Correspondence

Injuries and Deaths and the Use of All-Terrain Vehicles

N Engl J Med 2000; 343:1733-1734December 7, 2000

Article

To the Editor:

During the late 1980s and early 1990s, deaths and injuries associated with the recreational use of all-terrain vehicles steadily decreased; however, around 1993, this trend began gradually to reverse. U.S. Consumer Product Safety Commission (CPSC) data from 1985 through 1998 indicate that an estimated 273 persons die annually from all-terrain vehicle crashes, and 35 percent of them are less than 16 years old (David J, Directorate for Epidemiology, CPSC: personal communication). Data for the same period from the National Electronic Injury Surveillance System indicate that of the estimated 68,300 annual all-terrain vehicle–related injuries requiring emergency room care, 39 percent occurred in children. Injuries have also increased among adult users of all-terrain vehicles (Figure 1Figure 1Estimated All-Terrain Vehicle–Related Deaths in the United States from 1985 through 1998. and Figure 2Figure 2Estimated All-Terrain Vehicle–Related Injuries in the United States from 1985 through 1998.) (David J: personal communication).

All-terrain vehicles gained popularity in the United States in the late 1970s, and today nearly 4 million are in use. Dramatic increases in all-terrain vehicle–associated injuries and deaths in the early 1980s led the CPSC to issue a safety alert in May 1987 warning users to receive training, wear helmets, and carry no passengers.1 The American Academy of Pediatrics recommended that pediatricians warn parents that using an all-terrain vehicle requires skill, judgment, and experience, and that they should prohibit the use of all-terrain vehicles by children less than 14 years old.2 In 1988, a 10-year consent decree between the CPSC and manufacturers of all-terrain vehicles halted the sale of three-wheeled all-terrain vehicles, prohibited the sale of adult-sized all-terrain vehicles to children less than 16 years old, and required distributors to provide safety information and training.3

The explanation for the recent trends of increasing all-terrain vehicle–related injuries and deaths is not clear. Possibly the common-sense safety message is not getting to the users of all-terrain vehicles. The CPSC notes that the requirements for reporting incidents have not changed. Data have shown some increases in sales of all-terrain vehicles and exposure, but they are not enough to account for the observed increase in injuries and deaths (David J: personal communication). Renewed safety efforts initiated by the CPSC and the all-terrain vehicle industry (when the consent decree expired in 1998) should focus on youth-oriented information and safety education campaigns to help reverse the current trends.4 These efforts must be in concert with safety education offered at home and in the community. Parents must stress that riding in all-terrain vehicles can be fun and safe if basic safety guidelines are followed by all users, including themselves.

James C. Helmkamp, Ph.D.
West Virginia University, Morgantown, WV 26508-9151

4 References

1. 1

   CPSC urges caution for three- and four-wheeled all-terrain vehicles. CPSC document no. 540. Bethesda, Md.: Consumer Product Safety Commission, 1987.
   

2. 2

   American Academy of Pediatrics Committee on Accident and Poison Prevention. All-terrain vehicles: two-, three-, and four-wheeled unlicensed motorized vehicles. Pediatrics 1987;79:306-308
   Web of Science | Medline

3. 3

   U.S. District Court for the District of Columbia. 1988. United States of America v. American Honda Motor Co., Inc., et al. Washington, D.C.: U.S. District Court of the District of Columbia, 1992; Civil action no. 87-3525.
   

4. 4

   CPC announces all-terrain vehicle safety programs. CPSC release no. 99-034. Bethesda, Md.: Consumer Product Safety Commission, 1998.
   

Citing Articles (9)

Citing Articles

1. 1

   Robert S. Williams, James Graham, James C. Helmkamp, Rhonda Dick, Tonya Thompson, Mary E. Aitken. (2011) A Trial of an All-Terrain Vehicle Safety Education Video in a Community-Based Hunter Education Program. The Journal of Rural Health 27:3, 255-262
   CrossRef

2. 2

   Paul M. Balthrop, John Nyland, Craig S. Roberts. (2009) Risk Factors and Musculoskeletal Injuries Associated with All-Terrain Vehicle Accidents. The Journal of Emergency Medicine 36:2, 121-131
   CrossRef

3. 3

   James A. Sanfilippo, Corbett D. Winegar, James S. Harrop, Todd J. Albert, Alexander R. Vaccaro. (2008) All-Terrain Vehicles and Associated Spinal Injuries. Spine 33:18, 1982-1985
   CrossRef

4. 4

   James C. Helmkamp, Paul M. Furbee, Jeffrey H. Coben, Allison Tadros. (2008) All-Terrain Vehicle–Related Hospitalizations in the United States, 2000–2004. American Journal of Preventive Medicine 34:1, 39-45
   CrossRef

5. 5

   E. Michael Goldcamp, John Myers, Kitty Hendricks, Larry Layne, Jim Helmkamp. (2006) Nonfatal All-Terrain Vehicle?Related Injuries to Youths Living on Farms in the United States, 2001. The Journal of Rural Health 22:4, 308-313
   CrossRef

6. 6

   Nadia Murphy, Natalie L. Yanchar. (2004) Yet More Pediatric Injuries Associated with All-Terrain Vehicles: Should Kids Be Using Them?. The Journal of Trauma: Injury, Infection, and Critical Care 56:6, 1185-1190
   CrossRef

7. 7

   Ann M. Carr, Julian E. Bailes, James C. Helmkamp, Charles L. Rosen, Vincent J. Miele. (2004) Neurological Injury and Death in All-terrain Vehicle Crashes in West Virginia: A 10-year Retrospective Review. Neurosurgery 54:4, 861-867
   CrossRef

8. 8

   P. Moroney, M. Doyle, K. Mealy. (2003) All-terrain vehicles—unstable, unsafe and unregulated. Injury 34:3, 203-205
   CrossRef

9. 9

   J. C. Helmkamp. (2001) A Comparison of State-Specific All-Terrain Vehicle-Related Death Rates, 1990-1999. American Journal of Public Health 91:11, 1792-1795
   CrossRef