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Title: ACS: Ohio Trauma Surgeons Push for ATV Safety Laws
URL: http://www.pslgroup.com/dg/2473B2.htm
Doctor's Guide
October 14, 2004


By Mike Fillon

NEW ORLEANS, LA -- October 14, 2004 -- Trauma surgeons want stronger U.S. government safety measures put in place to restrict the riding of all-terrain vehicles (ATVs) and say they have the hard evidence to prove the need for such measures.

"We think we can save some lives even if we get some simple safety measures enacted such as keeping people under 16 off of them and passing helmet laws," said researcher Nathan Piovesan, MD, a trauma surgeon at Miami Valley Hospital, Dayton, Ohio.

Results of their study were displayed as a scientific poster presentation at the American College of Surgeons 90th Annual Clinical Congress, held here October 10-14.

The study featured a retrospective review of all ATV-related injuries admitted to the Level 1 adult/pediatric trauma center between January 1994 and December 2003 in the Dayton area. The researchers gathered information on patient demographics, types of injuries, injury severity scores (ISS), and outcomes.

Miami Valley Hospital in Dayton is a Level 1 trauma center that services a 17-county area of diverse urban and rural populations. Dr. Piovesan pointed out that the hospital admitted 152 patients involved in ATV crashes over the 10-year study period. Of those, 16% were children or adolescents, and 84% were male. The eight patients who died (5.2%) were all males with an average age of 34 years (range 16 to 83). Head injuries accounted for 62% of deaths.

The most common injuries included head injuries (44%), extremity fracture (30%), maxillofacial (20%) vertebral spine (18%), and chest (16%) injuries. Of the 152 ATV crashes, 14% wore helmets; 10% of the brain/maxillofacial injuries wore helmets.

All terrain vehicles (ATVs) were introduced in the U.S. in the early 1970s and are now a popular form of recreational activity. However, their widespread popularity is accompanied with significant morbidity and mortality, the researchers note. Many of these injuries and deaths happen to children and adolescents.

Typically, ATVs are recognized as motorized cycles, with three or four balloon-style tires, designed for off-road use on a variety of terrains. Although ATVs give the appearance of stability, the 3-wheeled design is especially unstable on hard surfaces, the researchers state. Their stability is further compromised by a high center of gravity, a poor or absent suspension system, and no rear-wheel differential. The danger is magnified because these vehicles can attain substantial speeds (50-80 km/h, or 30-50 mph), they say.

According to the US Consumer Product Safety Commission (CPSC), most injuries associated with ATVs occur when the driver loses control, the vehicle rolls over, the driver or passenger is thrown off, or there is a collision with a fixed object, the researchers point out. Studies in Alaska and Missouri have identified a number of risk factors for injury, including rider inexperience, intoxication with alcohol, excessive speed, and lack of helmet use, they add.

"The potential problems arising from the widespread ATV use have been known for many years," said Dr. Piovesan. This knowledge was the catalyst for the CPSC to enter a legally binding consent decree with ATV manufacturers and distributors in 1988, which banned the further manufacture of three-wheeled ATVs and provided that warning and age limitations be included on the vehicles and in advertising. The decree expired in 1998.

Dr. Piovesan said there are approximately 100,000 ATV related injuries annually in the U.S. Several articles in the literature have specifically addressed the problems of ATVs with children. Most, however, do not extend to the adult population, who are also involved in the significant morbidity and mortality that can result from ATV mishaps.

"There is a need for increased efforts at injury prevention with regard to helmet use, safety education and training, awareness of ATV hazards, and age requirements," said Dr. Piovesan.

Trauma is the leading cause of death in people under the age of 45, he said, adding, "Our overall goal as a Level I Trauma Center is to reduce trauma-related deaths in the region."

"We hope when our state officials see these statistics, it will prompt them to pass some safety prevention measures, particularly for the younger population," he added. Right now, Ohio doesn't have any helmet laws, even for motorcycles."


[Presentation title: "All-Terrain Vehicle Injuries: A Review in a Level I Trauma Center." SE 204]

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