Denning Gerene M, Harland Karisa K, Jennissen Charles A
Department of Emergency Medicine, Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa; and
Department of Emergency Medicine, Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa; and Iowa Injury Prevention Research Center, College of Public Health, University of Iowa, Iowa City, Iowa.
Pediatrics. 2014 Dec;134(6):1094-102. doi: 10.1542/peds.2014-1993.
To compare and contrast characteristics and determinants of fatal all-terrain vehicle (ATV) crashes among pediatric age groups.
Retrospective descriptive and multivariable analyses of Consumer Product Safety Commission fatality data (1985-2009) were performed.
Relative to 1985-1989 (baseline), pediatric deaths over the subsequent 4-year periods were lower until 2001-2004, when they markedly increased. Also, the proportion of vehicles involved in fatalities with engine sizes >350 cubic centimeter increased, reaching ∼50% of crashes in 2007-2009. Ninety-five percent of all pediatric fatalities were on adult-size vehicles. Victims <6 years old had the highest proportion of girls (24%) and passengers (76%), and the lowest helmet use (17%). More than half of 6- to 11-year-old children were vehicle operators; 1 in 4 were carrying passengers in their own age range. Over the study period, 12- to 15-year-old children accounted for more than half of all pediatric ATV-related fatalities. The proportion of youth riding on the road increased with age, as did the proportion of collisions with other vehicles. Older teens had the highest proportions of roadway fatalities (72%) and collision events (63%), and 19% of their crashes involved alcohol. Head injuries occurred in 63% of victims (the major determinant being roadway riding), and helmets reduced the likelihood of head injury among fatal crash victims by 58%.
There were significant differences between pediatric age groups in the relative contribution of known risk factors for ATV-related fatalities. Future injury prevention efforts must recognize these differences and develop interventions based on the age range targeted.
比较和对比不同儿童年龄组全地形车（ATV）致命事故的特征及决定因素。
对消费品安全委员会的死亡数据（1985 - 2009年）进行回顾性描述性分析和多变量分析。
与1985 - 1989年（基线）相比，在随后的4年期间，儿童死亡人数一直较低，直到2001 - 2004年显著增加。此外，发动机排量大于350立方厘米的涉事车辆比例增加，在2007 - 2009年达到约50%的事故比例。所有儿童死亡事故中，95%发生在成人尺寸的车辆上。6岁以下受害者中女孩比例最高（24%），乘客比例最高（76%），头盔使用率最低（17%）。6至11岁儿童中超过一半是车辆驾驶者；四分之一的儿童搭载同年龄段乘客。在研究期间，12至15岁儿童占所有与ATV相关的儿童死亡事故的一半以上。青少年在道路上骑行的比例随年龄增长而增加，与其他车辆碰撞的比例也如此。年龄较大的青少年道路死亡事故比例最高（72%），碰撞事故比例最高（63%），其中19%的事故涉及酒精。63%的受害者头部受伤（主要决定因素是在道路上骑行），头盔使致命事故受害者头部受伤的可能性降低了58%。
在与ATV相关的致命事故中，已知风险因素的相对贡献在不同儿童年龄组之间存在显著差异。未来的伤害预防工作必须认识到这些差异，并针对目标年龄范围制定干预措施。
