1. Nonfatal ATV-related injuries in children aged ≤ 15 years increased in frequency from 2001 to 2004, and subsequently decreased from 2004-2010. Injury type and severity remained constant over time.
2. Among children presenting to the ED with nonfatal ATV-related injuries, the most common injuries were fractures, contusions/abrasions, and lacerations.
Evidence Rating Level: 2 (Good)
Study Rundown: ATVs – motorized, gasoline-powered vehicles designed for unpaved road use – were previously shown to have higher risk of injury in children likely due to decreased physical strength, cognitive abilities, and fine motor skills when compared to adults. This study looked at nonfatal injuries in the ED among children aged ≤ 15 years from 2001-2010. Injuries among young riders increased to a peak in 2004 and then decreased through 2010. The most common injuries were fractures, contusions/abrasions, and lacerations. Though decreased in frequency, the types and severity of injuries over the 10-year timeframe remained similar. Limitations to this study include a database that covers only a small subset of EDs in the United States, and that non-ED clinical settings were not studied. Additional information, such as helmet use, was not incorporated. It is not well understood why the overall prevalence of ATV-related injuries has decreased, though one possibility suggests less use secondary to the economic recession of the mid-2000s. Nonetheless, ATV-related injuries among children persist and further evaluation of crash dynamics is warranted to guide injury prevention.
Study Author, Ruth A. Shults, PhD MPH, talks to 2 Minute Medicine: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
“We know that children riding adult-sized ATV is dangerous. Because they often lack the strength and necessary handling skills, they are more susceptible to crashing. We also know from other studies that many young riders do not wear a helmet, and the lack of helmet use increases the possibility of suffering a brain injury. The good news is that there is a recent decline in ATV-nonfatal injuries among young riders. While this study did not explore the reasons for the declines, I believe that it might be related to the economic recession and decreased sales of new ATVs. There are safety measures that can help such as prohibiting children from riding adult-sized ATVs, always wearing a helmet while riding, not riding on paved roads, and not riding as a passenger or carrying a passenger.”
In-Depth [retrospective chart review]: This analysis included 5472 ED cases of ATV-related injury from 2001 – 2010 in children aged ≤ 15 years from the National Electronic Injury Surveillance System – All Injury Program (NEISS-AIP) database. Injuries were stratified by age, gender, diagnosis, primary body part injured, and disposition from the ED; no differences in injury type and severity were noted over time. From 2001 to 2004, a 35% increase in ATV-related injuries (32280 to 43450, P = 0.07) was noted with a subsequent decrease from 2004 to 2010 (43450 to 27517, P < 0.01). Boys were twice as likely to be injured as girls; when injured, boys most commonly sustained fractures (29%) while girls presented with contusions/abrasions (31%). Children ages 0-5 were most likely to sustain an injury involving the face or mouth, whereas upper and lower extremity injuries were most common among older children.
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