All-terrain vehicles (ATVs) are motorized vehicles with over-sized, low-pressure tires, designed for uneven surfaces and off-highway work and recreation. ATV models can weigh up to 600 pounds1 and reach speeds up to 75 mph. Engine size ranges from 50cc to approximately 660cc. In the U.S. there is an estimated 7 million ATVs.2
In 2001, 97 percent of youth under 16 years with ATV-related injuries were operating ATVs larger than manufacturer’s recommendations.3 In 2001, the estimated number of ATV operators under 16 years increased by 13 percent and riders by nine percent.4 The amount of time operators under 16 years spent on ATVs increased by 19 percent.4
- One-third of all ATV-related fatalities (n=5,239) from 1982 to 2002 were youth under 16 years. 5
- Central nervous system injuries accounted for 80 percent of fatalities in ATV-related crashes. 6
- From 1999 to 2001, there were 698 reported fatalities to youth ages 1-19 years from off-road vehicle crashes. Off-road vehicles include ATVs, snowmobiles, and hovercraft. 7
- Helmets may reduce risk of death by 42%.8
Emergency Department (ED) Treated Injuries (Estimated)
- Youth under 16 years accounted for 37% of ATV-related injury from 1985 to 2002. 5
- From 2000 to 2002, 103,400 youth under 16 years were treated for ATV-related injuries. 5
- ATV operators under 16 years are nearly four times more likely than ATV operators over 16 years to experience an injury requiring emergency department treatment. 9
- From 1995 to 2003, 404,249 youth under 20 years were injured in ATV crashes and treated for nonfatal injuries in an ED. 10
- Males represent approximately three-quarters (77 percent) of ATV-related injuries treated in an ED from 1995 to 2003. 10
- Eleven percent of injured ATV operators seen in an ED are admitted to a hospital.10
- Helmets may reduce the risk of nonfatal head injury by 64 percent. 8
Cost is calculated by estimating medical expenditure, work lost, and loss of quality of life.
- The average annual cost of nonfatal ATV-related injuries treated in an ED for youth under 17 years is over $1.4 billion. 11
- Hospital admitted ATV-related injuries to youth under 17 years cost more than $5.2 million annually. 11
- Nearly 80 percent of the average annual cost of nonfatal ATV-related injuries are associated with males. 11
Factors associated with ATV-related injuries for youth under 16 years.
- No helmet use 12, 13, 15
- Poor judgment and risk-taking behaviors 6, 14
- Male gender 12, 13, 15
- Operating an ATV larger than that recommended for their size and age 3
- Lack of physical size, strength, and coordination to operate an ATV14
- Operating three-wheeled ATVs 2, 9
- Increased driving exposure 4
- Operating on public roads, streets, and highways 16
- Riding with a passenger 15
Policy/Legislation for Prevention
The U.S. Consumer Product Safety Commission (CPSC) and ATV manufacturers signed a 10-year consent decree (1989-1998) with ATV manufacturers to cease production of three-wheeled ATVs; offer safety training; prohibit sales of adult-sized ATVs to youth; promote safety warnings; and develop voluntary ATV manufacturing standards. The proportion of youth ATV-related injury did not decrease during the consent decree. 14
ATV Action Plan
Participating manufacturers with CPSC agreed to a voluntary ATV Action Plan after the consent decree expired to:
- Not market or sell adult-sized ATVs for use by youth under 16 years.
- Ban the manufacture and sale of three-wheeled ATVs.
- Promote training and conduct safety education campaign.
- Manufacturers can withdraw from the agreement with notice.
The American Academy of Pediatrics recommends legislation in all states to:
- Prohibit use of four-wheeled off-road vehicles by youth under 16 years.
- Ban sale of three-wheeled ATVs and recall all used three-wheeled ATVs. 17
- Rodgers GB. All-terrain vehicle injury risks and the effects of regulation. Accident Analysis and Prevention. 1993 June;25(3):335-46.
- Scutchfield SB. All-terrain vehicles: Injuries and prevention. Clinical Orthopaedics and Related Research. 2003;409:61-72.
- All-terrain vehicle (ATV) safety crisis: America’s children still at risk. Natural Trails and Waters Coalition and Consumer Federation of America. 2003.
- Levenson MS. All-terrain vehicle 2001 injury and exposure studies. U.S. Consumer Product Safety Commission. 2003.
- Annual Report: All-terrain vehicle (ATV)-related deaths and injuries. U.S. Consumer Product Safety Commission. 2002.
- Carr AM, Bailes JE, Helmkamp JC, Miele VJ, Rosen CL. Neurological injury and death in all-terrain vehicle crashes in West Virginia: A 10-year retrospective review. Neurosurgery. 2004 Apr;54(4):861-6.
- Center for Disease Control WONDER. Compressed Mortality Data. Retrieved Nov. 5, 2004, from http://wonder.cdc.gov/welcome.html
- Bratton SL, Keenan HT. All-terrain vehicle legislation for children: A comparison of a state with and without a helmet law. Pediatrics. 2004 Apr;113(4):330-4.
- Rodgers GB, Adler P. Risk factors for all-terrain vehicle injuries: A national case-control study. American Journal of Epidemiology. 2001 June;153(11):1112-8.
- U.S. Consumer Product Safety Commission, National Electronic Injury Surveillance System (NEISS). Nonfatal ATV Injuries, US 1995-2003. Average Annual Weighted Case Counts. (Unpublished data from the Children’s Safety Network Economics and Data Analysis Resource Center) Nov. 2004.
- U.S. Consumer Product Safety Commission, National Electronic Injury Surveillance System (NEISS). Nonfatal ATV Injuries, US 1999-2003. Average Annual Aggregate Costs (Year 2000 Dollars). (Unpublished data from the Children’s Safety Network Economics and Data Analysis Resource Center) Nov.2004.
- Lister DG, Carl J, 3rd, Morgan JH, 3rd et al. Pediatric all-terrain vehicle trauma: A 5-year statewide experience. Journal of Pediatric Surgery. 1998 Jul;33(7):1081-3.
- Lynch JM, Gardner MJ, Worsey J. The continuing problem of all-terrain vehicle injuries in children. Journal of Pediatric Surgery. 1998 Feb;33(2):329-32.
- Murphy N, Yanchar NL. Yet more pediatric injuries associated with all-terrain vehicles: Should kids be using them? The Journal of Trauma Injury, Infection, and Critical Care. 2004 Jun;56(6):1185-90.
- Bercher DL, Staley K, Turner LW, Aitken M. Pediatric injuries resulting from use of all-terrain vehicles. The Journal of Arkansas Medical Society. 2001 Apr;97(10):351-3.
- Helmkamp JC. ATV-related deaths in West Virginia: 1990-2003. The West Virginia Medical Journal. 2003 Nov-Dec;99(6):224-7.
- American Academy of Pediatrics Committee on Accident and Poison Prevention. All-terrain vehicle injury prevention: Two-,Three-, and Four-Wheeled Unlicensed Motor Vehicles. Pediatrics. 2000;105;1352-4.