Subcommittee on Injury Prevention and Control

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

Online August 8, 2002

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