title: All-terrain vehicle rules and regulations: impact on pediatric mortality.
abstract: OBJECTIVE
  All-terrain vehicles (ATV) use by children leads to severe injury and death. Since the US Consumer Product Safety Commission consent decree expired in 1998, there has been little movement in regulating ATV use for children (<16 yr). The authors hypothesized that states with laws and regulations restricting pediatric ATV use may abrogate excess death compared with states without such restrictions.
  
  
  METHODS
  Pediatric mortality data reported to the consumer product safety commission from 1982 to 1998 were analyzed as well as state all-terrain vehicle requirements compiled by the Specialty Vehicle Institute of America in August 2001. The authors calculated ATV mortality rate by dividing ATV mortality frequency by 1980-2000 pediatric census results. They compared the top 26 states with the highest ATV mortality rates (TOP) with those of all other states (OTH) in terms of age, ATV type, ATV occupancy, and ATV laws. Chi-square analysis was performed.
  
  
  RESULTS
  There were 1,342 ATV pediatric deaths during the 16-year period. The TOP states averaged approximately a 2-fold increase in adjusted ATV mortality rate compared with the national ATV pediatric mortality rate. Ninety-two percent of TOP states have no licensing laws compared with 73% of the OTH states (P <.07). There is no difference between groups with regard to minimum age requirements and safety certification.
  
  
  CONCLUSIONS
  Current legal and regulatory standards have low probability of decreasing ATV-related pediatric mortality. States should adopt laws that restrict the use of ATV's for children less than 16 years of age and potentially prevent excess ATV-related pediatric mortality.
authors.affiliation: Department of Pediatric Surgery, Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA 15213, USA.
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Upperman
authors.forename: Barbara
authors.initials: B
authors.lastname: Shultz
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Gaines
authors.forename: David
authors.initials: D
authors.lastname: Hackam
authors.forename: Laura D
authors.initials: LD
authors.lastname: Cassidy
authors.forename: Henri R
authors.initials: HR
authors.lastname: Ford
authors.forename: James
authors.initials: J
authors.lastname: Helmkemp
mesh_terms: D000056:Accident Prevention; D000059:Accidents / Q000401:mortality*; D000293:Adolescent; D002648:Child; D003257:Consumer Product Safety; D006801:Humans; D015541:Off-Road Motor Vehicles / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology