By Christina Frangou

Savannah, Ga.—Surgeons from North Carolina are calling for all states to pass legislation requiring moped drivers to obtain a license.

Orthopedic surgeon Anna N. Miller, MD, made the appeal based on results from a study that showed one out of every two moped drivers involved in collisions in North Carolina had previous convictions for driving while intoxicated, and many had convictions for other driving-related crimes.

“We believe that mopeds serve as a mode of transport for those who are driving without a license and who may have a history of prior high-risk behavior,” said Dr. Miller, lead study author and a surgeon at Wake Forest School of Medicine, Winston-Salem, N.C.

“The use of these vehicles without a license likely presents a risk to public safety,” she said.

Dr. Miller presented the study at the 2014 Annual Scientific Meeting of the Southeastern Surgical Congress.

By the Numbers

For those treated for injuries after a collision:


|   of moped drivers had a prior history of DWI compared with only 8% of motorcycle drivers.


|   of moped drivers were previously convicted of a crime, 44% more than motorcycle drivers.


|   of moped drivers had revoked drivers’ licenses compared with 6% of motorcycle drivers

Most states require that drivers possess a valid license to operate a moped, defined as a motor vehicle with less than 55 cc engine displacement. However, six states do not. They are North Carolina, Indiana, Kentucky, Montana, Utah and Virginia.

A handful of other states allow an individual to obtain a moped license regardless of eligibility for or status of their driver’s license.

Dr. Miller and her colleagues reviewed their hospital’s experience after noticing that moped drivers who arrived at the hospital following a collision were often intoxicated. The investigators felt that patients were using mopeds as a legal means of transportation after having their licenses revoked for driving offenses.

The investigators studied all adult patients from North Carolina who were treated at their level 1 trauma center between January 2005 and October 2010 following motorcycle or moped collisions. They compared the results with corrections databases from the state to identify any prior convictions for driving while intoxicated (DWI) and other non-DWI offenses.

Over the study period, 249 moped drivers and 730 motorcycle drivers were treated for injury following a collision. Of these, 49% of moped drivers had a history of DWI compared with only 8% of motorcycle drivers. Almost two-thirds of moped drivers (64%) were previously convicted of a crime, a rate 44% higher than that for motorcycle drivers. Moped drivers also had statistically higher rates of revoked licenses—28% versus 6%—and more than twice as many serious driving convictions (65% vs. 31%).

In response to questions at the meeting, Dr. Miller said moped drivers had blood alcohol levels that more than doubled those of motorcycle drivers on admission, and a significantly higher number of moped drivers were over the legal limit.

The findings have important implications for health care costs and injury prevention, said Ronald F. Sing, DO, a trauma surgeon from Carolinas Medical Center in Charlotte, N.C.

He noted that this is the third study from North Carolina in three years to demonstrate that a significant proportion of moped drivers who are treated at trauma centers are recidivists with multiple alcohol-related traffic charges (Am Surg 2011;77:304-306; 2011;202:697-700). Both prior studies, which Dr. Sing co-authored, called for changes to licensure laws.

But Dr. Sing questioned whether such changes would deter moped drivers from drinking and driving.

“These people have already shown a disregard for the law. It’s not clear if prohibiting individuals with prior DWI charges or revoked licenses will have an impact on this population.”

Mopeds have experienced a resurgence of popularity over the past decade, with a 60% increase in sales, according to a study published in the Journal of Trauma (2011;71:217-222). That study looked at more than 5,600 moped crashes in Florida between 2002 and 2008. Alcohol and drug use was a significant risk factor in severe and lethal crashes, investigators found.

Alcohol has consistently been involved in 40% to 50% of motor vehicle collision deaths annually and is implicated in nearly 50% of trauma admissions annually.