Injuries Involving Children Riding ATVs Up 14%

A new study suggests that prohibiting ATV passengers and implementing helmet use may prevent the severity of head and neck related injuries in children who are victims of ATV accidents.

Since the 1990s, all-terrain vehicle (ATV) related deaths and injuries have steadily increased. Surrounding this, the safety of ATVs has been questioned, especially as it is related to children. A new study suggests that prohibiting ATV passengers and implementing helmet use may prevent the severity of head and neck related injuries in children who are victims of ATV accidents.

ATVs have been popular recreational vehicles since their inception during the 1970s. Since that time, much concern has arisen over their safety and associated risks to operators, especially children. Similarly, the sale of ATVs has markedly risen in recent years. Between 1998 and 2003, the cumulative increase reached 150 percent, with a total of 800,000 vehicles purchased in 2003. In 2004, there were 136,100 total injuries with 44,700 of those less than 16 years of age; this total represents roughly a 14 percent increase over 2003. From 1998 to 2004, there was a 101 percent increase in adult and pediatric injuries related to ATVs and with an almost 80 percent increase in the number of injuries for children under age 16. Children under 16 make up roughly 14 percent of all ATV riders, but they suffered 33 percent of all injuries and accounted for 31 percent of total fatalities between 1982 and 2004.

A team of researchers consisting of Brian S. Wang, MD, MPH, Stacey L. Smith, MD, and Kevin D. Pereira, MD saw a need to analyze children’s head and neck trauma injuries resulting from these types of incidents. The researchers are presenting their findings at the 110th Annual Meeting & OTO EXPO of the American Academy of Otolaryngology — Head and Neck Surgery Foundation, being held Sept. 17-20, 2006, at the Metro Toronto Convention Centre, Toronto, Canada.

Methodology
Their review included medical records of 34 children admitted to Memorial Hermann Children’s Hospital (MHCH), a pediatric teaching hospital in Houston, Texas. The records belonged to children all under the age of 16 who experienced ATV-related head and neck injuries between January 2002 and February 2005. The majority of the children were between the ages of 12 and 16 and in 74 percent of the cases, the child was the driver of the ATV.

Results
The state of Texas mandates that in order to operate an ATV, a child must be at least 14 years old. Despite this, 17 of the 25 ATV drivers in the study failed to meet this requirement. At the time of the study, 24 states set no minimum age limit and 19 states permitted ATVs to be operated by children younger than 12 years old. Furthermore, ATVs can be driven with no training. To make matters worse, regardless of the young age of many ATV victims, federal policy is that only when an ATV is operated on public property must a helmet be worn.

These factors seem likely contributors to the study findings including 48 percent of injuries to the central nervous system, 28 percent soft tissue injuries, and 15 percent maxillofacial fractures. So why were these children victims? First, 76 percent of them did not wear a helmet. Secondly, against manufacturer’s recommendations, victims carried passengers, although ATVs are not intended for this use. ATVs can travel at over 65 miles per hour and at 100 to 500 pounds; generally weigh far more than the child operating them.

Conclusions
ATV-related morbidity and mortality in children remain significant public health issues that should be amenable to primary prevention. A multi-faceted approach to addressing the issue will be necessary to reduce these preventable injuries and deaths. This may involve state and federal government agencies, health providers, and ATV manufacturers. Responsibility ultimately belongs to those who choose to operate ATVs or permit their usage. Educating adults, parents, and children represents a necessary first step in promoting this responsibility.