Qin Evelyn S, Jennissen Charles A, Wadman Caroline A, Denning Gerene M
University of Iowa, Carver College of Medicine, Department of Emergency Medicine, Iowa City, Iowa.
West J Emerg Med. 2017 Aug;18(5):913-922. doi: 10.5811/westjem.2017.6.34404. Epub 2017 Jul 25.
Deaths and injuries from all-terrain vehicle (ATV) crashes result in approximately 700 deaths each year and more than 100,000 emergency department (ED) visits. Common misconceptions about ATV crashes are a significant barrier to injury prevention efforts, as is the lack of key information about where and how crashes occur. The purpose of this study was to determine ATV crash patterns within a state, and to compare and contrast characteristics of these crashes as a function of crash-site rurality.
We performed descriptive, comparative, and regression analyses using a statewide off-road vehicle crash and injury database (2002-2013). Comparisons were performed by rurality as defined using the 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.
ATV crashes occurred throughout the state; 46% occurred in urban and 54% in rural zip code areas. Comparisons of rider and crash characteristics by rurality showed similarities by sex, age, seating position, on vs. off the road, and crash mechanism. Conversely, helmet use was significantly lower among victims of isolated rural crashes as compared to other victims (p=0.004). Crashes in isolated rural and small rural areas accounted for only 39% of all crashes but resulted in 62% of fatalities. In both rural and urban areas, less than one-quarter of roadway injuries were traffic related. Relative crash rates varied 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.
This study suggests that ATV crashes are a public health concern for both rural and urban communities. However, isolated rural ATV crash victims were less likely to be helmeted, and rural victims were over-represented among fatalities. Traffic was not the major factor in roadway crashes in either rural or urban areas. Unique crash patterns for different riding populations suggest that injury prevention experts and public policy makers should consider the potential impact of geographical location when developing injury prevention interventions.
全地形车（ATV）碰撞导致的死亡和伤害每年约造成700人死亡，超过10万人前往急诊科就诊。对ATV碰撞的常见误解是伤害预防工作的重大障碍，关于碰撞发生地点和方式的关键信息匮乏也是如此。本研究的目的是确定一个州内的ATV碰撞模式，并比较和对比这些碰撞的特征与碰撞地点农村化程度的关系。
我们使用全州范围的越野车辆碰撞和伤害数据库（2002 - 2013年）进行描述性、比较性和回归分析。使用农村城市通勤区（RUCA）编码系统定义的农村化程度进行比较，我们使用地理信息系统（GIS）软件在邮政编码和县级层面绘制碰撞模式图。
ATV碰撞在全州各地发生；46%发生在城市邮政编码区域，54%发生在农村邮政编码区域。按农村化程度对骑手和碰撞特征进行比较，结果显示在性别、年龄、座位位置、道路上与道路外以及碰撞机制方面存在相似性。相反，与其他受害者相比，偏远农村碰撞受害者中头盔使用率显著较低（p = 0.004）。偏远农村和小农村地区的碰撞仅占所有碰撞的39%，但导致了62%的死亡。在农村和城市地区，道路伤害中与交通相关的不到四分之一。各县的相对碰撞率各不相同，涉及青年和道路骑手的碰撞观察到独特模式。在研究期间，所有碰撞的10%和50%分别发生在该州2%和20%的县。
本研究表明，ATV碰撞对农村和城市社区都是一个公共卫生问题。然而，偏远农村ATV碰撞受害者戴头盔的可能性较小，农村受害者在死亡人数中占比过高。在农村和城市地区，交通都不是道路碰撞的主要因素。不同骑行人群的独特碰撞模式表明，伤害预防专家和公共政策制定者在制定伤害预防干预措施时应考虑地理位置的潜在影响。
