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Jennissen CA, Denning GM, Aitken ME. A Comprehensive Report on All-Terrain Vehicles and Youth: Continuing Challenges for Injury Prevention. Pediatrics 2022; 150:189564. [PMID: 36180617 DOI: 10.1542/peds.2022-059280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/27/2022] [Indexed: 12/26/2022] Open
Abstract
All-terrain vehicles (ATVs) represent a serious and ongoing public health and safety concern for children and adolescents. Survey studies indicate that high proportions of youth ride ATVs in both rural and nonrural populations. The significant human and economic costs of pediatric ATV-related deaths and injuries result from a number of major risk factors that are highly common in pediatric ATV crashes: operating adult-size vehicles, riding with or as passengers, lack of protective equipment, and riding on public roads. Other less well-studied but potentially significant risk factors are speed, riding at night, alcohol use among older teenagers, and lack of training and supervision. Although potentially safer than adult ATVs, youth models present a number of safety concerns that have not been addressed with rigorous study. The most common ATV crash mechanism is a noncollision event-for example, a rollover. Common injury mechanisms include ejection from the vehicle, resulting in extremity and head injuries, and being pinned or crushed by the vehicle with resulting multiorgan trauma and/or compression asphyxia. Traumatic brain injury and multisystem trauma are the 2 most common causes of death and disabling injury. Taken together, a large multidecade body of evidence is the basis for the American Academy of Pediatrics policy statement recommendation that no child younger than 16 years of age ride on an ATV. Because children continue to be allowed to ride these vehicles, however, efforts to prevent pediatric ATV-related deaths and injuries require multipronged strategies, including education of both youth and parents, safety-based engineering, and enforcement of evidence-based safety laws.
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Affiliation(s)
- Charles A Jennissen
- Departments of Pediatrics.,Emergency Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Gerene M Denning
- Emergency Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Mary E Aitken
- Department of Pediatrics, McGovern Medical School, University of Texas Health Sciences Center at Houston (UTHealth), Houston, Texas
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Abstract
All-terrain vehicles (ATVs) remain a significant source of death and injury among youth. The purpose of this review is to provide an overview of the scope of the problem, the risk factors involved, crash-related outcomes and costs, and injury prevention strategies. There are currently more than 100 pediatric ATV-related fatalities each year and over 30,000 emergency department visits, with a potential annual cost for deaths and injuries approaching $1 billion. Major risk factors include lack of training, operating adult-size ATVs, riding as or carrying passengers, riding on the road, and not wearing a helmet. Extremity injuries are highly common, and the leading causes of death include brain injuries and multi-organ trauma. The latter increasingly involves being crushed by or pinned under the ATV. Reducing ATV-related deaths and injuries will require multiple strategies that integrate approaches from education, engineering, and evidence-based safety laws and their enforcement.
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Affiliation(s)
- Gerene M Denning
- a Department of Emergency Medicine , Roy J and Lucille A Carver College of Medicine, University of Iowa , Iowa City , IA , USA
| | - Charles A Jennissen
- a Department of Emergency Medicine , Roy J and Lucille A Carver College of Medicine, University of Iowa , Iowa City , IA , USA
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Qin ES, Jennissen CA, Wadman CA, Denning GM. Using Geospatial Mapping to Determine the Impact of All-Terrain Vehicle Crashes on Both Rural and Urban Communities. West J Emerg Med 2017; 18:913-922. [PMID: 28874944 PMCID: PMC5576628 DOI: 10.5811/westjem.2017.6.34404] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 06/29/2017] [Accepted: 06/06/2017] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Deaths and injuries from all-terrain vehicle (ATV) crashes result in approximately 700 deaths each year and more than 100,000 emergency department (ED) visits. Common misconceptions about ATV crashes are a significant barrier to injury prevention efforts, as is the lack of key information about where and how crashes occur. The purpose of this study was to determine ATV crash patterns within a state, and to compare and contrast characteristics of these crashes as a function of crash-site rurality. METHODS We performed descriptive, comparative, and regression analyses using a statewide off-road vehicle crash and injury database (2002-2013). Comparisons were performed by rurality as defined using the Rural Urban Commuting Area (RUCA) coding system, and we used geographic information system (GIS) software to map crash patterns at the zip code and county levels. RESULTS ATV crashes occurred throughout the state; 46% occurred in urban and 54% in rural zip code areas. Comparisons of rider and crash characteristics by rurality showed similarities by sex, age, seating position, on vs. off the road, and crash mechanism. Conversely, helmet use was significantly lower among victims of isolated rural crashes as compared to other victims (p=0.004). Crashes in isolated rural and small rural areas accounted for only 39% of all crashes but resulted in 62% of fatalities. In both rural and urban areas, less than one-quarter of roadway injuries were traffic related. Relative crash rates varied by county, and unique patterns were observed for crashes involving youth and roadway riders. During the study period, 10% and 50% of all crashes occurred in 2% and 20% of the state's counties, respectively. CONCLUSION This study suggests that ATV crashes are a public health concern for both rural and urban communities. However, isolated rural ATV crash victims were less likely to be helmeted, and rural victims were over-represented among fatalities. Traffic was not the major factor in roadway crashes in either rural or urban areas. Unique crash patterns for different riding populations suggest that injury prevention experts and public policy makers should consider the potential impact of geographical location when developing injury prevention interventions.
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Affiliation(s)
- Evelyn S Qin
- University of Iowa, Carver College of Medicine, Department of Emergency Medicine, Iowa City, Iowa
| | - Charles A Jennissen
- University of Iowa, Carver College of Medicine, Department of Emergency Medicine, Iowa City, Iowa
| | - Caroline A Wadman
- University of Iowa, Carver College of Medicine, Department of Emergency Medicine, Iowa City, Iowa
| | - Gerene M Denning
- University of Iowa, Carver College of Medicine, Department of Emergency Medicine, Iowa City, Iowa
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Kaprelian J, Berg RL, Barnes KL, Marlenga B. Integrating Agricultural Injury Prevention with Rural Pediatrics: A Pilot Assessment. J Agromedicine 2017; 22:416-419. [PMID: 28704168 DOI: 10.1080/1059924x.2017.1354114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Childhood agricultural injuries are an important public health problem. Pediatricians are a trusted source of expertise in children's health and safety and could serve as a sphere of influence to augment child agricultural injury prevention efforts. The purpose of this pilot study was to begin to explore the perspectives of pediatricians in a large rural health clinic about addressing child agricultural injury prevention within their practice. METHODS Structured interviews were conducted with nine pediatricians who maintain a clinical practice of at least 2 days a week and care for newborns through adolescents. Detailed interviewer notes were reviewed and summarized. RESULTS Rural pediatricians readily acknowledge substantial numbers of farm children in their practice. In general, these providers: (1) recognize farming environments as a safety risk and see agricultural injury prevention as an important topic to be addressed with their patients, (2) are comfortable discussing the topic, but seldom actually initiate such conversations, and (3) doubt farm parents would be receptive to integrating agricultural injury prevention into a rural pediatric practice. CONCLUSION While rural pediatricians recognize child safety risks in farm environments, they are reluctant to actually initiate this conversation with parents. Future research should explore both pediatricians' hesitancy to discuss agricultural injury prevention and farm parents' readiness for integrating the topic into pediatric primary care visits. Such would help to assess the viability of pediatricians as a sphere of influence for augmenting child agricultural injury prevention efforts.
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Affiliation(s)
- Julie Kaprelian
- a Department of Psychiatry & Behavioral Health , Marshfield Clinic Health System , Marshfield , Wisconsin , USA
| | - Richard L Berg
- b Biomedical Informatics Research Center , Marshfield Clinic Research Institute , Marshfield , Wisconsin , USA
| | - Kathrine Lynn Barnes
- c National Farm Medicine Center , Marshfield Clinic Research Institute , Marshfield , Wisconsin , USA
| | - Barbara Marlenga
- d National Children's Center for Rural and Agricultural Health and Safety, National Farm Medicine Center , Marshfield Clinic Research Institute , Marshfield , Wisconsin , USA
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Ho CV, Dunne JR, Stroud WR, Fonseca AH, Davis FE, Bromberg WJ. Analysis of All-Terrain Vehicle Trauma Data: Implications for Increased Regulation and Injury Prevention. Am Surg 2017. [DOI: 10.1177/000313481708300420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
To determine the incidence and severity of all-terrain vehicle crashes (ATVCs) compared with motorcycle crashes (MCCs) in all critically injured patients. Prospective data were retrospectively reviewed on 1840 patients involved in ATVCs and MCCs admitted to a rural level one trauma center over 16 years. ATVC patients (n = 655) were younger (25 vs 38, P < 0.0001), more likely female (20% vs 11%, P < 0.001), less severely injured (13.5 vs 16, P < 0.0001), had similar Glasgow Coma Score (13.3 vs 13.4, p = NS), less helmet use (6% vs 69%, P < 0.0001), more closed head injuries (59.7% vs 54.3%, P < 0.05), more facial injuries (16.9% vs 12.5%, P < 0.05), and lower mortality rate (2.8% vs 5.9%, P < 0.01) compared with MCC patients (n = 1172). Pediatric patients involved in ATVC were more common (29.8% vs 4.8%, P < 0.001), had decreased helmet use (12% vs 59%, P < 0.001) and decreased mortality (3.5% vs 14.3%, P < 0.01). Further injury prevention efforts regarding helmet use and increased regulations regarding ATVCs are needed to decrease the morbidity associated with these recreational vehicles.
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Affiliation(s)
- Cathy V. Ho
- Mercer University School of Medicine, Memorial University Medical Center, Savannah, Georgia
| | - James R. Dunne
- Mercer University School of Medicine, Memorial University Medical Center, Savannah, Georgia
| | - Wesley R. Stroud
- Mercer University School of Medicine, Memorial University Medical Center, Savannah, Georgia
| | - Alvaro H. Fonseca
- Mercer University School of Medicine, Memorial University Medical Center, Savannah, Georgia
| | - Frank E. Davis
- Mercer University School of Medicine, Memorial University Medical Center, Savannah, Georgia
| | - William J. Bromberg
- Mercer University School of Medicine, Memorial University Medical Center, Savannah, Georgia
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Jennissen CA, Harland KK, Wetjen K, Hoogerwerf P, O'Donnell L, Denning GM. All-terrain vehicle safety knowledge, riding behaviors and crash experience of Farm Progress Show attendees. JOURNAL OF SAFETY RESEARCH 2017; 60:71-78. [PMID: 28160816 DOI: 10.1016/j.jsr.2016.12.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 06/14/2016] [Accepted: 12/08/2016] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Although all-terrain vehicles (ATVs) are very popular in rural areas for both recreation and work purposes, the epidemiology of agricultural ATV use remains largely unknown. METHODS Farm Progress Show attendees in 2012 (Boone, Iowa) and 2013 (Decatur, Illinois) were surveyed about ATVs, including riding behaviors, crash history, and safety knowledge. Descriptive and comparative analyses were performed (N=635 surveys). RESULTS Over half of those surveyed lived on a farm and more than 90% had ridden on an ATV. Sixty-one percent rode at least once a week and 39% reported riding almost daily. Males and respondents who lived on farms were significantly more likely to be ATV riders. Regarding unsafe behaviors, >80% of ATV users had ridden with a passenger, 66% had ridden on a public road, and nearly one-half never or almost never wore a helmet. Nearly 40% reported having been in a crash. Multivariable logistic regression analysis of adult respondent's data showed males and younger adults were both more likely to report having crashed. In addition, those reporting riding on public roads (but not having ridden with passengers) were nearly five times more likely and respondents who reported both riding on public roads and having ridden with passengers were approximately eight times more likely to have been in a crash as compared to those not reporting these unsafe behaviors. Safety knowledge did not necessarily correspond with safer behaviors; 80% who knew there should be no passengers on an ATV still had ridden with extra riders. CONCLUSION ATV use is prevalent in rural populations and most riders report engaging in unsafe riding behaviors. PRACTICAL APPLICATIONS These findings may be used to inform ATV safety education and training programs targeted toward agricultural communities, with the goal of reducing occupational ATV-related deaths and injuries and their substantial economic costs.
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Affiliation(s)
- Charles A Jennissen
- Department of Emergency Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States.
| | - Karisa K Harland
- Department of Emergency Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States
| | - Kristel Wetjen
- Department of Surgery, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa; University of Iowa Stead Family Children's Hospital, University of Iowa, Iowa City, Iowa, United States
| | - Pamela Hoogerwerf
- University of Iowa Stead Family Children's Hospital, University of Iowa, Iowa City, Iowa, United States
| | - Lauren O'Donnell
- University of Iowa Stead Family Children's Hospital, University of Iowa, Iowa City, Iowa, United States
| | - Gerene M Denning
- Department of Emergency Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States
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A pilot quality improvement program to increase pediatrician injury anticipatory guidance. J Trauma Acute Care Surg 2015; 79:S9-14. [PMID: 26131790 DOI: 10.1097/ta.0000000000000672] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Because of a lack of time and training, many pediatricians often address few, if any, injury topics during well-child visits. The project goal was to increase the injury anticipatory guidance topics covered by pediatricians during well-child visits by offering screening tools and focused talking points through a quality improvement learning collaborative. METHODS Screening tools were developed and pretested. Pediatric practices, recruited through the Ohio American Academy of Pediatrics, were taught quality improvement theory and injury prevention strategies at a learning session. Pediatricians worked to implement screening tools and talking points into every well-child visit for children 1 year or younger. Monthly, providers reviewed five random charts for each of the six well-child visits for screening tool use and age-appropriate injury prevention discussion. Providers received maintenance of Certification IV credit. RESULTS Sixteen pediatricians (six practices) participated. Screening tool use increased from 0% to 97.2% in just 3 months of the program. For each well-child care visit, injury prevention discussion increased by 89.5% for newborn visit, 88.1% for 2-month, 93.6% for 4-month, 94.0% for 6-month, 88.1% for 9-month, and 90.3% for 12-month-old babies. During the quality improvement program, discussion points for all children 1 year or younger increased for all age-appropriate topics. The greatest percent increase in discussions occurred with water safety (from 10.8% to 95.7%, n = 231), play safety (from 17.9% to 93.5%, n = 154), and supervision safety (from 20.8% to 94.4%, n = 251). More commonly addressed topics also had a significant increase in discussions: sleep safety (from 48% to 93.9%, n = 262), choking (from 44.7% to 95.4%, n = 172), and car safety (from 41.2% to 80.1%, n = 332). CONCLUSION Participation in a maintenance of Certification IV quality improvement program within pediatric offices can increase screening and discussion of injury anticipatory guidance. LEVEL OF EVIDENCE Therapeutic/care management study, level IV.
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Jennissen CA, Peck J, Wetjen K, Hoogerwerf P, Harland KK, Denning GM. The Safety Tips for ATV Riders (STARs) programme: short-term impact of a school-based educational intervention. Inj Prev 2014; 21:166-72. [PMID: 25432939 DOI: 10.1136/injuryprev-2014-041408] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 11/03/2014] [Indexed: 11/04/2022]
Abstract
BACKGROUND Since 1985, one-third of all US all-terrain vehicle (ATV)-related injuries and one-quarter of deaths involved victims <16 years of age. ATV safety education of youth could help reduce these tragedies. OBJECTIVES To assess the efficacy of the Safety Tips for ATV Riders (STARs) school-based programme targeting adolescents. METHODS A survey was anonymously administered before and after the programme to determine demographics, knowledge and reported likelihood of using the information learned. RESULTS Over 4600 students in 30 Iowa schools participated from November 2010 to April 2013. Initially, 52% knew most ATVs are designed for one rider, 25% knew the recommended vehicle size for their age range and 42% knew riding on Iowa's roads was legal only for agricultural purposes. After the programme, this increased to 92%, 82% and 76%, respectively (p<0.0001 in each case), with 61% of students correct on all three. Better preintervention scores were associated with being males, higher riding frequency and being from isolated rural communities. After the programme, 48% and 32% said they were likely/very likely versus unlikely/very unlikely to use the safety information learned, respectively; younger students, females and infrequent riders reported higher likelihoods. CONCLUSIONS STARs increased short-term ATV safety knowledge and almost half the participants reported they would use the safety information presented. Males and frequent riders seemed more resistant, but some groups that may be more vulnerable to potential ATV crash and injury appeared amenable to the training with higher increases in postprogramme scores and greater intention of improving safety behaviours.
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Affiliation(s)
- Charles A Jennissen
- Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, USA
| | | | - Kristel Wetjen
- Division of Pediatric Surgery, Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, USA University of Iowa Children's Hospital, Iowa City, USA
| | | | - Karisa K Harland
- Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, USA Iowa Injury Prevention Research Center, Iowa City, USA
| | - Gerene M Denning
- Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, USA
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Jennissen CA, Harland KK, Wetjen K, Peck J, Hoogerwerf P, Denning GM. A school-based study of adolescent all-terrain vehicle exposure, safety behaviors, and crash experience. Ann Fam Med 2014; 12:310-6. [PMID: 25024238 PMCID: PMC4096467 DOI: 10.1370/afm.1663] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE More youth are killed every year in the United States in all-terrain vehicle (ATV) crashes than on bicycles, and since 2001, one-fifth of all ATV fatalities have involved victims aged 15 years or younger. Effectively preventing pediatric ATV-related deaths and injuries requires knowledge about youth riding practices. Our objective was to examine ATV use, crash prevalence, and riding behaviors among adolescent students in a rural state. METHODS We administered a cross-sectional survey to 4,684 youths aged 11 to 16 years at 30 schools across Iowa from November 2010 to April 2013. Descriptive and comparative analyses were performed. RESULTS Regardless of rurality, at least 75% of students reported having been on an ATV, with 38% of those riding daily or weekly. Among ATV riders, 57% had been in a crash. Most riders engaged in risky behaviors, including riding with passengers (92%), on public roads (81%), or without a helmet (64%). Almost 60% reported engaging in all 3 behaviors; only 2% engaged in none. Multivariable modeling revealed male youth, students riding daily/weekly, and those reporting both riding on public roads and with passengers were 1.61 (95% CI, 1.36-1.91), 3.73 (95% CI, 3.10-4.50), and 3.24 (95% CI, 2.09-5.04) times more likely to report a crash, respectively. CONCLUSIONS Three-fourths of youths surveyed were exposed to ATVs. The majority of riders had engaged in unsafe behaviors and experienced a crash. Given this widespread use and the potentially considerable morbidity of pediatric ATV crashes, prevention efforts, including anticipatory guidance by primary care clinicians serving families at risk, should be a higher priority.
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Affiliation(s)
- Charles A Jennissen
- Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa University of Iowa Children's Hospital, Iowa City, Iowa
| | - Karisa K Harland
- Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa University of Iowa Injury Prevention Research, Iowa City, Iowa
| | - Kristel Wetjen
- University of Iowa Children's Hospital, Iowa City, Iowa Division of Pediatric Surgery, University of Iowa Hospitals and Clinic, Iowa City, Iowa
| | | | | | - Gerene M Denning
- Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa
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Jennissen CA, Miller NS, Tang K, Denning GM. Optimising seat design for all-terrain vehicle injury prevention: wide variability illustrates need for evidence-based standardisation. Inj Prev 2013; 20:88-96. [PMID: 23838558 DOI: 10.1136/injuryprev-2013-040786] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND All-terrain vehicle (ATV)-related deaths and injuries are a growing public health concern, particularly in rural and suburban communities. More engineering approaches that address vehicle safety and promote injury prevention are critically needed. OBJECTIVES Our study was designed to determine the variability in seat characteristics among 2012 model-year, adult-size ATVs. METHODS Measurements of 67 models were performed using an image-based method. Seat characteristics were compared by manufacturer and by ATV type (sport vs utility). RESULTS There were significant differences in seat length and seat placement among manufacturers and between sport and utility ATVs. Seat lengths ranged from 19.8 to 37.0 inches, with sport models significantly longer than utility models. Longer seats resulted from the back of the seat extending further beyond the rear axle and/or the seat front extending closer to the handle grips. Seat front to handle grip distances ranged from 3.25 to 16.5 inches. Combined data showed a strong inverse correlation between seat length and the distance from the seat front to the handle grips, but no significant correlation with wheelbase or engine size. CONCLUSIONS We found wide variability in seat length and placement for adult-size ATVs. However, existing seat specifications were identified that may be a good starting point for improved seat design. Optimal design would allow for safe operation while reducing the likelihood of multiple riders and use by underaged operators, both major risk factors for ATV-related deaths and injuries. Ultimately, regulations may be needed to ensure standardised seat design is incorporated throughout the ATV industry.
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Affiliation(s)
- Charles A Jennissen
- Department of Emergency Medicine, University of Iowa, , Iowa City, Iowa, USA
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Jennissen CA, Miller NS, Tang K, Denning GM. An image-based method to measure all-terrain vehicle dimensions for engineering safety purposes. Inj Prev 2013; 20:115-20. [PMID: 23838559 DOI: 10.1136/injuryprev-2013-040787] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND All-terrain vehicle (ATV) crashes are a serious public health and safety concern. Engineering approaches that address ATV injury prevention are critically needed. Avenues to pursue include evidence-based seat design that decreases risky behaviours, such as carrying passengers and operation of adult-size vehicles by children. OBJECTIVES The goal of this study was to create and validate an image-based method to measure ATV seat length and placement. METHODS Publicly available ATV images were downloaded. Adobe Photoshop was then used to generate a vertical grid through the centre of the vehicle, to define the grid scale using the manufacturer's reported wheelbase, and to determine seat length and placement relative to the front and rear axles using this scale. Images that yielded a difference greater than 5% between the calculated and the manufacturer's reported ATV lengths were excluded from further analysis. RESULTS For the 77 images that met inclusion criteria, the mean±SD for the difference in calculated versus reported vehicle length was 1.8%±1.2%. The Pearson correlation coefficient for comparing image-based seat lengths determined by two independent measurers (20 models) and image-based lengths versus lengths measured at dealerships (12 models) were 0.95 and 0.96, respectively. CONCLUSIONS The image-based method provides accurate and reproducible results for determining ATV measurements, including seat length and placement. This method greatly expands the number of ATV models that can be studied, and may be generalisable to other motor vehicle types. These measurements can be used to guide engineering approaches that improve ATV safety design.
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Affiliation(s)
- Charles A Jennissen
- Department of Emergency Medicine, University of Iowa, , Iowa City, Iowa, USA
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Denning GM, Jennissen CA, Harland KK, Ellis DG, Buresh CT. Off-highway vehicle parks: combining environment, knowledge, and enforcement for all-terrain vehicle injury prevention. ACCIDENT; ANALYSIS AND PREVENTION 2013; 52:64-70. [PMID: 23298708 DOI: 10.1016/j.aap.2012.12.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Revised: 12/05/2012] [Accepted: 12/09/2012] [Indexed: 06/01/2023]
Abstract
The number of off-highway vehicle (OHV) parks continues to grow to meet the recreational needs of ATV enthusiasts and the increasing popularity of the vehicle. Little is known about how OHV park regulations and enforcement affect ATV safety among their users. This study was designed to determine whether there were differences in crash mechanisms and/or compliance with ATV safety laws and regulations when comparing off-road ATV crashes inside and outside state OHV parks. Relative to outside the parks, a smaller percentage of park victims were under the age of sixteen, a lower percentage were passengers, and a dramatically higher percentage were helmeted. Mean injury severity scores were not different inside and outside the parks, but 5% of outside victims had severe brain injuries, as compared to no park victims. Overall, park victims exhibited better compliance with ATV safety laws and regulations and suffered less severe brain injury outcomes. However, park crashes involved more jump-related injuries, suggesting that additional approaches are needed to improve park safety. These findings support the hypothesis that riding environments with safety regulations and effective enforcement can promote safe behaviors and may prevent injuries.
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Affiliation(s)
- Gerene M Denning
- Department of Emergency Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA.
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Wright S, Marlenga B, Lee BC. Childhood agricultural injuries: an update for clinicians. Curr Probl Pediatr Adolesc Health Care 2013; 43:20-44. [PMID: 23395394 DOI: 10.1016/j.cppeds.2012.08.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Revised: 07/23/2012] [Accepted: 08/03/2012] [Indexed: 10/27/2022]
Abstract
Every three days a child dies in an agriculture-related incident, and every day 45 children are injured in the United States. These tragedies should not be regarded as "accidents," as they often follow predictable and preventable patterns. Prevention is not only possible, but vital, since many of these injuries are almost immediately fatal. Major sources of fatal injuries are machinery, motor vehicles, and drowning. Tractor injuries alone account for one-third of all deaths. The leading sources of nonfatal injuries are structures and surfaces, animals (primarily horses), and vehicles (primarily all-terrain vehicles [ATVs]). Children living on farms are at a higher risk than hired workers, and are unprotected by child labor laws. Preschool children and older male youth are at the highest risk for fatal injury, while nonfatal injury was most common among boys aged 10-15 years. Multiple prevention strategies have been developed, yet economic and cultural barriers often impede their implementation. Educational campaigns alone are often ineffective, and must be coupled with re-engineering of machines and safety devices to reduce fatalities. Legislation has the potential to improve child safety, yet political and economic pressures often prohibit changes in child labor laws and mandated safety requirements. Clinicians play a pivotal role in injury prevention, and should actively address common rural risk-taking behaviors as part of the routine office visit in order to help prevent these tragedies.
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Affiliation(s)
- Suzanne Wright
- Marshfield Clinic Pediatric Residency, Department of Pediatrics, Marshfield, WI 54449, USA.
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Denning GM, Harland KK, Ellis DG, Jennissen CA. More fatal all-terrain vehicle crashes occur on the roadway than off: increased risk-taking characterises roadway fatalities. Inj Prev 2012; 19:250-6. [PMID: 23257569 PMCID: PMC3717765 DOI: 10.1136/injuryprev-2012-040548] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Background All-terrain vehicles (ATVs) have steadily increased in popularity, size and speed, characteristics that likely contribute to the alarming rise in ATV-related fatalities. One potentially high-risk activity is riding on the road. Objectives To compare fatal ATV crashes that occur on the roadway and off, to more fully understand factors that contribute to fatalities at each location. Methods Fatality data from the US Consumer Product Safety Commission (CPSC) were used for descriptive and comparative analyses. Multivariate logistic regression analysis was performed to determine relative risk. Results Over 60% of all fatalities (1985–2009) resulted from roadway crashes. After 1998, roadway fatalities increased at over twice the rate of off-road fatalities. Roadway crashes were more likely than off-road crashes to involve multiple fatalities, carrying passengers, alcohol use, collisions and head injuries. Roadway victims were less likely to be helmeted than off-road victims. Passengers and operators with passengers were also less likely to be helmeted than operators riding alone. Helmeted victims were half as likely to suffer a head injury. Conclusions Fatal roadway crashes were more likely than off-road crashes to involve risk-taking behaviours (eg, carrying passengers) that could exacerbate the inherent difficulty of operating ATVs on roadway surfaces. Higher crash forces from greater speed, and lower use of protective equipment, may also have contributed to higher roadway mortality rates. Eliminating non-essential ATV road use may be an effective way to reduce ATV-related fatalities. This will likely require a substantial investment in rider education and better enforcement of ATV road use restriction laws.
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Affiliation(s)
- Gerene M Denning
- Department of Emergency Medicine, University of Iowa, Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa 52242, USA.
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