American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Statement on All-Terrain Vehicle Injuries

The following statement was developed by the Subcommittee on Injury Prevention and Control of the Committee on Trauma and was approved by the ACS Board of Regents at its October 2008 meeting.

The American College of Surgeons' Committee on Trauma, through its Subcommittee on Injury Prevention and Control, prepared the following statement on all-terrain vehicle (ATV) injuries and prevention to educate surgeons and others about ATV injuries and encourage them to support ATV legislation in their respective states.

The American College of Surgeons supports legislative and manufacturing efforts to improve safety and prevent injuries from ATV use. Such legislation should include ATV safety design for rider protection, rider training and licensure, and a limitation of recreational use in children younger than 16 who are not otherwise licensed to drive. The College believes that surgeons, legislators, public safety advocates, and other government officials should be aware of the following facts related to ATVs when considering responsible regulation of these vehicles:

  • ATVs can reach speeds consistent with interstate highway traffic, but in a more hazardous environment; hence, ATVs deserve vehicle safety studies, occupant protection devices,1 and training and licensure similar to other motorized vehicles.
  • The annual incidence, severity of injuries, and economic burden of ATV injuries continues to rise.2,3
  • Children who operate ATVs are at increased risk both by number of riders and frequency of injury; hence, protection of this age group (younger than 16) should be a national priority.4 Recreational use of ATVs should be limited to people who have licenses to operate other motorized vehicles.
  • Although safety legislation has been associated with decreased death rates in some states,5 legislative efforts in general to prevent ATV injuries have had limited success.6
  • The most severe injuries and deaths are related to crash characteristics of the vehicle; hence, attention must be directed toward improving the safety of the vehicles themselves2 to decrease the likelihood of incident occurrence that can result in injury. Additional safety design should be directed toward protecting the rider from injury at the time of the incident.7


  1. Yanchar NL, Kennedy R, Russell C. ATVs: Motorized toys or vehicles for children. Injury Prevent. 2006;12:30-34.
  2. Mullins RJ, Brand D, Lenfesty B, et al. Statewide assessment of injury and death rates among riders of off-road vehicles treated at trauma centers. J Am Coll Surg. 2007;204(2):216-224.
  3. Helmkamp JC, Lawrence BA. The economic burden of all-terrain vehicle-related deaths in the United States. Pediatrics. 2007;119(1):223-225.
  4. Smith LM, Pittman MA, Marr AB, et al. Unsafe at any age: A retrospective review of all terrain vehicle injuries in two level I trauma centers from 1995 to 2003. J Trauma. 2005;58(4):783-788.
  5. Injury Prevention Committee, Canadian Paediatric Society. Preventing injuries from all-terrain vehicles. Paediatr Child Health. 2004;9(5):337-340.
  6. Su W, Hui T, Shaw K. All-terrain vehicle injury patterns: Are current regulations effective? J Pediatr Surg. 2006;41(5):931-934.
  7. Helmkamp J. Using Evidence-based Research on All-terrain Vehicles to Influence Policy Formulation. Public Health Grand Rounds. Morgantown, WV: WVU School of Medicine; 2004.


Reprinted from Bulletin of the American College of Surgeons
Vol.94, No. 2, February 2009