ATVs: motorized toys or vehicles for children?

OBJECTIVES To compare the nature of injuries from all-terrain vehicles (ATVs) to those from bicycling, dirtbikes/motocross, and motor vehicle crashes. DESIGN Data on injuries from the mechanisms outlined above were obtained through CHIRPP (the Canadian Hospitals Injury Reporting and Prevention Program) and hospital records. SETTING A Canadian tertiary pediatric center. SUBJECTS Cases presenting to the emergency department over a 10 year period. MAIN OUTCOME MEASURES Comparison between demographics, mechanisms and natures of injuries sustained, disposition from the emergency department, and lengths of hospital stay. RESULTS Contrary to bicycling, ATV related injuries occurred among older ages and appeared to result less often from loss of control. Severe injuries resulting in deep soft tissue trauma and fracture/dislocations were 1.7 and 1.5 times, respectively, more frequent among ATV trauma than bicycling (p<0.01). In addition, ATV related injuries were located more frequently in the trunkal, hip, lower extremity, and spinal regions. Conversely, ATV related trauma bore significant similarities regarding body part and nature of the injury to both motor vehicle crash (MVC) and dirtbike related injuries. Akin to dirtbike and MVC related trauma, ATV related injuries more frequently required admission to the ward or intensive care unit compared to bicycling injuries (30.8% v 9.6%, p<0.0001), and used a proportionally larger amount of hospital resources with respect to overall in-hospital and intensive care unit days. CONCLUSIONS Although ATVs may be considered recreational for children, their associated injury patterns, severity, and costs to the healthcare system more closely resemble those from motorized vehicles and are more significant than bicycling. Strict policy to reflect this must be developed and acknowledged by the public, industry, and legislative bodies.