Age-based risk factors for pediatric ATV-related fatalities

OBJECTIVES: To compare and contrast characteristics and determinants of fatal all-terrain vehicle (ATV) crashes among pediatric age groups. METHODS: Retrospective descriptive and multivariable analyses of Consumer Product Safety Commission fatality data (1985–2009) were performed. RESULTS: Relative to 1985–1989 (baseline), pediatric deaths over the subsequent 4-year periods were lower until 2001–2004, when they markedly increased. Also, the proportion of vehicles involved in fatalities with engine sizes >350 cubic centimeter increased, reaching ~50% of crashes in 2007–2009. Ninety-five percent of all pediatric fatalities were on adult-size vehicles. Victims <6 years old had the highest proportion of girls (24%) and passengers (76%), and the lowest helmet use (17%). More than half of 6- to 11-year-old children were vehicle operators; 1 in 4 were carrying passengers in their own age range. Over the study period, 12- to 15-year-old children accounted for more than half of all pediatric ATV-related fatalities. The proportion of youth riding on the road increased with age, as did the proportion of collisions with other vehicles. Older teens had the highest proportions of roadway fatalities (72%) and collision events (63%), and 19% of their crashes involved alcohol. Head injuries occurred in 63% of victims (the major determinant being roadway riding), and helmets reduced the likelihood of head injury among fatal crash victims by 58%. CONCLUSIONS: There were significant differences between pediatric age groups in the relative contribution of known risk factors for ATV-related fatalities. Future injury prevention efforts must recognize these differences and develop interventions based on the age range targeted.