Keeping Kids Healthy by Dr. Sally Robinson
Death is usually not the subject of articles about children’s health. In 1900 30.4% of all deaths occurred among children aged less than 5 years. The leading cause of death was infectious disease such as pneumonia, TB, diarrhea, diphtheria which caused a third of all deaths. Today with the help of vaccines and medicines, infectious disease is no longer the leading cause of death.
Researchers of causes of death in children study unintentional injuries. Guns are the leading cause of death which seems determined to stay the leader. The second leading cause of death is motor vehicle accidents. This is both traffic related and non-traffic related. Parents or caregivers seemed to have not realized the increased risks off-highway vehicles create for children.
Children are more likely to have serious injuries such as traumatic brain injuries, spinal fractures, and extremities trauma due to their smaller size, limited developmental capabilities, and lack of experience. Off-highway vehicles (OHV) include all-terrain vehicles (ATVs), utility terrain vehicles (UTVs), dirt bikes, golf carts, and snowmobiles. Injuries from OHVs are preventable public health problems.
Between 2018-2020, children younger than 16 years accounted for 27% of the 500,00 OHV-related injuries. That is 135,000 children. ATVs were the most frequently involved with 56% head and neck injuries and 27% fractures.
Injuries were most often due to overturns, collisions and ejections. Overturns were linked to steep terrain, sharp turns, high speeds and improper vehicle loading. 61% of the collisions were stationary objects and 30% included other vehicles. Ejections occurred in more than 80% of fatal cases.
Children,10-15 years, experience the highest number of ATV-related injuries due to risk-taking behavior, inexperience, improper use of helmets and seat belts and lack of adult supervision. Children younger than 10 years old experience the more severe head and spine trauma, likely due to their larger head-to-body ratio, weaker skeletal structure, and limited ability to react in high-risk situations.
Unfortunately, helmet use is alarmingly low contributing to high rates of traumatic brain injuries. Non-compliance with using helmets among ATV riders is as high as 96%. Studies indicate that helmet use can reduce head injuries by up to 58% with lower mortality rates observed in states enforcing helmet use.
The non-use of seat belts in golf carts is as high as 98% in golf cart users, which contributes to ejections. Golf cart restraints that are too small or not used on the vehicle allow children to be easily thrown from the vehicle during sharp turns or sudden stops.
Texas state laws for off-highway vehicles, including ATVs, mandate that children under 14 must be directly supervised by a parent, guardian or authorized adult while riding on public property. Children under 16 are strictly prohibited from riding or driving adult-sized vehicles. All operators and passengers are legally required to wear an appropriate safety helmet and eye protection. OHVs cannot be driven on roads for amusement, anyone under 16 cannot cross a highway without a safety certificate and an adult.
Then there are electric scooters and bikes.
Sally Robinson, MD Clinical Professor
UTMB Pediatrics - Children's Complex Care
Also see: Pediatric Primary Care