Child ATV Injuries On the Increase

U.S. study finds a three-year surge in all-terrain vehicle-related trauma

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By Alan Mozes
HealthDay Reporter

TUESDAY, Nov. 8, 2005 (HealthDay News) -- The widespread use of all-terrain vehicles (ATVs) by American children has spurred a 25 percent jump over three years in the number of ATV injuries involving kids, a new study reveals.

Boys between the ages of 11 and 15 accounted for more than half of all ATV injuries involving children in the period analyzed by researchers.

"Many children below a certain size don't have the motor skills and the ability to maneuver an ATV," warned study author Ruth A. Shults, a senior epidemiologist at the National Center for Injury Prevention and Control with the U.S. Centers for Disease Control and Prevention in Atlanta.

"So the (U.S.) Consumer Product Safety Commission (CPSC) recommends that children under the age of 16 not ride an adult-size ATV -- one that is larger than 90 cubic centimeters in engine size," she said. "But, in fact, most children do, and when a child is riding an ATV that is too big to handle, it's really dangerous."

By reviewing U.S. Census figures and medical charts from 66 hospitals, Shults and her colleagues estimated that nearly 109,000 children aged 15 or younger sustained ATV riding accidents requiring emergency room care between 2001 and 2003.

Injury rates rose 25 percent over that period, increasing from a total of 32,280 accidents in 2001 to more than 40,400 accidents in 2003.

In the November issue of Pediatrics, the researchers note that ATV-related injuries requiring ER treatment have risen each year for more than a decade, with minors accounting for almost a third of such injuries by 2003.

They also pointed out that because incidents treated in non-ER settings were not included in the study tallies, the actual number of annual ATV riding injuries is likely to be even higher. Children hurt when hit by an ATV or when in contact with a stationary ATV were also not included in the current calculations.

Among children aged 15 and younger, injuries were found to occur more than twice as often among males than females. Within that age range, 71 percent of injuries affected children between the ages of 11 and 15, and nearly 75 percent of that group were boys.

The most common injuries were fractures, contusions or abrasions, which taken together accounted for more than half of all ER-treated incidents. The type of injury and body part affected was similar for both boys and girls, although the part of the body most severely traumatized varied by age.

The youngest children -- those aged 5 and under -- were almost five times as likely as children between 11 and 15 to have suffered oral or facial injuries, the researchers found. Lower trunk and leg or foot injuries were more frequent among the older group.

Overall, 87 percent of children with ATV injuries were released from the ER the same day following treatment, while the remaining 13 percent were hospitalized.

Shults and her team believe parents may not be heeding state minimum age regulations, CPSC recommendations, safety decals, and/or medical association warnings concerning their children's use of ATVs.

As well, while 28 states have established a minimum age for ATV use -- and most states have regulations of some sort on the books -- the researchers noted there are no federal laws in place governing ATV use.

For example, although public health recommendations discourage children from riding adult-sized ATVs, there is no federal ban on the sale of such ATVs for use by children -- and most ATVs now operated by children are, in fact, adult-sized.

The study authors believe health-care providers should better educate parents about the risks involved in ATV use among children, while calling for more strict minimum age guidelines at the state level.

"I'm absolutely -- and unfortunately -- unsurprised by the findings," said Dr. Mary Aitken, an associate professor of pediatrics at the University of Arkansas for Medical Sciences College of Medicine, and a staff physician with the Arkansas Children's Hospital, in Little Rock, Ark.

"I think there's a remarkable lack of awareness of parents about the risk for their kids when they're riding ATVs," she said. "They don't appreciate the dangers. So we need to improve the education of consumers, and examine very carefully the effectiveness of existing laws and their enforcement."

Scott Wolfson -- a spokesman for the CPSC -- said that while federal laws are not yet part of the equation, ATV child safety is nonetheless "an extremely high-priority issue for the commission."

He said the commission is engaged in its own detailed study of the problem, possibly leading to legislation recommendations down the road. Meanwhile, Wolfson said the CPSC routinely monitors adherence to a series of voluntary agreements long in place with ATV manufacturers, which encourage dealers to properly label ATVs by size, eschew sales of adult-sized vehicles for use by children, and provide free training at the time of any ATV purchase.

Mike Mount, an industry spokesman at the Specialty Vehicle Institute of America (SVIA) in Irvine, Calif., said his organization is working with the CPSC to ensure ATV safety.

He said the organization specifically discourages "risky and irresponsible behaviors" -- such as "children riding adult-sized ATVs, riding without a helmet, riding with a passenger on a single-rider vehicle, riding on public roads, and riding at excessive speed."

In a written statement, the SVIA said it believes that "rider training, parental supervision, and appropriate state safety legislation is the best means to effect change."

Highlighting the important need for such change, another new study published in this month's Archives of Pediatric and Adolescent Medicine underlines the magnitude of suffering vehicle-related trauma can inflict on children and adults alike. The study found that even in the absence of physical injury, accidents can provoke serious stress reactions for those involved.

According to researchers at the Children's Hospital of Philadelphia, up to 25,000 children may be at risk of developing post-accident traumatic stress symptoms. They base this figure on the fact that, of the more than 1.5 million motor vehicle accidents involving children in the United States each year, 2 percent of children involved (and 5 percent of their parents) are emotionally and psychologically damaged following a crash.

More information

For more on ATV safety, check out the Injury-Free Coalition for Kids.

SOURCES: Ruth A. Shults, Ph.D., senior epidemiolgist, National Center for Injury Prevention and Control, U.S. Centers for Disease Control and Prevention, Atlanta; Mary Aitken, M.D., associate professor, pediatrics, University of Arkansas for Medical Sciences College of Medicine, and staff physician, Arkansas Children's Hospital, Little Rock, Ark.; Mike Mount, spokesman, Specialty Vehicle Institute of America, Irvine, Calif.; Scott Wolfson, spokesman, U.S. Consumer Product Safety Commission, Bethesda, Md.; November 2005 Pediatrics

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