All-terrain vehicles (ATVs) are popular recreational vehicles that can be used for various purposes, such as hunting, farming, racing, and exploring. However, ATVs also pose a serious and ongoing public health and safety concern, especially for children and adolescents. According to the US Consumer Product Safety Commission (CPSC), there were an estimated 81,800 ATV-related injuries treated in emergency departments in 2019, of which 26% involved children younger than 16 years. Moreover, there were 563 reported ATV-related fatalities in 2019, of which 17% involved children younger than 16 years.
One of the most common and fatal injuries that occur in ATV crashes is head trauma. According to a comprehensive report by the American Academy of Pediatrics (AAP), traumatic brain injury (TBI) and multisystem trauma are the two most common causes of death and disabling injury among ATV riders. TBI can result from direct impact to the head, such as hitting the ground, a tree, or another vehicle, or from rapid acceleration and deceleration of the brain within the skull, such as in a rollover or ejection. TBI can cause various symptoms, such as loss of consciousness, confusion, memory loss, headache, nausea, vomiting, dizziness, blurred vision, and seizures. TBI can also lead to long-term complications, such as cognitive impairment, behavioral changes, mood disorders, and epilepsy.
The AAP report also found that head injuries are more likely to occur in ATV crashes involving certain risk factors, such as operating adult-size vehicles, riding with or as passengers, lack of protective equipment, and riding on public roads. These risk factors are highly common in pediatric ATV crashes, and contribute to the severity and frequency of head injuries. For example, the report stated that adult-size ATVs are heavier and more powerful than youth models, and are more difficult to control and maneuver by children. Riding with or as passengers increases the risk of losing balance and stability, and also exposes the passenger to the possibility of being crushed by the driver or the vehicle. Lack of protective equipment, such as helmets, goggles, gloves, and boots, leaves the head and other body parts vulnerable to injury. Riding on public roads exposes ATV riders to collisions with other vehicles, such as cars and trucks, which can cause devastating injuries
The AAP report concluded that the best way to prevent pediatric ATV-related deaths and injuries is to prohibit children younger than 16 years from riding on ATVs. This recommendation is based on a large multidecade body of evidence that shows that children lack the physical and cognitive abilities to safely operate these vehicles. The report also suggested other strategies to reduce the risk of head injuries and other harms, such as requiring helmets and other protective gear, limiting ATV size and speed, restricting passengers, banning ATV use on public roads, and enforcing evidence-based safety laws.
