ATV Self-regulation Crashes; Injuries Rise Again

In 1988, the U.S. Consumer Product Safety Commission and all-terrain vehicle (ATV) manufacturers agreed on a ten-year period of a consent decree requiring safety regulations. As a direct result of the high number of injuries relating to ATVs, the decree:

• stopped the sale of three-wheel ATVs;
• led to the development of training and safety education programs;
• prohibited the use of larger ATVs by children younger than 16 years;
• prohibited the use of smaller ATVs by children younger than 12 years;
• recommended no passengers;
• recommended riders less than 16 years to have adult supervision; and
• required helmet use at all times.

During the ten-year period, the national injury and death rates fell. In 1998 the decree ended – the injury and death rate rates rose again. A retrospective review of all patients admitted to a level I trauma center, Memorial Health University Medical Center in Savannah, Georgia, sought to quantify the effect of the safety decree.

Study Results

A total of 573 patients were studied from January 1998 through August 2004, the period immediately after the end of the ATV industry’s self-regulation. Of this total, 221 (38.6%) had been involved in an ATV crash and 352 (61.4%) in a motorcycle crash. Motorcycle crashes were used as a comparison for the risk of ATV use and all data was compared to data from the ten years of regulation. The number of patients with an equal injury severity score increased. Statistically significant increases in injuries from ATV crashes among females and children were noted compared to the motorcycle crashes among female and pediatric riders. Also significant was the helmet usage by all riders: 64.7% by motorcycle riders; 8.6%  by ATV riders. There was no significant difference between the two groups for number severely injured or killed. Most patients in both groups had multi-system injuries. However, there was a significantly greater proportion of closed head injury in ATV crashes than in motorcycle crashes.

Discussion

The injury and mortality rate among children can be attributed to either a lack of appropriate training or a child’s inability to physically control the ATV or to use appropriate judgment while operating it. Georgia has a helmet law for motorcycle riders but not for off-road ATV use, which explains the large difference in helmet use between the two groups studied and presumably explains the difference in the number of closed head injuries.

The authors suggest that legislation and strict enforcement could lead to a decrease in ATV-related injury. Public awareness of the dangers of ATVs needs to be emphasized. Injury prevention strategies could play a major role in reducing injury, health care costs and loss of productivity.

The article is followed by questions and discussion about the study from 8 physicians. The lead author, A.H. Fonseca, M.D. responds.

Reference
Fonseca AH, Ochsner MG, Bromberg WJ, Gantt D. All-terrain vehicle injuries: are they dangerous? A 6-year experience at a level I trauma center after legislative regulations expired. Am Surg 2005; 71(11): 937-40; discussion 940-1

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