Off-Road Vehicle Crash Risk during the Six Months after a Birthday.
BACKGROUND
Off-road vehicles are popular and thrilling for youth outside urban settings, yet sometimes result in a serious crash that requires emergency medical care. The relation between birthdays and the subsequent risk of an off-road vehicle crash is unknown.


METHODS
We conducted a population-based before-and-after longitudinal analysis of youth who received emergency medical care in Ontario, Canada, due to an off-road vehicle crash between April 1, 2002, and March 31, 2014. We identified youth injured in an off-road vehicle crash through population-based health-care databases of individuals treated for medical emergencies. We included youth aged 19 years or younger, distinguishing juniors (age ≤ 15 years) from juveniles (age ≥ 16 years).


RESULTS
A total 32,777 youths accounted for 35,202 emergencies due to off-road vehicle crashes within six months of their nearest birthday. Comparing the six months following a birthday to the six months prior to a birthday, crashes increased by about 2.7 events per 1000 juniors (18.3 vs 21.0, p < 0.0001). The difference equaled a 15% increase in relative risk (95% confidence interval 12 to 18). The increase extended for months following a birthday, was not observed for traffic crashes due to on-road vehicles, and was partially explained by a lack of helmet wearing. As expected, off-road crash risks did not change significantly following a birthday among juveniles (19.2 vs 19.8, p = 0.61).


CONCLUSIONS
Off-road vehicle crashes leading to emergency medical care increase following a birthday in youth below age 16 years. An awareness of this association might inform public health messages, gift-giving practices, age-related parental permissions, and prevention by primary care physicians.
Department of Medicine, University of Toronto, Toronto, Canada.|Evaluative Clinical Sciences Program, Sunnybrook Research Institute, Toronto, Canada.|Institute for Clinical Evaluative Sciences in Ontario, Toronto, Canada.
Jason D
JD
Woodfine
Evaluative Clinical Sciences Program, Sunnybrook Research Institute, Toronto, Canada.|Institute for Clinical Evaluative Sciences in Ontario, Toronto, Canada.
Deva
D
Thiruchelvam
Department of Medicine, University of Toronto, Toronto, Canada.|Evaluative Clinical Sciences Program, Sunnybrook Research Institute, Toronto, Canada.|Institute for Clinical Evaluative Sciences in Ontario, Toronto, Canada.|Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, Canada.|Center for Leading Injury Prevention Practice Education & Research, Toronto, Canada.
Donald A
DA
Redelmeier
D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D000367:Age Factors; D000846:Anniversaries and Special Events; D002648:Child; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D015541:Off-Road Motor Vehicles / Q000706:statistics & numerical data; D009864:Ontario / Q000453:epidemiology; D012307:Risk Factors; D012959:Socioeconomic Factors; D055815:Young Adult
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