | Facebook 

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Article Title

Heat Island-Related Surgical Outcome Burden under Global Warming, Demographic and Adaptation in 3,144 Counties across the United States

Article Publication Date

25-Sep-2026

 

Prostate cancer surgery and radiation have different long-term effects on urinary, sexual, and survival outcomes 

Surgery was linked to more urinary and sexual side effects, while radiation was associated with certain urinary complications and higher all-cause mortality, national study finds 

American College of Surgeons

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Key Takeaways 

• A national study of more than 20,000 men with prostate cancer compared long-term outcomes after radiation therapy or surgical removal of the prostate, with follow-up of up to 20 years. 

• Men who underwent surgery had higher rates of urinary incontinence and erectile dysfunction. In contrast, men treated with radiation had higher rates of certain urinary complications and higher all-cause mortality, corresponding to a 45% higher rate of death from any cause during follow-up. Researchers could not determine whether treatment contributed to the difference in deaths. 

• Neither treatment was free of long-term consequences, and the authors emphasize that risks, benefits, and side effects of the options should be discussed carefully with patients. 

• The findings will be presented at the American College of Surgeons Clinical Congress 2026 in Washington, Sept. 26-29. 

WASHINGTON — Men with prostate cancer face different long-term risks depending on whether they choose surgery or radiation therapy, with surgery linked to higher rates of urinary incontinence and erectile dysfunction and radiation linked to higher all-cause mortality, according to a national analysis of more than 20,000 men followed for up to 20 years. 

The research will be presented at the American College of Surgeons (ACS) Clinical Congress 2026 in Washington, Sept. 26-29, where thousands of surgeons will convene to advance surgical quality, patient safety, and access to care. 

Prostate cancer is the most common cancer diagnosed in men after skin cancer, with more than 300,000 men expected to be diagnosed this year. For men whose cancer has not spread beyond the prostate, radiation therapy and surgical removal of the prostate, known as radical prostatectomy, are two common treatment options. Choosing between them can involve weighing potential effects on urinary and sexual function and other long-term health outcomes. 

“Treatment for prostate cancer can be life changing for many men, whichever option they choose,” said Jeffrey P. Weiss, MD, PhD, FACS, professor and chair of urology at SUNY Downstate Health Sciences University, and senior author of the abstract. “Both of these treatments can affect urinary and sexual function, though those risks are balanced against the potential for a cure.” 

Researchers analyzed medical records from more than 20,000 men in the TriNetX Research Network who underwent either radiation therapy or radical prostatectomy (including both open and laparoscopic/robotic surgical approaches). Patients were followed for up to 20 years, with a median follow-up of five years. 

Each treatment group included more than 10,000 men and about 17% of patients were Black, making the study population more reflective of the demographics of men diagnosed with prostate cancer today than many earlier studies, noted Juliana Viola, first author of the study and a medical student at SUNY Downstate College of Medicine. Researchers also closely matched patients based on demographic and health characteristics to make the two treatment groups as comparable as possible. 

Study Findings 

• Urinary and sexual side effects: Men who underwent surgery had higher rates of urinary incontinence (28.5% vs. 6.1%) and erectile dysfunction (35% vs. 13.9%). Urinary tract infections (7.4% vs. 4.7%) and obstructive urinary complications (3.6% vs. 2.6%) were also more common after surgery. 

• All-cause mortality: Men treated with radiation had higher all-cause mortality during follow-up than men who underwent surgery (7.8% vs. 6.5%). In a time-to-event analysis, radiation was associated with a 45% higher rate of death from any cause at any given point during follow-up. Because the study measured deaths from any cause, researchers could not determine whether treatment contributed to the difference. 

• Other urinary complications: Men treated with radiation had higher rates of urinary retention (4.4% vs. 4.1%), bladder inflammation (4.3% vs. 3.5%), blood in the urine (11% vs. 10.1%), and inflammation and pain of the prostate gland (0.49% vs. 0.17%). 

While researchers closely matched the two treatment groups, other differences between patients may have influenced the results. As an observational study, the research cannot show that the treatments caused the outcomes. 

“The treatment choice matters in prostate cancer. Patients should understand how the main options differ before they decide,” Dr. Weiss said. “Clinicians need to recognize that these treatments differ in significant ways. The specific risks, benefits, and side effects should be discussed carefully with each patient.” 

The authors noted that future research could examine prostate cancer-specific survival, recurrence, and other long-term outcomes. 

“In prostate cancer, clinicians and patients tend to be driven by avoiding side effects, but we need to better understand the long-term outcomes of each of these treatment options,” Dr. Weiss said. 

Co-authors are Myles Goliger, BS; Robert Adler, BA; Michael Kozlov, BA; Nikolaos Karanikolas, MD, FACS; and Andrew G. Winer, MD, FACS.  

Disclosures: Authors have no disclosures to report.  

Citation: Viola J, et al. Radiation Therapy versus Radical Prostatectomy: A Propensity-Matched Analysis of Mortality and Long-Term Urologic Sequelae. Scientific Forum, American College of Surgeons (ACS) Clinical Congress 2026. 

Note: Research abstracts presented at the ACS Clinical Congress Scientific Forum are reviewed and selected by a program committee but are not yet peer reviewed.  

# # # 

About the American College of Surgeons   

The American College of Surgeons (ACS) is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and improve the quality of care for all surgical patients. The ACS is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The ACS has approximately 95,000 members and is the largest organization of surgeons in the world. “FACS” designates that a surgeon is a Fellow of the ACS.   

Follow the ACS on social media: X | Instagram | YouTube | LinkedIn | Facebook 

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Method of Research

Data/statistical analysis

Subject of Research

People

 

E-scooter trauma admissions nearly double as youngest riders are hurt most severely

Trauma admissions rose 92%; helmet use was documented in only 12%, and nearly two-thirds of injured riders under 16 sustained major injuries

American College of Surgeons

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Key Takeaways 

• E-scooter trauma admissions nearly doubled from 2021 to 2023, increasing 92%, according to a national analysis of more than 10,000 admissions. 

• Helmet use was associated with lower odds of ICU admission but was documented in only 12% of e-scooter trauma admissions. 

• A separate study found that riders under 16 sustained more severe injuries despite lower reported speeds, highlighting potential increased risk for younger riders. 

• The findings will be presented at the American College of Surgeons Clinical Congress 2026 in Washington, Sept. 26-29. 

WASHINGTON — E-scooter trauma admissions nearly doubled from 2021 to 2023, and nearly two-thirds of injured riders under 16 sustained major injuries, according to two national analyses. 

The studies will be presented at the American College of Surgeons (ACS) Clinical Congress 2026 in Washington, Sept. 26-29, where thousands of surgeons will convene to advance surgical quality, patient safety, and access to care. 

Together, the studies provide a national look at the growing burden of e-scooter injuries and the factors that may influence their severity. The findings arrive against an uneven policy backdrop: e-scooter age limits, speed restrictions, and helmet requirements vary by state and locality. 

E-Scooter Trauma Admissions Nearly Double 

E-scooter trauma admissions increased 92% from 2021 to 2023, and helmet use was documented in only a small proportion of cases, according to a national analysis of more than 10,000 trauma admissions. 

Researchers from Howard University Hospital in Washington analyzed national trauma data from 2021-2023, the first years a standardized diagnostic code was available to track e-scooter injuries. Among 10,151 e-scooter trauma admissions: 

• Admissions increased from 2,311 in 2021 to 4,430 in 2023, a 92% increase. E-scooter cases also increased from 0.19% to 0.34% of all trauma admissions in the database. 

• Helmet use was documented in only 12.1% of admissions. 

• Although most injuries were considered minor or moderate (85%), 16.2% of patients required ICU admission and 11.3% underwent an operation. 

• Most patients were male (72.4%) and between the ages of 18 and 64 (72.5%). 

• After adjusting for other factors, patients younger than 18 or 65 and older, those with a rapid heart rate, and those presenting with moderate or severe impairment in consciousness based on the Glasgow Coma Scale had higher odds of ICU admission. Helmet use and obesity were associated with lower odds of ICU admission. 

“It’s important to recognize that e-scooters are not innocuous vehicles; there is danger to them,” said Quyen D. Chu, MD, MBA, FACS, a professor of surgery at Howard University Hospital and senior author of the study. “We need to counsel patients that when they ride these vehicles, they should slow down, obey traffic rules, and wear helmets. Injuries can lead to serious consequences, including a greater than 10% chance of needing an operation.” 

The authors said future research should examine injury patterns and helmet use more closely, including potential differences across communities. 

“We may just be seeing the tip of the iceberg when it comes to understanding trauma related to e-bikes and e-scooters,” said Edward E. Cornwell III, MD, FACS, FCCM, a professor of surgery at Howard University College of Medicine and co-author of the study. “Although this was a national study, injury patterns may differ in urban, suburban, and rural settings. We need to understand this better to prevent more injuries and actively plan for treating these injuries in the trauma bay.” 

Younger Riders Injured More Severely 

In a separate study, younger age was associated with more severe e-scooter injuries among children and adolescents, even though older riders reported traveling at higher speeds, according to research led by a team at Mass General Brigham for Children in Boston. 

Researchers analyzed e-scooter injuries among patients 18 and younger using the National Electronic Injury Surveillance System, examining whether age and reported speed were associated with injury severity. Among 2,185 patients: 

• The average age was 12.8 years, and nearly three-quarters of patients were between the ages of 6 and 15. 

• Patients under 16 sustained major injuries at a significantly higher rate than patients older than 16: 65.6% compared with 53.7%. 

• After adjusting for other factors, older age was associated with three times the odds of sustaining a minor injury and 58% lower odds of sustaining a major injury. 

• Older patients reported traveling at higher average speeds than younger patients (20.3 mph vs. 17.6 mph), suggesting younger age was associated with greater injury severity despite lower reported speeds. 

“A child’s body is still developing, and that—more than the speed of the scooter—is what seems to determine how badly they get hurt,” said Cornelia L. Griggs, MD, MPH, FACS, a pediatric surgeon and surgical critical care specialist at Mass General Brigham for Children, and senior author of the study. 

“An e-scooter is not a toy. We know they’re convenient and many families enjoy them, but a child can get hurt far worse on one than on a regular bike,” she added. 

Co-authors of the national study on e-scooter trauma admissions are Siobhan Nnorom, MD; Nathan B. Lam, BS, MS; Lerone A. Ainsworth, MBBS; Marco Ayad, MD; Valentine Nofong, MBChB; Oluwasegun A. Akinyemi, MD, MSc, PhD; Alexander Evans, MD, MBA, FACS; and Kakra Hughes, MD, PhD, FACS. The authors do not report any relevant disclosures. 

Co-authors of the study on e-scooter injury severity and age are Fiona Beltran, MD; Ikem Nzenwa, MBCHB, MSc; Reagan Collins, MD; and Matthew P. Shaughnessy, MD, MHS. The authors do not report any relevant disclosures. 

Citations: 

Nnorom S, et al. National Trauma Burden of Electric Scooter Injuries Since Standardized ICD-10 Coding. Scientific Forum, American College of Surgeons (ACS) Clinical Congress 2026. 

Beltran F, et al. Severity of Electric Scooter Injury Is Disproportionately Associated with Younger Age. Scientific Forum, American College of Surgeons (ACS) Clinical Congress 2026. 

Note: Research abstracts presented at the ACS Clinical Congress Scientific Forum are reviewed and selected by a program committee but are not yet peer reviewed.  

# # # 

About the American College of Surgeons   

The American College of Surgeons (ACS) is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and improve the quality of care for all surgical patients. The ACS is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The ACS has approximately 95,000 members and is the largest organization of surgeons in the world. “FACS” designates that a surgeon is a Fellow of the ACS.   

Follow the ACS on social media: X | Instagram | YouTube | LinkedIn | Facebook 

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Method of Research

Data/statistical analysis

Subject of Research

People