ATV (quad bike) injuries in New Zealand children: their extent and severity.

AIMS: Primary: To ascertain how many New Zealand (NZ) children are being injured or killed as the result of all-terrain vehicle (ATV) injuries and to define the nature and severity of their injuries. Secondary: to examine the effect of age, weight, helmet use, and ATV size on injury severity and to compare the demographics of injury in NZ to other countries.
METHODS: A retrospective review was undertaken of 643 cases of children less than 16 years old hospitalised between 2000-2006 due to possible ATV-related injury. New Zealand Health Information Statistics (NZHIS) identified the cases through discharge information, supplemented by a search of Auckland's Paediatric Intensive Care trauma database. Only confirmed ATV injuries were included.
RESULTS: Records were unavailable for 150 cases (26%). There were 218 confirmed cases of ATV injury. Mechanisms of injury were: a fall from the ATV, 105 cases (48%), a collision, 59 cases (31%), rolling 31 cases (14%). Mean age was 9.9 years (SD 3.9) with 133 (61%) under 12 years, and 32 (15%) 5 years and under. The child was the driver in 116 cases (53%) and the passenger in 61 cases (28%). Male to female ratio was 2:1. Mean injury severity score was 7.9 (SD 5.2). Median (IQR) length of stay was 2 days (1-4). Helmet use not stated in 62%, with only 30 cases (14%) identified as wearing helmets. The majority of injuries were orthopaedic, soft tissue injuries and head injuries. Multiple injuries occurred in 74 cases (34%). One hundred and eleven children (51%) required a general anaesthetic. Seventeen (7.8%) children required admission to intensive care. Six (2.8%) children were left with a permanent disability. Sixteen children died. There was no correlation between ISS and age or weight (Rho=-0.089, p=0.08 and Rho=0.49, p=0.79 respectively). The observed differences in ISS between helmet users and non-users, ATV drivers and passengers and size of ATV were not statistically significant. There was a trend towards reduced risk of head injury with helmet use RR =0.63 (95%CI 0.36-1.1), Chi-squared=3.09, p=0.09. The mean age of injured NZ children was lower than other countries and length of hospital stay was shorter. Gender distribution, injury type, and severity were similar to elsewhere.
CONCLUSION: ATVs are potentially lethal and have the capacity to inflict significant harm.. It is clear that it is not appropriate for a young child to ride an adult sized ATV due to the risk of serious injury and death. Public debate is needed as to whether education or legislation is the answer.