AAP: Off-road vehicles and kids: Injury risk and prevention

All-terrain vehicles (ATV) were introduced to the public in 1972, and are now the fastest growing sports vehicle in the US. M. Denise Dowd, MD, MPH of the University of Missouri-Kansas City said to attendants of the American Academy of Pediatrics (AAP) 2008 National Conference and Exhibition that the number purchased rose from 5 million in 1972 to 50 million in 2006.

In 1982, 29 deaths were attributed to ATVs. From 1982 to 2006, she said, 2,300 additional children have been killed in ATV crashes. In a more recent report, based on information from 1994 to 2006, 39,300 children have suffered serious injuries on ATVs.

The number of injuries doubles in children who are younger than 16 years old. Those under 16 years account for 28% of deaths, and 33% of injuries. The average age of child operators of ATVs, Dowd said, is 11 years old. These children are usually white males, and over half are from rural areas. Forty percent of the injuries occur in the summer, between the hours of 4 and 8 pm, on paved roads and off-road.

ATV injury costs are much higher than bicycles, Dowd said, and there is no comparison in the severity of injury from an ATV. In addition, ATVs are built to appeal to children of all ages, starting at age 5 to 6. ATVs for children at this age can go to a maximum speed of 40 mph. However, the traditional models are more attractive to children, especially preadolescent boys. They can go in excess of 50 mph.

ATVs are regulated by the Consumer Product Safety Commission (CPSC), which handles everything from swimming pools to toys. Due to the statistically significant rise in injury and mortality, the CPSC banned the sale of the three-wheel ATV in 1987. It was recommended that engine size be appropriate to age, and that warning labels appear on the vehicles.

However, in 1998 this consent decree expired. The ATV industry now regulates itself. There continue to be no uniform restrictions for the use of ATVs, no helmet regulations, no speed or size requirements. Restrictions vary from state to state and on federal lands.

The AAP position paper on ATVs recommends that: children under 16 not operate ATVs, a drivers license should be required, ATVs should not drive on unpaved roads, and children should wear helmets.

The AAP also suggests educating parents about the danger of ATVs. It is actively involved in testifying before Congress. AAP has also petitioned the CPSC to ban sales of ATVs to children under 16. But until that happens, millions will be sold every year, and legally ridden by kids without licenses, helmets, or even all their permanent teeth.