Introduction: Deaths and injuries from all-terrain vehicle (ATV) crashes result in approximately700 deaths each year and more than 100,000 emergency department (ED) visits. Commonmisconceptions about ATV crashes are a significant barrier to injury prevention efforts, as is the lackof key information about where and how crashes occur. The purpose of this study was to determineATV crash patterns within a state, and to compare and contrast characteristics of these crashes as afunction of crash-site rurality.
Methods: We performed descriptive, comparative, and regression analyses using a statewide off-roadvehicle crash and injury database (2002-2013). Comparisons were performed by rurality as defined usingthe Rural Urban Commuting Area (RUCA) coding system, and we used geographic information system(GIS) software to map crash patterns at the zip code and county levels.
Results: ATV crashes occurred throughout the state; 46% occurred in urban and 54% in rural zip codeareas. Comparisons of rider and crash characteristics by rurality showed similarities by sex, age, seatingposition, on vs. off the road, and crash mechanism. Conversely, helmet use was significantly loweramong victims of isolated rural crashes as compared to other victims (p=0.004). Crashes in isolatedrural and small rural areas accounted for only 39% of all crashes but resulted in 62% of fatalities. In bothrural and urban areas, less than one-quarter of roadway injuries were traffic related. Relative crash ratesvaried by county, and unique patterns were observed for crashes involving youth and roadway riders.During the study period, 10% and 50% of all crashes occurred in 2% and 20% of the state’s counties,respectively.
Conclusion: This study suggests that ATV crashes are a public health concern for both rural and urbancommunities. However, isolated rural ATV crash victims were less likely to be helmeted, and rural victimswere over-represented among fatalities. Traffic was not the major factor in roadway crashes in eitherrural or urban areas. Unique crash patterns for different riding populations suggest that injury preventionexperts and public policy makers should consider the potential impact of geographical location whendeveloping injury prevention interventions. [West J Emerg Med. 2017;18(5)913-922.]