Epidemiology of ATV and motocross injury in children

All-terrain vehicle (ATV) use and off-road motorcycling (motocross) are growing in popularity for a variety of reasons. They are used widely for recreation and in competitive sporting events, both on public trails and on formal courses. They are also used in industry and in agriculture to navigate difficult terrain.

In a study published by Mayo Clinic pediatric orthopedic specialists A. Noelle Larson, M.D., and Amy L. McIntosh, M.D., the investigators cite the rising number of ATVs in the U.S. as a cause for concern about child safety. In the 1970s, Americans owned an estimated 400,000 ATVs. By 2009 that number reached 10.5 million, with one telephone survey showing that 30 percent of the residents of one rural state owned an ATV.

This trend provides children with more opportunities for interaction with the vehicles, which poses the risk of poorly supervised experiences. Minor children are not developmentally able to fully perceive the potential for danger, or to reliably control the machines when given turns to drive.

Youngest most at risk

The Mayo analysis shows that children younger than 16 years old are most prone to injury from motocross and ATV use. Moreover, ATV use appears more dangerous than motocross due to a higher mortality rate that disproportionately affects children.

The team collected epidemiologic data for their study by reviewing 22 relevant PubMed articles, starting in 1980. They also investigated records of the Consumer Product Safety Commission to determine the prevalence, type, morbidity and mortality associated with off-road motor-sport accidents.

Extremities, spine and head most often injured

Common injuries associated with the use of off-road vehicles predominantly affect the extremities, spinal cord and head. Head trauma was the most common cause of death associated with motocross and ATV use. While children typically recover more fully from brain trauma due to head injury, the authors note that similar injuries in adults have resulted in permanent brain damage, paraplegia and tetraplegia.

To improve the safety profile of this increasingly popular pastime — especially for children — the Mayo team suggests developing programs that emphasize safety training, use of protective helmets and restricting minors' access to ATVs.