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      More fatal all-terrain vehicle crashes occur on the roadway than off: increased risk-taking characterises roadway fatalities

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          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.

          Objectives

          To compare fatal ATV crashes that occur on the roadway and off, to more fully understand factors that contribute to fatalities at each location.

          Methods

          Fatality data from the US Consumer Product Safety Commission (CPSC) were used for descriptive and comparative analyses. Multivariate logistic regression analysis was performed to determine relative risk.

          Results

          Over 60% of all fatalities (1985–2009) resulted from roadway crashes. After 1998, roadway fatalities increased at over twice the rate of off-road fatalities. Roadway crashes were more likely than off-road crashes to involve multiple fatalities, carrying passengers, alcohol use, collisions and head injuries. Roadway victims were less likely to be helmeted than off-road victims. Passengers and operators with passengers were also less likely to be helmeted than operators riding alone. Helmeted victims were half as likely to suffer a head injury.

          Conclusions

          Fatal roadway crashes were more likely than off-road crashes to involve risk-taking behaviours (eg, carrying passengers) that could exacerbate the inherent difficulty of operating ATVs on roadway surfaces. Higher crash forces from greater speed, and lower use of protective equipment, may also have contributed to higher roadway mortality rates. Eliminating non-essential ATV road use may be an effective way to reduce ATV-related fatalities. This will likely require a substantial investment in rider education and better enforcement of ATV road use restriction laws.

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          Most cited references34

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          Risk factors for all-terrain vehicle injuries: a national case-control study.

          A case-control study design was used to determine and quantify all-terrain vehicle (ATV) risk factors. The analysis was based on the results of two national probability surveys conducted in 1997: a survey of injured ATV drivers treated in hospital emergency departments and a survey of the general population of ATV users. Cases were drawn from the injury survey; controls (ATV drivers who had not been injured) were drawn from the user survey. Risk factors were quantified by means of a binary logistic regression analysis. After adjustment for covariates, injury risks were systematically related to a number of driver characteristics (age, gender, driving experience), driver use patterns (monthly driving times, recreational vs. nonrecreational use), and vehicle characteristics (number of wheels, engine size). The results of the analysis suggest that future safety efforts should focus on reducing child injuries, getting new drivers to participate in hands-on training programs, and encouraging consumers to dispose of the three-wheel ATVs still in use.
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            Impact of helmets on injuries to riders of all-terrain vehicles.

            Although helmet use has been shown to be effective in reducing traumatic brain injuries (TBIs) due to motorcycle and bicycle crashes, it is unknown whether helmet use is associated with different injury patterns and severity for users of all-terrain vehicles (ATVs). To compare likelihood of injury and death between helmeted and unhelmeted riders of ATVs. The National Trauma Data Bank for years 2002-2006 was used to examine the records of 11 589 patients hospitalized for injuries resulting from ATV use. The likelihood of receiving a TBI diagnosis or a significant injury to other body regions and differences in injury severity and in-hospital mortality between helmeted and unhelmeted ATV riders were compared. After multivariable adjustment, compared with helmeted riders, unhelmeted riders were significantly more likely to sustain any TBI (OR 1.62, 95% CI 1.49 to 1.76, p<0.001) and major/severe TBI (OR 3.19, 95% CI 2.39 to 4.25, p<0.001). Unhelmeted riders were significantly more likely to die while in hospital than were helmeted riders (OR 2.58, 95% CI 1.79 to 3.71, p<0.001). Significant injuries to the neck and face regions were also significantly more likely in unhelmeted riders (OR 3.53, 95% CI 1.28 to 9.71, p = 0.015, and OR 1.94, 95% CI 1.32 to 2.84, p = 0.001, respectively). ATV riders who do not wear helmets are more likely to receive significant injuries to the head, face, and neck. Prevention strategies and enforceable policy interventions to increase helmet use among ATV riders appear warranted.
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              Rural adolescent alcohol, tobacco, and illicit drug use: a comparison of students in Victoria, Australia, and Washington State, United States.

              There are inconsistent research findings regarding the impact of rurality on adolescent alcohol, tobacco, and illicit substance use. Therefore, the current study reports on the effect of rurality on alcohol, tobacco, and illicit drug use among adolescents in 2 state representative samples in 2 countries, Washington State (WA) in the United States and Victoria (VIC) in Australia. The International Youth Development Study (IYDS) recruited representative samples of students from Grade 7 (aged 12 to 13 years) and Grade 9 (aged 14 to 15) in both states. A total of 3,729 students responded to questions about alcohol, tobacco, cannabis, and other illicit substance use (n(VIC) = 1,852; n(WA) = 1,877). In each state, males and females were equally represented and ages ranged from 12 to 15 years. Data were analyzed to compare lifetime and current (past 30 days) substance use for students located in census areas classified as urban, large or small town, and rural. Findings were adjusted for school clustering and weighted to compare prevalence at median age 14 years. Rates of lifetime and current alcohol, tobacco, and cannabis use were significantly higher in rural compared to urban students in both states (odds ratio for current substance use = 1.31). In both Washington State and Victoria, early adolescent rural students use substances more frequently than their urban counterparts. Future studies should examine factors that place rural adolescents at risk for alcohol, tobacco, and illicit drug use. © 2011 National Rural Health Association.
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                Author and article information

                Journal
                Inj Prev
                Inj. Prev
                injuryprev
                ip
                Injury Prevention
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                1353-8047
                1475-5785
                August 2013
                20 December 2012
                : 19
                : 4
                : 250-256
                Affiliations
                [1 ]Department of Emergency Medicine, University of Iowa , Roy J and Lucille A Carver College of Medicine , Iowa City, Iowa, USA
                [2 ]Injury Prevention Research Center , College of Public Health, University of Iowa , Iowa City, Iowa, USA
                Author notes
                [Correspondence to ] Dr Gerene Denning, Department of Emergency Medicine, 1008 Roy Carver Pavilion, University of Iowa, Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242, USA; gerene-denning@ 123456uiowa.edu
                Article
                injuryprev-2012-040548
                10.1136/injuryprev-2012-040548
                3717765
                23257569
                695844e1-1f9c-44b0-aeea-7b526128c82e
                Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions

                This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/

                History
                : 3 July 2012
                : 5 November 2012
                : 25 November 2012
                Categories
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                Original Article
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                Medicine
                Medicine

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