| Literature DB >> 23257569 |
Gerene M Denning1, Karisa K Harland, David G Ellis, Charles A Jennissen.
Abstract
BACKGROUND: All-terrain vehicles (ATVs) have steadily increased in popularity, size and speed, characteristics that likely contribute to the alarming rise in ATV-related fatalities. One potentially high-risk activity is riding on the road.Entities:
Mesh:
Year: 2012 PMID: 23257569 PMCID: PMC3717765 DOI: 10.1136/injuryprev-2012-040548
Source DB: PubMed Journal: Inj Prev ISSN: 1353-8047 Impact factor: 2.399
Figure 1(a) CPSC data from 1985–2006 were used to plot the increase in fatalities over time. The rate of increase in roadway and off-road fatalities from 1998 to 2006 was then determined using linear regression analysis. The roadway rate was more than twice the off-road rate, p<0.0001. (b) CPSC data from 1985 to 2009 were used to determine the percentage of fatalities for the indicated age ranges on the roadway and off.
Comparison of the proportion and odds of crashes with multiple fatalities occurring on versus off the road from 1985 to 2009 (n=5788 crashes)
| Roadway (n=3658) | Off-road (n=2130) | Roadway versus off-road | ||
|---|---|---|---|---|
| n (column %) | n (column %) | OR (95% CI) | p Value | |
| Fatalities/crash | ||||
| Single (%) | 3552 (97.1) | 2110 (99.1) | (ref) | <0.0001 |
| Multiple (%) | 106 (2.9) | 20 (0.9) | 3.15 (1.95 to 5.09) | |
Rider, crash and injury characteristics for ATV fatalities that occurred on versus off the road, CPSC, 1985–2009, (n=9615 fatalities)
| Roadway (n=5978)* | Off-road (n=3637)* | p Value | |
|---|---|---|---|
| n (column %) | n (column %) | ||
| Demographics | |||
| Sex | |||
| Male (%) | 4596 (89) | 2649 (88) | 0.35 |
| Female (%) | 574 (11) | 354 (12) | |
| Age | |||
| <16 (%) | 1409 (24) | 1070 (29) | <0.0001 |
| ≥16 (%) | 4568 (76) | 2567 (71) | |
| Seating position | |||
| Operator alone (%) | 3345 (69) | 2109 (75) | <0.0001 |
| Operator w/passenger (%) | 799 (16) | 364 (13) | |
| Passenger (%) | 721 (15) | 336 (12) | |
| Helmet use | |||
| All riders | |||
| Yes (%) | 650 (16) | 559 (24) | <0.0001 |
| No (%) | 3488 (84) | 1736 (76) | |
| <16 years old | |||
| Yes (%) | 249 (25) | 198 (27) | 0.30 |
| No (%) | 754 (75) | 534 (73) | |
| ≥16 years old | |||
| Yes (%) | 401 (13) | 361 (23) | <0.0001 |
| No (%) | 2734 (87) | 1202 (77) | |
| Operator alone | |||
| Yes (%) | 507 (18) | 474 (28) | <0.0001 |
| No (%) | 2328 (82) | 1229 (72) | |
| Operator w/passenger | |||
| Yes (%) | 74 (11) | 37 (12) | 0.5302 |
| No (%) | 629 (89) | 275 (88) | |
| Passenger | |||
| Yes (%) | 55 (11) | 34 (16) | <0.05 |
| No (%) | 453 (89) | 174 (84) | |
| Alcohol and drugs | |||
| Alcohol | |||
| Yes (%) | 1520 (45) | 581 (30) | <0.0001 |
| No (%) | 1850 (55) | 1388 (70) | |
| Drugs | |||
| Yes-medication (%) | 47 (2.1) | 45 (3.1) | 0.087 |
| Yes-illicit (%) | 215 (9.5) | 83 (5.7) | <0.0001 |
| No (%) | 1998 (88.4) | 1335 (91.2) | |
| Crash characteristics | |||
| Mechanism of crash | |||
| ATV-vehicle collision (%) | 1671 (29) | 203 (5.7) | <0.0001 |
| ATV-other collision (%) | 2168 (37) | 779 (22.5) | |
| Non-collision | 1959 (34) | 2482 (71.8) | |
| Injury (%) | |||
| Head | |||
| Yes (%) | 3741 (66) | 1770 (50) | <0.0001 |
| No (%) | 1959 (34) | 1751 (50) | |
| Neck | |||
| Yes (%) | 478 (8.4) | 333 (9.5) | 0.08 |
| No (%) | 5222 (91.6) | 3188 (90.5) | |
| Spine | |||
| Yes (%) | 181 (3.2) | 130 (3.7) | 0.18 |
| No (%) | 5519 (96.8) | 3391 (96.3) | |
| Torso | |||
| Yes (%) | 1610 (28) | 944 (26) | 0.13 |
| No (%) | 4090 (72) | 2577 (73) | |
*Column totals may not equal overall totals due to missing values.
ATV, All-terrain vehicle.
Figure 2(a) The percentage of vehicles with engine sizes within the indicated size range was determined for the indicated year. Data show an increase in the proportion of vehicles with larger engine sizes that were involved in fatal crashes over time. (b) The percentage of fatalities due to compression asphyxia was calculated for the indicated time periods.
Unadjusted and adjusted odds of ATV fatalities comparing on versus off the road; CPSC, 1985–2009, (n=9615 fatalities)
| Roadway versus off-road* | ||
|---|---|---|
| OR (95% CI) | aOR (95% CI)* | |
| Rider characteristics | ||
| Sex | ||
| Male | 1.07 (0.93 to 1.23) | 0.95 (0.81 to 1.12) |
| Female | 1.0 (ref) | 1.0 (ref) |
| Age | ||
| <16 | 0.74 (0.67 to 0.81) | 0.74 (0.65 to 0.85) |
| ≥16 | 1.0 (ref) | 1.0 (ref) |
| Seating position | ||
| Operator alone | 1.0 (ref) | 1.0 (ref) |
| Operator w/passenger | 1.38 (1.21 to 1.58) | 1.19 (1.02 to 1.38) |
| Passenger | 1.35 (1.18 to 1.56) | 1.48 (1.23 to 1.77) |
| Helmet | ||
| Yes | 0.68 (0.62 to 0.75) | 0.56 (0.49 to 0.65) |
| No | 1.0 (ref) | 1.0 (ref) |
| Alcohol | ||
| Yes | 1.96 (1.74 to 2.21) | 1.77 (1.53 to 2.05) |
| No | 1.0 (ref) | 1.0 (ref) |
| Drugs | ||
| Yes-medication | 0.70 (0.46 to 1.06) | 0.78 (0.49 to 1.22) |
| Yes-illicit | 1.73 (1.33 to 2.25) | 1.17 (0.87 to 1.57) |
| No | 1.0 (ref) | 1.0 (ref) |
| Mechanism of crash | ||
| ATV-vehicle collision | 10.4 (8.9 to 12.2) | 11.1 (9.24 to 13.32) |
| ATV-other collision | 3.5 (3.19 to 3.90) | 3.74 (3.31 to 4.22) |
| Non-collision | 1.0 (ref) | 1.0 (ref) |
ATV, All-terrain vehicle.
*Adjusted odds ratios (aOR) were controlled for all other covariables in the table.
Unadjusted and adjusted odds of ATV fatalities comparing helmet versus no helmet and with head injury versus no head injury; CPSC, 1995–2009, (n=9615 fatalities)
| Helmet use* | Head injury† | |||
|---|---|---|---|---|
| OR (95% CI) | aOR (95% CI) | OR (95% CI) | aOR (95% CI) | |
| Rider characteristics | ||||
| Sex | ||||
| Male | 1.17 (0.95 to 1.43) | 1.22 (0.98 to 1.52) | 0.93 (0.81 to 1.08) | 0.98 (0.83 to 1.15) |
| Female | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) |
| Age | ||||
| <16 | 1.79 (1.57 to 2.05) | 1.76 (1.51 to 2.07) | 1.21 (1.10 to 1.33) | 1.28 (1.12 to 1.45) |
| ≥16 | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) |
| Seating position | ||||
| Operator alone | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) |
| Operator w/passenger | 0.44 (0.36 to 0.55) | 0.41 (0.33 to 0.51) | 1.27 (1.11 to 1.45) | 1.04 (0.90 to 1.20) |
| Passenger | 0.52 (0.41 to 0.65) | 0.42 (0.33 to 0.54) | 1.66 (1.44 to 1.92) | 1.41 (1.19 to 1.67) |
| Helmet | ||||
| Yes | NA | 0.52 (0.46 to 0.59) | 0.54 (0.47 to 0.62) | |
| No | 1.0 (ref) | 1.0 (ref) | ||
| Alcohol | ||||
| Yes | 0.70 (0.60 to 0.81) | 0.55 (0.46 to 0.67) | 1.20 (1.07 to 1.34) | 1.16 (1.01 to 1.33) |
| No | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) |
| Drugs | ||||
| Yes-medication | 0.47 (0.24 to 0.90) | 0.47 (0.24 to 0.94) | 0.60 (0.40 to 0.91) | 0.65 (0.41 to 1.01) |
| Yes-illicit | 0.66 (0.47 to 0.93) | 0.99 (0.68 to 1.42) | 1.28 (0.99 to 1.65) | 1.19 (0.91 to 1.56) |
| No | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) | 1.0 (ref) |
| Helmeted victim | ||||
| On-road | NA | 1.46 (1.13 to 1.88) | 1.33 (1.00 to 1.76) | |
| Off-road | 1.0 (ref) | 1.0 (ref) | ||
| Mechanism of crash | ||||
| ATV-vehicle collision | NA | 1.62 (1.44 to 1.82) | 1.08 (0.93 to 1.27) | |
| ATV-other collision | 1.35 (1.22 to 1.49) | 1.01 (0.89 to 1.15) | ||
| Non-collision | 1.0 (ref) | 1.0 (ref) | ||
| Location | ||||
| Roadway | NA | 1.89 (1.74 to 2.06) | 1.45 (1.30 to 1.62) | |
| Off-road | 1.0 (ref) | 1.0 (ref) | ||
*Referent is not using a helmet.
†Referent is without head injury.
ATV, All-terrain vehicle; NA, not applicable.