Study finds 50% increase in ATV-related brain and spinal injuries

Brain and spinal cord injuries related to all-terrain vehicles (ATVs) appear to be increasing, reports a study in the October issue of Neurosurgery, official journal of the Congress of Neurological Surgeons. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health, a leading provider of information and business intelligence for students, professionals, and institutions in medicine, nursing, allied health, and pharmacy.

Brain and spinal injuries related to ATV use are most common in younger riders and are often fatal or serious. "Helmet use may decrease the likelihood of admission to the intensive care unit, head injuries, and death," according to the study by Drs. Michael A. Finn and Joel D. MacDonald of University of Utah, Salt Lake City.

Fifty Percent Increase in ATV-Related Brain and Spinal Injuries
Using multiple databases, the researchers analyzed trends in ATV-related brain and spinal injuries occurring in Utah between 2001 and 2005. During this time, approximately 1,500 patients were injured in ATV-related incidents. About half of these patients (741) had injuries to the head, spine, or both. For each year studied, there was a trend toward an increased number of ATV-related head and spinal injuries. Comparing 2001 to 2005, there was a 50 percent increase in the number of injuries.

About 500 patients had injuries severe enough to require transport to the hospital. More than half of these patients required intensive care; the average hospital stay was four days. The injuries ranged from facial lacerations, to skull and facial fractures, to spinal cord injuries. Four patients were dead on arrival and 15 died in the hospital. Of the surviving patients, about 100 were discharged to home health care, a nursing home, or rehabilitation center.

Vehicle rollover was the most common type of injury, accounting for nearly 30 percent of cases. Some rollover injuries occurred when the ATV was being unloaded from a trailer. Other common causes of injury were loss of control with separation of the rider and vehicle, 20 percent; and collisions with stationary objects or other vehicles, about ten percent.

Patients under age 20 had a disproportionately high rate of ATV-related head and spinal injuries. By far, most injuries were related to recreational use—only a few were related to ATV use on farms or other occupational settings.

Although helmet use wasn't consistently documented, head injuries were more likely for patients without helmets. Only a few cases had documented drug and alcohol use was recorded in relatively few cases, although the authors suspect that the contribution of substance abuse to ATV injuries is "vastly underestimated." Based on limited available data, the injuries were associated with high costs for hospital care.

Because their wheelbase is short relative to the height of the vehicle and rider, ATVs are "inherently unstable" vehicles, according to Drs Finn and MacDonald. Previous studies have documented the injury risks associated with ATV use, especially in children.

Although some efforts have been made to increase safety—including a ban on three-wheeled ATVs—injuries and deaths related to ATV use continue to be common. State regulations on ATV use vary considerably. In Utah, children as young as 8 are allowed to operate ATVs on public lands, and there is no legal helmet requirement.

The new study documents a sharp increase in ATV-related head and spinal cord injuries in Utah. Based on analysis of the injury and accident characteristics, "many of these crashes involve high-energy impact and require significant medical care," the researchers write.

The findings may aid in developing strategies to reduce injuries and deaths. "Interventions to improve ATV safety should be directed toward public awareness, helmet use, increasing supervision of children, and perhaps mandating rider training," Drs. Finn and MacDonald conclude.