A prospective, multi-institutional study of pediatric all-terrain vehicle crashes
Ioanna Mazotas1, Megan Toal, Kevin Borrup
1From the Department of Pediatric Surgery (I.M., M.T., K.B., H.S., G.L., G.B., S.T., B.T.C.), Connecticut Children's Medical Center, Hartford, Connecticut; Arkansas Children's Hospital (A.L.H., D.C.), Little Rock, Arkansas; and University of Massachusetts Memorial Health Care System (P.D.D., A.D.), Worcester, Massachusetts.
Insights
Pediatric all-terrain vehicle (ATV) injuries are rising, with dangerous behaviors like not wearing helmets linked to severe outcomes. Children under 16 should not operate ATVs, and stricter laws are needed to prevent these injuries.
Area of Science:
- Pediatric Traumatology
- Injury Prevention
- Public Health
Background:
- Pediatric all-terrain vehicle (ATV) injuries show a concerning annual increase.
- Previous research highlights the need to understand crash circumstances and outcomes.
Purpose of the Study:
- To prospectively evaluate crash circumstances and clinical outcomes in pediatric ATV crashes.
- To identify risk factors associated with severe injuries in children.
Main Methods:
- Prospective data collection from three pediatric trauma centers (July 2007-June 2012).
- Patient questionnaires on crash details (ATV size, safety gear, experience).
- Collection of clinical data including injuries and surgical interventions.
Main Results:
- 84 pediatric patients (mean age 13.0 years) were enrolled; 65% were male.
- Common injuries included musculoskeletal (42%) and central nervous system (39%); 27% had multisystem injuries.
- Dangerous practices were prevalent: 70% lacked helmets, 56% lacked supervision, 71% ignored engine size recommendations.
- Helmet use was significantly associated with reduced head injury (p=0.03). Rollover crashes were most frequent (44%).
Conclusions:
- A strong link exists between dangerous ATV riding behaviors and severe pediatric injuries.
- Children under 16 should not operate ATVs due to high risk.
- Urgent need for legislation to restrict ATV use in children and enhance safety measures.
Background:
Pediatric all-terrain vehicle (ATV) injuries have been increasing annually for more than a decade. The purpose of this study was to prospectively evaluate crash circumstances and clinical outcomes resulting from pediatric ATV crashes.
Methods:
Three pediatric trauma centers prospectively collected data from patients during their hospitalization for injuries sustained in ATV crashes from July 2007 through June 2012. Patients completed a 35-item questionnaire describing the crash circumstances (ATV engine size, safety equipment use, and training/experience). Clinical data (injuries, surgical procedures, etc.) were collected for each patient.
Results:
Eighty-four patients were enrolled, with a mean (SD) age of 13.0 (3.1) years, and were predominantly male (n = 55, 65%). Injuries were musculoskeletal (42%), central nervous system (39%), abdominal (20%), thoracic (16%), and genitourinary (4%). Multisystem injuries were prevalent (27%), and two patients died. Thirty-three patients (43%) required operative intervention. Most children were riding for recreation (96%) and ignored ATV manufacturers' recommendation that children younger than 16 years ride ATVs with smaller (≤90 cc) engines (71%). Dangerous riding practices were widespread: no helmet (70%), no adult supervision (56%), double riding (50%), riding on paved roads (23%), and nighttime riding (16%). Lack of helmet use was significantly associated with head injury (53% vs. 25%, p = 0.03). Rollover crashes were most common (44%), followed by collision with a stationary object (25%) or another vehicle (12%). Half (51%) of children said that they would ride an ATV again.
Conclusion:
These data demonstrate a relationship between dangerous ATV riding behaviors and severe injuries in children who crash. Children younger than 16 years should not operate ATVs, and legislation that effectively restricts ATV use in children is urgently needed.
Level Of Evidence:
Epidemiologic study, level III.
