Sir, - We wrote in these pages in August 2025 to highlight our concerns about a worrying rise in admissions of children with traumatic brain injuries (TBIs) sustained in e-scooter accidents (“Parents should not allow children on e-scooters”, Letters, August 27th, 2025). By mid-2025, e-scooters had become the leading cause of TBI resulting in admission to Children’s Health Ireland at Temple Street, Ireland’s paediatric neurosurgical centre. This is despite the fact it is illegal for anyone under 16 to use an e-scooter.The Road Safety Authority collaborated with us to produce an awareness campaign which was broadcast in the media from late 2025. At Government level, there have been no changes to regulations or legislation regarding e-scooters.We write now to highlight that the situation one year on is even worse. Admissions of children with TBIs due to e-scooter accidents have increased again by 50 per cent compared to the previous 12 months. They now account for over one-third of all TBI admissions to Temple Street. Children present to Children’s Health Ireland emergency departments with e-scooter-related injuries on a daily basis. The severity of these injuries ranges from minor trauma to serious and life-threatening presentations.There is no year-long record where a single cause of brain injury has caused as many admissions as e-scooters in the last 12 months. These injuries are serious – if admitted, children spend an average of 20 days in hospital, are often admitted to intensive care or undergo emergency neurosurgery. They are often discharged with newly-acquired disabilities which could be persistent. We are seeing children in clinic for follow-up care relating to ongoing difficulties with learning, fatigue, mental health and other difficulties. These problems continue for many months after their injuries. E-scooters cause injuries which can be life-changing.As consultants in paediatric rehabilitation, neurosurgery, emergency medicine and intensive care, we call for an urgent escalation in the response to an emerging and significant public health concern. The response thus far has focused on increasing awareness and on enforcement of existing regulations and laws. This response is clearly insufficient. Devolving responsibility to young people and their parents appears, based on current experience, to be a dereliction of the State’s duty. We ask for consideration of additional measures as soon as possible to keep children and young people safe on Ireland’s roads. Such measures could include new regulations regarding mandatory licensing and insurance, but should also consider an outright ban. – Yours, etc,Dr IRWIN GILL,Prof DARACH CRIMMINS,Dr PATRICK FITZPATRICK,DR CAROLINE FOX,Dr ORNA GRANT,Dr MARTON MÁRTON DELI,Children’s Health Ireland.