title: Analysis of pediatric all-terrain vehicle trauma data in Middle Tennessee: implications for injury prevention.
abstract: BACKGROUND
  Trauma registries capture data about injuries that can be used to objectively guide injury prevention initiatives. This article analyzes trauma registry data to describe the nature and distribution of all-terrain vehicle (ATV) injuries in Middle Tennessee. A community injury prevention effort, based on this analysis, is also presented.
  
  
  METHODS
  A retrospective analysis of data (2007-2009) from the trauma registry of a Level I pediatric trauma center in Middle Tennessee was conducted. Patients younger than 16 years with ATV-related injuries were included in the analysis (n = 163). The key variables examined were demographics, injury severity, helmet use, injury mechanism, length of stay, and patient's county of residence. In addition, Geographic Information Systems software was used to examine the distribution of injuries and graphically represent counties with highest injury rates in the youth population.
  
  
  RESULTS
  ATV injuries were more prevalent among boys than girls (66% vs. 34%; p < 0.001). Approximately 64% of the ATV injuries were in the age group 10 years to 15 years. Most injuries were either moderately severe (44%) or severe (30%). Injury mechanism varied by age; younger children experienced more rollovers while older children tended to be injured from ejections (p < 0.05). Helmet use was low (33%). Data from this study suggest that helmet use resulted in fewer injuries to the head, neck, and face. Counties with high rates of ATV injuries were targeted for ATV training programs. 4-H agents trained by the ATV Safety Institute provided ATV training classes.
  
  
  CONCLUSIONS
  Rural youth are clearly at greater risk for ATV injuries than urban populations. Young ATV riders are often self-taught and lack the knowledge to ride ATVs safely. Organizations such as the 4-H, provide effective injury prevention outreach.
  
  
  METHODS
  Epidemiologic study, level III.
authors.affiliation: Department of Pediatric Surgery, and Surgical Services, Monroe Carell Jr Children's Hospital at Vanderbilt, Vanderbilt University, Nashville, Tennessee 37232, USA. purnima.unni@Vanderbilt.edu
authors.forename: Purnima
authors.initials: P
authors.lastname: Unni
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Morrow
authors.forename: Barbara
authors.initials: B
authors.lastname: L Shultz
mesh_terms: D000056:Accident Prevention / Q000379:methods*; D000063:Accidents, Traffic / Q000517:prevention & control / Q000706:statistics & numerical data*; D000293:Adolescent; D000367:Age Factors; D002648:Child; D005260:Female; D006260:Head Protective Devices / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D015541:Off-Road Motor Vehicles; D010372:Pediatrics; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012309:Risk-Taking; D012424:Rural Population; D017751:Safety Management; D013714:Tennessee; D014193:Trauma Centers; D015599:Trauma Severity Indices; D014505:Urban Population; D014947:Wounds and Injuries / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*