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© 2001 American Public Health Association
RESEARCH |
James C. Helmkamp is with the Center for Rural Emergency Medicine, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown.
Correspondence: Requests for reprints should be sent to James C. Helmkamp, PhD, Center for Rural Emergency Medicine, Robert C. Byrd Health Sciences Center, West Virginia University, PO Box 9151, Morgantown, WV 26506-9151 (e-mail: jhelmkamp{at}hsc.wvu.edu).
The US Consumer Product Safety Commission estimated that an average of 254 allterrain vehicle (ATV)–related deaths occurred annually in the 1990s.1,2 Despite widespread education and training efforts by the Consumer Product Safety Commission and major ATV manufacturers,3 average annual deaths have risen to 267 since 1995.1 Renewed efforts are directed at adolescents younger than 17 years, among whom more than one third of ATV-related deaths have occurred.4
The Specialty Vehicle Institute of America's annual list5 of state-specific ATV safety requirements for 2000 can be viewed as 3 mutually exclusive groups: (1) helmet and other safety equipment requirements (21 states), (2) machine-related safety but no helmet requirement (23 states), and (3) no safety legislation (6 states and the District of Columbia). Death data, obtained from the Consumer Product Safety Commission, were divided into 4 age groups: 1–16 years, 17–49 years, 50–64 years, and 65–84 years. The few deaths in persons older than 84 years were not included. Although the Consumer Product Safety Commission has estimated death rates based on national ATV user information to identify broad populations at risk,6 reliable and accurate state-specific user information is not consistently available from ATV distributors. Therefore, population-based rates were calculated on the basis of US Census Bureau state-, age-, and sex-specific population estimates.7 Rates were based on 10-year composites of numerator and denominator data for 1990 to 1999 and were not calculated for any cell with fewer than 5 deaths.
States without safety legislation had a collective death rate twice that of the other 2 groups—0.17 deaths per 100 000 vs 0.08 and 0.09, respectively (see Table 1
). Pennsylvania led all states with 137 deaths, and West Virginia had the highest fatality rate among all states: 0.70 (7.8 times the overall national rate). The 124 deaths in West Virginia ranked second among all states. Arkansas had the highest rate (2.11) among female adolescents aged 1 to 16, and Arizona had the highest rate (0.56) among women aged 17 to 49; both of these rates were based on 6 fatalities. No state had more than 5 deaths in either of the 2 oldest female age groups. Among male deaths, West Virginia had the highest rates in each of the 4 age groups: 1–16 (1.04), 17–49 (1.51), 50–64 (0.67), and 65–84 (0.98). Across the entire United States, 87% of all deaths related to ATVs were in males, with a death rate 8 times that of females (0.16 vs 0.02).
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Rates based on few events are often subject to large fluctuations. This phenomenon is likely at play with the crude rates presented here. Accepting that limitation and the notion that these rates are not the most valid assessment of risk in terms of ATV user populations, these rates do provide a broad state-by-state population-based risk comparison. To my knowledge, this report is the first comprehensive state listing of sex- and age-specific ATV-related fatality rates. These results also show clearly that states with some level of safety legislation, be it mandated helmet use or machine-related requirements, have substantially fewer deaths and lower fatality rates than do states that have no ATV safety laws.
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Acknowledgments |
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The research was supported by grant R49/CCR308469 from the Centers for Disease Control and Prevention to the West Virginia University Injury Control Training and Demonstration Center.
I am most grateful to Suzanne Marsh for collating census data, assisting in the calculation of rates, and critically reviewing this brief.
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Footnotes |
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Peer Reviewed
Accepted for publication April 4, 2001.
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References |
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 TOP References |
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1. Helmkamp JC. Injuries and deaths and the use of all-terrain vehicles. N Engl J Med.2000;343:1733–1734.
2. US Consumer Product Safety Commission. 1999 Annual Report: All-Terrain Vehicle-Related Deaths and Injuries. Washington, DC: Directorate for Epidemiology, Consumer Product Safety Commission; June 13, 2000.
3. United States of America v American Honda Motor Co Inc. Washington, DC: US District Court for the District of Columbia. Civil Action No. 87-3525, filed Dec 30, 1987.
4. CPSC announces all-terrain vehicle safety programs [press release]. Washington, DC: US Consumer Product Safety Commission; December 9, 1998. CPSC Release 99-034.
5. Specialty Vehicle Institute of America. State All-Terrain Vehicle Requirements. Arlington, Va: Government Relations Office; November 2000.
6. All-Terrain Vehicle Exposure, Injury, Death and Risk Studies. Bethesda, Md: US Consumer Product Safety Commission; April 1998.
7. Population estimates for the US and states by single year of age and sex: July 1, 1994 (ST-99-15). Washington, DC: Population Estimates Program, Population Division, US Census Bureau; 2000. Available at: http://www.census.gov/population/estimates/state/stats/st-99-15.txt. Accessed January 4, 2001.
This article has been cited by other articles:
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  S M Bowman, M E Aitken, J C Helmkamp, S A Maham, and C J Graham Impact of helmets on injuries to riders of all-terrain vehicles Inj. Prev., February 1, 2009; 15(1): 3 - 7. [Abstract] [Full Text] [PDF]
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H. T. Keenan and S. L. Bratton All-Terrain Vehicle Legislation for Children: A Comparison of a State With and a State Without a Helmet Law Pediatrics, April 1, 2004; 113(4): e330 - e334. [Abstract] [Full Text] [PDF]
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