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Pediatric all-terrain vehicle (ATV) related head injury rates and patterns: A 10-year nationwide analysis
Arjun Ganga1, Eric J Kim2, Ermias S Araia2
1Warren Alpert School of Medicine, Brown University, Providence, RI 02903, United States of America; Department of Neurosurgery, Warren Alpert School of Medicine, Brown University, Providence, RI 02903, United States of America.
Insights
Pediatric all-terrain vehicle (ATV) head injuries are a significant concern, with over 67,000 injuries recorded between 2012-2021. The incidence increased during the COVID-19 pandemic, highlighting the need for prevention strategies.
Area of Science:
- Public Health
- Trauma Surgery
- Pediatric Emergency Medicine
Background:
- All-terrain vehicle (ATV) use presents substantial risks of severe injury and fatality, particularly for children.
- Pediatric head injuries from ATVs are common, often exacerbated by lack of helmet use and increased rollover incidents.
- Existing research often relies on single-center studies, with limited focus on the specific epidemiology of pediatric ATV-related head trauma.
Purpose of the Study:
- To determine the annual incidence of pediatric all-terrain vehicle (ATV)-related head injuries from 2012 to 2021.
- To classify and compare the types of head injuries sustained by children in ATV accidents.
- To identify demographic and situational characteristics of children experiencing ATV-related head injuries.
Main Methods:
- Utilized the National Electronic Injury Surveillance System (NEISS) database from the US Consumer Product Safety Commission.
- Queried emergency department data for head injuries in individuals under 18 years old associated with ATV operation or riding.
- Analyzed patient demographics, injury diagnoses, and incident characteristics, estimating national injury counts.
Main Results:
- An estimated 67,957 pediatric ATV-related head injuries occurred between 2012 and 2021.
- A notable 20% increase in annual incidence was observed during the COVID-19 pandemic (2019-2021).
- The most frequent injuries were unspecified closed head injuries (38%) and concussions (27%), with 91 cases of intracranial hemorrhage. Injuries were most common in males aged 14-17, and among white children. Younger children (<9 years) were more likely to be injured at home.
Conclusions:
- Pediatric ATV-related head injuries represent a significant public health issue with increasing trends.
- The findings underscore the need for targeted prevention efforts, potentially including helmet use and enhanced supervision for younger children.
- Further research into injury prevention strategies and the associated costs is warranted.
Introduction:
The use of all-terrain vehicles (ATVs) carries significant risk of permanent injury and death, disproportionately affecting children. These injuries commonly affect the head and are especially severe among children as they are often unhelmeted and more likely than adults to experience rollover injuries. Many studies examining patients with ATV-related injuries are single-center cohort studies, with few focusing specifically on head injuries. In the present study, we aimed to characterize the annual incidence of ATV-related head injuries between 2012 and 2021, classify and compare head injury types, and identify descriptive characteristics of ATV-related head injury victims.
Methods:
Using the US Consumer Product Safety Commission's National Electronic Injury Surveillance System (NEISS) database, we queried all head injuries associated with operating or riding an ATV in children under 18 years-old from over 100 emergency departments (EDs). Patient information regarding age, race, sex, location of incident, diagnoses, and sequelae were analyzed. We also collected the estimated number of ATV-related head injuries from all US EDs using the NEISS algorithm provided by the database.
Results:
Using the NEISS algorithm we identified 67,957 (95% CI: 43,608 - 92,305) total pediatric ATV-related head injuries between 2012 and 2021. The annual incidence of ATV-related head injury was similar throughout this study period except for a 20% increase during the COVID-19 pandemic period of 2019-2021 (2019: 6382 injuries, 2020: 6757 injuries, 2021: 7600 injuries). A subset of 1890 cases from approximately 100 EDs were then analyzed. Unspecified closed head injuries were the prevailing type of injury (38%, 900/1890), followed by concussions (27%, 510/1890). More severe injuries included intracranial hemorrhages in 91 children (3.8%, 91/1890). Injuries of all types were predominantly seen in 14-17 year-old's (780/1890, 41%) and in males (64.1%, 1211/1890). In addition, ATV-associated injuries were significantly more common in those coded as white (58.0%, 1096/1890) than any other racial group. ATV-associated accidents among children younger than 9 more commonly occurred at the home compared to accidents involving children older than 9 (57% vs. 32%, p < 0.0001).
Conclusion:
ATV-related head injuries cause a significant annual burden among children, with growing incidence in recent years. Further research may wish to explore potential benefits of helmet use and supervision of younger children in possible prevention of these accidents and their associated economic and non-economic costs.
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