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     KANSAS JOURNAL of  MEDI CIN E                              dangerous than motocross , dirt bikes, and snowmobiles. 4
                                                                  Use of ATVs has been associated with significant injury, mortality,
                                                                and healthcare cost.  Reported ATV related injuries include: bone
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                                                                fractures at or below the cervical spine, specifically femur and tibia ,
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                                                                upper extremities, thoracic, peripheral nerve, and soft tissue injuries
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      A Survey of Safety Recommendations for                    and traumatic brain injuries.  A recent national review of ATV fatali-
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         All-Terrain Vehicle Dealers and Track                  ties reported a rate of .32 per 100,000 ; while Garay and colleagues
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                      Owners in Kansas                          observed a 1.5% mortality rate among all pediatric ATV injuries in
           Morgan J. Martin, PA-C , Rychael Morton, PA-C ,      Pennsylvania. Hospital costs associated with ATV related injuries
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             Shawn Rau, PA-C , Sue Nyberg, MHS, PA-C ,          were reported upwards of $300,000, with a mean cost of approxi-
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                     Gina M. Berg, Ph.D., MBA 2,3               mately $33,000. 5
                      1 Wichita State University,                 Many of these injuries could be prevented by using safety equip-
            Department of Physician Assistant, Wichita, KS      ment such as helmets, gloves, boots, goggles, chest protectors, knee
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          2 University of Kansas School of Medicine-Wichita,    pads, and elbow pads.  Fatalities, injury severity scores and incidence
     Department of Family and Community Medicine, Wichita, KS   of traumatic brain injury decreased when riders wore helmets. 7,10-
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                 3 Wesley Medical Center, Wichita, KS           12  Keenan and Bratton  compared injuries between Pennsylvania
                                                                (helmet law and road restrictions) to North Carolina (no restrictions)
     ABSTRACT                                                   and observed that restrictions were associated with decreased ATV
     Introduction. All-terrain vehicles (ATVs) are associated with injury,   related injuries. As of 2014, the National Conference of State Leg-
     mortality, and healthcare costs. ATV related injuries are less severe   islatures  reported the following state laws regarding ATV use: 34
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     when consistent safety practices are followed, however, ATV safety   states required helmet and/or eye protection, 34 states mandated
     regulations are varied among states. This study sought to survey   a minimum age ranging from 6 - 18 years old, 23 states required an
     Kansas ATV dealers and track owners to determine safety promotion   education course. Kansas, however, had none of these laws in place
     practices.                                                 regarding ATV use. The three Kansas state laws regarding ATV use
     Methods. A cross-sectional telephone survey was conducted of   include: ATVs must be titled, ATVs may not be operated on an inter-
     Kansas ATV dealers and tracks. Survey questions included promotion   state, federal, or state highway, and ATVs must be equipped with
     and sale of safety equipment, provision of ATV safety information,   headlights and taillights.  Helmet use for three-wheel ATVs is in
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     and respondent characteristics.                            accordance with Kansas motorcycle laws:  riders under 18 must wear
     Results.  Of those contacted, 32% of  dealers  and 31% of tracks  a helmet.
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     responded to the survey. Most ATV dealers sell safety gear (70% -     ATV safety may be dependent on the safety campaigns and promo-
     100%) and all recommend safety gear to buyers and riders. All ATV   tion of public awareness through influential change agents associated
     tracks reported requiring helmets (100%) but were varied regarding   with ATV use. Jennissen and colleagues  evaluated a safety aware-
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     other forms of safety gear. The majority of ATV dealers (77%) rec-  ness initiative targeting agribusinesses and found that most did or
     ommended safety courses, but only 31% of dealers and 40% of tracks   would have posted the safety material (if received). Another target for
     offered courses. Eighty percent of ATV tracks and 52% of dealers felt   safety awareness could be where ATVs are sold (dealers) and recre-
     they had a professional responsibility to educate riders/owners on   ationally used (tracks). Thus, this study was an exploratory study on
     safety.                                                    the safety promotion and recommendations by ATV dealers and track
     Conclusions. Safety promotion by ATV dealers in Kansas consis-  owners in Kansas.
     tently was recommended, but often limited to the sales of safety gear   METHODS
     (helmets and gloves) or the provision of manufacturer provided safety     Study Design and Study Population. This was a cross-sectional
     materials. Further, ATV dealers reported rarely offering skills tests or   telephone survey of ATV dealers and track owners in the state of
     safety courses to buyers. In Kansas, safety promotion at the point of   Kansas. A list of ATV dealers and track owners was compiled from
     sale or track level could be improved to increase public awareness of   a Google™ search of ATV dealers and tracks in Kansas. The survey
     ATV safety practices. KS J Med 2017;10(4):76-78.           consisted of predominantly yes or no questions regarding the respon-
     INTRODUCTION                                               dents’ safety promotion practices and included promotion and sale of
        All-terrain vehicles (ATVs) are defined as any motorized vehicle   various safety equipment (questions were specific to safety item, such
     with three or four low-pressure tires, a straddle seat, and a handle bar.   1  as Department of Transportation (DOT) or Snell certified helmet)
     Models can vary in size and power with engine capabilities upwards   and provision of ATV safety information.  Respondent characteristics
     of 400 cubic centimeters (cc), which may achieve speeds up to 70   such as ATV use and experience were included.  Dealer respondents
     miles per hour (mph). ATVs are used both commercially (farming   were queried regarding their experience with ATV accidents. The
     and ranching) and recreationally.  Commercially, ATVs are used more   identified survey participants were contacted once and the dealer or
     often by youths (younger than 16) than tractors.  However, recre-  track owner, or someone who was knowledgeable about the opera-
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     ational use has been related to more injury  and noted to be more   tion was requested to respond to the survey. The informed consent
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