ATVs: All Too Vulnerable

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Crozet Annals of Medicine
by Dr. Robert Reiser

Spring is finally here! The signs are unmistakable in the ER. Just as the daffodils suddenly proliferate, so do the motorcycle crashes. Brush up on your skills, motorcycle people, it was a long winter off.

The soft beauty of the first crocuses heralds the arrival of pediatric athletic calamities as outdoor team sports seasons begin. Hey kids, watch where you are going! This isn’t major league soccer.

The bluegills are biting and so are the fishermen. I saw my first fishhook impalement in an arm last weekend. Watch that backswing on your casts!

St. Paddy’s day has come and gone and yet the alcohol keeps flowing and we keep stitching up the stumbling revelers. Begorra! Can Foxfield be far behind?

The impossibly green grass of early spring makes horses all the friskier. Wear your riding helmet, please. I have already admitted one head bleed after a bucking good time was had (by the horse).

The maple trees are beginning to bud and the pollen count (all that red stuff on your car) is soaring, as are our asthma cases. Yes, spring is glorious outdoors and busy for us in the ER.

Last night I also saw one of the most concerning signs of the coming warmer weather, a child injured on an ATV. Simultaneously a 4-year-old was killed in Maryland this past weekend while driving a 50cc ATV. Yes, you read that correctly, a four-year-old was driving an ATV solo.

Pediatricians, trauma surgeons, orthopedists, and ER doctors have all recognized the growing danger of these ever more powerful and ever more prevalent vehicles being piloted by inexperienced and unsupervised young riders. In 2008, the latest year with completed statistics, there were 135,000 ATV injuries treated in U.S. ERs with over 800 fatalities. Of those injuries, 38,000 were in children under the age of 16, including 124 fatalities. This is an increase of 140 percent since 1997. Many of the injured required amputations or involved spinal cord injuries. In fact, the risk of spinal injury from a childhood ATV accident was 7.4 percent, an increase of 467 percent since 1997. If you are injured on one of the larger multi-passenger ATVs you are 10 times more likely to require an amputation. Size definitely matters when your ATV rolls over on you.

In Virginia there were 50 deaths between 2006-2008, while in nearby West Virginia the rate was more than double that with 134 deaths. Of note: West Virginia has one-quarter the population of Virginia.

There are currently 9.5 million ATVs in use in the U.S., so I don’t really expect them to go away. But there is much parents can do to make young riders safer. Helmets should be obvious. Eighty percent of the fatalities were due to head injuries. Helmet use can decrease this by 42 percent. ATV safety courses should be required. Adult supervision is obligatory. And probably the biggest impact is horsepower limitation. At a minimum children under 12 should be limited to 70cc or smaller engines and children under 16 should be limited to 90cc engines. This keeps the speed, the torque and, as importantly, the weight of these machines down.

Come to think of it, if your child is under the age of 12, horsepower should probably be limited to what they can generate with their own legs on their bicycles. This would help the epidemic of childhood obesity as well.

Well, enough of my rant. I am driving home to do some yard work with my 200cc lawnmower. Now where did I park my motorcycle?

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