In Massachusetts, ER visits down as much as 50 percent, study found
MONDAY, Sept. 11, 2017 (HealthDay News) -- A strict new law on the use of off-road vehicles by children in Massachusetts is likely behind a drop in related ER visits by kids, a new study says.
One type of off-road vehicle, the all-terrain vehicle (ATV), has been involved in more than 3,000 child deaths in the United States over the past three decades, with 12- to 15-year-olds accounting for more than half of those deaths, researchers noted.
ATVs "have a high center of gravity and they are not meant for small children to maneuver them," explained Dr. Michael Flaherty, one of the study's authors.
"Children have a tendency to lose control when they are driving them, and they can also tip over, causing crush injuries and death in children," he said. Flaherty is a pediatric critical care physician at Massachusetts General Hospital in Boston.
In 2010, Massachusetts enacted "Sean's Law" to honor the death of 8-year-old Sean Kearney killed on such a vehicle four years earlier.
The law banned children ages 13 and younger from riding on an off-road vehicle on public or private property, except in rare cases with direct supervision by an adult.
Older children, ages 14 to 17 years old, were also required to take education and training classes and be supervised by an adult when riding an off-road vehicle.
For all children, the law required helmets, limited the vehicle's engine size, banned driving while under the influence of alcohol, and required all vehicles to be registered with the state.
The study looked at nine years before the law was passed, as well as three years after. Flaherty and his team compared emergency department visits and hospitalizations for those 17 and under to adults between the ages of 25 and 34 to get a better idea of what effect the law was having on young people.
The team found that ER visits dropped by a third for children under 9 years old, and visits for 10- to 13-year-olds dropped by half. There was also an almost 40 percent decline in ER visits for 14- to 17-year-olds after the law was enacted, the study found.
In comparison, during the study period, there was no significant drop in emergency room visits for young adults using off-road vehicles.
The study also found that hospitalizations related to off-road vehicle use dropped by 41 percent for kids 17 and under after the law began. For young adults, hospitalizations related to the vehicles dropped by 26 percent, the study showed.
"In general, there is a science to injury prevention that we've known for years, and it's actually true for all public health issues: It is that policy works," said Dr. Gary Smith, president of the Child Injury Prevention Alliance.
"Redesign of products and environments also work. They work much better than just education alone," he said.
Both Flaherty and Smith said this problem with ATVs dates back to the 1980s when the vehicles began to rise in popularity.
"We've really been struggling to find the best way to reduce injuries and death with these vehicles," Flaherty said.
"There wasn't a lot known about how dangerous these vehicles could be to children until we began to see the surge in emergency room visits that disproportionally affected younger kids," Flaherty said.
According to Smith, it's more difficult to pass legislation and regulations to prevent injury than it is for other health problems.
"We've seen this for years," said Smith, who is also director of the Center for Injury Research and Policy at Nationwide Children's Hospital in Columbus, Ohio.
"We have fundamentally thought of injuries differently than other public health problems. Some people don't even recognize it as a true public health problem, and it is," Smith said.
"What we often hear in injury is that parents should watch their kids more closely or people should be more careful, making it all about personal choice. There's guilt, blame and fault when we hear discussions about injury, but we learned years ago that that's a dead-end street; it doesn't work," he explained.
"We need to take a public health approach to injury because we know that it works," Smith said.
Smith hopes that the findings of this study will encourage other states to pass similar laws to protect children.
The study was published online Sept. 11 in the journal Pediatrics.
There's more on ATV safety at the U.S. Consumer Products Safety Commission (https://www.cpsc.gov/Safety-Education/Safety-Education-Centers/ATV-Safety-Information-Center/Quick-Facts-for-a-Safer-Ride/ ).
SOURCES: Michael Flaherty, D.O., pediatric critical care physician, Massachusetts General Hospital, Boston; Gary Smith, M.D., president, Child Injury Prevention Alliance, and director, Center for Injury Research and Policy, Nationwide Children's Hospital, Columbus, Ohio; Sept. 11, 2017, Pediatrics, online