Paediatric trauma associated with all-terrain vehicles

All-terrain vehicles (ATVs) are used extensively in the agricultural and forestry industries where they are marketed as an inexpensive alternative to tractors. Recent years have seen an increase in recreational use of ATVs, particularly quad bikes. More worrying is the increased use of privately owned ATVs among the paediatric population. In Ireland it is a legal requirement to provide adequate professional training for ATV use in the agriculture and forestry industries, however, at present there is no legislation that regulates the recreational use of ATVs by children. The United States Consumer Product Safety Commission CPSC collects data on ATV related death and trauma. Between 1982 and 2005 there have been 7188 reports of ATV related deaths, 917 (13%) of victims were under 12 years of age. It is estimated that there is one death for every 10,000 four-wheeled ATV in use. We report four cases of paediatric trauma associated with ATV use. The children had been taking part in an organised racing event. The discussion includes a literature review and a call for new legislation that bans recreational ATV use in children below sixteen years of age.