In Brief

  • All-terrain vehicle crashes have killed more than 10,000 and injured hundreds of thousands of riders since 1985; most were related to overturns.

  • Behavior-based interventions have been implemented over decades reaching their limit of success.

  • As with tractors, engineering controls have the potential to mitigate or prevent most of these fatal and nonfatal injuries.

  • In this regard, much controversy has surrounded a single potentially effective crush prevention device.

On June 6, 2014, in Scottsdale, AZ, Amy Van Dyken-Rouen, an Olympic gold-medal-winning swimmer, was driving an all-terrain vehicle (ATV) in a restaurant parking lot when the machine hit a curb. It tipped over a 5- to 7-ft drop-off. She was seen lying on the ground unconscious next to the machine and received help from a firefighter and off-duty emergency room doctor, both of whom were at the restaurant. The ambulance arrived 15 minutes later. She had a severed vertebra. Vikas Patel, a doctor at the University of Colorado hospital, said, "It's a huge amount of force required to, basically, take on half of the spine and go one direction and the other half go the other direction…. To me, to have a fracture like this means that most likely there was so much force involved that the ATV was on top of her" (Stanley & Zelinger, 2014). She was paralyzed from the waist down. By August 2014 with a powered exoskeleton, she was able to stand up and walk (Mazza, 2014).

Such events are part of a modern epidemic: injuries from ATV-related overturns. CDC (2011) defines an epidemic as: [T]he occurrence of more cases of disease, injury or other health condition than expected in a given area or among a specific group of persons during a particular period. Usually, the cases are presumed to have a common cause or to be related to one another in some way.

Once upon a time (perhaps many times), a farmer who survived death from a tractor overturn said, "Well, that never happened before." That is an individual's perspective, but with a broader, population-based perspective, studies have shown that tractor overturns occur often. Indeed, they were the highest cause of death from injury on farms for many years, including up to the present.

Like tractors, Garland (2014) found that ATV overturns are the highest cause of death associated with crashes of these machines at 60.6%. From 1985 to 2009, 10,561 people were killed by ATV-related incidents (Figure 1, p. 38). One possible explanation for the decrease in the number of fatalities during 2008 and 2009 is the recession, which may have reduced the number of new ATVs purchased (Clapperton, Herde & Lower, 2013). Consumer Product Safety Commission (CPSC) is still collecting decedent data beyond 2009. This article addresses the problem and controversy that surrounds the epidemic of serious injury and death regarding the design, manufacture and use of ATVs.

Consumer Product Safety Commission

CPSC defines an ATV as an off-road, motorized vehicle having three or four low-pressure tires, a straddle seat for the operator and handlebars for steering control (Topping & Garland, 2014). In 1985, CPSC commenced rulemaking to address hazards associated with ATVs, declaring that ATVs are an "imminently hazardous consumer product" (CPSC, 2006). By 1988, the final consent decree included the prohibition of the sale of three-wheeled ATVs, which were known to be more unstable regarding rollovers than four-wheeled ATVs (David, 1998). The consent decree included other agreements for providing labeling and education programs.

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