Kids, big 4-wheelers: asking for injury

April 21, 2005 - Injury Free Coalition for Kids of Little Rock

Children’s Hospital responds to rise in ATV accidents. Leslie Newell Peacock Arkansas Times April 21,2005

NOT CHILD'S PLAY: Powerful ATVs. A couple of Saturdays ago, 12-year-old Chad House, who’s just under 5 feet tall, climbed on top of his grandfather’s 400 Arctic Cat all-terrain vehicle, started off down a gravel road and drove right into Arkansas Children’s Hospital’s statistics on ATV injuries among children.

Chad was lucky — he wasn’t one of the 15 or so people killed in Arkansas each year in four-wheeler accidents. Nor did he mash his brain, the most common trauma Dr. Mary Aitken and other pediatricians at Children’s Hospital see in the 60-plus kids hospitalized each year for significant injuries related to ATVs.

But when Chad’s ATV hit loose gravel atop the packed pea-gravel road in the Glen Rose community, it skidded and, as Chad described it, “the steering got crooked.” The 623-pound machine flipped, threw Chad and bounced on his left leg before he was able to get his body clear of it.

A Medflight helicopter summoned by a local volunteer firefighter landed in the parking lot of the Glen Rose kindergarten campus and airlifted the boy to Little Rock.

Chad’s left femur (the thigh bone) was broken and he had a hole in his upper right arm wide and deep enough that the bone was visible; it had been scraped by gravel. His surgeon used “flexible nails” — wire — to pull the two ends of his broken femur back together and immobilize the leg so the bones can grow back together. Doctors cleaned the gravel out of the hole in his arm, discovered his elbow was chipped and that his upper right arm was fractured. Repair of the hole will eventually require a skin graft.

With a broken right arm and left leg, Chad can’t use crutches. He must be helped from bed to wheelchair, and on Thursday he was getting pretty cranky, his mother, Pam House, said.

House said the nurse at the Children’s ER asked her son if he’d been wearing a helmet when he wrecked. “He said, ‘No, but if I ever ride one again, I will.’ ”

The co-director of Children’s Center for Health Promotion, certainly hopes he will. She’d also like him and other children under 16 to stay off ATVs built for, and sold only to, adults, and stick with those with 90 cubic centimeter engines. Off roads, where wheels don’t grip. With training so they know to avoid steep slopes, creeks, road shoulders.

More adolescent females are injured in ATV-related accidents in Arkansas than in any other state in the nation, Aitken reported in research last year. Arkansas is fifth overall in ATV-related injuries. Injuries cause an estimated 100 hospitalizations a year, and 300 ambulance runs.

You can’t protect children from all injuries, and in a rural state like Arkansas, ATVs are a way of life. But no one would argue anymore that seat belts and infant car seats are unnecessary safety devices. As sales and use of ATVs have increased, so have injuries, and Aitken and her colleagues at Children’s would like to stop the flow of brain injuries and broken bones they’re steering the ER’s way.

Between 1997 and 2001, injuries among children ages 15 to 18 rose 104 percent, Aitken and ACH colleagues — Dr. Rhonda Dick and public health professionals Jeffrey Killingsworth, John Tilford, James Parker and James Graham — reported in the national journal “Pediatrics.”

For boys 9 and under, the rise was 30 percent; for all children 10 to 14, it was 67 percent. The increase reflects the growing sales and use of ATVS nationally — but especially in the South, which has the most injuries.

Aitken and her colleagues began gathering data on ATV injuries in Arkansas in 2001 when trauma program coordinator Donna Parnell reported the growing number of injuries Children’s was seeing. Aitken and her colleagues, who work in the Arkansas Children’s Hospital Research Institute, began pulling together hospital admission numbers and ambulance run data from all over the state.

At Children’s, where annual numbers of children admitted for ATV-related injuries stand at 60 and above, most of what doctors are seeing are traumatic brain injuries and severe orthopedic injuries, including “nasty pelvic fractures,” Aitken said, in children ranging in age from just a few months old to teen-agers. Some kids have suffered paralyzing spinal cord injury; young children whose small feet can get between the floorboard and wheels have lost toes and more.

Children’s Hospital has treated seven children for severe face and neck lacerations after the kids drove their ATVs through barbed wire fences; one of those children was nearly decapitated.

An ATV taskforce created by Aitken and her research team worked with the state Game and Fish Commission and the Farm Bureau to find participants for a study, reported in 2004, on safety strategies. The 40 participants (23 children and 17 adults) answered safety questions anonymously and discussed what kind of safety advertising they thought would be most effective.

The findings: most drivers ignore manufacturers’ safety instructions by riding with passengers (the long seats, meant to provide the driver with room to shift his weight while steering, invite riders); kids ride ATVs too big for them, and they seldom wear helmets or other safety clothing (Aitken said the state’s lifting of the helmet requirement for motorcyclists makes it hard to convince kids they need to wear one when driving ATVs).

More than half reported that children ages 12 and younger in their households rode as passengers or drove ATVs. Most drivers acknowledged they’ve occasionally taken risks on the ATVs, by performing stunts and such. While youths felt competent at driving, few had been told by their parents about the dangers of riding on gravel, up steep hills or crossing streams.

Most were aware that manufacturers recommended against children riding adult-sized ATVs, but some did not take the recommendation seriously, interpreting it as the manufacturers’ efforts to escape liability.

Now, the ATV workgroup is about to begin pilot intervention projects in the counties with the highest number of ATV accidents — Newton (no. 1) and Polk (no. 2). The workgroup will go to the schools in each county to survey students (anonymously) about their ATV use habits. They will kick off safety campaigns in schools and communities in the fall, and plan to observe riders in action during the course of the campaign. After a year, they’ll survey the kids again.

A year isn’t enough time to change habits, Aitken knows; “we’re still working on interventions with those who don’t use seat belts or car seats.”

But, she said, children and their parents need to hear the message — her bottom line warning — that ATVs are not toys.


Dr. Mary Aitken
800 Marshall St. Slot 512-26
Little Rock, Ar. 72202

Hope Mullins
800 Marshall St. Slot 512-26
Little Rock, Ar. 72202