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Pediatric Hospitalizations for ATV-Related Injuries More than Double

All-Terrain Vehicles (ATVs) are associated with a significant and increasing number of hospitalizations for children in the U.S., according to a new report by the Center for Injury Research and Policy at the Johns Hopkins Bloomberg School of Public Health.

Over a nine- year period (1997-2006) hospitalizations for ATV injuries increased 150 percent among youth younger than 18 years, with important demographic variations.

Rates increased the most dramatically in the South and Midwest, and among teens ages 15 to 17. While males between 15 to 17 have the highest rate of ATV hospitalization, females ages 15 to 17 experienced the sharpest rise in ATV hospitalizations over the study time period, an increase of 250 percent. The report is published in the October issue of the Journal of Trauma.

“All-Terrain Vehicles are inherently dangerous to children,” said Stephen M. Bowman, PhD, MHA, assistant professor with the Johns Hopkins Center for Injury Research and Policy and the report’s lead author. “While manufacturers are required to label vehicles with engine sizes greater than 90cc as inappropriate for children younger than sixteen, our data indicate that a growing number of children are receiving serious injuries due to ATV use, suggesting that parents are unaware of these recommendations or are choosing to ignore them.”

In 1988, the Consumer Product Safety Commission (CPSC) and representatives of the ATV industry entered into a decade-long consent decree to reduce the risk of injury associated with ATV use; provisions included a ban on the sale of three-wheeled ATVs, a free nationwide training program for all ATV purchasers, improved safety labeling and a public awareness campaign. This consent decree expired in 1998 and is only continued by some manufacturers on a voluntary basis. While previous studies have examined the impact of the expiration of the consent decree between the CPSC and the ATV industry immediately following its termination, this is the first study to examine whether rates of ATV-injury hospitalizations have continued to increase.

“Clearly, too many children are being injured on these vehicles,” said co-author, Mary E. Aitken, MD, MPH, professor of pediatrics with the University of Arkansas for Medical Sciences and director of the Injury Prevention Center at Arkansas Children’s Hospital. “Given the dramatic increases in hospitalization that we report, a renewed effort by the public health community, the ATV industry and the CPSC to address this problem is warranted.”

The researchers analyzed hospital discharge data from the Kid’s Inpatient Database (KID) of the Healthcare Cost and Utilization Project, which is sponsored by the Agency for Healthcare Research and Quality. Injury Severity Scores (ISS), a widely accepted measure of injury severity, were calculated for each hospitalization. Results showed that all types of injury (minor, moderate and major) increased over the study time period, with rates for hospitalizations with moderate to severe traumatic brain injury tripling during the study time period.

“In our study 30 percent of patients hospitalized for ATV-related injuries had a diagnosis of traumatic brain injury,” said Bowman. “Increasing helmet use through a combination of policy and education is critical to curbing the increasing trend in ATV-related hospitalizations among children.”

Support for this research came from the Arkansas Biosciences Institute.

Contact for Johns Hopkins Bloomberg School of Public Health: Tim Parsons at 410-955-7619 or

Additional media contact: Alicia Samuels, MPH, Johns Hopkins Center for Injury Research and Policy, 410-614-5555 or

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Tim Parsons | EurekAlert!
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