Why the Need for Speed?     ATVs, Speed, and ATV-related            Head InjuriesCharles Jennissen, MD, Curtis Brown, BS, ...
Increase in ATV-Related Injuries105,000                 Adult                                                  The incide...
Canadian Sales Data Provide Some Insights                                ATV Engine Sizes Sold                            ...
Hypothesis                                               ATV Engine Sizes Sold105,000                                     ...
Objective of Our Studies Common types of ATV-  related injuries have been  described. However, the circumstances  under ...
Methods A retrospective chart analysis of all patients entered into the  University of Iowa Hospitals and Clinics Trauma ...
Demographic Results                           Patients with ATV Injuries by Gender 345 ATV-related cases                 ...
Documentation                               Medical Record Documentation of Contributing Factors                          ...
Light Conditions         Light Conditions: Percentage of ATV Injuries                                     Day             ...
Crash Mechanisms Crash Mechanism  • Rollovers (42%) were the most common mechanism of    injury.  • Striking an object (2...
Helmet Use 21% of all patients were reportedly wearing helmets. Younger riders (<16 years old) were more likely to be  h...
Head Injury and SpeedThe greater the ATV                    Injuries Related to Speed speed, the worse the patient’s head...
Head Injury and Speed Higher ATV speeds trended toward lower the Glasgow             Coma Scale (GCS) scores.             ...
Helmets and Head InjuryUnlike other studies, helmets did not appear to be very protective.We noticed a significant numbe...
Head Injury and Helmet UseCompared to non-racing helmeted riders, non-racing riderswithout helmets had significantly lower...
Head Injury and Helmet Use•Compared to non-racing helmeted riders, helmetedracers had significantly lower GCS scores (p=0....
Speed Kills……and causes greater injuries.Not a new concept but an important one.                            17
Speed and the Work Setting Eleven Australian dairy farmer’s  ATVs were fitted with two GPS units  and accelerometer for 1...
Why the Need for Speed? Why are these vehicles manufactured to go so fast? They are an off-road vehicle manufactured for...
Consumer Product Safety Improvement Act                                                   In effect since April, 2009    ...
Speed Limiters Most ATVs have a throttle limiting screw as their  speed limiter.    Often the children know how to adjus...
Speed Limiters…. Should be code-protected and tamper-proof so that they cannot be  changed or bypassed by other operators...
Conclusions The ever increasing and higher speeds of today’s ATVs are likely contributing to more deaths and serious inju...
Future Directions Improve crash and injury surveillance in the emergency  department:  • A multicenter ATV research netwo...
Thank You            25
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ATV Safety Summit: Vehicle Characteristics/Other Rulemaking Topics - Need for Speed

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Dr. Charles Jennissen, of the University of Iowa Department of Emergency Medicine presented this at CPSC's ATV Safety Summit Oct. 11, 2012. The study objective was to better understand the relationship between speed and ATV crash-related head injuries. Methods: A retrospective chart review was performed of ATV-related injuries from 2002-2009 at a university hospital. Results: 345 cases were identified; 30% were children <16>s ATVs are likely contributing to more serious injuries, including more severe head injuries. Although helmets are protective, there may be ATV crash speeds or mechanisms of brain injury at higher speeds that reduce helmet effectiveness. All ATVs should have a code-protected, tamper-proof speed governor. This would particularly assist parents in protecting children and teens from the serious risks associated with high operating speeds.

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  • No statistical significance for speed by GCS Overall p for max head is 0.09 BUT when you compare &lt; 16 to 26-40 (p=0.05) and &lt; 16 to 40+ (p=0.02)
  • No statistical significance for speed by GCS Overall p for max head is 0.09 BUT when you compare &lt; 16 to 26-40 (p=0.05) and &lt; 16 to 40+ (p=0.02)
  • ATV Safety Summit: Vehicle Characteristics/Other Rulemaking Topics - Need for Speed

    1. 1. Why the Need for Speed? ATVs, Speed, and ATV-related Head InjuriesCharles Jennissen, MD, Curtis Brown, BS, Ali Maamar-Tayeb, MD Kari Harding, PhD, Gerene Denning, PhD Department of Emergency Medicine, University of Iowa Carver College of Medicine 1
    2. 2. Increase in ATV-Related Injuries105,000 Adult  The incidence of ATV- 90,000 Pediatric (< 16 years old) related deaths and injuries has escalated 75,000 over the past 15 years. 60,000  But what has been 45,000 particularly striking are 30,000 the increases among adults. 15,000 10-Year Consent Decree  What might be 0 contributing to these increases? YearData from the National Electronic Injury Surveillance System (NEISS) 2
    3. 3. Canadian Sales Data Provide Some Insights ATV Engine Sizes Sold (Canadian Sales Data) ATVs engines sizes have dramatically increased. More recent sales data and US data unavailable. Models available that have >850 cc engines. Can weigh over 800 pounds and travel over 80 mph. Murphy et al. J. Trauma,. 56:1185-1190, 2004. 3
    4. 4. Hypothesis ATV Engine Sizes Sold105,000 (Canadian Sales Data) Adult 90,000 Pediatric (< 16 years old) 75,000 60,000 45,000 30,000 15,000 0 Year The growing popularity of larger, faster vehicles may be contributing to the increase. 4
    5. 5. Objective of Our Studies Common types of ATV- related injuries have been described. However, the circumstances under which they occur are poorly defined in the literature. The objective of the study was to better understand the mechanisms and contributing factors of ATV-related injuries. Patient records from a Level 1 trauma center. 5
    6. 6. Methods A retrospective chart analysis of all patients entered into the University of Iowa Hospitals and Clinics Trauma Registry with ATV-related injuries from 2002-2009. Potential subjects coded as having had an off-road vehicle incident were identified. Vehicles other than traditional 3 or 4-wheeled ATVs (motorbikes, scooters, utility vehicles, etc.) were excluded. A systematic review of each medical chart was performed. Details of injury events, potential contributing factors, and resulting injuries were determined and evaluated. 6
    7. 7. Demographic Results Patients with ATV Injuries by Gender 345 ATV-related cases Male were identified (2002- 79% Female 2009). 21% 79% of patients were males. Patients with ATV Injuries by Age 32% were children <18 Adults 68% years of age. Children (<18) 32% 7
    8. 8. Documentation Medical Record Documentation of Contributing Factors Seating Position 97.1% Helmet Use 94.8% Time of Day 92.2% 4 vs. 3 Wheels 90.3%Contributing Factors Road/trail/offroad 50.3% Slope of Terrain 39.4% Speed 35.3% Surface Type 33.2% Path(straight/turning) 7.7% ATV Size 2.4% ATV Model 0.9% Electronic Device Use 0.0% Weather 0.0% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Percent of Medical Records that Featured Documentation Vehicle parameters were poorly documented. 8
    9. 9. Light Conditions Light Conditions: Percentage of ATV Injuries Day 61.16% Night 30.43% Dusk Unknown 3.77% 4.35% Dawn 0.29%More than 30% of crashes occurred in limited light conditions 9
    10. 10. Crash Mechanisms Crash Mechanism • Rollovers (42%) were the most common mechanism of injury. • Striking an object (20%) and ejection/fall from the machine (13%) were also common. • Collision with another ATV occurred in 7% of crashes. The victim was struck by the ATV in 21% and pinned in 9% of the cases. Larger vehicles may be associated with more crush injuries. 10
    11. 11. Helmet Use 21% of all patients were reportedly wearing helmets. Younger riders (<16 years old) were more likely to be helmeted than those older (p=0.03). Helmet Use by ATV Crash Victims No Helmet 74% Helmet 21% Unknown 5% 11
    12. 12. Head Injury and SpeedThe greater the ATV Injuries Related to Speed speed, the worse the patient’s head injury (p=0.09). 2 N=38 N=23 N=224 1.5 N=33 Max Head Scores 1 MAX HEAD N=27 • <16 vs. 26-40 0.5 (p=0.05) 0 <16 16--25 26--40 >40 Unknown • <16 vs. >40 (p=0.02) Speed (mph) 12
    13. 13. Head Injury and Speed Higher ATV speeds trended toward lower the Glasgow Coma Scale (GCS) scores. Injuries Related to Speed 15 N=27 N=33 14.5 N=38 N=23 14 N=224GCS 13.5 13 <16 16--25 26--40 >40 Unknown Speed (mph) 13
    14. 14. Helmets and Head InjuryUnlike other studies, helmets did not appear to be very protective.We noticed a significant number of victims were racers. 14
    15. 15. Head Injury and Helmet UseCompared to non-racing helmeted riders, non-racing riderswithout helmets had significantly lower GCS scores (p=0.01). 15
    16. 16. Head Injury and Helmet Use•Compared to non-racing helmeted riders, helmetedracers had significantly lower GCS scores (p=0.02). 16
    17. 17. Speed Kills……and causes greater injuries.Not a new concept but an important one. 17
    18. 18. Speed and the Work Setting Eleven Australian dairy farmer’s ATVs were fitted with two GPS units and accelerometer for 14 days. Average Daily Exposure 1 1/2 hrs Average Speed 5.2 mph (1.5-10.4) Average Maximum Speed 29.0 mph (16.8-48.0) 95% of the time were travelling 18.6 mph (30 kph) or less Operators over-estimated their speed Ave. speed 11.8 mph Average Max. Speed 36 mph 18
    19. 19. Why the Need for Speed? Why are these vehicles manufactured to go so fast? They are an off-road vehicle manufactured for off-road use. Who can safely travel greater than 40 mph on most off-road surfaces? No one! So how can you experience the speed your ATV can achieve? Go on the road! This is a big reason why the rate of roadway deaths are increasing at a much higher rate than those off-road. 19
    20. 20. Consumer Product Safety Improvement Act  In effect since April, 2009  Use vehicle maximum and restricted speed limitations for determining the ageatvscene.com appropriateness of ATVs  Rather than engine size. Category Age Range Maximum Speed Maximum Speed (Restricted) (Unrestricted) Y-6+ Age 6 or older 10mph/16kph or Less 15mph/24kph Y-12+ Age 12 or older 15mph/24kph or Less 30mph/48kph 20
    21. 21. Speed Limiters Most ATVs have a throttle limiting screw as their speed limiter.  Often the children know how to adjust better than their parents with simple use of a screwdriver. Some vehicles have speed limiters that are plugged into the electrical systems Capacitor Discharged Ignition (CDI). www.anythingatv.com  Only needs to be unplugged.  Cut the wire that connects the limiter to the CDI to remove the restriction. A collar or spacer (which limits pulley travel and reduces higher gear ratios). forums.atvconnection.com  May be removed from the Continuously Variable Transmission (CVT) for extra speed in some models. 21
    22. 22. Speed Limiters…. Should be code-protected and tamper-proof so that they cannot be changed or bypassed by other operators. Should be incorporated into both youth- and adult-size machines. Allow parents to limit speed of their vehicles for children of all ages, family as well as non-family. Allow employers to limit the speed of their vehicles for their employees. 22
    23. 23. Conclusions The ever increasing and higher speeds of today’s ATVs are likely contributing to more deaths and serious injuries. Although protective, there may be crash speeds or mechanisms of brain injury at higher speeds that reduce helmet effectiveness. All ATVs should be equipped with a coded and/or programmable speed limiter that cannot be changed or bypassed by another operator. 23
    24. 24. Future Directions Improve crash and injury surveillance in the emergency department: • A multicenter ATV research network. • Prospectively data collection. • Standardized collection tool. Educational and training approaches to increase user knowledge about the danger of speed. Engineering approaches to limit speed for safer operation. Get ATVs off the road except for work-related purposes! 24
    25. 25. Thank You 25

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