In just under a decade, hospitalizations related to all-terrain vehicles (ATVs) in Canada increased by 25%, rising from 3,296 in 1996–1997 to 4,104 in 2004–2005, according to new analysis from the Canadian Institute for Health Information (CIHI). ATVs include both snowmobiles and off-road vehicles.
Snowmobile-related hospitalizations decreased by almost 20% over nine years, while hospitalizations for injuries related to off-road vehicles increased by two-thirds (66%), rising from nearly 1,700 admissions in 1996–1997 to more than 2,800 in 2004–2005.
“In many rural and remote communities across the country, snowmobiles and other off-road vehicles are used not only for recreation, but also as an essential mode of transportation,” says Margaret Keresteci, Manager of Clinical Registries at CIHI. “On average, 11 Canadians were hospitalized per day in 2004–2005 because of ATV-related injuries. These machines can reach high speeds and often travel on rough terrain, so the impact of a fall or a collision can be quite dramatic.”
In 2004–2005, the majority of those admitted to hospital for an injury related to an ATV had multiple injuries, and more than half had fractures of the upper or lower limbs. The proportion of head injuries was considerably higher for those whose injury involved an off-road vehicle (19%) compared to a snowmobile (12%), with those admitted for a snowmobile-related injury more likely to suffer from a fractured vertebra, rib or sternum (26% compared to 20% for off-road vehicle admissions).
Teenagers and young adults at highest risk of injury
A person hospitalized for ATV-related injuries in 2004–2005 was, on average, 32 years old. This is considerably younger than the average age for all trauma admissions to hospital in Canada for the same year (53 years). In each age group, males accounted for the majority of injury admissions, with the largest proportion of injuries seen among 15- to 19-year-olds, followed by 20- to 24-year-olds. These two age groups accounted for more than one-fourth (29%) of all ATV-related injury admissions.
When examining trends over time, the largest change is seen in the 20-to-24-year age group, which experienced a 41% increase in the number of ATV-related injury admissions over the nine years of the study. Those aged 15 to 19 years experienced an 18% increase.
ATVs among leading recreation-related causes of severe trauma requiring specialized care
Overall, between 3% and 5% of all injuries requiring hospitalization are classified as severe trauma and require treatment in a specialized facility. Among ATV injuries, 10% were classified as severe in 2004–2005.
Snowmobile-related injuries accounted for 40% of winter sports and recreation–related injuries in a specialized trauma unit in 2004–2005, compared to snowboarding (24%), skiing (19%), hockey (11%), tobogganing (7%) and ice-skating (3%). Off-road vehicles accounted for 25% of admissions for summer sports and recreation–related severe injuries in 2004–2005, second only to cycling (43%).
More than half of those admitted to a specialized trauma facility with severe ATV-related injuries had sustained a head injury requiring treatment. Many were also treated for fractures to the vertebrae, ribs or sternum (46%) and internal injuries (45%). In those cases where blood-alcohol concentration was recorded, 27% of these severe injury ATV incidents involved alcohol levels above the legal limit of .08%. Alcohol use above the legal limit was a factor in 23% of specialized trauma unit admissions for snowmobiling incidents and 28% of incidents involving off-road vehicles. Of those injured with alcohol levels above the legal limit, 94% were the drivers.
ATV injury rate lowest in Ontario and British Columbia
In 2004–2005, ATV-related injury hospitalizations varied considerably across Canada. The territories had the highest rate (per 100,000 population) of both snowmobile and off-road vehicle–related hospitalizations, at 28.0 and 26.6, followed by Newfoundland and Labrador, with 13.7 and 15.6. The lowest rate of snowmobile-related hospitalizations was seen in Nova Scotia (1.7), and Ontario had the lowest rate of off-road vehicle hospitalizations (4.9).
“Snowmobiles and off-road vehicles are used more frequently in some parts of the country than others, and for different reasons”, says Keresteci. “The variations we see in injury rates may be, in part, a reflection of these differences.”
CIHI’s analysis also examined legislation across provinces and territories surrounding the use of ATVs, and found differences in age restrictions and protective equipment requirements between jurisdictions.
ATV-related emergency department visits in Ontario
In addition to the injuries that resulted in an overnight stay in hospital, in 2004–2005, there were 7,109 emergency department (ED) visits in Ontario for injuries related to ATVs, translating to more than 19 visits to the ED by Ontarians a day. Of these, 4,843 (68%) were due to injury resulting from off-road vehicles. The vast majority of all ED visits were by males (80%) and occurred during the months of January to March for snowmobiles and July to September for off-road vehicles.