Published online June 1, 2006
PEDIATRICS Vol. 117 No. 6 June 2006, pp. 2190-2195 (doi:10.1542/peds.2005-2603)
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Pediatric All-Terrain Vehicle–Related Injuries in Ohio From 1995 to 2001: Using the Injury Severity Score to Determine Whether Helmets Are a Solution

Michael A. Gittelman, MDa, Wendy J. Pomerantz, MD, MSa, Jonathan I. Groner, MDb and Gary A. Smith, MD, DrPHc

a Division of Emergency Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
b Department of Surgery
c Center for Injury Research and Policy, Columbus Children’s Research Institute, Columbus Children’s Hospital, Columbus, Ohio

OBJECTIVE. The goal was to identify regions in Ohio with severe pediatric all-terrain vehicle–related injuries and to determine whether helmet usage was associated with lower injury severity scores.

METHODS. We performed a retrospective review of data for all patients entered into the registries of Ohio’s major pediatric trauma centers for the period of January 1, 1995, to December 31, 2001.

RESULTS. Seven hospitals participated. A total of 285 children were admitted; 2 patients died, and 13 required rehabilitation. The mean age was 11.1 years, with 76.1% of patients being male and 88.1% white. Most patients came from the central and southwestern regions of Ohio. An average of 30 admissions per year occurred from 1995 to 1998, but the number increased to 55 admissions per year from 1999 to 2001. Among the 285 injured children, 869 injuries were sustained; 57% of patients sustained multiple injuries. The most commonly injured body parts were the head (22.3%) and lower extremities (12.6%). The most common injuries sustained were fractures (31.4%) and contusions/abrasions (22.2%). Of patients for whom documentation was available, 72.2% (171 of 237 patients) were not helmeted. There was no significant difference in mean injury severity scores between helmeted and nonhelmeted riders (9.58 vs 9.12). Helmet usage was not associated with a reduction in head/facial injuries.

CONCLUSIONS. All-terrain vehicle–related injuries to children nearly doubled between 1995 to 1998 and 1999 to 2001. Fewer than 30% of injured children were wearing helmets at the time of injury. With the injury severity score as an indicator, helmets provided no significant protection for all-terrain vehicle riders in this pediatric population.

Key Words: injury • all-terrain vehicle • injury severity score

Abbreviations: ATV—all-terrain vehicle • ISS—injury severity score

Accepted Dec 28, 2005.




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C. L. Collins, G. A. Smith, and R. D. Comstock
Children Plus All Nonautomobile Motorized Vehicles (Not Just All-Terrain Vehicles) Equals Injuries
Pediatrics, July 1, 2007; 120(1): 134 - 141.
[Abstract] [Full Text] [PDF]