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High Proportions of Roadway Deaths and Injuries on ATVs Suggest Poor

Knowledge and Compliance with Road Use Laws

Gerene Denning, PhDCharles Jennissen, MDKarisa Harland, PhD

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Background

22 states, including Iowa, have road use laws restricting use to work-related purposes.

However, survey studies suggest that riding on the road is a widespread practice, including among Iowa youth:

• 81% of Future Farmer’s of America (FFA) members (Burgus et al. 2009)

• 82% of 4 H Clubs of America members (Hafner et al 2010)

• 81% Iowa school students (11-16 yrs old) (Jennissen et al.)

In addition, West Virginia reported that 60% of statewide ATV-related deaths were due to crashes on the roadway (Helmkamp et al. 2008).

Why and how are ATVs more dangerous on the road?

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Not all tires are created equal.

Automobile Tires

Well inflated automobile tires with

good tread are designed to GRIP and RELEASE the ROAD

surface to help maintain control of the

vehicle.

ATV Tires

Under-inflated, knobby ATV tires are designed to

handle UNEVEN, ROUGH off-road

surfaces.

They can GRAB the road surface and throw a rider off, or cause the

ATV to ROLL OVER,

particularly while turning.

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Many factors contribute to loss of control on the road.

Need wider turning radius than road is

designed for.

CM

Entering roadway from ditch has

visibility problems.

Knobby tires can grab when accelerating.

High center of gravity.

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Objective of Our Studies

To compare roadway and off-road deaths and injuries to determine whether there were differences in:

Demographics

Riding practices and risk factors

Injury outcomes, including head injuries

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Consumer Product Safety Commission (CPSC) National

Fatality Database

Iowa Statewide ATV Injury Surveillance Database

Data Sources Used

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Iowa ATV Injury Surveillance Database

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Fatal crashes have increased at a greater rate on the roadway vs. off.

•Dramatic increase followed expiration of the 10-Year Consent Decree.

•Fatal roadway crashes increased at more than twice the rate of off-road crashes.

•From 1985-2009, 62% of all fatal ATV crashes were on the roadway!

0

100

200

300

400

500

600 RoadwayOff-Road

48 + 2.8More Roadway

Deaths/yr

20 + 1.8More Off-road

Deaths/yr

Year

Roadway vs. Off-Road Deaths Per Year

10-Year Consent Decree

CPSC Fatality Database

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Teens and young adults are over-represented in roadway deaths.

0

5

10

15

20

25

30

35

RoadwayOff-Road

Age Range

% of Roadway vs. Off-Road Deaths by Age

Off-road > Roadway

Off-road > Roadway

Roadway > Off-Road

CPSC Fatality Database

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ATV-related injuries also disproportionately affect the young.

Iowa Injury Surveillance Database

30% 33%

70% 67%

64%58%

36%42%

Approximately 3 out of 10 injuries in our database were among

victims less than 16 years of age.

Twice that number (6 out of 10) involved victims 25 years of age

and younger.

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Fatal roadway crashes were more likely to involve multiple deaths than off-road crashes.

Single vs. Multiple Fatalities per CrashN= 3,658 Crashes (1985-2009)

Fatalities Roadway Off-Road

Single 97% 99%

Multiple 3% 1%

Roadway vs. Off-Road Why were roadway crashes 3X more likely to involve multiple

deaths?

aOR 3.15

95% CI 1.95-5.09

P value <0.0001

CPSC Fatality Database

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69%16%

15%

75%

13%

12%

CPSC Fatality Database

31% Multiple Riders 25% Multiple Riders

Fatal roadway crashes involved more multiple riders than off-road crashes.

>

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More than 1 out of 10 non-fatal Iowa crash victims were passengers.

Iowa Injury Surveillance Database

16% 15%

84% 85%

Over 50% of passenger victims were female and over 60% were children under the age of 16.

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Fatal and non-fatal roadway crashes were more likely than off-road crashes to involve collisions.

Injury Mechanism Roadway Off-Road Relative risk

ATV-Vehicle Collision 35% 5% Odds Ratio 4.7

ATV-Other Collision 27% 20% 95% CI 3.51-6.34

Rollover 38% 74% P value <0.001

Fatality Mechanism Roadway Off-Road Relative risk

ATV-Vehicle Collision 29% 6% Odds Ratio 10.4

ATV-Other Collision 37% 22% 95% CI 8.9-12.2

Rollover 34% 72% P value <0.001

CPSC Fatality Database

Iowa Injury Surveillance Database

Over 10 times

Almost 5 times

ATVs on the roadway are a serious traffic safety hazard!

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Involved Alcohol Roadway Off-Road Relative risk

Yes 13% 8% Odds Ratio 1.91

No 87% 92% 95% CI 1.09-3.36

P value <0.001

Fatal and non-fatal roadway crashes were more likely than off-road crashes to involve alcohol.

Involved Alcohol Roadway Off-Road Relative risk

Yes 45% 30% Odds Ratio 1.96

No 55% 70% 95% CI 1.74-2.21

P value <0.001

CPSC Fatality Database

Iowa Injury Surveillance Database

Almost twice

Almost twice

Better enforcement of laws prohibiting alcohol use are needed!

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Vehicles in fatal crashes are getting bigger and more powerful.

1985-1990 1991-1998 1999-2003 2004-20090

10

20

30

40

50

60

70

80

90

100

225-350 cc

<90 cc

100-200 cc

375-450 cc

475-600 cc

625-750 cc

775-900 cc

Years

CPSC Fatality Database

Do higher rates of roadway fatalities reflect the growing popularity of large vehicles capable of achieving highway speeds?

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Head injuries are among the leading causes of death and disability from ATV

crashes.

Roadway vs. Off-Road Outcomes

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Fatal and non-fatal roadway crashes were associated with more head injuries.

CPSC Fatality Database Iowa State Trauma Registry

Fatal Roadway vs. Off-road crashes were 2X more likely to

involve a head injury.

Non-fatal Roadway vs. Off-roadcrashes were 3X more likely to

involve a head injury.

66%

50%

34%

50%

74%

90%

9% 5%

17%

5%

Crashes Glasgow Coma Scale

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Helmets reduced the likelihood of head injuries.

Helmets reduced the likelihood of head injury:

•77% for Iowa non-fatal crashes.

•46% for national fatal crashes.

Fatal Non-fatal

Roadway Off-Road Roadway Off-Road

Helmet useP value

16%p<0.0001

24% 14%p<0.01

23%

All states need ATV helmet laws that are effectively enforced!

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CPSC Fatality Database

62% of fatal ATV crashes occurred on the roadway.

ATV-related roadway fatalities were more likely than off-road fatalities to involve:

• Teens and young adults

• Multiple deaths

• Multiple riders

• Collisions with another vehicle

• Alcohol

• Head injuries

ATV-related roadway fatalities were less likely than off-road fatalities to involve:

• Helmet use among riders.

Helmets reduced the risk of head injury.

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Iowa ATV Injury Surveillance Database

ATV-related roadway injuries were more likely than off-road injuries to involve:

•Teens and young adults

•Collisions with another vehicle

•Alcohol

•Head injuries

•Severe trauma (ISS >15)

ATV-related roadway injuries were less likely than off-road injuries to involve:

•Helmet use among riders

Helmets reduced the risk of head injury.

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Conclusions

ATV riders in states with road use laws are not complying with the law.

Compliance with laws requires:

• Knowledge of the laws.

• Enforcement of the laws.

• Removal of economic barriers with compliance.

ATV riders in states with the following laws also appear to have poor compliance.

• No passenger laws.

• Alcohol prohibition.

• Helmet laws.

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To reduce ATV-related deaths and injuries…

All states need evidence-based ATV

laws that are effectively enforced.

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Deaths And Injuries From ATV Crashes Are Preventable!

To prevent deaths and injuries and their accompanying financial costs, we need:

• EDUCATION and Public Awareness

• ENGINEERING Safer Vehicles

• ENFORCEMENT of Evidence-Based Public Health and Safety Laws

It takes all stakeholders working together.

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THANK YOU

When we have the power to save lives and health, we have the responsibility to do so.