Dr. Charles Jennissen, of the University of Iowa Department of Emergency Medicine presented this at CPSC's ATV Safety Summit Oct. 11, 2012. The study objective was to determine adolescent exposure to ATVs and their riding behaviors. Methods: A survey was administered to ~3,100 students, mostly 11-15 years of age, as part of an in-classroom ATV safety program. Results: Participants were distributed between urban (38%), rural (24%), and isolated rural (38%) communities. 85% reported riding an ATV at least a few times a year and 31% reported riding at least once a week. For those exposed, 92% had ridden with more than one person, 81% had been on a public road, and over 60% reported never or almost never wearing a helmet. 54% engaged in all three unsafe behaviors; 2% engaged in none. 59% had been in at least one ATV crash. Students from isolated rural communities were more likely to have ridden an ATV in the last year relative to their peers, but the likelihood of a crash was not different by rurality. Increased crash likelihood was seen for males and for youth engaged in multiple risky behaviors. Conclusions: A high percentage of youths in Iowa have been exposed to ATVs, engage in unsafe behaviors, and have experienced a crash. Significant efforts are needed to reduce ATV-related deaths and injuries in this high-risk pediatric population.

1. Adolescent
All-Terrain Vehicle
Exposure and
Riding Behaviors
Charles Jennissen, MD Kristel Wetjen, RN
Gerene Denning, PhD Pamela Hoogerwerf
Karisa Harland, PhD Jeffrey Peck

2. Background
 833 ATV-related deaths in the U.S. in
2006.
 Since 1982, children < 16 yrs have
comprised just over a quarter of ATV
crash fatalities.
 Roughly 1/3 ATV-related injuries are
children <16 years of age
 Well-over ½ are under 24 years of age
US Consumer Product Safety Commission: 2010 Annual Report of ATV Deaths and Injuries.
Data from the National Electronic Injury Surveillance System (NEISS)

3. Background
 In fact, more children die from ATV-related
events than from bicycle crashes.
Helmkamp JC, Aitken ME, Lawrence BA. ATV and bicycle deaths and associated costs in the United States, 2000-2005. Public
Health Rep. 2009;124(3):409-418.

4. Objective of Study
To determine ATV exposure, safety
practices, and crash rates among
students taking part in a school-based
ATV safety program

5. American Academy of Pediatrics recommends
no children under 16 drive an ATV.

6. University of Iowa Data
2002-2009
Number of Crash Victims by Age
18
16
14
12
10
8
6
m
N
V
o
b
u
e
c
s
r
t
f
i
4
2
0
0 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 56 61 66 72 81
Age (years)

7. ATV Press Clippings in Nine
Great Plains States 2009
Number of Victims by Specific Age
18
16
14
3 per. Mov. Avg. (Number of Victims)
12
10
8
m
V
c
s
t
i
6
4
2
0
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53 55 57 59 61 63 65
Age

8. Methods
• Target age range of 12-15 years of age
• School based Curriculum

9. Methods
• A classroom response system was utilized to
obtain:
– Demographic information
– Determine ATV exposure and safety behaviors

10. Results
 18 schools in Eastern and Central Iowa participated
(3,185 students).
 Males and females were equally represented.
10%
 74% were in our original target 17%
age range of 12-15 years old.21%
53%
53%

11. Results
 Rurality was based on zip codes
and the Rural Urban Commuting
Codes (RUCA) 39% 38%
 Both Rural And Urban 24%
Youth Were Represented In
The Study.

12. Results
15%
 Exposure for all groups NO
rural and urban was over 85%
YES
80%.
 Around 4 out of 10
reported riding frequently 39%
Daily/
61%
(daily/weekly). Monthly/
Weekly
Yearly

13. Results
 ATV exposure
was very similar 59% 62% 63%
for rural and urban
youth
41% 38% 37%
ATV use by youth is not just a rural public health issue.

14. Results
Have you ever ridden or
driven an ATV with more
than one person on it?
9% NO
91% YES

15. Passengers
 Carrying passengers greatly
increases the risk of a crash.
 Multiple riders contributes to:
• Multiple deaths in fatal ATV
crashes.
• Multiple injured in non-fatal ATV
crashes.
Young ATV users and their parents may not know the
danger of multiple riders and Iowa’s no passenger law.

16. Results
Have you ever ridden or driven
an ATV on a public road?
19% NO
81% YES

17. Riding on Public Roads
 62% of all U.S. ATV-related
deaths from 1985-2009.
 Approximately 1 out of 3
serious injuries in Iowa.
 ATVs are not designed for
road use.
Young ATV users and their parents may not know the
danger of riding on the road and Iowa’s road use laws.

18. Results
How often do you wear a
helmet when riding an ATV?
18%
62% 9%
12%

19. Helmet Use
 Too many youth are not wearing helmets.
 Many states do not have ATV helmet laws.
 Effective helmet laws require:
• User knowledge of the law
• Consistent enforcement
• Removing economic barriers
Young ATV users and their parents may not understand
the risk of brain injury and the benefits of helmets.

20. Youth Are Engaging in Multiple
Unsafe Behaviors.
2%
 Riding on an ATV with 10%
passengers.
 Riding on public roads. 34%
54%
 Never or almost never
wearing a helmet.

21. Crashes
Have you ever been in an ATV
crash (rolled over, hit something,
fallen off)?
41% NO
59% YES

22. Crashes
Crashes Among These Youth
Are Alarmingly High.
 1-Year follow-up:
27% of students who had
ridden an ATV the preceding
year reported having had a
crash.
High exposure, multiple unsafe behaviors, and lack of
understanding likely contribute to high risk of crashes.

23. Crashes
 Students from isolated rural
communities were more likely to
have ridden an ATV, but the
likelihood of a crash was not
different by rurality.
 Increased crash likelihood was
seen for males and for youth
engaged in multiple risky
behaviors.

24. Conclusions
 A very high percentage of
youths in Iowa are exposed to
ATVs.
 They engage in unsafe
behaviors and most have
experienced a crash.
 Significant efforts are needed to
reduce ATV-related deaths and
injuries in this high-risk pediatric
population.

25. Questions?