ATVs and Kids: A Deadly Summer Mix

June 21, 2007 — -- With the arrival of warmer weather, thousands of people will be dusting off their outdoor recreational vehicles and zipping along back roads, climbing sand dunes and negotiating mountain trails. In recent years, the popularity of off-road vehicles has soared, particularly all-terrain vehicles known as ATVs.

While all this sounds like good, clean fun, ATV use has led to what some have called an ongoing epidemic of injury and death, especially in children.

ATVs have been around for more than 30 years. They were introduced into the United States in 1971 by Honda Motor Corp. In fact, three-wheeled ATVs were featured in the popular James Bond movie "Diamonds Are Forever," deftly maneuvering across the Nevada desert.

Designed for off-road or nonpaved terrain, ATVs have motorcycle-type handlebars and large, low-pressure tires set on three or four wheels. They do not require a license to operate and they are regulated by any governmental agency. Currently, more than 1 million of them are sold annually in the United States.

The rising popularity of ATVs has been accompanied by an increasing number of injuries and deaths related to their use. According to the Consumer Product Safety Commission, more than 7,000 deaths have occurred as the result of ATV-related accidents from 1982 to 2005.

After a decline in the early 1990s, annual injuries and deaths related to ATVs have been steadily increasing. In 2005, more than 136,000 people required emergency room visits to treat ATV-related injuries. Children younger than 16 have accounted for approximately 30 percent of these injuries and deaths.

The types of nonfatal injuries in children include fractures, contusions, lacerations, concussions and burns. These nonfatal injuries can be life-threatening and life-altering, with at least 40 percent of hospitalized children requiring intensive care.

Helmets offer children some protection, but the fatalities seen in this age group are not always due to traumatic brain injury. In fact, one study found that 50 percent of children involved in an ATV-related accident died from causes other than head trauma.

Keep Out of Hands of Children

Children may be especially susceptible to injuries while riding ATVs for a number of reasons.

ATVs are prone to instability because of a high center of gravity. Moreover, they can reach speeds of 50 to 60 mph, which, when coupled with inexperienced drivers with immature judgment and motor skills, can lead to devastating consequences.

The economic impact of ATV-related injury and death in both children and adults is significant and growing. The National Highway Traffic Safety Administration estimated that associated costs related to fatalities alone in children rose from $493 million in 1999 to $723 million in 2003. In adults, these costs rose from $1.7 billion to more than $2.5 billion during the same time period.

Given the increasing awareness and understanding of the potential dangers of ATVs, many states have passed legislation regulating their use by children. The regulations vary widely by state and include stipulations on where ATVs can be ridden (public vs. parent's land), age restrictions and requirements for safety training and helmet use.

Some states have age restrictions for use on public land but allow use of ATVs by children on their parent's land, where many are used on farms.

Only New York bans use by children younger than 10 years old regardless of locale. Twelve states have no laws regulating ATV use by children, while some states trying to pass legislation have been met with opposition. For example, in Oregon, a vocal ATV lobby and ATV enthusiasts have hindered a legislature trying to enact tougher restrictions designed to protect children.

Laws No Perfect Solution

Do laws regulating ATV use actually work to decrease injuries in children? According to a 2004 study published in the journal Pediatrics, legislation regulating age restrictions and mandating helmet use may have had some effect to reduce not only injuries to younger children, but also the number of riders not wearing helmets.

But this study, which compared childhood injuries between two states with and without ATV regulations, also found that even in a state with ATV laws, a significant number of injuries and deaths in children still occurred.

Because of these dangers, ATV manufacturers accepted a consent decree in 1988 to cease production of three-wheeled models, initiate driver safety training programs, post warning labels, establish age recommendations for use of adult-size models by children and to assure dealers were conveying age recommendations to consumers.

In addition, ATV manufacturers began producing smaller, less-powerful vehicles for children.

Despite these efforts and state legislation, the majority of children still ride and are injured on adult-size models. As a result, consumer and advocacy groups believe voluntary steps are not enough. The American Academy of Pediatrics has even called for states to pass laws banning all children younger than 16 years old from riding any ATV.

Protecting Your Child

As parents, what can you do to help protect your child from serious injury when he or she is riding an ATV?

By far, the best strategy may be not to allow them to drive one. However, if your child is going to ride an ATV, the following steps may help keep them safer:

Follow manufacturer age recommendations and never allow children to ride adult-size or three-wheeled models.

Always wear helmets and eye protection.

Never ride an ATV on public streets or highways.

Do not allow passengers to ride.

Never drive an ATV between sundown and sunrise.

Perhaps most importantly, it is a parent's responsibility to always make sure there is adult supervision around.

More information regarding safety is also available from the Consumer Product Safety Commission, which began a campaign to reduce deaths and injuries caused by ATVs. The campaign includes education through radio and television public service announcements and a new Web site www.ATVSafety.gov. The Web site provides safety tips, summarizes state legislation and links to consumer information and training courses.

Edward G. Seferian, assistant professor of pediatrics at Mayo Clinic, specializes in pediatric critical care medicine.