All-Terrain Vehicles Potentially Lethal

All-Terrain Vehicles Potentially Lethal

All-terrain vehicles (ATVs) are potentially lethal and have the capacity to inflict serious harm, a study of injuries to children has confirmed.

Dr Kate Anson, formerly from Auckland District Health Board in New Zealand and now Alice Springs Hospital, studied deaths and injuries to children from an all-terrain vehicle.

Overseas data suggests that children are more likely to be killed and injured than adults riding ATVs and are also likely to be more severely injured.

As more ATVs are sold and ATVs become larger, heavier, and more powerful, the number of children and adults being injured or killed in the US continues to rise.

Until this study was conducted, there was little data on the use of ATVs by New Zealand children or the nature and extent of the injuries caused, despite a number of high-profile child deaths from ATV accidents.

Death by injury is the leading cause of death of children in developed countries, and NZ children find themselves close to the bottom of a league table of rich countries for child death by injury – 22nd out of 26 countries.

NZ children have an annual mortality rate of 13.7 per 100,000 compared to 9.5 per 100,000 in Australia and 6.1 per 100,000 in the UK.

Dr Anson conducted a retrospective review of 643 cases of children less than 16 years old hospitalised between 2000 and 2006 due to ATV-related injury in New Zealand.

Of these, 212 children were confirmed as having been injured by an ATV.

The most common mechanisms of injury were a fall from the ATV, a collision, or the ATV rolling.

The average age of the children was 9.8 years, with 130 of them under 12 years, and 32 five years and under.

Only 19 ATVs were recorded as “child-sized” (less than 90 cc). Only 27 of the children were noted to be under adult supervision at the time of the injury.

Of great concern, only 29 children (14%) were noted to have been wearing a helmet.

The child was driving the ATV in over half the cases (53%) and was a passenger in 59 cases (28%). The youngest child injured as a driver was two years old.

Males were injured twice as frequently as females.

Injuries were generally orthopaedic, soft tissue injuries, head and facial injuries.

There were 123 fractures of the arms and legs, most commonly of the wrist or lower leg, with 11 open fractures.

Eighty of these children needed the fracture manipulated under anaesthetic, with 36 of these needing metal plates to hold the broken bones in position.

Soft tissue injuries such a deep lacerations were often severe, with 40 children requiring a general anaesthetic to explore and repair the wounds.

Overall, over half the injured children required an anaesthetic for their injuries.

Other severe injuries included 10 children with skull fractures and nine children with moderate to severe head injuries, including bleeding around and within the brain.

Ten children sustained fractures of facial bones, and six children had significant chest injuries, including multiple rib fractures, punctured lungs, and bleeding within the lungs.

One child had a ruptured spleen and two others sustained a ruptured liver.

Seventeen children (8%) required admission to intensive care. All six children admitted to Auckland’s Paediatric Intensive Care unit between 2000 and 2006 sustained head injuries.

In 2007 a 4-year-old child sustained life-threatening chest injuries which required immediate surgery and a 14-year-old child was left paraplegic after a fracture of his thoracic spine.

Six children had a permanent disability such as a below knee amputation, higher cognitive functioning deficits, post-traumatic brain injury, and blindness in one eye.

There were 15 deaths between 2000 and 2005, most of which occurred when the ATV rolled.

Dr Anson found that the average age of injured NZ children was lower than that of other countries and length of hospital stay was shorter. Gender distribution, injury type and severity were similar to elsewhere.

NZ guidelines recommend no child under 12 years ride an adult-sized ATV and that ATVs should never carry passengers, and it is also recommended that a helmet and other protective clothing such as boots and gloves be worn. If these guidelines had been followed 140 (2/3 or 66%) of these children may not have been injured.

“Parents, healthcare workers and safety authorities need to be aware that ATVs are dangerous machines that can cause serious and potentially life threatening injuries”, she said.

“Although they appear easy to ride and handle, riding an ATV requires the same or greater skill, judgement and experience as for driving a car.

“Many children do not have the weight, strength, or co-ordination to safely control an ATV, as the ATVs are heavy and powerful machines.

“ATVs also appear to be stable vehicles but in fact have a high centre of gravity, a short wheel base, and a narrow track width which make the vehicle inherently unstable, though the 4-wheel ATV is more stable than the 3-wheel ATV.”

Dr Anson is calling for greater efforts to ensure safety guidelines are followed and for public debate on whether legislation is necessary.

At the very least children riding an ATV should be supervised and wear a full face motorcycle helmet.

ENDS