All-terrain vehicle (ATV) manufacturer warning labels aimed at children under age 16 are largely ineffective, and formal dealer-sponsored training is infrequently offered and deemed unnecessary by most young ATV users, according to new research presented at the Oct. 22 at the American Academy of Pediatrics (AAP) National Conference and Exhibition in New Orleans. The study of ATV crashes involving children also found less than 35 percent of children were wearing a helmet when injured in an ATV crash, and nearly 60 percent were riding again within six months.

Children under age 16 suffer nearly 40 percent of all ATV-related injuries and fatalities in the U.S. each year, despite warnings from the AAP and the Consumer Product Safety Commission against child ATV use. In the study, “Pediatric ATV Injuries and Manufacturer Warnings are Not Enough to Change Behavior,” researchers surveyed children who were hospitalized at a Level I trauma center following an ATV crash between 2004 and 2009. Families were questioned about their child’s injuries, the cause of the crash, ATV features, risk-taking behaviors and safety practices. A follow-up phone survey was given 6 months later.

Parents of 44 children completed the initial survey and 44 completed both surveys. Primary injuries included head/neck (34.7 percent), chest (10.2 percent) abdomen (10.2 percent), fractures (30.6 percent) and soft tissue injuries (14.3 percent). The injuries resulted from collisions (36 percent), rollovers (32 percent) and falls from the ATV (23 percent).

In most cases (82 percent), the children were driving the ATV when the crash occurred, and 61 percent of the respondents acknowledged the presence of a warning label on their ATV, warning against use of the ATV by children less than 16 years of age and against carrying passengers. Most children had permission to ride the ATV (79.5 percent) and were under adult supervision when they were hurt (63.6 percent). No respondents underwent formal course training for safe ATV operation, although 47 percent reportedly received training from a friend or relative. Only seven were offered informal training by the ATV dealer, of which two participated.

While respondents reported frequent use of safety equipment (77.6 percent) and wearing a helmet (65.9 percent) “frequently/sometimes” prior to the crash, only 36.7 percent were actually helmeted at the time of the crash. Post-injury, 59 percent of the respondents continued to ride, and there was no significant change in risk-taking behaviors including wearing helmets or safety gear, riding on paved roads, performing difficult maneuvers, and children continued to carry or ride as passengers on ATVs despite warning labels against this activity.

“Although ATVs have surged in popularity over the past several years, they pose significant dangers for children 16 and under who simply do not have the physical strength, cognitive skills, maturity or judgment to safely operate ATVs,” said study author Rebeccah L. Brown, MD, Cincinnati Children’s Hospital Medical Center.“These are hefty motorized vehicles that weigh up to 600 pounds and are capable of reaching speeds of up to 85 miles per hour.

“ATV manufacturer warning labels are largely ineffective, and ATV training is infrequently offered to ATV users, most of whom deem it unnecessary,” said Dr. Brown. “Mandatory safety courses and licensing, and enforceable helmet legislation, are needed to reduce ATV use by children.

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Debbie Jacobson
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American Academy of Pediatrics