Getting a bicycle to put under the Christmas tree this year?

Honolulu first responders urge the public to remember the importance of bike helmets and basic safety rules as the holidays approach.

“Bikes are fun, generally very safe, but we do see and have been seeing an increase in accidents or EMS response, in the last year, particularly with the e-bikes,” said Dr. Jim Ireland, director of the Honolulu Emergency Services Department. “We’re seeing a combination of things that are potentially preventable.”

At a news conference at The Bike Shop in Kailua on Thursday, Honolulu EMS, along with Adventist Health Castle, urged residents to keep safety in mind if bicycles are on the Christmas shopping list.

In particular, they urged bicyclists of all ages to wear properly fitted helmets. Under Hawaii law, anyone under the age of 16 must wear a helmet while riding a bike.

Ireland said there has been a noticeable uptick in the number of e-bike-related injuries this year, particularly as they grow in popularity.

In the first 11 months of this year, EMS responded to 206 injuries related to e-bike and e-motorcycle riders. During the same time, EMS also responded to 163 injuries related to pedal bicycle riders.

More than half of injured bicyclists, including e-bikes and pedal bikes, required transport to the hospital. The majority were not wearing helmets.

Dr. Alexander Berk, director of Adventist Health Castle’s Emergency Department, said bicycle-related injuries account for nearly 300,000 visits to ERs in the U.S. each year.

With e-bikes, which can travel at higher speeds, the injury factor goes up, which is something parents should be aware of.

“Speed equals injury,” said Berk, “so if you double the speed, you’re actually quadrupling the injury to these kids.”

Someone who falls off a bike going about 10 mph might suffer a sprain, scrape, bump and bruise, he said, but someone falling from a bike going 20 mph will experience four times the amount of force, potentially resulting in broken bones and significant head injuries.

“Wearing a properly fitted helmet will decrease the risk of traumatic brain injury, and significant intracranial bleeding by up to 88%,” said Berk. “So when you think about that number right there, it’s a no-brainer, no pun intended, to put a helmet on.”

Parents should also be aware of what kind of bicycle is the right fit for their child.

Under current law the minimum age to operate a “low-speed” e-bike in Hawaii is 15, as long as it is registered to an adult household member.

But there appears to be rampant disregard of age limits, and many say regulations have not kept up with e-bikes’ evolving technology.

The City and County of Honolulu’s newly formed working group discussed these safety issues and regulations needed for e-bikes, including consideration of all the various classes and speeds, and how to better educate parents about them.

Mel Nakahata, general manager of The Bike Shop, says there are three classes of e-bikes.

Class 1 generally goes up to 20 mph, with pedal-assist only; Class 2 goes up to 20 mph with the choice of a pedal-assist or a throttle; and Class 3 goes up to 28 mph.

Due to their increased weight and speeds, Nakahata emphasized it was important for e-bike cyclists in particular — as well as all cyclists — to wear helmets.

Ireland said there are several categories of injuries paramedics are seeing related to e-bikes, with some riders as young as 9 years old.

There are e-bike riders who lose control and crash solo, whether colliding into parked cars or poles or skidding out on the street.

Sometimes these e-bike riders are doing wheelies and “performing,” putting on exhibitions of speed.

“Especially with no helmet, we’re seeing head injuries, intracranial bleeding and facial fractures,” said Ireland.

There are also e-bike riders who disregard laws, weave in and out of traffic and collide with other vehicles. These result in some of the worse injuries, including chest and head injuries and fractures, he said.

A smaller number of e-bike riders are following the rules but are cut off or struck by cars.

The message, Ireland said, is to “use safety equipment, be safe when you’re on two wheels and really just have a safe holiday season.”