All-terrain Vehicle-related Injuries Research Articles

All-terrain vehicle (ATV)-related injuries among different age groups: insights from a 9-year observational study

PurposeTo describe the epidemiology, patterns, seasonality and outcome of all-terrain vehicle-related injuries (ATVRIs) among different age groups in Qatar.MethodsA retrospective analysis of all patients hospitalized with ATVRI from 2010 to 2018 was conducted. Data were analyzed by age, gender, seasonality, and Injury severity Score (ISS). Chi-square, Student t and ANOVA tests were used for analysis. Multivariate regression analysis was performed to find out predictors of head injury and severe injury among ATV users.ResultsOut of 15,000 trauma admissions, 521 had ATVRI (4%) with a mean age of 23.3 ± 12.3. The male-to-female ratio was 4:1 and the pediatric population represented 40%. The compliance with helmet use was 3.6%. The most injured regions were chest (29.8%), upper extremities (28.8%) and the head (25.9%). The mean ISS was 10.6 ± 7.7. Fracture fixation was the most operative intervention. Among hospitalized patients, 7.7% were transferred to rehabilitation . ATVRIs occurred more frequently between October and April and a large proportion (57.8%) occurred during weekends. The overall ATV-related hospital mortality rate was 2.1%. Young and older ATV users were more likely to suffer spine injuries than the pediatric population (p = 0.001). The mean ISS was greater in the older groups (p = 0.03). There were no statistically significant differences regarding the use of protective devices, mortality, or length of hospital stay between the different age groups. On multivariate analysis, young age and ISS were predictors of head injury among ATV users after adjusting for gender and helmet use.ConclusionThis is a nationwide study looking at all age groups who sustained ATVRI in Qatar. ATVRIs were observed in all age groups following leisure and recreational use. It follows a seasonal pattern with poor protective measures compliance. There is a need to reinforce helmet use and raise public awareness.

Pediatric hospitalizations and in-patient mortality from all-terrain vehicle crashes, 2006–2016

PurposeTo evaluate trends in national frequency of hospitalizations and in-patient mortality in the United States for children injured in all-terrain vehicle crashes during the past decade.MethodsRetrospective review of the 2006, 2009, 2012, and 2016 Kids' Inpatient Databases to identify hospitalizations of patients <19 years of age for all-terrain vehicle-related injuries. External-cause-of-injury codes were used to identify patients hospitalized for injuries sustained in all-terrain vehicle crashes. Odds ratios for in-patient mortality were calculated by logistic regression incorporating multiple individual demographic and hospital variables.ResultsEstimated all-terrain vehicle-related hospitalizations ranged from 3666 in 2006 (5.2/100,000 persons <19 years of age) to 2558 in 2012 (3.3/100,000). Crude in-patient mortality was low, and varied slightly from year to year (range, 0.55–1.04%). Patients hospitalized for all-terrain vehicle-related injuries were 76.8–78.4% White and 72.1–77.2% male. Totally 61.0–64.3% had private insurance, 35.3–39.3% were from rural areas, 37.4–38.3% were in the 10–14-year age group, and patients from the West region accounted for 40.4–43.6% of patients. There were no risk factors identified as being consistently associated with mortality in this cohort. Average total charges increased from $26,996 to $67,370 over the course of the study ( p < 0.001).ConclusionsHospitalizations for all-terrain vehicle-related injuries in children have fallen in the past decade although the reasons for this change are unknown. In-patient mortality rates have stayed relatively constant and while no factors were predictive of in-patient mortality, demographic data may provide an opportunity for targeted interventions to further reduce injuries and associated hospital costs.

A Survey of Safety Recommendations for All-Terrain Vehicle Dealers and Track Owners in Kansas

All-terrain vehicles (ATVs) are associated with injury, mortality, and healthcare costs. ATV related injuries are less severe when consistent safety practices are followed, however, ATV safety regulations are varied among states. This study sought to survey Kansas ATV dealers and track owners to determine safety promotion practices. A cross-sectional telephone survey was conducted of Kansas ATV dealers and tracks. Survey questions included promotion and sale of safety equipment, provision of ATV safety information, and respondent characteristics. Of those contacted, 32% of dealers and 31% of tracks responded to the survey. Most ATV dealers sell safety gear (70% - 100%) and all recommend safety gear to buyers and riders. All ATV tracks reported requiring helmets (100%) but were varied regarding other forms of safety gear. The majority of ATV dealers (77%) recommended safety courses, but only 31% of dealers and 40% of tracks offered courses. Eighty percent of ATV tracks and 52% of dealers felt they had a professional responsibility to educate riders/owners on safety. Safety promotion by ATV dealers in Kansas consistently was recommended, but often limited to the sales of safety gear (helmets and gloves) or the provision of manufacturer provided safety materials. Further, ATV dealers reported rarely offering skills tests or safety courses to buyers. In Kansas, safety promotion at the point of sale or track level could be improved to increase public awareness of ATV safety practices.

Potential predictors of hospital length of stay and hospital charges among patients with all-terrain vehicle injuries in rural Northeast Texas.

:Background:All-Terrain Vehicles (ATVs) have become popular for recreation use in recent years. Texas has had more ATV related fatalities than any other state in the nation, with rural Northeast Texas having even higher rates of injuries. There is limited data examining the relationship between ATV injuries and the length of hospital stay, as well as hospital costs. This paper examines both issues in children as well as adults. Methods:The regional trauma registry was analyzed for all ATV related injuries between January 2011- October 2016. Injury Severity Score, Glasgow Coma Scale and if they are seen at a Level I Trauma center are predictive for both hospital length of stay and charges. Results:Length of Stay was predicted positively by Injury Severity Score, Emergency Department Respi-ration Rate and facility at which patients were treated and negatively by Glasgow Coma Scale. Hospital charges were predicted positively by age, Injury Severity Score, facility of treatment, means of transportation, and Emergency Department pulse and negatively by Glasgow Coma Scale. Conclusions:The study found that vital signs can be useful in predicting length of stay and hospital charges. This study not only confirms the findings of other studies regarding what predictors can be used, but expands the research into rural traumatic injuries. It is hoped that this data can help contribute to the development of algorithms to predict which patients will be most likely to require resource intensive treatment.

All-terrain vehicle-related injuries and deaths in Newfoundland and Labrador between 2003 and 2013: a retrospective trauma registry review.

Injury and death involving all-terrain vehicles (ATV) has been reported in a number of Canadian provinces. The objective of this study is to describe the frequency, nature, severity, population affected, immediate health costs, efficacy of related legislation, and helmet use in ATV related injuries and deaths in Newfoundland and Labrador (NL). A retrospective review of injured or deceased ATV riders of all ages entered in the Newfoundland and Labrador Trauma Registry from 2003 to 2013 was conducted. Variables studied included demographics, injury type and severity, use of helmets, admission/discharge dates, and referring/receiving institution. Data was also obtained from the Newfoundland and Labrador Center for Health Information (NLCHI) and included all in-hospital deaths and hospitalizations due to ATVs between 1995 and 2013. There were a total of 298 patients registered in the trauma registry, resulting in 2759 admission days, nine deaths, and a total estimated immediate healthcare system cost in excess of $1.6 million. More males (N=253, 84.9%) than females (N=45, 15.1%) were injured in ATV related incidents, t(20)=7.12, p<.0001. Head and thorax injuries were the most serious. 38.6% of patients were confirmed to be wearing helmets. Mean injury severity scores are as follows: head injury (M=11, SD=9.51), thorax (M=10, SD=8.3), abdominal/pelvis (M=9, SD=7.62), upper extremity (M=9, SD=8.53), other injuries (M=9, SD=10.56) lower extremity (M=8, SD=8.34), and spine (M=8, SD=6.52). This study describes ATV related injuries and deaths in NL. Information from this study may guide physician practice, public education, and future legislation.

Age and the risk of All-Terrain Vehicle-related injuries in children and adolescents: a cross sectional study

BackgroundThe study was designed to determine if youth <16 years are at a greater risk of serious injuries related to all-terrain vehicle (ATV) use compared to older adolescents and adults.MethodsWe performed cross sectional study of children and adults presenting to pediatric and adult emergency departments between 1990 and 2009 in Canada. The primary exposure variable was age <16 years and the primary outcome measure was moderate to serious injury determined from physician report of type and severity of injury.ResultsAmong 5005 individuals with complete data, 58% were <16 years and 35% were admitted to hospital. The odds of a moderate to serious injury versus minor injury among ATV users <16 years of age was not different compared with those ≥16 years of age (OR: 0.94; 95% CI: 0.84, 1.06). After adjusting for era, helmet use, sex and driver status, youth <16 years were more likely to present with a head injury (aOR: 1.45; 95% CI: 1.19–1.77) or fractures (aOR: 1.60; 95% CI: 1.43–1.81), compared with those ≥16 years. Male participants (aOR: 1.21; 95% CI: 1.06–1.38) and drivers (aOR: 1.30, 95% CI: 1.12–1.51) were more likely to experience moderate or serious injuries than females and passengers. Helmet use was associated with significant protection from head injuries (aOR: 0.59; 95% CI: 0.44–0.78).ConclusionsYouth under 16 years are at an increased risk of head injuries and fractures. For youth and adults presenting to emergency departments with an ATV-related injury, moderate to serious injuries associated with ATV use are more common among drivers and males. Helmet use protected against head injuries, suggesting minimum age limits for ATV use and helmet use are warranted.

All-Terrain Vehicle-Related Nonfatal Injuries Among Young Riders in the United States, 2001-2010

All-Terrain Vehicle-Related Nonfatal Injuries Among Young Riders in the United States, 2001-2010

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 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.

Trends in All-Terrain Vehicle-related Spinal Injuries in Children and Adolescents

Despite the significant morbidity and mortality associated with all-terrain vehicle (ATV) use in children, their use continues to increase dramatically. To determine the frequency and impact of spinal fractures in children and adolescents injured in ATV accidents, we reviewed all 4 of the available Kids' Inpatient Databases. The Kids' Inpatient Databases (http://www.ahrq.gov/data/hcup/hcupkid.htm) from 1997, 2000, 2003, and 2006 were reviewed using e-codes for children (age less than 18 y) injured in ATV accidents. From the data on ATV accidents, children who sustained spinal injuries were identified by ICD-9 codes. Statistical analysis was done using SAS Windows. An estimated 4,483 children were admitted because of ATV-related accidents in 2006. Spinal injury occurred in 7.4% of patients. The most common level of fracture was thoracic (39%), followed by lumbar (29%) and cervical (16%). Pelvic fractures were the most common associated fractures, accounting for 44% of all musculoskeletal injuries, followed by forearm/wrist fractures (15%) and femoral fractures (9%). Although fewer girls were injured in ATV accidents than boys, the risk of spinal injury was higher in girls than boys (10.1% vs. 6.7%, P < 0.005), and children with spinal injuries were older than those without (14.7 y vs. 12.7 y, P < 0.001). Despite educational and legislative efforts, children account for a disproportionate percentage of morbidity and mortality from ATV-related accidents. The injury rate for children from ATV accidents has increased 240% since 1997, whereas the spinal injury rate has increased 476% over the same time frame. The risk of spinal injury in ATV-related accidents is higher for girls than for boys and for older children. Multiple injuries are frequent in children involved in ATV accidents and may be related to the high-energy nature of ATV accidents. It is important to have a high index of suspicion for multiple injuries, not only within the spine, but in other organ systems as well.

All-Terrain Vehicle-Related Injuries and Hospitalization: An Examination of the Influence of Age and Alcohol or Drugs

All-terrain vehicle (ATV) related injuries are a significant source of morbidity, mortality, disability, and hospitalization, and serious injuries among the elderly are increasing. In addition, alcohol and drug use are prevalent among those injured in ATV-related incidents. However, studies indicate varying alcohol and drug use patterns among age groups and less attention has been paid to the experience of older adults and to the influence of substance abuse (alcohol or drug involvement). Therefore, the purpose of this study was to examine the relationship between age, substance abuse and hospitalization resulting from ATV incidents among injured adults over the age of 21 (legally old enough to consume alcohol). A secondary purpose of this study was to explore the relationships between age and substance abuse, substance abuse and injured body sites, and age and injured body sites. Using a cross-sectional, quantitative approach and archival data from the National Electronic Injury Surveillance System (NEISS) from 2007, 1884 incidents were evaluated and results of multiple logistic regression analysis indicated that age and substance abuse add independent information in predicting the odds of hospitalization. Using the chi-square test, similar substance abuse involvement among young, middle-aged and older adults was found and differences in the distribution of injured body sites existed between those with and without substance abuse and between the three age groups. The results of this study suggest the need for age-specific prevention, specialized safety training for older adults, and more aggressive enforcement of drinking and driving restrictions while operating ATVs in order to reduce deaths, disabilities, and considerable financial costs associated with ATV-related hospitalizations.

Prevention of severe injuries in preschool children: what are the priorities?

Injury is the leading cause of death in childhood. Most of these injuries are preventable events. With limited resources, strategies for prevention should target severe injuries and be based on...

ATVs: motorized toys or vehicles for children?

Objectives: To compare the nature of injuries from all-terrain vehicles (ATVs) to those from bicycling, dirtbikes/motocross, and motor vehicle crashes. Design: Data on injuries from the mechanisms outlined above were...

Emergency Department Pediatric All-terrain Vehicle Injuries in West Central Illinois

This study was prepared to evaluate pediatric all-terrain vehicle-related injuries treated in a tertiary care emergency department in West Central Illinois. A retrospective descriptive study was performed of local emergency department cases entered into the US Consumer Product Safety Commission database. All visits involving an all-terrain vehicle-related injury in children younger than 18 years from January 1994 to December 2001 were explicitly reviewed and compared with aggregate national Consumer Product Safety Commission pediatric all-terrain vehicle data. One hundred eighty-seven children (age range, 2-17 years) from 14 West Central Illinois counties were treated in the emergency department during the study period. Injury patterns followed a national trend of an increasing annual incidence after 1998 (P = 0.05). The majority of patients were boys (78%) and were 12 years or younger (71%). Contusions (31.8%), fractures (25%), and lacerations (18.8%) accounted for the majority of injuries. Although observed injuries correlated well with national injury estimates for injury position, age, and sex, more head and chest injuries were noted locally. Derived injury severity scores had a mean of 3.1 (range, 1-50), and no difference was noted in the injury severity score for helmet use, sex, or age younger than 12 years. Overall, the incidence of all-terrain vehicle-related injuries in West Central Illinois in the emergency department is increasing, and local injury patterns correlate well with those reported on a national level.

Emergency medical services for children assessment of all-terrain vehicle–related injuries in Illinois

Study objectives: This study seeks to describe injuries in children related to all-terrain vehicle (ATV) use during a 4-year period in Illinois before development of an injury prevention program. Methods: Patients were identified using a state Trauma Registry Database that is composed of data from 67 hospitals within Illinois designated as either a Level I or Level II trauma center. Patients entered into the state database met the following criteria: sustained an injury that required treatment at a trauma center and admission to a trauma center, transferred to a trauma center, died on arrival to the hospital, or died in the emergency department. The Trauma Registry identified ATV-related injuries using E-codes. Four age groups (0 to 4, 5 to 9, 10 to 14, and 15 to 16 years) were retrospectively reviewed between 1998 and 2001. Patients were categorized into nonhelmeted, helmeted, or unknown helmet use rider status. Results: Two hundred seventy-five (80 nonhelmeted, 56 helmeted, and 139 unknown helmet use) children aged 16 years or younger in Illinois sustained ATV-related injuries during the study period. One hundred forty-three (52%) of the patients were between 10 and 14 years old. Extremities were the most frequently injured body region in nonhelmeted (61), helmeted (47), and unknown helmet use (113) groups (76%, 84%, and 82%, respectively). Head and neck injuries were the second most common category of injury in the nonhelmeted (44), the helmeted (29), and in the unknown helmet use group (62; 55%, 52%, and 45%, respectively). The nonhelmeted group had a cumulative length of stay in the hospital of 228 days compared with the helmeted and unknown helmet use group length of stay of 137 days and 400 days, respectively. The nonhelmeted group and helmet use unknown group had a similar number of cumulative days in the ICU of 58 days and 52 days, respectively, compared with the helmeted group of 20 cumulative days in the ICU. The cumulative hospital charges for the nonhelmeted, helmeted, and unknown helmet use rider groups were $754,096, $457,409, and $1,269,314, respectively, for a total of $2,480,819. The 10- to 14-year-old age group comprised the highest percentage of total hospital charges of $1,330,585 (54%). Conclusion: The majority of pediatric ATV-related injuries in Illinois occurred in the 10- to 14-year-old age group. Upper and lower extremity injuries were the most common type of injury. The cost of injuries increased throughout the study period, similar to national trends. As the incidence of ATV injuries in children continues to increase, injury prevention programs should target methods to reduce injuries of extremities and head and neck, especially in the 10- to 14-year-old age group.

Fatal and non-fatal machine-related injuries suffered by children in Alberta, Canada, 1990-1997.

Children raised on farms are exposed to many hazardous types of machinery. The objective of this study was to describe the magnitude of non-fatal and fatal farm machinery injuries in Alberta children and adolescents (0-17 years) for the years 1990-1997. To date, there have been no published studies of pediatric farm injuries in Western Canada. Data were collected through the Canadian Agricultural Injury Surveillance Program (CAISP). Death certificates and hospital charts were audited to provide enhanced information about the circumstances of injuries related to farm machinery for farm persons aged 17 years and younger. A total of 302 farm machinery injuries were recorded for the years 1990-1997. Of these, 14 resulted in death. All-terrain vehicles (ATVs) were the most common cause of injury (n = 76), followed by tractors (n = 72), and power take-offs (n = 15). The predominant injury mechanism was entanglement (n = 69), followed by falls from machines (n = 57), and being pinned/struck by a machine (n = 49). The median length of hospital stay for injuries was 2.0 days. Males (median = 2.0 days) had significantly longer hospital stays than females (median = 1.0 days). There were significantly more injuries reported during the summer and autumn than during the winter and spring. Those injured in the autumn were significantly older (median = 13.0 years) than children injured in the spring (median = 9.0 years). Injury rates dropped significantly during the study period from 119.9/100,000 per year in 1990 to 50.7/100,000 in 1997. While injury rates have dropped, the number of injuries occurring to children on Alberta farms is of concern. The large number of ATV related injuries suggests that preventative strategies need to be focused in this area. Am. J. Ind. Med. 45:177-185, 2004.

Musculoskeletal trauma in four-wheeled all-terrain vehicles.

A longitudinal study of four-wheeled all-terrain vehicle-related musculoskeletal injuries requiring orthopedic surgery was performed. Avoidable risk factors such as alcohol intake, lack of helmets, inexperience, and excess speed were identified. This study also shows that the quantity, severity, cost, and frequency of preventable accidents while riding continue to be the same as prior to a Consent Decrees issued by the Consumer Products Safety Commission > 10 years ago.