All-Terrain Vehicle Injuries and Their Prevention

Chris Cribari, MD, FACS

Epidemiology

Use of ATVs has rapidly increased in rural America and so has the number of ATV-related injuries and deaths
U.S. Consumer Product Safety Commission reports up to 90,000 ATV-related injuries per year and 120 deaths
50% of the injuries and fatalities involve children under 16 years old
Risk of injury is 2.5 times greater if the driver is under 16 years old than for drivers ages 16–34, and 4.5 times higher than for drivers ages 35–50
Poor judgment and risk-taking behaviors are often factors related to accidents
Helmets were worn by only 30% of patients
Skin and orthopaedic injuries are the most frequent injuries reported
Head and facial injuries are second most common
61% of fractures are classified as open or comminuted

Mechanisms of injury

Loss of control of vehicle and fall from vehicle (most common mechanisms)
Collision with stationary or moving objects
Rollover
Fall from vehicle

Landscape features that influence ATV accidents and injury

Fences
Cliffs or steep drop-offs
Rocks and ditches
Frozen lakes, rivers, or streams
Wooded areas

Prevention efforts

Sale of ATV to children under 16 prohibited in 1988
Consent decree restricting access to children under 16 not effective in reducing incidence of injury in children
Hands-on training programs; some are now linked to manufacturer warranty eligibility
Encourage consumers to dispose of three-wheel ATVs still in use
Future safety efforts must focus on reducing childhood injuries
Health care providers should utilize "teachable moments"
Adults must be role models by embracing and teaching practical preventative measures
Parental education concerning:
- ATV risks for children under 16
- Use of safety equipment
- Use of helmet
- Restriction of use

Bibliography

Anon: All-terrain vehicle injury prevention: Two-, three-, and four-wheeled unlicensed motor vehicles. Pediatrics 105(6):1352–1354, Jun 2000

Brown RL, Koepplinger ME, Mehlman CT, et al: All-terrain vehicle and bicycle crashes in children: Epidemiology and comparison of injury severity. J Pediatr Surg 37(3):375–380, Mar 2002

Cvijanovich NZ, Cook LJ, Mann NC, et al: A population-based assessment of pediatric all-terrain vehicle injuries. Pediatrics 108(3):631–635, Sep 2001

Lister DG, Carl J III, Morgan JH III, et al: Pediatric all-terrain vehicle trauma: A 5-year statewide experience. J Pediatr Surg 33(7):1081–1083, Jul 1998

Lynch JM, Gardner MJ, Worsey J: The continuing problem of all-terrain vehicle injuries in children. J Pediatr Surg 33(2):329–332, Feb 1998

Rodgers GB: The characteristics and use patterns of all-terrain vehicle drivers in the United States. Accid Anal Prev 31(4):409–419, Jul 1999

Rodgers GB, Adler P: Risk factors for all-terrain vehicle injuries: A national case-control study. Am J Epidemiol 153(11):1112–1118, Jun 2001

Ross RT, Stuart LK, Davis FE: All-terrain vehicle injuries in children: Industry-regulated failure. Am Surg 65(9):870–873, Sep 1999

Russell A, Boop FA, Cherny WB, et al: Neurologic injuries associated with all-terrain vehicles and recommendations for protective measures for the pediatric population. Pediatr Emerg Care 14(1):31–35, Feb 1998

Injury Prevention and Control

Trauma Programs

Online August 8, 2002