All-terrain Vehicle Injuries Research Articles

Safety factors related to all-terrain vehicle injuries in children

All-terrain vehicle (ATV)-related injuries are a significant source of pediatric trauma. We hypothesized that these injuries are caused by poor safety behavior. To test this hypothesis, we surveyed both injured and uninjured ATV riders. A prospective convenience sample-based survey was initiated at Children's Hospital of Pittsburgh, a Level I pediatric trauma center. Patients with an ATV-related injury were asked to complete the survey for the study group (INJ), while uninjured pediatric ATV-riders completed the survey for the control group (UnINJ). The Fisher's exact probability test was used for data analysis. There were 38 surveys completed for INJ and 11 for UnINJ. Both groups had similar demographics. ATVs in both groups were mostly used for recreation, and most of the INJ patients were in a rural setting. Half of the ATVs were purchased second hand, and less than half were purchased from a dealer. Most dealers reviewed age recommendations for ATV use; however, many safety recommendations were not followed. INJ group had a higher percentage of children riding inappropriately sized ATVs and a lower rate of helmet use when compared with UnINJ group. In addition, there were a significant number of regulatory violations in the INJ group, including nine children (24%) riding as passengers and 5 (13%) driving on a road. These data suggest that there may be decreased safety behavior among injured pediatric ATV-riders; however, uninjured riders also demonstrate poor safety habits. The study showed that dealers do review safety regulations with consumers; however, most of the ATVs are not purchased through dealers. Therefore, we may need to shift our safety and educational focus to reach these families. Prognostic/epidemiologic study, level III.

All-terrain vehicles on the road: a serious traffic safety concern

BackgroundOn-road all-terrain vehicle (ATV) crashes are frequent despite most US states having laws restricting road use.Aims/Objectives/PurposeTo determine the demographics, and the mechanisms and outcomes of injuries of on-road versus off-road...

Barriers to helmet use for drivers of all-terrain vehicles

BackgroundInjuries from all-terrain vehicles (ATV) often result in head injuries with substantial risk of death and disability. Despite these risks, helmet use is less than 50%.ObjectiveTo identify barriers to helmet...

368 Off-Highway Vehicle Parks: Do Increased Regulations and Enforcement Improve All-Terrain Vehicle Safety?

Study Objectives: All-terrain vehicle (ATV) popularity has risen dramatically in the past 15 years and has been accompanied by an even greater increase in crash-related deaths and injuries. The number of off-highway vehicle parks, both public and private, continues to grow to meet the recreational needs of ATV enthusiasts. These parks require users to obey all state laws, often have additional safety regulations, and in our state have personnel dedicated to enforcement of laws and regulations. Little is known about how off-highway vehicle park regulations and enforcement affects ATV user behavior and safety. The objective of this study was to determine whether there were differences in crash mechanisms and/or compliance with ATV safety laws and regulations when comparing off-road ATV crashes inside and outside state off-highway vehicle parks. Methods: Data were derived from our statewide ATV injury surveillance database (2002-2009). Descriptive analyses were performed for demographics, risk factors (eg , carrying passengers), crash mechanisms, and outcomes of injuries. Comparisons of categorical and continuous variables were performed. Results: A total of 813 injured persons were included in the final analysis; 6% of victims were from OHV park crashes. Relative to outside the parks, a smaller percentage of park victims were under the age of 6teen (7% versus 31%, p<0.01), a lower percentage were passengers (2.5% versus 13%, p=0.07), and a dramatically higher percentage were helmeted (90% versus 24%, p<0.0001). However, park crashes involved more jump-related injuries (34% versus 5%, p<0.001). Mean injury severity scores were not different between the 2 locations, but 5% of victims outside the parks had severe brain injuries (GCS <8) as compared to no park victims. Conclusion: Off-highway vehicle park crashes involved more jump-related events, suggesting that additional studies of individual parks may be necessary to identify high-risk areas and to improve park safety. However, park victims exhibited better compliance with ATV safety-related laws and regulations and suffered less severe brain injury outcomes. These findings support the hypothesis that ATV safety regulations accompanied by effective enforcement promote safe behaviors that may prevent injuries.

All-Terrain Vehicle Dealership Point-of-Sale Child Safety Compliance in Illinois

In 2008, an estimated 37,700 children younger than 16 were treated in US emergency departments for nonfatal all-terrain vehicle (ATV) injuries. This study identifies safety guidelines and recommendations dealers convey to consumers at the point of sale. A telephone survey of all 2004 licensed motorcycle dealers in Illinois was conducted. Trained investigators, using aliases and posing as a parent of a 13-year-old teenager, spoke with dealership personnel. Investigators indicated they wished to purchase an ATV with the dealership, but had no knowledge of ATV use or safety issues. The telephone call's true purpose was concealed during the survey. Specific responses from the salesperson, models and brands of ATVs, price quotes, engine sizes, and safety information/recommendations were recorded in a written survey instrument. One hundred twenty-seven ATV dealers completed the survey. A salesperson most often fielded the telephone interview (124/127). Telephone interviews by male investigators were longer than those by female interviewers (5 minutes 37 seconds vs 3 minutes 51 seconds; P = 0.001). Dealers recommended Consumer Product Safety Commission-based child-size ATVs (<90 mL engine size) during 75% of the calls. Nearly all dealers recommended helmet use (108/127), and few (3/127) labeled the vehicles as "safe." Most dealers (83.5%) recommended some form of rider training, with half (49.6%) offered point-of-purchase training. All-terrain vehicle dealers in Illinois recommend child-size vehicles, safety training, and helmet use for the majority of telephone inquiries. Injury prevention efforts targeting ATV dealers may be less needed than those using other populations.

Evaluation of a Standardized All-Terrain Vehicle Safety Education Intervention for Youth in Rural Central Illinois

Although research investigating all-terrain vehicle (ATV) riders and ATV injury patterns has led to support for legislative and educational efforts to decrease injuries in users younger than 16 years, there is little published data regarding the utility of ATV safety education programs. This study investigates the effectiveness of a standardized adolescent ATV safety program in changing the safety knowledge and safe ATV riding practices reported by rural Central Illinois youths. A convenience sample of 260 rural Central Illinois middle and high school students received an ATV safety presentation with both didactic and interactive features during the 2009-2010 school year. Preintervention and postintervention surveys were distributed and collected by teachers. Survey questions consisted of multiple-choice questions pertaining to demographics, ATV safety knowledge, and ATV riding practices. More than 200 surveys were collected prior to the intervention and 165 surveys were collected 12 to 24 weeks after the intervention. Percentages are reported, with differences in nominal variables tested by χ(2) test and interval variables by t test. Following the intervention, there was a significant increase in the correct response rate for ATV safety knowledge questions (45.2% vs 56.2%, P < .001). For adolescents who reported riding ATVs, both safety gear use (11.8% to 21.2%, P = .05) and helmet use (25.4% to 29.0%, P = .56) increased; changes were not significant. Adolescent ATV riders reporting 2 or more accidents showed a slight nonsignificant decrease (25.2% vs 23.4%, P = .77) between the time of the pretest and posttest. This safety program was effective at increasing ATV safety knowledge but demonstrates limited effect on safe riding practices.

Pediatric All-Terrain Vehicle Trauma

The popularity of all-terrain vehicles (ATVs) continues to increase, but this form of recreation is not as well regulated and can impact children disproportionately. This study examines the epidemiology of ATV injuries in Arizona with emphasis on pediatric injuries and compares ATV injuries to those associated with motorcycle (MCC) and motor vehicle crashes (MVC). The trauma registry of a level 1 trauma center was used to identify all ATV crashes during a 5-year period (2004-2008) in patients younger than 16 years. Registration data of ATV were obtained from the state DMV. All-terrain vehicle-related injuries were compared with both MVC and MCC. A total of 250 pediatric ATV crashes were observed during the 5-year period, rising from 29 in 2004 to 53 in 2008. The median age of patients with ATV-related injuries was 13 years, which is higher than that of patients with MVC-related injuries (9 years). Only 34% of the patients with ATV-related injuries were helmeted, compared with 55% of patients with MCC-related injuries. All-terrain vehicle-related crashes were at least 30 times more likely than MVCs and almost 20 times more likely than MCCs. Statewide pediatric ATV deaths rose during the study period. All-terrain vehicle-related crashes have increased during this study period and have become a significant source of injuries. Public education and awareness of the dangers associated with ATV use need to be targeted toward both parents and children likely to use ATVs.

All-Terrain Vehicle Injury Prevention: Healthcare Providers’ Knowledge, Attitudes, and the Anticipatory Guidance They Provide

All-terrain vehicles (ATVs) continue to be an increasing cause of injuries and deaths in children, especially in rural communities. More children die in the United States each year from ATV-related events than from bicycle crashes. The purpose of this study was to determine the ATV anticipatory guidance practices of primary care providers, as well as their attitudes, knowledge, and the barriers faced in educating families about the risk of ATV use. An electronic survey was administered to primary care providers belonging to state medical societies. More than 60% of respondents (Total N = 218) believed that ATV anticipatory guidance was important to provide to pediatric patients and their families. However, 78% stated they provide ATV safety counseling less than 10% of the time during regular pediatric exams, and only 12% stated they do so greater than 25% of the time. Families rarely ask providers for advice on ATV safety issues; 84% of providers were asked once a year or less. ATV knowledge scores were low (median score 2 of 12); however, those with previous ATV exposure had significantly higher scores. Many respondents affirmed insufficient knowledge (47%) and inadequate resources (63%), but the most commonly identified barrier was that it was not a routine part of their practice. Providers in the study demonstrated limited knowledge, reported multiple barriers, and provided little or no ATV safety counseling. However, they consider ATV anticipatory guidance important for their patients. Armed with increased knowledge and appropriate resources, providers could play a significant role in promoting ATV safety.

All-Terrain Vehicle Injuries in Texas, Mapping the Path to Intervention with a Geographic Information System

ABSTRACT The state of Texas was ranked 10th for all-terrain vehicle-related deaths among all states from 2007–2009. Health Service Region 4/5N of eastern Texas has a statistically significant higher rate of all-terrain vehicle-related injuries in children under the age of 18 than Texas as a whole (p < 0.001.) It is unknown why east Texas has a higher all-terrain vehicle-related injury rate. A retrospective analysis of the registry of the Texas Trauma Service Area G, which serves the east Texas area, from the years 2004–2010 was performed. Variations within the region were assessed using a geographic information system and the analysis demonstrated that the highest rates of all-terrain vehicle-related injuries in east Texas are found in two neighboring rural eastern counties. Recording mechanism of injury was an important adjunct to identifying all-terrain vehicle-related injuries. Using E-codes alone underestimated the actual injuries. Other findings demonstrated that children under age 16 had a high rate of injury, one third of those injured sustained a head injury, and helmet use was very low.This analysis can be used by the Texas Department of State Health Services in conjunction with key regional partners to direct further investigation in these areas into the role of the rural environment, other factors associated with the high injury rates, and to plan and conduct preventive intervention at the community level.

Spectrum of all-terrain vehicle injuries in adults: A case series and review of the literature

INTRODUCTIONSerious injury secondary to all terrain vehicle usage has been widely reported since the 1970s. All-terrain vehicles (ATV) or ‘quad bikes’ are four wheeled vehicles used for agricultural work, recreation and adventure sport. Data collected in the U.S. indicates that ATV related injury and fatality is increasing annually. PRESENTATION OF CASESThis case series describes 3 cases of significant ATV related trauma in adults presenting to one regional hospital in the West of Ireland over a 12month period. DISCUSSIONEpidemiology, mechanisms of injury, spectrum of injury in adults and preventative measures to reduce the number of ATV related injuries and fatalities are discussed here with a review of the literature. CONCLUSIONA paucity of research outside of North America is highlighted by this case series. Mandatory reporting of ATV related injury, educational, training and legislative measures are suggested as injury prevention strategies.

Pediatric all-terrain vehicle related temporal bone fractures

Objectives To determine the prevalence of helmet use in children involved in all-terrain vehicles (ATV) accidents. Study design Retrospective chart review. Setting Tertiary Academic Medical Center. Subjects and methods Retrospective review was performed using the trauma registry of an academic tertiary medical center identifying ATV injured patients under 13 years of age between 2003–2008. Data regarding age, gender, ethnicity, driver/passenger status, helmet status, length of hospital stay, Glascow Coma Scale, Injury Severity Score, Abbreviated Injury Score, and presence of temporal bone fracture were analyzed. Results Seventy-four ATV injured pediatric subjects were identified. Average age was 8.6 years, 62% male, 38 were drivers, 32 were passengers. Helmet use data were available on 47 (64%) subjects, of these 9 (19%) wore helmets, and 38 (81%) were not wearing helmets. There was no observed statistical difference between helmeted and unhelmeted riders when comparing age, gender, ethnicity, driver/passenger status, length of hospital stay, Glascow Coma Scale (GCS), Injury Severity Score, Abbreviated Injury Score, or presence of temporal bone fracture. Conclusions This review found that documented helmet use in pediatric ATV injuries to be profoundly low (19%). Within our cohort no protective benefit from helmet use was identified, suggesting the inherent and potentially unalterable dangers of pediatric ATV recreation.

Cranial Impalement in a Child Driving an All-Terrain Vehicle

All-terrain vehicle (ATV) injury is a serious problem in children and adolescents. We report an unusual case of a child with cranial impalement in a rollover ATV crash. An 8-year-old, reportedly helmeted, was driving an ATV uphill when it rolled over causing cranial impalement of the brake handle just above the left ear. The child was awake and alert at the scene and on arrival in the pediatric emergency department. The child was taken to the operating room where he underwent fiber-optic intubation followed by removal of the brake handle. He was discharged home after 3 days with a normal neurological examination. All-terrain vehicle injury is an increasing problem in children. This case demonstrates that serious injury can occur even while wearing a helmet. The case demonstrates the dangers associated with children driving or riding ATVs.

Pediatric All-Terrain Vehicle Injuries

We sought to determine whether North Carolina legislation pertaining to all-terrain vehicles (ATVs) has affected the frequency, distribution, or severity of injury in children. This retrospective study reviewed the Wake Forest University Baptist Medical Center Trauma Registry from 2003 to 2008 along with North Carolina Medical Examiner's child fatality data for all children injured on an ATV. Patients were excluded if the accident did not occur in North Carolina, incomplete data, or if the vehicle was not an ATV. We evaluated the use of helmets, the extent of injury, and the mechanism of injury, comparing the patterns before the laws went into effect (2003-2005) with those after the law was enacted (2006-2008). Eighty-eight patients were included for analysis, predominantly white boys with a mean age of 12.1 ± 4.1 years. Children not wearing helmets were 5-fold more likely to have a significant head/neck injury (odds ratio [OR], 5.1; confidence interval [CI], 1.61-15.88; P = 0.01) and 3.7-fold more likely to have a significant chest injury (OR, 3.73; CI, 1.01-13.86; P = 0.05). Passengers were 5-fold more likely to die or require inpatient rehabilitation (OR, 5.0; CI, 1.2-20.8; P = 0.03) and 13.7 times as likely to have a significant injury to their head/neck (OR, 13.7; CI, 3.07-60.93; P = 0.01). There were no significant changes seen in the children injured without and then with legislation, which may be significant if ATV use indeed is increasing. A child's vehicular position was the most significant predictor of morbidity and mortality. Helmet use was not increased once mandated by law. Further efforts to implement such legislation and educate the public are necessary to make a significant change in injuries.

Still Unsafe, Still in Use: Ongoing Epidemic of All-Terrain Vehicle Injury Hospitalizations Among Children

The injury risks to children who ride all-terrain vehicles (ATVs) are well documented and include increased risk of death or hospitalization. We identify pediatric hospitalization trends for ATV injuries, provide national benchmarks, and discuss policy and prevention implications. We used data (1997-2006) from the kid's inpatient database, the only all-payer inpatient care database for children in the United States. Children and adolescents aged 0 year to 17 years were included. We generate national estimates of hospitalizations. Total pediatric hospitalizations for ATV injuries have increased 150% from an estimated 1,618 in 1997 to 4,039 in 2006. The overall ATV-related injury hospitalization rate increased 139% from 2.3 per 100,000 in 1997 to 5.5 per 100,000 in 2006. Rates increased for both males and females, although the rate for males remained much larger than for females in 2006 (8.1 per 100,000 vs. 2.7 per 100,000, p < 0.001). For all age groups, ATV hospitalizations increased significantly between 1997 and 2006, but this change was most pronounced among those aged 15 years to 17 years. ATV hospitalization rates also increased significantly for patients hospitalized with traumatic brain injuries. ATVs are associated with a significant and increasing number of hospitalizations for children. Reexamination of previous federal policies, including the potential for a new consent decree between the Consumer Product Safety Commission and ATV industry representatives, should be considered to address this alarming trend and to adopt effective strategies to minimize the use by children. Enforceable state-level policy to promote helmet use among ATV riders seems to be critically needed.

Ten Years of All-Terrain Vehicle Injury, Mortality, and Healthcare Costs

All-terrain vehicles (ATVs) are increasing in popularity worldwide. The province of Alberta accounts for 25% of Canadian ATV sales. This study describes the epidemiology, outcomes, and associated healthcare costs for a decade of ATV traumatic injury incidents. This is a retrospective population based cohort study using two provincial databases: the Alberta Trauma Registry and the Office of the Chief Medical Examiner of Alberta. Data for individuals aged 18 years or older with Injury Severity Score ≥ 12 or deaths between April 1, 1998, and March 31, 2008 were included. Healthcare costs were extrapolated using figures from a Level I trauma center. ATV incidents resulted in 459 serious trauma cases, 395 trauma center admissions (a total of 4,117 days), and a 17% mortality rate. Postdischarge care was required for nearly 30% of patients. Male patients aged 18 years to 19 years had the highest incidence (6.5 of 100,000 people). Head, neck, and cervical spine injuries were most common (59%) and predictive of mortality (relative risk [RR], 2.19; interquartile range [IQR], 1.35-3.54; p = 0.001). Vehicle rollovers (RR, 2.75; IQR, 1.13-6.70; p = 0.01), vehicle ejection (RR, 4.18; IQR, 1.70-10.32; p = 0.000), alcohol intake (RR, 2.33; IQR, 1.52-3.56; p = 0.000), helmet use (RR, 1.82; IQR, 1.11-3.02; p = 0.01), and incident location were predictive of mortality. Increasing rates of ATV-related serious trauma and death are described in young males riding without helmets after consuming alcohol. Serious injuries contributed to healthcare costs in excess of $6.5 million USD. Predictors of mortality include rider behaviors and mechanical factors. Prevention should include rider education and industry measures to improve ATV stability.

A Trial of an All-Terrain Vehicle Safety Education Video in a Community-Based Hunter Education Program

All-terrain vehicle (ATV) injury is an increasingly serious problem, particularly among rural youth. There have been repeated calls for ATV safety education, but little study regarding optimal methods or content for such education. The purpose of this study was to determine if an ATV safety video was effective in increasing ATV safety knowledge when used in a community-based statewide hunter education program. During the baseline phase, surveys focusing on ATV safety were distributed to students in the Arkansas hunter safety program in 2006. In the intervention phase a year later, an ATV safety video on DVD was provided for use in required hunter education courses across Arkansas. The same survey was administered to hunter education students before and after the course. In the baseline phase, 1,641 precourse and 1,374 postcourse surveys were returned and analyzed. In the intervention phase, 708 precourse and 694 postcourse surveys were completed. Student knowledge of ATV safety after watching the video was higher than in preintervention classes. Knowledge of appropriate helmet usage increased from 95% to 98.8% (P < .0001). Awareness of the importance of not carrying a passenger behind the driver increased from 59.5% to 91.1% (P < .0001). Awareness of importance of hands-on ATV rider training increased from 82.1% to 92.4% (P < .0001). A brief ATV safety video used in a hunter education course increased ATV safety knowledge on most measures. A statewide hunter education program appears to be a useful venue for ATV safety education.

A trip unplanned: an ATV safety story

All-terrain vehicle (ATV) injury is a common and growing problem among children and adolescents, particularly in rural areas. In 2007 alone, US children under 16 years old sustained an estimated...

All-terrain vehicle riding among youth: how do they fair?

Purpose Pediatric all-terrain vehicle (ATV) injuries have been increasing annually for more than a decade. The objective of this study was to describe the riding behaviors, helmet use, and crash history of young ATV riders. Methods A 38 question self-administered survey was distributed to a convenience sample of children at 4 agricultural fairs during 2007. A total of 228 surveys were reviewed. Collected data included demographic information, ATV characteristics, helmet use, driving habits, and crash history. Results Survey respondents were predominantly male (71%) with an average age of 13.6 ± 2.0 years. Riding began at a young age (9.2 ± 3.2 years). Few children reported using age-appropriate sized engines (3% < 90 cm 3), and 22% of children rode ATVs with engines more than 300 cm 3. Respondents rode primarily for recreation (94%), and more than a third reported riding without a helmet (40%). More than 70% of children reported riding with passengers, 60% without adult supervision, and nearly half (46%) rode after dark. Less than 5% of riders received any formal ATV riding/safety instruction. Of the respondents, 45% reported being involved in an ATV crash. Those children who reported a crash also rode more powerful ATVs, were more often self-taught, and overall reported higher rates of riding with passengers and without supervision, and riding after dark ( P < .05). Conclusion Dangerous driving behavior among children who ride ATVs is widespread, and current safety recommendations are largely ignored. Renewed efforts are needed to improve safety programs and create policy measures that prevent pediatric ATV crash-related injuries.

Genitourinary Injuries in Pediatric All-terrain Vehicle Trauma—A Mechanistic Relationship?

To define and discuss the characteristics of all-terrain vehicle (ATV)-related pediatric (<16 years) genitourinary (GU) trauma. ATV collisions represent a significant and growing portion of trauma cases in rural America. ATV-related renal injuries have been reported in adults but a comprehensive review of ATV-related pediatric GU trauma cases is needed. A retrospective analysis of admissions to 2 trauma centers in Kentucky between 1997 and 2007 was performed, identifying youth who presented with ATV-related GU injuries. Demographics, injury data, and treatment records for children with GU trauma in this study population were recorded and analyzed. A total of 429 youth were admitted after ATV injuries during the study period. Of these, 13 (7 boys, 6 girls) had GU injuries (3%) and the average age was 10.7 years. Of 13 patients, 12 (92%) were unhelmeted and the mean injury severity score was 10.3. Twelve of 13 (92%) suffered renal injuries (7 contusions, 5 lacerations) and 1 (8%) had an extraperitoneal bladder rupture. Renal lacerations were grade I-V. Hematuria was very common (10/12, 83%) and intensive care unit care was required in 5 of 12 (42%) patients. Mean length of stay was 5 days and 12 of 13 (92%) were discharged home. The most common associated injury was splenic laceration (4/13, 31%). GU trauma in ATV-injured youth is uncommon but when it occurs, renal injuries predominate. Most present with hematuria. Prevalence of renal trauma among GU injuries in children suggests a unique injury mechanism (crush during ATV roll or strike of the handlebars) and more study of injury mechanics is warranted. A high index of suspicion is warranted in evaluating these children.

All-Terrain Vehicle Injuries at Arrowhead Regional Medical Center (Level II): Epidemiology, Risks, and Outcome

The growing popularity of all-terrain vehicles (ATVs) has contributed to a rise in the number of injuries and fatalities nationwide. The Consumer Product Safety Commission reported 8,104 fatalities from 1982 to 2006 and over 146,600 emergency room-treated visits in 2006 with children 16 years of age and younger comprising roughly 29 per cent in both categories. To investigate the epidemiology and outcome of ATV-related injuries and to explore variables contributing to morbidity and mortality, we conducted a single-center, retrospective study of ATV-injured patients presenting to trauma emergency between 2003 and 2007 at a Level II trauma center. In summary, we witnessed an upward trend in the incidence of ATV injuries during this 5-year span. With 156 documented cases, adolescents aged 17 to 20 years represented the largest group (19.2%), whereas children 16 years of age and younger contributed to 12.8 per cent. Overall mortality rate was 0.64 per cent. Positive blood alcohol concentration was detected in 21 per cent. Individuals using protective gear were 1.4 and four times less likely to suffer loss of consciousness and Glasgow Coma Scale score 8 or less, respectively, compared with those without protection. Abrasions, concussions, fractures, and other life-threatening solid organ injuries were documented in virtually every organ system. With such poor outcomes, we conclude that riding an ATV is an inherently dangerous activity. To minimize the burden of injury, riders are encouraged to develop competency through training courses, compliance with safety precautions, and modification of high-risk behaviors.