{"id":199726,"date":"2026-10-01T13:18:15","date_gmt":"2026-10-01T11:18:15","guid":{"rendered":"https:\/\/www.erasmusmagazine.nl\/en\/?p=199726"},"modified":"2026-10-01T13:18:19","modified_gmt":"2026-10-01T11:18:19","slug":"er-moet-een-minimumleeftijd-komen-voor-fatbikes","status":"publish","type":"post","link":"https:\/\/www.erasmusmagazine.nl\/en\/2026\/10\/01\/er-moet-een-minimumleeftijd-komen-voor-fatbikes\/","title":{"rendered":"‘There should be a minimum age for fatbikes’"},"content":{"rendered":"\n

The number of cyclists seriously injured in the Netherlands has risen by 18 per cent in five years. Teenagers in particular are among the victims. This autumn, the House of Representatives will vote on a bill requiring minors to wear helmets on electric bikes. Meanwhile, Dennis den Hartog is seeing the consequences at Erasmus MC. “Teenagers race past without any protection. It’s life-threatening”, the trauma surgeon says.<\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\t
\n\t\t

Dennis den Hartog is a trauma surgeon at Erasmus MC, specialising in treating patients with multiple injuries, with a particular focus on injuries to the shoulder, elbow and pelvis. Since 2010, he has been head of the Southwest Netherlands Acute Care Network.<\/p>\n\n\t<\/div>\n\n\n\n

What do you think: should cyclists on e-bikes have to wear helmets or not?<\/strong><\/p>\n\n\n\n

“Medically speaking, there’s no question: it’s simply a very sensible idea. At any age. Whether you’re 10, 16 or 60, you can suffer serious injuries if you fall off your bike at 25 kilometres per hour. And many of these bikes go even faster. From a clinical perspective, I can’t really think of any argument against it.<\/p>\n\n\n\n

“And it’s not just about the individual. We live in a time when pressure on healthcare is increasing and healthcare costs are rising enormously. Injuries like these put even more pressure on the system, even though they’re essentially avoidable because they’re easy to prevent. From a societal perspective, to prevent is better than to cure as well.”<\/p>\n\n\n\n

How big is the problem? How many people are injured in cycling accidents each year?<\/strong><\/p>\n\n\n\n

“The number of people seriously injured is rising. Since 2021, it has increased by 18 per cent nationwide, and we’re also seeing a clear rise among teenagers and young adults. Last year, there were 1,114 trauma patients with serious injuries from cycling accidents in our Southwest region. And that doesn’t include people who went to their GP or the emergency department after an accident and may have been treated in hospital later. These are people who needed emergency treatment here.<\/p>\n\n\n\n

“That’s a striking increase, because the figure had been fairly stable for years. What’s behind it? With the rise of e-bikes and fatbikes, it seems to me that one plus one equals two. Sixty per cent of all the road traffic accidents we saw last year involved cyclists. We weren’t yet systematically recording how many of those involved an electric bike. When ambulance crews wrote ‘cycling accident’, we didn’t know whether it had involved an e-bike or a regular bike. Even so, we recorded more than 300 electric-bike accidents last year, so the true figure is higher.”<\/p>\n\n\n\n\t

\n\t\t
\n\t\t\t
\n\t
\n\t\t'They're often riding two or even three on a bike, with a phone in their hand, and then they race past you on the cycle path'\n\t<\/blockquote>\n\n\t<\/figure>\n\t\t<\/div>\n\t<\/div>\n\n\n\n

Who are the patients who come in?<\/strong><\/p>\n\n\n\n

“The average age of patients with serious injuries from fatbike accidents is 14! That’s really alarming. These are children who have very little awareness of traffic. They’re often riding two or even three on a bike, with a phone in their hand, and then they race past you on the cycle path. The average age of patients with serious injuries from e-bike accidents was 63. That’s worrying too: people whose reaction times are slowing and who are becoming more physically fragile are choosing a form of transport that goes much faster than they’re used to. They come off just as easily.”<\/p>\n\n\n\n

What kind of injuries do you encounter?<\/strong><\/p>\n\n\n\n

“We see some very serious injuries. Complex fractures to the feet or legs. We also see a lot of degloving injuries, where large areas of skin are torn away by the force of the impact. There are often problems with the lungs or airways. And, of course, there are serious head injuries: skull fractures and brain injuries. I treated a 16-year-old boy with several skull fractures; that’s genuinely life-threatening. If you don’t treat it immediately, the patient will die.<\/p>\n\n\n\n

“There’s a difference between the two groups. With fatbikes, the young children mostly have injuries to their lower legs: from the knee down, including the lower leg, ankle and foot. These can sometimes cause lasting damage, such as difficulty walking or chronic pain. Older people on e-bikes are more likely to suffer brain injuries, as well as broken ribs and hips. They often land on their head or side.”<\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

Does wearing a helmet help prevent injuries?<\/strong><\/p>\n\n\n\n

“Yes. In the clinic, we see that brain injuries are much more severe and occur much more often when patients aren’t wearing a helmet. There are more skull and facial fractures, as well as internal bleeding that requires emergency surgery.<\/p>\n\n\n\n

“A nationwide study<\/a> I was involved in also found that wearing a helmet significantly reduces cyclists’ risk of a skull fracture. The study found that fewer than 12 per cent of the 304 cyclists with serious brain injuries were wearing helmets. This allowed us to show that wearing a helmet offers protection.”<\/p>\n\n\n\n

The Dutch Cyclists’ Union is against a helmet requirement<\/a>, because it fears that people will cycle less often as a result. What’s your view?<\/strong><\/p>\n\n\n\n

“I don’t believe that at all. Just look at the ski slopes in the Alps. I don’t think fewer people have taken up skiing because they have to wear a helmet. And in countries where cyclists up to a certain age already have to wear helmets, such as Sweden or France, the proportion of people who cycle hasn’t fallen.<\/p>\n\n\n\n

“People never like change. People didn’t want to wear seatbelts either. They came up with all sorts of excuses: it was only a short drive to the supermarket, and they drove slowly. No one thinks that way now. Or take scooter helmets: my daughters didn’t like them at first either, because they messed up their hair and so on, but eventually it just becomes normal. I think it’ll be exactly the same with bike helmets.”<\/p>\n\n\n\n

As a trauma surgeon, can you do anything to reduce the number of accidents?<\/strong><\/p>\n\n\n\n

“Absolutely. We work together internationally to do that, for example through an international training programme for trauma doctors. Recently, I shared my experience of fatbike and e-bike accidents with colleagues from other European countries and the United States. We can learn a lot from each other. For example, we can see how crucial it is to improve the way we record whether accidents involved an e-bike or a regular bike.<\/p>\n\n\n\n\t

\n\t\t
\n\t\t\t
\n\t
\n\t\t'A universal helmet requirement, for all ages, and a minimum age for riding an electric bike'\n\t<\/blockquote>\n\n\t<\/figure>\n\t\t<\/div>\n\t<\/div>\n\n\n\n

“We need that data for prevention. Prevention involves three areas: the design of the bike and its surroundings, education, and enforcement. For example, we ran a campaign to encourage older people to wear helmets on e-bikes, and it really had an effect. There are now school programmes about fatbikes too, and we as trauma surgeons can contribute to them, for example by documenting the injuries these children sustain. I’m also in contact with policymakers at the Ministry of Infrastructure and Water Management. We can provide them with figures and clinical experience to help support the bill they’re working on.”<\/p>\n\n\n\n

What regulations would you introduce if it were up to you?<\/strong><\/p>\n\n\n\n

“A universal helmet requirement, for all ages, and a minimum age for riding an electric bike. These children are young \u2013 why do they need pedal assistance? You have to be 16 to ride a scooter, and there’s a reason for that. You could even consider requiring people to pass a theory or practical test to ride an electric bike.<\/p>\n\n\n\n

And what about withdrawing insurance coverage if you’ve modified your fatbike to make it go faster? So that if a young person causes an accident on a modified fatbike, the bill goes to their parents rather than the public having to pay. That would probably be legally difficult, but it would probably put a stop to it more quickly.”<\/p>\n\n\n\n\t

\n\t\t\t\t\t

Een lijst met artikelen<\/h2>\n\t\t\n\t\t
\n\n\t\t\t\n\t\t\t