The dark side of nighttime all-terrain vehicle use

The association between county ordinances allowing off-road vehicles on public roads and crash rates

BACKGROUND

Legislative bodies across the country have increasingly allowed off-road vehicles (ORVs) including all-terrain vehicles (ATVs) and utility task vehicles (UTVs) on public roads, an environment for which they are not designed. In 2004, Iowa gave individual counties the discretion to pass ordinances allowing ORVs on public roadways. The objective of this study was to evaluate the relationship between the passage of ORV ordinances and ORV crash rates, especially on public roads.

METHODS

An Iowa ORV roadway ordinance database and an Iowa ORV crash database (2002-2018) for all 99 counties were compiled. Crashes for which county location could not be determined were excluded. Utilizing a zero-inflated Poisson model, correcting for background crash frequency trends and population, investigators compared the relative rates of crashes after ordinance passage to time points before ordinance implementation and to counties without such ordinances. Sub-analyses, including that focused on more recent years (2008-2018), were also performed.

RESULTS

Forty-five county ORV roadway ordinances went into effect between 2011 and 2018 and 2,347 crashes (69%) met inclusion criteria. Adjusted for year, there was a 58% greater ORV crash rate in counties after passing an ORV roadway ordinance (incidence rate ratio (IRR) 1.58, 95% CI 1.32-1.90). Roadway crashes (n = 834) increased 48% after ordinance passage (IRR 1.48, 95% CI 1.14-1.94). This roadway crash association remained statistically significant when analysis was limited to the years 2008-2018 (IRR 1.39, CI 1.06-1.83, n = 544); to ATV crashes only (IRR 1.70, CI 1.20-2.40, n = 683); and to ATV crashes excluding counties with UTV-only ordinances (IRR 1.74, CI 1.40-2.15, n = 2,011).

CONCLUSIONS

ORV roadway and total crashes increased significantly after implementation of county ordinances allowing ORVs on public roadways and when compared to counties without such ordinances. It is likely that these increased crashes have resulted in more injuries and possibly deaths. Results from this study may help inform policymakers as they consider legislation regarding ORV usage on public roads.

Alcohol is a risk factor for helmet non-use and fatalities in off-road vehicle and motorcycle crashes

OBJECTIVES

Off-road vehicle (ORV) and motorcycle use is common in Canada; however, risk of serious injury is heightened when these vehicles are operated without helmets and under the influence of alcohol. This study evaluated the impact of alcohol intoxication on helmet non-use and mortality among ORV and motorcycle crashes.

METHODS

Using data collected from the Nova Scotia Trauma Registry, a retrospective analysis (2002-2017) of ORV and motorcycle crashes resulting in major traumatic brain injury was performed. Patients were grouped by blood alcohol concentration (BAC) as negative (< 2 mmol/L), legally intoxicated (2-17.3 mmol/L) or criminally intoxicated (> 17.3 mmol/L). Logistic regression models were constructed to test for helmet non-use and mortality.

RESULTS

A total of 424 trauma patients were included in the analysis (220 ORV, 204 motorcycle). Less than half (45%) of patients involved in ORV crashes were wearing helmets and 65% were criminally intoxicated. Most patients involved in motorcycle crashes were helmeted at time of injury (88.7%) and 18% were criminally intoxicated. Those with criminal levels of intoxication had 3.7 times the odds of being unhelmeted and were 3 times more likely to die prehospital compared to BAC negative patients. There were significantly increased odds of in-hospital mortality among those with both legal (OR = 5.63), and criminal intoxication levels (OR = 4.97) compared to patients who were BAC negative.

CONCLUSION

Alcohol intoxication is more frequently observed in ORV versus motorcycle crashes. Criminal intoxication is associated with helmet non-use. Any level of intoxication is a predictor of increased in-hospital mortality.

Understanding the factors of road crash severity in Benin: a matched case-control study

Background

In Benin, due to the unavailability of comprehensive data on road crashes, road safety policies are mainly based on partial statistics provided by the police. These remain unreliable in terms of injury severity and risk factors. This study aims to determine the factors influencing the severity of injuries after a road crash in Benin.

Methods

The present nested case-control study, matched for age and sex, was based on a hospital cohort of road crash victims set up in five hospitals in Benin between July 2019 and January 2020. A sample of severely injured patients according to the Abbreviated Injury Scale (cases) was compared to non-severely injured patients (controls).

Results

The severe crash occurred mainly during the night between 8 p.m. and midnight (36.2% of cases vs. 24.4% of controls) and on main roads (57.8% of cases vs. 34.7% of controls). Factors associated with injury severity were the time of the crash: night between 8 p.m. and midnight [Adjusted Odd Ratio (AOR): 2.1; CI 95%: 1.4-3.2], major roads (national interstate roads and national roads) (AOR: 2.8; CI 95%: 2.0-4.0) and non-work-related travel (AOR: 1.8; CI 95%: 1.2-2.7).

Conclusions

Factors associated with road crash severity in Benin were night-time, main roads, and non-work related travel. Raising user awareness about compliance with traffic rules and improving public lighting, especially along main roads could help reduce the number of serious injuries.

Risk factors associated with quadbike crashes: a systematic review

Background

Quadbikes or all-terrain vehicles are known for their propensity for crashes resulting in injury, disability, and death. The control of these needless losses resulting from quadbike crashes has become an essential contributor to sustainable development goals. Understanding the risk factors for such injuries is essential for developing preventive policies and strategies. The aim of this review was to identify the risk factors associated with quadbike crashes at multiple levels through a systematic review of a wide range of study designs.

Methods

The study incorporated a mixed-method systematic review approach and followed the PRISMA 2020 guidelines for reporting systematic reviews, including a peer reviewed  protocol. This systematic review included observational studies investigating the risk factors associated with quadbike crashes, injuries, or deaths. Seven electronic databases were searched from inception to October 2021. Studies were screened and extracted by three researchers. Quality appraisal was conducted using the Mixed Methods Appraisal Tool (MMAT). Due to extensive heterogeneity, meta-analysis was not conducted. All the risk factors have been presented in a narrative synthesis for discussion following the guidelines for Synthesis without Meta-analysis (SWiM).

Results

Thirty-nine studies combining an aggregate of 65,170 participants were included in this systematic review. The results indicate that modifiable risk factors, such as the increasing age of driving initiation, reducing substance use, and the use of organized riding parks, could reduce quadbike injuries. Riding practices such as avoiding passengers, avoiding nighttime riding, and using helmets could significantly reduce crashes and injuries among riders. Vehicle modifications such as increasing the wheelbase and limiting engine displacement could also help reduce crash incidence. Traditional interventional methods, such as legislation and training, had a weak influence on reducing quadbike injuries.

Conclusion

Multiple risk factors are associated with quadbike injuries, with most of them modifiable. Strengthening policies and awareness to minimize risk factors would help in reducing accidents associated with quadbikes.

PROSPERO registration number CRD42020170245

All-Terrain Vehicle-Related Emergency Department Visits: Interaction of Sex and Age, NEISS, 2019

BACKGROUND

Epidemiologic patterns of all-terrain vehicle (ATV)-related emergency department (ED) visits by male and female individuals may vary at different ages. To our knowledge, this has not been researched previously.

OBJECTIVE

The purpose of this study was to determine the interaction of sex and age differences in their association with ATV-related ED visits.

METHODS

Data from the 2019 National Electronic Injury Surveillance System were extracted for ATV-related ED visits, including sex, age, race, location of crash, injured body part, and whether alcohol was involved. Descriptive statistics and logistic regression analyses were conducted. We modeled sex in separate multivariable models, adjusting for the same independent variables.

RESULTS

There were an estimated 95,995 (unweighted n = 1999) ATV-related ED visits. There was a significant age-by-sex interaction in the association between ATV-related ED visits vs. other ED injuries, indicating that the effect of age on ATV-related ED visits differed by sex and vice versa. Overall, male individuals were 1.7 times as likely to have an ATV-related ED visit as female individuals. In the stratified analysis for female individuals, odds were substantially greater for girls younger than 18 years (adjusted odds ratio [AOR] 2.33; 95% confidence interval [CI] 1.61-3.69) and women aged 18-35 years (AOR 4.76; 95% CI 3.48-6.51) compared with woman older than 35 years. For men, odds were significant for ages 18-35 years (AOR 2.21; 95% CI 1.72-2.85) compared with men older than 35 years.

CONCLUSIONS

As newer ATVs become more powerful and faster, there is a need to know who is at greatest risk for ATV-related ED visits to develop policies and safety measures.