{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T11:17:44Z","timestamp":1779880664434,"version":"3.53.1"},"reference-count":40,"publisher":"BMJ","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Inj Prev"],"accepted":{"date-parts":[[2012,11,25]]},"published-print":{"date-parts":[[2013,8]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>All-terrain vehicles (ATVs) have steadily increased in popularity, size and speed, characteristics that likely contribute to the alarming rise in ATV-related fatalities. One potentially high-risk activity is riding on the road.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To compare fatal ATV crashes that occur on the roadway and off, to more fully understand factors that contribute to fatalities at each location.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Fatality data from the US Consumer Product Safety Commission (CPSC) were used for descriptive and comparative analyses. Multivariate logistic regression analysis was performed to determine relative risk.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Over 60% of all fatalities (1985\u20132009) resulted from roadway crashes. After 1998, roadway fatalities increased at over twice the rate of off-road fatalities. Roadway crashes were more likely than off-road crashes to involve multiple fatalities, carrying passengers, alcohol use, collisions and head injuries. Roadway victims were less likely to be helmeted than off-road victims. Passengers and operators with passengers were also less likely to be helmeted than operators riding alone. Helmeted victims were half as likely to suffer a head injury.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Fatal roadway crashes were more likely than off-road crashes to involve risk-taking behaviours (eg, carrying passengers) that could exacerbate the inherent difficulty of operating ATVs on roadway surfaces. Higher crash forces from greater speed, and lower use of protective equipment, may also have contributed to higher roadway mortality rates. Eliminating non-essential ATV road use may be an effective way to reduce ATV-related fatalities. This will likely require a substantial investment in rider education and better enforcement of ATV road use restriction laws.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/injuryprev-2012-040548","type":"journal-article","created":{"date-parts":[[2012,12,20]],"date-time":"2012-12-20T23:32:10Z","timestamp":1356046330000},"page":"250-256","source":"Crossref","is-referenced-by-count":60,"title":["More fatal all-terrain vehicle crashes occur on the roadway than off: increased risk-taking characterises roadway fatalities"],"prefix":"10.1136","volume":"19","author":[{"given":"Gerene M","family":"Denning","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, University of Iowa, Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karisa K","family":"Harland","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of Iowa, Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa, USA"},{"name":"Injury Prevention Research Center, College of Public Health, University of Iowa, Iowa City, Iowa, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David G","family":"Ellis","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of Iowa, Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles A","family":"Jennissen","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of Iowa, Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2012,12,20]]},"reference":[{"key":"2025092603430203000_19.4.250.1","unstructured":"Consumer Product Safety Commission. 2010 Annual Report of ATV-Related Deaths and Injuries. 2011. http:\/\/www.cpsc.gov\/library\/foia\/foia12\/os\/atv2010.pdf (accessed 11 Apr 2012)."},{"key":"2025092603430203000_19.4.250.2","unstructured":"Consumer Federation of America. All-Terrain Vehicle (ATV) Safety Crisis: America's Children at Risk. 2007. http:\/\/ www.consumerfed.org\/pdfs\/ATV_Fact_Sheet_07_final.pdf"},{"key":"2025092603430203000_19.4.250.3","unstructured":"Consumer Product Safety Commission. 2009 Annual Report of ATV-Related Deaths and Injuries. 2010. http:\/\/www.consumerfed.org\/news-room\/studies#2003 (accessed 6 Dec 2012)."},{"key":"2025092603430203000_19.4.250.4","doi-asserted-by":"publisher","DOI":"10.1080\/10599240902773181"},{"key":"2025092603430203000_19.4.250.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsr.2005.01.002"},{"key":"2025092603430203000_19.4.250.6","doi-asserted-by":"publisher","DOI":"10.1136\/ip.2003.004176"},{"key":"2025092603430203000_19.4.250.7","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2005-2603"},{"key":"2025092603430203000_19.4.250.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.aap.2007.09.021"},{"key":"2025092603430203000_19.4.250.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.aap.2009.10.007"},{"key":"2025092603430203000_19.4.250.10","unstructured":"General Accounting Office (GAO). All-terrain vehicles: How they are used, crashes, and sales of adult-sized vehicles for children's use. Report to Congressional Committees (GAO-10-418). 2010. http:\/\/ www.gao.gov\/new.items\/d10418.pdf (accessed 20 Jan 2012)."},{"key":"2025092603430203000_19.4.250.11","first-page":"224","article-title":"ATV-related deaths in West Virginia: 1990\u20132003","volume":"99","author":"Helmkamp","year":"2003","journal-title":"W V Med J"},{"key":"2025092603430203000_19.4.250.12","doi-asserted-by":"publisher","DOI":"10.1016\/0001-4575(90)90006-7"},{"key":"2025092603430203000_19.4.250.13","unstructured":"Krueger D . Investigation of Lateral Performance of an ATV Tire on Natural, Deformable Surfaces. Master of Science Thesis, Auburn University, 2007. (accessed 26 Oct 2012)."},{"key":"2025092603430203000_19.4.250.14","doi-asserted-by":"publisher","DOI":"10.1111\/j.1748-0361.2009.00267.x"},{"key":"2025092603430203000_19.4.250.15","unstructured":"Helmkamp JC Ramsey WD Haas SM . All-terrain vehicle (ATV) deaths and injuries in West Virginia: A summary of surveillance and data sources. Charleston, WV: Criminal Justice Statistical Analysis center, Division of Criminal Justices Services, Department of Military Affairs and Public Safety. 2008. http:\/\/ www.wvdcjs.com\/statanalysis (accessed 21 Nov 2011)."},{"key":"2025092603430203000_19.4.250.16","unstructured":"CPSC Clearinghouse. 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