Substance exposure and helmet use in all-terrain vehicle accidents: Nine years of experience at a level 1 trauma center

Abstract

Introduction The surging popularity of all-terrain vehicles (ATV) in the United States has caused an “epidemic of injuries and mortality.” The U.S. Consumer Product Safety Commission reported 99,600 injuries and 426 fatalities from ATV accidents in 2013. The aim of this study was to examine the relationship between helmet use and positive toxicology screenings on outcomes in ATV accident victims. Methods This is a retrospective study of patients admitted to a Level 1 Trauma Center in southwestern West Virginia following an ATV accident between 2005 and 2013. Data were obtained from the institution’s Trauma Registry. Results A total of 1,857 patients were admitted during the study period with 39 (1.9%) reported deaths. Positive serum alcohol and/or urine drug screens were obtained in 66.4% of the patients tested (n = 1,293). Those with positive screenings were 9.5% less likely to utilize a helmet (13.2% vs. 22.7%, p < 0.001); and the lack of helmet use was associated with an increase in traumatic brain injury (57.1% vs. 41.7%, p < 0.001). Positivity for substances or the lack of helmet use was significantly associated with higher morbidity. Lack of helmet use resulted in a 3.94-fold increase in the risk of discharge in a vegetative state or death. Conclusions Drugs and alcohol use may predispose riders to be less likely to wear helmets and significantly increase the risk of a poor clinical outcome following an ATV accident. Rigorous efforts should be made to enhance safety measures through educational endeavors and amendment of current regulations to promote safe and responsible use of ATVs. Practical applications Modification of regulatory requirements should be considered in order to mandate the wearing of helmets during ATV operation. In addition, expansion of safety programs should be considered in an effort to improve availability, affordability and awareness of safe ATV practices.

Risk factors associated with quadbike crashes: a systematic review

“…Some studies, based on retrospective surveillance data, scored low because the analysis did not adjust for confounding [10,12,39,49,[55][56][57]. One cross-sectional study had a weak sampling strategy and did not represent the target population [58].…”

“…Helmet use Several studies have shown that helmet nonuse among riders predisposes them to more severe head injuries, traumatic brain injuries, and death [51,56,[63][64][65]. Helmets are known to reduce the severity of head and neck injuries and crash injuries occurring during rollover [66].…”

“…He also noted that non-intoxicated riders were more likely to have less severe injuries [64]. Other studies showed similar observations of a higher risk for musculoskeletal injury, hospitalizations, and death among riders under the influence of alcohol, narcotics, etc., especially when riding at night [49,56,60,62]. Intoxicated riders were also four times less likely to be helmeted [62,64], increasing the risk for severe injuries.…”

Enforcement of Off-Road Vehicle Laws in Iowa

“…Independent risk factors that increase the likelihood of ORV-related deaths and injuries include roadway riding [9,11,12], being male and/or <16 years of age [13,14,32], youth operating adult-size ATVs [10], carrying passengers on ATVs designed for a single rider [9][10][11]33], alcohol [34][35][36], and lack of helmet use by ATV riders [34,[37][38][39]. Safety laws are designed to reduce crashes and injuries by focusing on risk factors, and Iowa's ORV laws and OHV park regulations do address some of these issues.…”

The Impact of Alcohol Consumption on Mortality Among Patients with Complex Cervical Trauma

“…Alcohol represents one of the most important risk factors for serious and fatal injuries [5][6][7][8], being the most frequent toxic with health and social effects [7]. Epidemiological data show statistically significant associations between alcohol consumption and the socio-economic level [10].…”