Published: July 05, 2008 11:23 pm      

Youth injuries down on bikes, up on ATVs

Fewer children are turning up in emergency rooms nowadays after getting hurt in bicycle crashes.

Conversely, the number of walking wounded in need of bodily repair is up among juveniles riding all-terrain vehicles.

What’s the difference?

Safety leaders point to the use of headgear as one reason, a key provision in an extensive bicycle law that appears far more comprehensive than the one governing four-wheelers.

In West Virginia, helmets are only required for riders under 15, but over the years, a cultural change has inspired widespread usage of them by adults as well.

A bareheaded adult on a bicycle is a rare sight.

“Maybe it’s a cultural phenomenon and it’s maybe taking 15 years to get there,” says Dr. James Helmkamp, director of the West Virginia University Injury Control Research Center.

“I would hope the same type of movement would be noted among ATV riders. I hope it doesn’t take that long.”

Placed side by side, the laws on bicycle and ATV riders, without question, are as different in scope as night and day.

For instance, bike riders may venture on any paved road. ATVs are limited to unlined asphalt, the so-called country roads that embrace some 20,000 miles.

Bicycles must be equipped with a bell or similar device that provides a signal audible for at least 100 feet, but this excludes sirens and whistles.

Four-wheelers aren’t recognized as licensed vehicles, so fewer regulations govern them. Basically, an ATV is banned from roads with a centerline stripe, or more than two lanes, and anyone under 18 is required to wear a helmet when on public property. To a large degree, laws are winked at. For instance, Helmkamp found in a survey that just over half of the ATV riders bothered to wear helmets.

“I don’t think bicycles necessarily are held to a higher standard,” says Helmkamp, a leading figure in a years-long crusade to impose more stringent regulations on ATVs.

“But I think there was a more concerted effort to make bicycle riding safer. What I mean by that is, when laws were passed or considered, there was a tremendous amount, I think, of popular appeal and popular backing to ensure that people knew about the laws and they in fact could work.”

In the late 1980s and early 1990s, scientific research pointed to the increased protection provided by helmets and how usage, in fact, saved lives and lowered severe injuries, the WVU official said.

“And I don’t think that has generally been the case for ATV safety, particularly in West Virginia, and I think nationwide as well,” he said.

“While we’ve seen bicycle injuries go down in kids, we’ve seen a commensurate or much sharper rise in deaths and injuries for ATVs in kids.”

Helmkamp conducted a comprehensive, five-year study on bicycles and ATVs for the Washington-based charity Arabella Legacy Fund which revealed four-wheeler hospitalizations cost an estimated $1.25 million while the cost of bike-related injuries ran $1.5 million. The cost per ATV injury was pegged at $21,304, while bicycle injuries averaged $16,478.

Deaths per 100,000 rose 24 percent among youthful ATV riders and 35 percent in adults. Among adult bicyclists, the death rate shot up 23 percent in the five-year period but fell 18 percent among the young.

Helmkamp found the total economic burden involving ATV deaths rose 45 percent among children and 50 percent among adults, but there was a 5 percent falloff in bicycle deaths among children.

In his study period, the researcher learned that 2 1/2 times as many children went to the hospital with a bicycle injury compared to ATV accidents, but overall four-wheeler hospitalizations rose 70 percent while the total number of bicycle-related injuries fell 12 percent.

Among children, the leading injury on an ATV was a lower limb fracture. On bicycles, it was an upper limb break. For both vehicles, skull fractures ranked fifth, but intracranial injury was the second-leading diagnosis in children for both ATV and bike injuries.

Helmkamp discovered that hospital admission rates are consistently higher among bicycle riders than ATV users, although they fell among children. For both types of vehicles, the admission rates are higher in children than adults.

In the five-year research time frame, the rate of death per 100,000 rose 24 percent among young ATV riders and 35 percent among adults, and 23 percent among adults on bicycles. But the number of deaths and the death rate fell 18 percent among young bicycle riders.

In conclusion, Helmkamp said he learned the death rate in ATV and bicycle crashes are “similar and don’t vary remarkably by age group.”

Combined, the ATV and bicycle-related deaths and hospitalizations cost $32.6 million, with ATV crashes accounting for 53 percent of the total, or $17.3 million.

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One estimate holds that roughly one-third of ATVs are registered in West Virginia, where no such requirement exists.

Just how many four-wheelers are owned is difficult to say, but estimates range from 460,000 to 500,000, which averages about two per household.

For almost two decades, West Virginia has suffered the highest population-based death rates for males and females and in all age groups in the nation.

In the five-year period alone, Helmkamp found the economic burden linked to ATV deaths nationally rose 50 percent. In that span, the number of people needing hospital treatment for an ATV crash jumped 90 percent across the country.

West Virginia’s first and only ATV law was enacted in 2004, the last year of Gov. Bob Wise’s administration, and since then, the state has averaged 45 deaths. Eighty-seven percent of the fatalities were male and one-fifth were under 18.

West Virginia’s economic burden based on the 2004 estimates totaled $120 million.

Of the 45 deaths last year, a survey by the state showed 26 occurred on paved roads, streets and highways. Only four had bothered to strap on a helmet, and alcohol was known to be a factor in one-third of the deaths.

About one-third of the victims at the time of the fatal crash had a revoked, suspended on surrendered driver’s license. Fifty-three percent of the fatal accidents occurred in the 16 southernmost counties of West Virginia. When the speed was determined, excessive speed was involved in one half of the deaths.

In 2006, Helmkamp learned, there were 778 patients treated for ATV injuries, as registered by the West Virginia 123 Trauma Registry. The largest number of injured patients was found in the 10-to-19-year-old bracket.

Among the 45 deaths two years ago on ATVs, Kanawha led with 55, while Raleigh had 20, Wyoming, 18, Boone, 14, Fayette, 8, Nicholas and McDowell, 4 apiece, Greenbrier, 2, Monroe, Summers, and Mercer, 1 apiece.

Among the injured, the helmet statistic was as glaring as the deaths — 70 percent were helmetless. And 29 percent of the 681 injured patients 15 and older tested positive for alcohol, and among those 200, 70 percent were legally drunk.

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Without fail, the Legislature wrestles with a fresh ATV bill each year, but doesn’t act.

Gov. Joe Manchin lent his support to one last winter calling for a ban on all paved roads. That measure was detoured to a committee and never got out of the garage.

Citizens complain often about the appearance of four-wheelers on roads where they clearly are forbidden.

“It’s ridiculous,” Helmkamp says. “I live on a fairly busy road in Monongalia County, and on a Saturday or Sunday evening, good Lord, they’re going up and down this road, sometimes double and triple riding, without helmets, on a double-lined road.”

— E-mail: mannix@register-herald.com