title: Age and the risk of All-Terrain Vehicle-related injuries in children and adolescents: a cross sectional study.
abstract: The study was designed to determine if youth <16 years are at a greater risk of serious injuries related to all-terrain vehicle (ATV) use compared to older adolescents and adults.
  
  
  
  We performed cross sectional study of children and adults presenting to pediatric and adult emergency departments between 1990 and 2009 in Canada. The primary exposure variable was age <16 years and the primary outcome measure was moderate to serious injury determined from physician report of type and severity of injury.
  
  
  
  Among 5005 individuals with complete data, 58% were <16 years and 35% were admitted to hospital. The odds of a moderate to serious injury versus minor injury among ATV users <16 years of age was not different compared with those ≥16 years of age (OR: 0.94; 95% CI: 0.84, 1.06). After adjusting for era, helmet use, sex and driver status, youth <16 years were more likely to present with a head injury (aOR: 1.45; 95% CI: 1.19-1.77) or fractures (aOR: 1.60; 95% CI: 1.43-1.81), compared with those ≥16 years. Male participants (aOR: 1.21; 95% CI: 1.06-1.38) and drivers (aOR: 1.30, 95% CI: 1.12-1.51) were more likely to experience moderate or serious injuries than females and passengers. Helmet use was associated with significant protection from head injuries (aOR: 0.59; 95% CI: 0.44-0.78).
  
  
  
  Youth under 16 years are at an increased risk of head injuries and fractures. For youth and adults presenting to emergency departments with an ATV-related injury, moderate to serious injuries associated with ATV use are more common among drivers and males. Helmet use protected against head injuries, suggesting minimum age limits for ATV use and helmet use are warranted.
authors.affiliation: Children's Hospital of Winnipeg, The Department of Paediatrics and Child Health, Faculty of Medicine, The University of Manitoba, Winnipeg, MB, Canada.|The Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada.|Department of Pediatrics and Child Health, Faculty of Medicine, University of Manitoba, 511 JBRC. Children's Hospital Research Institute of Manitoba, 715 McDermot Ave., Winnipeg, MB R3E 3P4, Canada.
authors.forename: Lianne
authors.initials: L
authors.lastname: McLean
authors.affiliation: Children's Hospital of Winnipeg, The Department of Paediatrics and Child Health, Faculty of Medicine, The University of Manitoba, Winnipeg, MB, Canada.|The Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada.
authors.forename: Kelly
authors.initials: K
authors.lastname: Russell
authors.affiliation: The Public Health Agency of Canada, Ottawa, Ontario, Canada.
authors.forename: Steven
authors.initials: S
authors.lastname: McFaull
authors.affiliation: Children's Hospital of Winnipeg, The Department of Paediatrics and Child Health, Faculty of Medicine, The University of Manitoba, Winnipeg, MB, Canada.|The Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada.
authors.forename: Lynne
authors.initials: L
authors.lastname: Warda
authors.affiliation: Children's Hospital of Winnipeg, The Department of Paediatrics and Child Health, Faculty of Medicine, The University of Manitoba, Winnipeg, MB, Canada.
authors.forename: Milton
authors.initials: M
authors.lastname: Tenenbein
authors.affiliation: Children's Hospital of Winnipeg, The Department of Paediatrics and Child Health, Faculty of Medicine, The University of Manitoba, Winnipeg, MB, Canada. jmcgavock@chrim.ca.|The Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada. jmcgavock@chrim.ca.
authors.forename: Jonathan
authors.initials: J
authors.lastname: McGavock
mesh_terms: D000059:Accidents / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015541:Off-Road Motor Vehicles; D012307:Risk Factors; D015599:Trauma Severity Indices; D014947:Wounds and Injuries / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D055815:Young Adult
keywords: All-terrain vehicles; Children; Head injuries; Policy; Serious injuries