All-terrain vehicle injuries in children and adolescents

I know that all-terrain vehicles (ATVs) are commonly used for recreational purposes, and that recently an adolescent was injured while driving one. What are the dangers of ATV use among adolescents, and what are some preventative measures to recommend to families in my clinic to reduce ATV-related injuries in children?

There is a disproportionately high rate of ATV accidents in children compared with adults, and the safety of ATVs has become a public health concern in recent years because of their association with increased pediatric morbidity and mortality. Children account for more than one-third of ATV-related hospitalizations and they are at an increased risk of head injuries compared with adults. Orthopedic injuries are the most common injuries sustained by children as a result of ATV use. The most common causes of injury include inexperience, inadequate physical size and muscle strength to handle the vehicle, not wearing a helmet, poor judgment, loss of control, immature motor and cognitive development, and (in older children) substance use. Medical providers should recommend ATVs be limited to those over 16 years of age and that any adolescent using an ATV wears an appropriate helmet.