Manufacturer Consent Decrees had Little Effect on All-Terrain Vehicle Injuries in Children

ABSTRACT & COMMENTARY

Synopsis: American manufacturers of all-terrain vehicles (ATV) in 1985 signed legally binding "Consent Decrees" with the Consumer Product Safety Commission designed to decrease accidents and death of children. These had little effect on reducing accidents associated with the use of these dangerous vehicles.

Source: Lynch JM, et al. The continuing problems of all- terrain vehicle injuries in children. J Pediatr Surg 1998;33:329-332.

Pediatric trauma and injury prevention are receiving increasing attention in a wide number of settings, notably the pediatric surgical literature. Lynch and colleagues from Pittsburgh highlight the dangers of All-Terrain Vehicles (ATVs) in the pediatric population. In particular, they made an effort to determine whether the Consent Decrees signed in 1988 by the Consumers Product Safety Commission (CPSC) and ATV manufacturers have had the intended effect of lowering the number of ATV-related injuries and deaths in children. Data were abstracted from their institution's trauma registry regarding all patients injured as the result of an incident involving an ATV during the five-year period of 1991 to 1995.

A total of 51 patients were identified, 44 males and seven females, with a mean age of 11.5 years. Extremity fractures predominated; more concerning was the large number of brain and spinal cord injuries. A total of 15 patients suffered head injuries-15 required rehabilitation. Two spinal cord injures were reported-one resulting in quadriplegia, the other in paraplegia. Also reported were significant chest and abdominal injuries, most of which required operative procedures. Only 15 of the 51 patients were known to have been wearing helmets at the time of the accident.

COMMENT BY DAVID BACHMAN, MD, FAAP

Lynch and associates review the history of ATV related injuries in the United States. Introduced in the early 1970s, ATVs quickly became popular, and the number of injuries reported climbed dramatically, with 86,000 in 1985 alone. Legal action initiated by the CPSC led to Consent Decrees, whereby manufactures agreed to stop production of three-wheeled ATVs, as well as made efforts to encourage helmet use and discourage passengers and use by children. Helmets were worn by only 30% of children at the time of injury. An approximate 30% reduction in injuries and deaths occurred, but the effect was much less pronounced in younger riders than in adults. Efforts to ban use by individuals younger than age 16 were discontinued by the CPSC in 1993. Lynch et al suggest that such a ban should be reconsidered, given the ongoing alarming rate and severity of injuries suffered by children in ATV accidents.

I must admit that I have never understood the fascination that exists for ATVs-or for motorcycles or snowmobiles or other such high-powered machines. Any interest I might have had has certainly been dampened by reports such as the recent one from Pittsburgh. The dangers of ATVs for children is seemingly self-evident; nonetheless, use remains widespread and severe injuries in the pediatric age group continue. We as practitioners can certainly counsel against their use as well as support efforts to ban children as passengers and operators.