Surgeons Report Injuries are Far More Serious After Accidents Involving Four-Wheel All-Terrain Vehicles than Motorcycles

National Trauma Data Bank research finds ATV riders more likely to die or require aggressive trauma treatment

WASHINGTON, Oct. 6 /PRNewswire-USNewswire/ -- With four wheels rather than two, all-terrain vehicles (ATV) would seem to be safer than motorcycles for off-road traveling or sports.  However, a study presented at the 2010 Annual Clinical Congress of the American College of Surgeons (ACS) found that ATV riders were far more likely to die or need aggressive trauma care than motorcyclists  after an accident.

In the first study to compare the severity of injuries sustained by motorcycle versus ATV riders, researchers from Johns Hopkins Center for Surgery Trials and Outcomes Research, Baltimore, MD, reviewed data on nearly 50,000 accident victims who received trauma care between 2002 and 2006.  Data were gathered from the National Trauma Data Bank of the American College of Surgeons on 13,749 patients who had an off-road motorcycle accident and 44,509 patients who had an accident involving an ATV.  Although the initial degree of severity of the injuries was similar for both groups, ATV riders were 50 percent more likely to die.  These patients also were 50 percent more likely to require admission to an intensive care unit and need mechanical ventilation.

The difference in morbidity and mortality is not solely related to helmet use.  About 60 percent of motorcyclists in the study wore helmets compared with only 30 percent of ATV riders.  "But even when both types of patients were wearing helmets, the person on the ATV did much worse than the person on the motorcycle," said trauma surgeon Adil Haider, MD, MPH, FACS, who is an assistant professor of surgery at Johns Hopkins School of Medicine.

The underlying cause is still unclear.  "We can't tell why [ATV riders are more at risk than motorcyclists] from this database.  We think there are much more energy transfers when an ATV turns over, but we can't tell whether that is because of the stability of the vehicle or the weight of the vehicle as it rolls over on a rider," Dr. Haider explained.

Findings from the study nevertheless carry messages for parents, legislators, and educators as well as ATV dealers and manufacturers.  ATVs may be suitable for teenagers or older children, but they are not appropriate for youngsters, the researchers believe.  

"Parents may think that ATVs are less dangerous than motorcycles because they have four wheels.  But they should know that ATVs not only are not safer, they are probably more dangerous because the injuries people have after accidents are so severe," Dr. Haider said.

There has been a considerable amount of legislation advocating helmet use by motor-cycle riders.  However, little advocacy work has been done to require helmet use by ATV riders.  At the present time, only a few states have laws mandating the use of safety helmets by all riders of off-road motor vehicles.  "One of the questions we have to think about is whether legislation is an avenue to pursue to make these activities a little bit safer," said Cassandra V. Villegas, a medical student and trauma outcomes fellow with Dr. Haider who is the lead author on this study.

There is also an educational component to the overall message from this study.  "We may want to stress the need for education about how to choose the motor vehicle that is best for a particular rider," said Ms. Villegas.  

ATV dealers often try to sell parents on larger vehicles their children will grow into, public health scientist Stephen Bowman, PhD, from the Johns Hopkins Center for Injury Research and Policy and who is a co-investigator on this study, explains.  "You go to a dealer and say, 'I want to buy my nine-year-old a small ATV.'  But the dealer will try to sell you an ATV big enough for a 13-year-old.  The problem is that smaller children end up using ATVs that have a lot of power and a significant amount of weight that could cause more serious injuries if they have an accident."  

Manufacturers of motorcycles have made significant improvements in safety technology that could be applied to ATVs.  "We think there could be more safety technology development for the ATV population," Villegas said.  "There are pneumatic air devices that inflate on impact. These devices could be embedded in ATVs," she added.

Results from the study reflect the clinical experience of trauma surgeons in the field.

"We know that ATV use is rising in the U.S.  We also know that injuries are increasing in this population.  We're seeing more injuries, and we're also seeing much more serious injuries in patients who are riding off-road ATVs," Dr. Haider said.

"While there has been a lot of information about motorcycle use and safety profiles, the dangers of motorcycle riding, and the ways to prevent injuries, there is not enough information about off-road vehicles and ATVs.  Our study may help people who are trying to figure out what is the safer mode of transportation with regard to off-road motor sports and encourage policy makers and politicians to look at this growing problem carefully," Ms.Villegas said.

"This study shows there is a burden of disease related to ATV injuries.  This burden might be reduced through either legislative initiatives or improved engineering and does provide the impetus for looking at what can be done to reduce injuries following ATV incidents," observed Avery B. Nathens, MD, PhD, FACS, who is the Canada research chair in systems of trauma care, division head of general surgery, and director of trauma, St. Michael's Hospital, Toronto, ON.  Dr. Nathens also Chairs the National Trauma Data Bank Subcommittee of the ACS Committee on Trauma.

Eric B. Schneider, PhD; Elliot R. Haut, MD, FACS; Kent A. Stevens, MD, MPH; and David T. Efron, MD, also participated in the study.  The researchers evaluated data from the National Trauma Data Bank (NTDB) of the American College of Surgeons, Version 7.1, for admission years 2002-2006.

SOURCE American College of Surgeons