Objective To examine the rising casualty rate related to electric bicycle usage. Design Analysis of the Hangzhou Police Bureau's data on electric-bicycle-related injuries and deaths. Setting Hangzhou, China, 2004-2008. Patients or subjects Electric-bicycle riders. Main outcome measure Electric-bicycle-related casualty rates in Hangzhou from 2004 to 2008. Results There was a significant average annual increase in electric-bicycle-related casualty rates of 2.7 per 100 000 population (95% CI 1.5 to 3.9, p=0.005). At the same time, overall road traffic and manual-bicyclerelated deaths and injuries decreased. Conclusion As it is difficult to ban the use of electric bicycles in China, laws, rules and regulations need to be reinforced and strengthened. New regulations should be created for the safety of electric bicycle riders and others on the road, and mandatory helmet use should be considered.
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