The incidence of children admitted to Pennsylvania trauma centers because of accidents while riding all-terrain vehicles (ATV) fell 13% from the first 5 years to the last 6 years of a 2004-2014 study – but that decrease was not statistically or clinically significant, reported Mariano Garay, MD, of Pennsylvania State University, Hershey, and his associates.
In the American Academy of Pediatrics’ most recent policy statement in 2000, the academy recommended that use of ATVs be restricted to people older than 16 years and to off-road use only, with no passengers.
In a retrospective study using Pennsylvania’s state trauma database to obtain data from 32 trauma centers from Jan. 1, 2004, to Dec. 31, 2014, in patients aged 0-17 years, 1,912 patients met the criteria of fractures at or below the cervical spine (Pediatrics. 2017 Jul 7. doi: 10.1542/peds.2017-0945). The estimated mean annual incidence of ATV injuries from 2004 to 2014 was six cases per 100,000 children, with a 13% decrease in the mean incidence comparing the first 5 years with the last 6 years (6.7 per 100,000 children to 5.8 per 100,000 children, respectively; P = .08). Mean mortality incidence was 0.09 deaths per 100,000 during the 11-year period; Of the almost 2,000 children, 1.5% died.The median age of patients was 14 years, with a range of 1-17 years. Boys accounted for three-quarters of the patients. Being a passenger or being pulled behind the ATVs accounted for 24% of the injured patients. Of the crashes, 15% occurred on a street or roadway, and 49% of the riders reportedly wore a helmet. The majority of children who died were age 12-15 years, 25% were passengers, and 32% were injured while the ATV was being used on a street or roadway.
“Researchers in numerous studies, as well as professional organizations and ATV manufacturers, have concluded that children less than 16 years of age do not have the capacity to safely operate ATVs,” Dr. Garay and associates cautioned. “We advise primary care providers to be the forefront of the prevention effort and to continue to provide families with safety information and recommendations of age restrictions for ATV use by children.”