{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T18:15:34Z","timestamp":1783102534505,"version":"3.54.6"},"reference-count":27,"publisher":"BMJ","license":[{"start":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:00:00Z","timestamp":1783036800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000036","name":"Institute of Population and Public Health","doi-asserted-by":"publisher","award":["CPP-137910"],"award-info":[{"award-number":["CPP-137910"]}],"id":[{"id":"10.13039\/501100000036","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Inj Prev"],"accepted":{"date-parts":[[2026,6,18]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The aim of this study was to describe differences and trends in all-terrain vehicle (ATV)-related hospitalisations for urban and rural-dwelling youth in Canada.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a cross-sectional study of patients admitted for an ATV-related injury to hospitals in Canada between 2002 and 2019. The primary exposure was rural residence. Rural\u2013urban comparisons were stratified by age: children (&lt;16 years), adolescents (16\u201320 years) and adults (\u226521 years). The primary outcome was annual prevalence of any hospitalisation; secondary outcomes were head, fracture, crush and spinal cord injuries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 34\u2009390 patients, 83% (n=28\u2009487) were male; 17% (n=5846) were children and 14% (n=4815) were adolescents and 47% lived rurally. The population-adjusted annual hospitalisation rates ranged from 4 to 9\/100 000 for children to 8 to 21\/100 000 for adolescents and 4 to 8\/100 000 for adults. The rate difference for being hospitalised for an ATV-related injury was higher for rural dwelling children (17.29; 95%\u2009CI 16.54 to 18.04)\u2009and adolescents (38.10; 95%\u2009CI 16.18 to 40.02) compared with urban dwelling peers. Rate ratios (RRs) for ATV-related hospitalisations were fivefold higher among rural-dwelling children (RR: 5.62; 95%\u2009CI 5.33 to 5.92)\u2009and adolescents (RR: 5.22; 95%\u2009CI 4.93 to 5.53), compared with urban-dwelling peers. The RRs were highest for ATV-related crush (RR: 10.54; 95%\u2009CI 5.80 to 19.15)\u2009and spinal cord injuries (RR: 5.24; 95%\u2009CI 3.35 to 8.19) for rural-dwelling adolescents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and conclusions<\/jats:title>\n                    <jats:p>In Canada, ATV-related hospitalisations among rural children and adolescents are fivefold to sixfold\u2009higher than among their urban peers. These differences in hospitalisation rates may be related to greater time spent riding ATVs among rural youth.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/ip-2025-045910","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T17:20:31Z","timestamp":1783099231000},"page":"ip-2025-045910","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Rural\u2013urban differences in ATV-related hospitalisations among children, adolescents and adults in Canada from 2002 to 2019: a population-based descriptive study"],"prefix":"10.1136","author":[{"given":"Mattea","family":"Heck","sequence":"first","affiliation":[{"name":"The Children\u2019s Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shamsia","family":"Sobhan","sequence":"additional","affiliation":[{"name":"The Children\u2019s Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Balshaw","sequence":"additional","affiliation":[{"name":"Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3741-5248","authenticated-orcid":false,"given":"Jonathan","family":"McGavock","sequence":"additional","affiliation":[{"name":"The Children\u2019s Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada"},{"name":"Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,3]]},"reference":[{"key":"2026070310201798000_ip-2025-045910v1.1","doi-asserted-by":"crossref","DOI":"10.1093\/pch\/17.7.NP","article-title":"Preventing injuries from all-terrain vehicles","volume":"17","author":"Yanchar","year":"2012","journal-title":"Paediatr Child Health"},{"key":"2026070310201798000_ip-2025-045910v1.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2006.01.011"},{"key":"2026070310201798000_ip-2025-045910v1.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.pedhc.2005.10.002"},{"key":"2026070310201798000_ip-2025-045910v1.4","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-0751"},{"key":"2026070310201798000_ip-2025-045910v1.5","unstructured":"Yanchar NL . Preventing injuries from all-terrain vehicles. Ottawa, ON: Canadian Paediatric Society, 2020."},{"key":"2026070310201798000_ip-2025-045910v1.6","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2022-059280","article-title":"A Comprehensive Report on All-Terrain Vehicles and Youth: Continuing Challenges for Injury Prevention","volume":"150","author":"Jennissen","year":"2022","journal-title":"Pediatrics"},{"key":"2026070310201798000_ip-2025-045910v1.7","doi-asserted-by":"crossref","unstructured":"Jennissen CA , Karunatilaka SR , Iverson BJ , et al . Rural adolescent attitudes and use of helmets while riding ATVs, motorcycles and dirt bikes. Inj Epidemiol 2024;11. doi:10.1186\/s40621-024-00532-2","DOI":"10.1186\/s40621-024-00532-2"},{"key":"2026070310201798000_ip-2025-045910v1.8","doi-asserted-by":"publisher","DOI":"10.1370\/afm.1663"},{"key":"2026070310201798000_ip-2025-045910v1.9","doi-asserted-by":"crossref","first-page":"S277","DOI":"10.1097\/TA0b013e31826b00d7","article-title":"Analysis of pediatric all-terrain vehicle trauma data in Middle Tennessee: implications for injury prevention","volume":"73","author":"Unni","year":"2012","journal-title":"J Trauma Acute Care Surg"},{"key":"2026070310201798000_ip-2025-045910v1.10","first-page":"351","article-title":"Pediatric injuries resulting from use of all-terrain vehicles","volume":"97","author":"Bercher","year":"2001","journal-title":"J Ark Med Soc"},{"key":"2026070310201798000_ip-2025-045910v1.11","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2023.16060","article-title":"Severity of All-Terrain Vehicle-Related Injuries by Age in Canada, 2002-2019","volume":"6","author":"MacDougall","year":"2023","journal-title":"JAMA Netw Open"},{"key":"2026070310201798000_ip-2025-045910v1.12","unstructured":"Canadian Institute for Health Information . Discharge abstract database 2002-2021. Available: https:\/\/www.cihi.ca\/en\/discharge-abstract-database-metadata-dad [Accessed 16 Mar 2021]."},{"key":"2026070310201798000_ip-2025-045910v1.13","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwac115"},{"key":"2026070310201798000_ip-2025-045910v1.14","unstructured":"Canadian Institutes for Health Information . Available: https:\/\/www.cihi.ca\/en"},{"key":"2026070310201798000_ip-2025-045910v1.15","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39335.541782.AD"},{"key":"2026070310201798000_ip-2025-045910v1.16","doi-asserted-by":"crossref","first-page":"389","DOI":"10.2147\/CLEP.S110528","article-title":"The RECORD reporting guidelines: meeting the methodological and ethical demands of transparency in research using routinely-collected health data","volume":"8","author":"Nicholls","year":"2016","journal-title":"Clin Epidemiol"},{"key":"2026070310201798000_ip-2025-045910v1.17","unstructured":"Parachute Group . All-terrain vehicle (ATV) Canadian legislation chart. 2019. Available: https:\/\/parachute.ca\/en\/injury-topic\/all-terrain-vehicles\/"},{"key":"2026070310201798000_ip-2025-045910v1.18","doi-asserted-by":"publisher","DOI":"10.1136\/ip.2004.005561"},{"key":"2026070310201798000_ip-2025-045910v1.19","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2022-059279","article-title":"American Academy of Pediatrics Recommendations for the Prevention of Pediatric ATV-Related Deaths and Injuries","volume":"150","author":"Jennissen","year":"2022","journal-title":"Pediatrics"},{"key":"2026070310201798000_ip-2025-045910v1.20","first-page":"135","article-title":"Youth Personality Factors as Predictors of Risky All-Terrain Vehicle (ATV) Driving Behaviors","volume":"22","author":"Jinnah","year":"2016","journal-title":"J Agric Saf Health"},{"key":"2026070310201798000_ip-2025-045910v1.21","unstructured":"Canadian Institute for Health Information . 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Toronto, ON Canadian Institutes for Health Information; 2007."},{"key":"2026070310201798000_ip-2025-045910v1.22","doi-asserted-by":"crossref","DOI":"10.1186\/s12887-017-0807-y","article-title":"Age and the risk of All-Terrain Vehicle-related injuries in children and adolescents: a cross sectional study","volume":"17","author":"McLean","year":"2017","journal-title":"BMC Pediatr"},{"key":"2026070310201798000_ip-2025-045910v1.23","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1016\/j.jemermed.2016.12.035","article-title":"All-Terrain Vehicle Injury in Children and Youth: Examining Current Knowledge and Future Needs","volume":"53","author":"Doud","year":"2017","journal-title":"J Emerg Med"},{"key":"2026070310201798000_ip-2025-045910v1.24","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2017.01.039"},{"key":"2026070310201798000_ip-2025-045910v1.25","doi-asserted-by":"publisher","DOI":"10.1177\/003335490912400310"},{"key":"2026070310201798000_ip-2025-045910v1.26","doi-asserted-by":"crossref","first-page":"106","DOI":"10.3171\/2021.6.PEDS21225","article-title":"The impact of helmet use on neurosurgical care and outcomes after pediatric all-terrain vehicle and dirt bike crashes: a 10-year single-center experience","volume":"29","author":"Allen","year":"2022","journal-title":"J Neurosurg Pediatr"},{"key":"2026070310201798000_ip-2025-045910v1.27","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/153.11.1112"}],"container-title":["Injury Prevention"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/ip-2025-045910","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T17:20:43Z","timestamp":1783099243000},"score":1,"resource":{"primary":{"URL":"https:\/\/injuryprevention.bmj.com\/lookup\/doi\/10.1136\/ip-2025-045910"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,3]]},"references-count":27,"alternative-id":["10.1136\/ip-2025-045910"],"URL":"https:\/\/doi.org\/10.1136\/ip-2025-045910","relation":{},"ISSN":["1353-8047","1475-5785"],"issn-type":[{"value":"1353-8047","type":"print"},{"value":"1475-5785","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,3]]}}}