Age Legislation and Off-Road Vehicle Injuries in Children

Flaherty, Michael R.; Raybould, Toby; Kelleher, Cassandra M.; Seethala, Raghu R.; Lee, Jarone; Kaafarani, Haytham M.A.; Masiakos, Peter T.

doi:10.1542/peds.2017-1164

Cited by 20 publications

(19 citation statements)

References 35 publications

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“…6 In the past, states with stricter laws regarding youth recreational vehicles have had lower rates of pediatric injury and mortality. 1,40,41 For example, legislation passed in 2010 in Massachusetts required supervision of child riders, expanded helmet requirements, and mandated training classes for teen riders. Since implementation of this law, Massachusetts has observed sustained decreases in the rates of ED visits and inpatient hospitalizations, including a 50% reduction ED visits among 10-to 13-year-old patients.…”

Section: Discussionmentioning

confidence: 99%

The impact of helmet use on neurosurgical care and outcomes after pediatric all-terrain vehicle and dirt bike crashes: a 10-year single-center experience

Allen

Yengo‐Kahn²,

Vittetoe

et al. 2022

Journal of Neurosurgery: Pediatrics

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OBJECTIVE All-terrain vehicle (ATV) and dirt bike crashes frequently result in traumatic brain injury. The authors performed a retrospective study to evaluate the role of helmets in the neurosurgical outcomes of pediatric patients involved in ATV and dirt bike crashes who were treated at their institution during the last decade. METHODS The authors analyzed data on all pediatric patients involved in ATV or dirt bike crashes who were evaluated at a single regional level I pediatric trauma center between 2010 and 2019. Patients were excluded if the crash occurred in a competition (n = 70) or if helmet status could not be determined (n = 18). Multivariable logistic regression was used to analyze the association of helmet status with the primary outcomes of 1) neurosurgical consultation, 2) intracranial injury (including skull fracture), and 3) moderate or severe traumatic brain injury (MSTBI) and to control for literature-based, potentially confounding variables. RESULTS In total, 680 patients were included (230 [34%] helmeted patients and 450 [66%] unhelmeted patients). Helmeted patients were more frequently male (81% vs 66%). Drivers were more frequently helmeted (44.3%) than passengers (10.5%, p < 0.001). Head imaging was performed to evaluate 70.9% of unhelmeted patients and 48.3% of helmeted patients (p < 0.001). MSTBI (8.0% vs 1.7%, p = 0.001) and neurosurgical consultation (26.2% vs 9.1%, p < 0.001) were more frequent among unhelmeted patients. Neurosurgical injuries, including intracranial hemorrhage (16% vs 4%, p < 0.001) and skull fracture (18% vs 4%, p < 0.001), were more common in unhelmeted patients. Neurosurgical procedures were required by 2.7% of unhelmeted patients. One helmeted patient (0.4%) required placement of an intracranial pressure monitor, and no other helmeted patients required neurosurgical procedures. After adjustment for age, sex, driver status, vehicle type, and injury mechanism, helmet use significantly reduced the odds of neurosurgical consultation (OR 0.250, 95% CI 0.140–0.447, p < 0.001), intracranial injury (OR 0.172, 95% CI 0.087–0.337, p < 0.001), and MSTBI (OR 0.244, 95% CI 0.079–0.758, p = 0.015). The unadjusted absolute risk reduction provided by helmet use equated to a number-needed-to-helmet of 6 riders to prevent 1 neurosurgical consultation, 4 riders to prevent 1 intracranial injury, and 16 riders to prevent 1 MSTBI. CONCLUSIONS Helmet use remains problematically low among young ATV and dirt bike riders, especially passengers. Expanding helmet use among these children could significantly reduce the rates of intracranial injury and MSTBI, as well as the subsequent need for neurosurgical procedures. Promoting helmet use among recreational ATV and dirt bike riders must remain a priority for neurosurgeons, public health officials, and injury prevention professionals.

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Section: Discussionmentioning

confidence: 99%

The impact of helmet use on neurosurgical care and outcomes after pediatric all-terrain vehicle and dirt bike crashes: a 10-year single-center experience

Allen

Yengo‐Kahn²,

Vittetoe

et al. 2022

Journal of Neurosurgery: Pediatrics

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“…Off‐road riding is a popular recreational activity and common in rural Australia, as it is elsewhere around the world. Clinicians treating injured children have an important role not just in managing injuries, but also as injury prevention messengers and advocates to patients, their families and communities 25 . This study informs such advocacy by illustrating patterns of riding and injury and antecedent causes of crashes.…”

Section: Discussionmentioning

confidence: 93%

Paediatric off‐road vehicle injury in rural and regional Australia

Mulligan

Adams

Soundappan

et al. 2021

Australian J Rural Health

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Objective Off‐road riding of quad bikes and motorcycles is common among children across rural and remote Australia, but is a significant source of injury and hospitalisation. An in‐depth analysis of paediatric off‐road vehicle crashes was undertaken to inform injury prevention countermeasures by characterising injury patterns and sources of injury. Design This is a prospective in‐depth case series. Participants Participants are children aged 16 and under who have been hospitalised due to injury sustained from the use of an off‐road motorcycle or quad bike in New South Wales, Australia. Interventions Crash investigation techniques (medical data, structured interview, vehicle and crash site inspection) were used to ascertain details of the crash event, protective gear, injury information and contributory factors. Results Thirty children were recruited, 27 boys and 3 girls, ranging in age from 4 to 16 years, having crashed on off‐road motorcycles (n = 27) or quads (n = 3). Most (73.3%) were participating in unstructured social riding. A total of 67 separate injuries were observed, with overall Injury Severity Scores between 1 and 35. There were high rates of wearing helmets and motorcycle‐specific garments. The most commonly injured areas were the upper and lower extremities. The most common sources of injury were from impacting the ground, obstacles/other riders or the vehicle. Conclusion This study demonstrates the patterns of riding and injury in rural paediatric off‐road vehicle riders, occurring despite high rates of helmet/protective gear use. This underscores the need for investigation into the injury mitigation and fit properties of protective gear and the inherent risks for physically and developmentally maturing children.

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“…While safety legislation has been well studied with regards to motorcycles, automobiles, and other roadway vehicles, only a few studies have focused on ORVs. Of these, some showed positive effects on riding behavior [23][24][25], whereas others suggested little benefit [26,27]. However, none of these studies addressed law enforcement, and in studies with limited effects, authors speculated that the most likely reason was lack of enforcement [28].…”

Section: Introductionmentioning

confidence: 99%

Enforcement of Off-Road Vehicle Laws in Iowa

Qin¹,

Denning²,

Jennissen³

2019

Safety

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Safety laws are among the most successful means of reducing injuries, but their effectiveness is strongly influenced by the level of enforcement. To characterize enforcement of off-road vehicle (ORV) laws statewide, analyses of citations were performed using Iowa Court Information System data. From 2005–2015, 5173 individuals were charged with 5643 citations issued. Citations averaged <5/county/year, decreased dramatically over time, and varied by county when normalized to registered all-terrain vehicles (ATVs). Over 90% of operators cited were male and Caucasian. One-fifth were <18 years old. The top five violations were: operation on a highway/snowmobile trail (51%), registration/identification number not documented/displayed (19%), prohibited use in a park/preserve (5.5%), and operation with more persons than the vehicle is designed to carry (4.4%). The Department of Natural Resources issued the highest percentage of citations, followed in decreasing order by Sheriff, Police, State Patrol, and Conservation officers. Significant differences were identified when citations were compared by sex, age, race, enforcement agency, disposition (guilty vs. not guilty), and when comparing counties with or without an ORV park. These characteristics suggest limited and variable enforcement of laws statewide that may reduce their potential to prevent deaths and injuries, and that improved strategies to support ORV law enforcement are needed.

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Age Legislation and Off-Road Vehicle Injuries in Children

Cited by 20 publications

References 35 publications

The impact of helmet use on neurosurgical care and outcomes after pediatric all-terrain vehicle and dirt bike crashes: a 10-year single-center experience

The impact of helmet use on neurosurgical care and outcomes after pediatric all-terrain vehicle and dirt bike crashes: a 10-year single-center experience

Paediatric off‐road vehicle injury in rural and regional Australia

Enforcement of Off-Road Vehicle Laws in Iowa

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