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Dr. Mark A. Brandenburg is author of the book, CHILD SAFE: A Practical Guide for Preventing Childhood Injuries.

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The Danger of ATV's: A Warning to All Parents
By Mark A. Brandenburg, MD

An all-terrain vehicle (ATV) is a three- or four-wheeled motorized vehicle predominantly used in off-road conditions. These vehicles can weigh up to 600 pounds and reach speeds of up to 60 mph. They are designed for single riders only, although there is usually room on the large seats for multiple passengers. The tall wheels and general design of ATV's are responsible for a high center of gravity that predisposes them to flip and rollover during use.

First introduced in 1971, ATV's quickly gained in popularity with nearly 4 million currently in use. These off-road recreational vehicles have become the cause of a great number of serious injuries to children. Soon after their introduction to the market, the Consumer Product Safety Commission (CPSC) became involved and in 1988 helped ban the extraordinarily dangerous three-wheeled ATV's. Also, the CPSC entered into a 10-year binding consent decree with manufacturers that brought about warning labels, restrictions of the sales of adult-sized ATV's for use by children less than 16, industry voluntary standards for safer vehicles and implementation of a nationwide training program. Research has shown that the binding consent decree that has since expired, did not significantly impact the injury rate to children riding ATV's.

Each year in the United States, approximately 70,000 emergency room visits and 275 deaths result from ATV accidents. Approximately 20,000 children are injured and 100 killed annually while riding ATV's. Children account for 35 percent of all ATV-related deaths.

Among medical experts around the nation there is no debate about the dangers that ATV's pose to children. Numerous papers have been published in which physicians have recommended that politicians enact strict laws regulating the use of ATV's by children. It is clear that ATV's require a high degree of coordination and strength and mature judgment for safe operation. Children less than 16 usually lack these skills.

Unfortunately, state legislatures have failed to enact proper legislation that would help diminish the number of injuries and deaths to children resulting from ATV accidents. Utah for example allows children 8 years and older to operate ATV's on public land without restriction. Arkansas allows children under the age of 12 to operate ATV's with adult supervision, while children older than 12 can operate ATV's on their own. The American Association of Pediatrics (AAP) recommends that an ATV only be operated by those who are 16 years and older.

My personal experience as an emergency physician in the Trauma Emergency Center at St. Francis Hospital (Tulsa, OK) confirms what I am reading in the medical literature. During the warmer months of the year, we are routinely treating children for serious injuries sustained while riding ATV's. Many of the injuries to children involve brain and spinal cord damage.

My recommendations to parents regarding ATV's are as follows:

1. Regardless of age, never allow children to ride an ATV. The activity is just too dangerous.

2. If an adult operates an ATV, be sure he or she always wears an appropriate helmet.

3. Make sure that any adult who operates an ATV first attend a safety class.

4. Insist that any adult operating an ATV always follow the manufacturer's riding instructions.

Mark A. Brandenburg, M.D., his wife Kelly and their son live in Tulsa, Oklahoma. Dr. Brandenburg attended medical school at the University of Oklahoma in Oklahoma City, graduating in 1992. He did his emergency medicine training at the University of Oklahoma in Oklahoma City at University Hospital and Children's Hospital of Oklahoma, completing it in 1997. Currently, he is an emergency physician in the Trauma Emergency Center at St. Francis Hospital in Tulsa, the busiest emergency department in Oklahoma with approximately 70,000 patient visits each year. The Trauma Emergency Center is the regional pediatric trauma center for Eastern Oklahoma. His book, CHILD SAFE: A Practical Guide for Preventing Childhood Injuries, is the top selling child injury prevention book in the U.S. He also serves as Medical Advisor to the Tulsa Chapter of the Safe Kids Coalition, and is an instructor in the internationally acclaimed Advanced Trauma Life Support (ATLS) and Pediatric Advanced Life Support (PALS) courses for physicians. His advice on child safety has appeared in Parents, Parenting, Tulsa Kids, Child, and Redbook, among numerous other magazines, newspapers, radio and television shows. He speaks and writes extensively on all areas of child injury prevention. His wonderful style of lecturing provides humorous and interesting stories from the ER that provide many, many valuable lessons in child safety.