title: Safety factors related to all-terrain vehicle injuries in children.
abstract: BACKGROUND
  All-terrain vehicle (ATV)-related injuries are a significant source of pediatric trauma. We hypothesized that these injuries are caused by poor safety behavior. To test this hypothesis, we surveyed both injured and uninjured ATV riders.
  
  
  METHODS
  A prospective convenience sample-based survey was initiated at Children's Hospital of Pittsburgh, a Level I pediatric trauma center. Patients with an ATV-related injury were asked to complete the survey for the study group (INJ), while uninjured pediatric ATV-riders completed the survey for the control group (UnINJ). The Fisher's exact probability test was used for data analysis.
  
  
  RESULTS
  There were 38 surveys completed for INJ and 11 for UnINJ. Both groups had similar demographics. ATVs in both groups were mostly used for recreation, and most of the INJ patients were in a rural setting. Half of the ATVs were purchased second hand, and less than half were purchased from a dealer. Most dealers reviewed age recommendations for ATV use; however, many safety recommendations were not followed. INJ group had a higher percentage of children riding inappropriately sized ATVs and a lower rate of helmet use when compared with UnINJ group. In addition, there were a significant number of regulatory violations in the INJ group, including nine children (24%) riding as passengers and 5 (13%) driving on a road.
  
  
  CONCLUSIONS
  These data suggest that there may be decreased safety behavior among injured pediatric ATV-riders; however, uninjured riders also demonstrate poor safety habits. The study showed that dealers do review safety regulations with consumers; however, most of the ATVs are not purchased through dealers. Therefore, we may need to shift our safety and educational focus to reach these families.
  
  
  METHODS
  Prognostic/epidemiologic study, level III.
authors.affiliation: Division of Pediatric General and Thoracic Surgery, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania 15224, USA.
authors.forename: Sohail R
authors.initials: SR
authors.lastname: Shah
authors.forename: Christine
authors.initials: C
authors.lastname: McKenna
authors.forename: Marianne
authors.initials: M
authors.lastname: Miller
authors.forename: Barbara
authors.initials: B
authors.lastname: Shultz
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Upperman
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Gaines
mesh_terms: D000056:Accident Prevention / Q000379:methods; D000063:Accidents, Traffic / Q000517:prevention & control / Q000706:statistics & numerical data*; D002648:Child; D003257:Consumer Product Safety; D003430:Cross-Sectional Studies; D005260:Female; D006260:Head Protective Devices / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D008297:Male; D015541:Off-Road Motor Vehicles; D012016:Reference Values; D018570:Risk Assessment; D012309:Risk-Taking; D017751:Safety Management; D011795:Surveys and Questionnaires; D014481:United States; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology