title: Pediatric all-terrain vehicle trauma: the epidemic continues unabated.
abstract: OBJECTIVE
  The popularity of all-terrain vehicles (ATVs) continues to increase, but this form of recreation is not as well regulated and can impact children disproportionately. This study examines the epidemiology of ATV injuries in Arizona with emphasis on pediatric injuries and compares ATV injuries to those associated with motorcycle (MCC) and motor vehicle crashes (MVC).
  
  
  METHODS
  The trauma registry of a level 1 trauma center was used to identify all ATV crashes during a 5-year period (2004-2008) in patients younger than 16 years. Registration data of ATV were obtained from the state DMV. All-terrain vehicle-related injuries were compared with both MVC and MCC.
  
  
  RESULTS
  A total of 250 pediatric ATV crashes were observed during the 5-year period, rising from 29 in 2004 to 53 in 2008. The median age of patients with ATV-related injuries was 13 years, which is higher than that of patients with MVC-related injuries (9 years). Only 34% of the patients with ATV-related injuries were helmeted, compared with 55% of patients with MCC-related injuries. All-terrain vehicle-related crashes were at least 30 times more likely than MVCs and almost 20 times more likely than MCCs. Statewide pediatric ATV deaths rose during the study period.
  
  
  CONCLUSIONS
  All-terrain vehicle-related crashes have increased during this study period and have become a significant source of injuries. Public education and awareness of the dangers associated with ATV use need to be targeted toward both parents and children likely to use ATVs.
authors.affiliation: Division of Trauma, Department of Surgery, University of Arizona College of Medicine, Tucson, AZ, USA. blecker@email.arizona.edu
authors.forename: Nathan
authors.initials: N
authors.lastname: Blecker
authors.forename: Peter
authors.initials: P
authors.lastname: Rhee
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Judkins
authors.forename: Julie L
authors.initials: JL
authors.lastname: Wynne
authors.forename: Randall S
authors.initials: RS
authors.lastname: Friese
authors.forename: Narong
authors.initials: N
authors.lastname: Kulvatunyou
authors.forename: Rifat
authors.initials: R
authors.lastname: Latifi
authors.forename: Terence
authors.initials: T
authors.lastname: O'Keeffe
mesh_terms: D000063:Accidents, Traffic / Q000639:trends*; D000293:Adolescent; D017677:Age Distribution; D001130:Arizona / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000639:trends; D008297:Male; D015541:Off-Road Motor Vehicles; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D015996:Survival Rate / Q000639:trends; D014193:Trauma Centers / Q000706:statistics & numerical data*; D015599:Trauma Severity Indices; D014505:Urban Population; D014947:Wounds and Injuries / Q000175:diagnosis / Q000453:epidemiology*