For young people who ride all-terrain vehicles (ATVs) without a helmet, the risk of head trauma is an established and serious concern. New research, however, finds that these vehicles may also pose a high risk for severe chest injuries.
“I believe that many parents are unaware of how serious ATV-related injuries can be,” said the study's author, Dr. Kelly Hagedorn. She's a radiology resident at McGovern Medical School at the University of Texas Health Science Center at Houston.
“Some parents view ATVs as being more similar to bicycles. However, many of the injury patterns are more similar to those sustained in motor vehicle collisions,” she explained.
ATVs are motorized recreational vehicles with three or four tires, designed for off-road use. Because they can weigh 300 to 400 pounds and travel at speeds of up to 75 miles an hour, ATVs can often be involved in serious accidents, including crashes, rollovers and ejections, the researchers said.
In many states, children younger than 16 can drive ATVs designed for adults, according to the U.S. Consumer Product Safety Commission (CPSC). The American Academy of Pediatrics recommends that children under that age be prohibited from riding ATVs.
While ATV-related injuries have declined since 2007, nearly 25,000 children under the age of 16 were treated for ATV-related injuries in hospital emergency rooms nationwide in 2014, the CPSC reported.
“As ATVs have gotten bigger and heavier, riders have a harder time separating from the vehicle in a crash,” said Gerene Denning. She's director of emergency medicine research at the University of Iowa Carver College of Medicine.
“The increasing size and weight of ATVs leads to more cases of the vehicle striking the rider. There is also a growing trend of riders being pinned by the vehicle, which can lead to compression asphyxia [a condition where the body doesn't get enough oxygen],” said Denning, who wasn't involved in this study.
The study included records from 455 patients, 18 years old and younger. All had chest imaging at a trauma center in Houston after ATV-related incidents. The accidents occurred between 1992 and 2013. Of those admitted, 102 (22 percent) suffered a chest injury.
The researchers said that 40 percent of patients with chest injuries were treated in an intensive care unit (ICU), compared to 22 percent of patients without chest injuries. On average, patients with chest injuries were 13 years old.
The most common chest injury, occurring in 61 percent of patients, was pulmonary contusion, or bruising of the lung. About 45 percent of patients had a collapsed lung and 34 percent had rib fractures. Eight deaths occurred among the 102 patients who had chest trauma, the study found.
Although not specifically evaluated in this study, Hagedorn said these types of injuries may lead to long hospital stays, high medical bills and missed school.
The study authors found that the biggest cause of chest injury was rollover (43 percent), followed by collision with landscape (20 percent) and falls (16 percent).
In 41 cases, the injured child had been driving the ATV. In 33 cases, he or she had been riding along as a passenger. In the remaining 28 cases, it wasn't known whether the injured child was the driver or passenger.
Denning said that a contributing factor toward these accidents is the fact that many parents are allowing their children to operate adult-size vehicles.
“This increases both the risk of crashing and the severity of vehicle-related trauma,” Denning said. “A group called Concerned Families for ATV Safety have story after story of children killed in ATV crashes. A common thread through those stories is a parent saying they didn't know how dangerous these vehicles were for their children.”
To help prevent injuries, Hagedorn advises young people who ride ATVs to wear protective gear, take a hands-on safety course, and adhere to state laws.
In addition, Denning recommends that parents ensure that their children ride appropriate youth-size ATVs, never have two riders on an ATV designed for one, and always wear a helmet.
“Changes in behavior are going to take everyone, especially parents, following the safety rules,” she said.
Hagedorn was scheduled to present the study results on Tuesday at the annual meeting of the Radiological Society of North America, in Chicago. Findings presented at meetings are generally viewed as preliminary until they've been published in a peer-reviewed journal.