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The Effect of Passengers on All-Terrain Vehicle Crash Mechanisms and Injuries

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The Effect of Passengers on All-Terrain Vehicle Crash Mechanisms and Injuries
Kristel Wetjen, RN1, Charles Jennissen, MD2, Gerene Denning, PhD3 and Karissa Harland, PhD3, 1University of Iowa Children's Hospital, Iowa City IA, 2University of Iowa Children's Hospital, Iowa City IA, 3University of Iowa Hospitals and Clinics, Iowa City IA

Traditional all-terrain vehicles (ATVs) are designed for one rider. ATVs require “active riding,” meaning that the operator needs to rapidly adjust body position to maintain vehicle control. It is believed that passengers alter the ability for drivers to actively ride and increase the center of gravity. Methods: A retrospective chart review and analysis was performed of trauma registry patients with ATV-related injuries at a university hospital from 2002-2013. Results: 537 cases of ATV-related injuries were identified of which 20% were passengers or drivers with passengers. Children and females were more likely to be passengers than adults and males (both p <0.0001). Rollovers (52%) were the most common mechanism of injury. Striking an object (16%) and ejection/fall (11%) were next. The victim was struck by their ATV in 19% and pinned in 10%. Rollovers on sloped terrain were more likely to have passengers (p=0.03). Backward rollovers were almost twice as likely to have passengers as all other rollovers (p=0.02, OR = 2.2 [1.2-4.2]). Victims that had falls/ejections to the rear were nearly eight times more likely to have been on an ATV with passengers than other types of ejections (p<0.0001, OR 7.8 [2.0-7.8]). They were also more likely to have passengers than those involved in non-ejection events (p<0.0001). Victims who fell or were ejected to the rear had worse head injury scores than those with side or self-ejections (p=0.001). Self-ejections and forward ejections were less likely if passengers were present (p=0.0001), and had the highest extremity injury scores (p<0.0001).

Objective: The objective of this study was to better understand the effect passengers have on the mechanisms and injuries seen in ATV crashes.

Objective Content: This study provides insight on how passengers on ATVs may contribute to crash likelihood and injury severity. Passengers on ATVs may be at greater risk for fall/ejection to the rear which appears to increase the risk of head injury. ATV operators who self-eject receive extremity injuries but may be more able to protect their heads; passengers limit the ability of a driver to self-eject when losing vehicle control. Legislation and enforcement of regulations prohibiting carrying passengers on traditional ATVs, and families adopting a strict no rider rule could reduce the risk of some ATV crashes and their associated injuries.


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