It's All Fun — Until Someone Gets Hurt

ATV injuries among children has decreased but remains high in general

/ Author:  / Reviewed by: Dominique Brooks, M.D

(RxWiki News) Riding all-terrain vehicles (ATVs) has become more popular in the past three decades. Among children, however, injury rates remain high.

A recent study found that the rate of injuries among kids aged 15 and younger has decreased from 2004 to 2010.

But even after the decrease, injury risk remains high, with about 42 of every 100,000 kids riding ATVs needing to visit the ER.

"Because children often lack the physical strength, cognitive abilities and fine motor skills to operate ATVs properly, their risk for injury is greater," the study authors wrote.

"The AAP recommends kids under 16 not ride ATVs."

The study, led by Ruth A. Shults, PhD, MPH, of the National Center for Injury Prevention and Control at the Centers for Disease Control and Prevention, looked at the ATV-related injury rates for youngsters from 2001 to 2010.

The researchers analyzed the data in the National Electronic Injury Surveillance System for all injuries among riders aged 15 or younger that did not result in a death.

Over the entire time period, approximately 361,161 young ATV riders received treatment in the emergency room for injuries related to riding on the ATV.

At the start of the decade, the rate of injuries gradually increased, hitting a peak in 2004, when 67 out of every 100,000 children riding on ATVs were injured.

Then the injury rate began to decrease gradually. By 2010, this rate had dropped to 42 out of every 100,000 children getting injured while riding on an ATV.

Twice as many boys were getting hurt as girls. For every 100,000 boys riding on ATVs, 73 were injured. Among girls, however, 37 of every 100,000 got injured.

Kids aged 11 to 15 made up about two-thirds (66 percent) of the patients suffering from injuries related to ATVs.

About a quarter (26 percent) of the patients were aged 6 to 10, and the remaining 9 percent were 5 years old or younger.

The majority of the kids (86 percent) were treated and released from the ER, but 13 percent were hospitalized.

The most common injury was broken bones, which occurred in 28 percent of the injuries and accounted for almost half (48 percent) of the hospitalizations.

The second most common injuries were bruises and abrasions, which made up 27 percent of the injuries.

Children were treated for cuts in 15 percent of the cases and for strains or sprains in 11 percent of the cases.

Eight percent of the injuries were internal injuries, 3 percent were concussions, 2 percent were burns and 6 percent were other injuries.

The most common part of the body to be injured was the head, face or neck, which was injured in 29 percent of the cases.

The arm or hand was injured in 27 percent of the cases, and the leg or foot was injured in 26 percent of the cases.

The decrease in injuries over time is good news, even though the authors are not sure why it has occurred.

They did not find information about any changes in ATV design that might explain the decrease, but it may be that fewer children are riding on ATVs.

"However, based on our findings related to diagnosis and proportion of emergency department patients hospitalized, the severity of nonfatal ATV-related injury appears to have remained constant over the decade," the authors wrote.

They noted that the rate of injuries among children aged 15 and younger was "...nearly seven times higher compared with emergency department visits for all injuries and two times higher compared with motor vehicle occupant injuries among children" in that age group.

"I've seen some horrific ATV injuries in the ER, and the great majority occur in young children and adolescents," said Chris Galloway, MD, a dailyRx expert specializing in emergency medicine.

"ATVs have become much more powerful and exceed the capabilities of the rider quite quickly, as this study shows," Dr. Galloway said. "Riding an ATV can be fun, but the rider must be old enough to handle the power and understand the risks and dangers that these vehicles pose even when wearing appropriate safety gear."

The American Academy of Pediatrics (AAP) recommends that children under age 16 not ride ATVs.

"Riders are completely exposed to low hanging objects and are easily ejected upon any type of impact, which increases the chances of secondary injuries," Dr. Galloway said.

"Parents should follow the recommendations of the AAP and put themselves and their family members through appropriate rider training courses," he said.

The Consumer Product Safety Commission (CPSC) recommends that children under age 16 should not ride adult-sized ATVs and that children should always wear a helmet while riding.

They should not ride on paved roads and should not carry any passengers unless the ATV is specifically designed to do so.

Although it's not clear if safety courses reduce the risk of injuries, the CPSC does recommend that riders first take a safety training course.

The study was published July 1 in the journal Pediatrics. The research did not receive external funding. The authors reported no conflicts of interest.

Reviewed by: 
Review Date: 
June 29, 2013
Last Updated:
July 30, 2013