Published online January 2, 2007
PEDIATRICS Vol. 119 No. 1 January 2007, pp. 223-225 (doi:10.1542/peds.2006-2890)

This Article Extract Full Text (PDF) Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services E-mail this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Web of Science (1) Citing Articles via Google Scholar Google Scholar Articles by Helmkamp, J. Articles by Lawrence, B. A. Search for Related Content PubMed PubMed Citation Articles by Helmkamp, J. Articles by Lawrence, B. A. Related Collections Office Practice Social Bookmarking                         What's this?

LETTER TO THE EDITOR

The Economic Burden of All-Terrain Vehicle–Related Pediatric Deaths in the United States

Jim Helmkamp, PhD
Injury Control Research Center
West Virginia University
Morgantown, WV 26506

Bruce A. Lawrence, PhD
Pacific Institute for Research and Evaluation
Calverton, MD 20705-3102

To the Editor.—

The estimated average annual number of all-terrain vehicle (ATV)–related deaths has increased from 273 per year in 1985–1998 to 609 per year in 1999–2003.^1,2 Although the overall number of deaths has been steadily increasing, fortunately the proportion of deaths in children under age 16 has decreased from 35% in the earlier period to 22% in the later period.² The Consumer Product Safety Commission (CPSC) indicates that increases in mortality are not solely a result of increased sales and exposure.^1,3 Fatality increases could be a function of data-collection changes and coding differences between the International Classification of Diseases, Ninth Revision (ICD-9), and ICD-10. Thus, it is likely that estimates before 1999 were undercounts.²

The National Highway Traffic Safety Administration model for the economic impact of motor vehicle crashes,⁴ which incorporates medical, work loss, and quality-of-life components, was used to calculate national costs (in 2000 dollars) for ATV-related fatalities among children and older victims for the period 1999–2003. Cases were identified from the National Center for Health Statistics Multiple Cause-of-Death public-access file.

ATV deaths and associated economic costs steadily increased in both age groups (see Fig 1): children (from $493 million in 1999 to $723 million in 2003) and adults (from $1706 million in 1999 to $2517 million in 2003). The quality-of-life component accounted for 63.8% of the total cost, with work loss accounting for 36.0% and medical for 0.2%. Males accounted for 77.5% of the younger deaths and 89.0% of the older deaths. The median age of victims was 28.0 years, the mean age was 31.8 years, and the mean years of productive life lost based on a typical life span of 75 years was 43.2 years.

View larger version (14K): [in this window] [in a new window]   FIGURE 1 Economic costs for ATV-related deaths (reported number of deaths) in the United States from 1999 to 2003.

 
It seems that little has changed in the past 20 years despite continuous, but relatively benign, national efforts to improve ATV safety through a federal decree,⁵ voluntary agreements between manufacturers and distributors,⁶ safety alerts,⁷ public hearings, and a recent top-to-bottom CPSC review of all existing ATV safety standards leading to the issuance of a notice of proposed rule-making in June 2006⁸ and a major campaign to address deaths and serious injuries.⁹ Although a broad spectrum of consumer advocacy groups, physicians, professional medical organizations, and researchers have called for federal regulation of the use of ATVs, especially banning the sale of adult-sized ATVs to children under 16 years of age,¹⁰ it seems that the CPSC has shied away from these recommendations. Many of the same initiatives outlined in the 10-year decree in 1988⁵ have seemingly been dusted off and repackaged in the latest safety campaign⁹ (eg, free training and public awareness, no passengers, use of helmets, no riding on paved surfaces, ATV modifications). Prevention efforts by the CPSC or others should be in concert with safety education (both community and school based) that is strongly reinforced at home. Perhaps new approaches using insurance or warranty incentives for both training and helmet use might provide an impetus to users to act more responsibly to increase safe behavior and help reduce the appalling public health and economic burden exacted by ATV-related deaths and injuries. Most importantly, parents must stress that riding ATVs can be fun and safe if basic safety guidelines are followed by all users, including themselves.

REFERENCES

1. Helmkamp JC. Injuries and deaths and the use of all-terrain vehicles. N Engl J Med. 2000;343 :1733 –1734[Free Full Text]
2. US Consumer Product Safety Commission. 2004 Annual Report of ATV Deaths and Injuries. Washington, DC: Directorate for Epidemiology; 2005. Available at: www.cpsc.gov/library/foia/foia05/brief/atv2004.pdf. Accessed August 28, 2006
3. Levenson MS. All-Terrain Vehicle 2001 Injury and Exposure Studies. Washington, DC: US Consumer Productive Safety Commission; 2003
4. National Highway Traffic Safety Administration. The Economic Impact of Motor Vehicle Crashes. Washington, DC: National Highway Traffic Safety Administration; 2000. DOT report HS 809 446. Available at: http://lhsc.lsu.edu/OutsideLinks/EconomicImpact-1.pdf. Accessed August 30, 2006
5. United States of America v American Honda Motor Co. Inc, et al. Washington, DC: District Court of the District of Columbia; 1988. Civil action 87-3525
6. US Consumer Product Safety Commission. News for CPSC: CPSC announces all-terrain vehicle safety programs [press release]. December 9, 1998. CPSC release 99-034. Available at: www.cpsc.gov/cpscpub/prerel/prhtml99/99034.html. Accessed November 2, 2006
7. US Consumer Product Safety Commission. All-terrain vehicles. Consum Prod Saf Rev. 2003;8(1) :1 –2
8. US Consumer Product Safety Commission. Briefing package: ATV safety review. May 2006. Available at: www.cpsc.gov/LIBRARY/FOIA/FOIA06/brief/ATVpt1.pdf. Accessed August 27, 2006
9. US Consumer Product Safety Commission. CPSC launches major campaign to drive down deaths and serious injuries associated with all-terrain vehicles [press release]. September 21, 2006. CPSC release 06-265. Available at: www.cpsc.gov/cpscpub/prerel/prhtml06/06265.html. Accessed November 2, 2006
10. Consumer Federation of America. In the matter of the petition of Consumer Federation of America, U.S. PIRG et al to ban all-terrain vehicles for use by Children under 16 years old and to provide refunds for consumers (CP-02-4/HP-02-1). August 2002. Available at: www.pirg.org/consumer/products/atvpetition.pdf. Accessed September 22, 2006

---

PEDIATRICS (ISSN 1098-4275). ©2007 by the American Academy of Pediatrics

CiteULike    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				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]

				J. C Helmkamp Family fun family tragedy: ATV-related deaths involving family members Inj. Prev., December 1, 2007; 13(6): 426 - 428. [Full Text] [PDF]

This Article Extract Full Text (PDF) Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services E-mail this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Web of Science (1) Citing Articles via Google Scholar Google Scholar Articles by Helmkamp, J. Articles by Lawrence, B. A. Search for Related Content PubMed PubMed Citation Articles by Helmkamp, J. Articles by Lawrence, B. A. Related Collections Office Practice Social Bookmarking                         What's this?