Jim Helmkamp, Senior Epidemiologist for the National Institute for Occupational Safety and Health Western States Office, presented this at CPSC's ATV Safety Summit Oct. 12, 2012. State-specific ATV fatality rates were compared between 1990-1999 and 2000-2007 grouping states according to helmet, and training and licensure requirements (per SVIA state ATV requirement charts). 2,226 deaths occurred from 1990-1999 at a rate of 0.09 deaths per 100,000 population and 7,231 deaths from 2000-2007 at a rate of 0.32. Male rates were at least six times higher than female rates. Males accounted for about 86% of the deaths overall. Children under 17 years accounted for over one-third of the deaths in the earlier period decreasing to about 17% in the latter. The number of deaths increased 225% from the earlier period to the latter with a three-fold increase in the death rate. There was little collective difference between rates for states with or without helmet requirements and between states with or without training and licensure requirements. Policy-oriented prevention strategies over the past decade seem to have largely failed. This failure may be due to lack of enforcement and the casual attitude of many ATV riders to not wear a helmet or take training.
ATV Safety Summit: State Legislation (Enforcement) - Policy-Oriented Prevention Strategies
1. ATV Safety Summit - ‘Keeping Families Safe on ATVs’
U.S. Consumer Product Safety Commission
Bethesda, MD
October 11-12, 2012
State Legislation: Enforcement’s Role in Regulation
Jim Helmkamp, PhD, MS
Baby seat!!
2. What the data tells us
-- numbers and rates: gender differences
Helmet use requirements
-- gender
-- age
-- rate differences
Training and licensure requirements
-- gender
-- age
-- rate differences
Conclusions
3. Group 1990-1999* 2000-2007** Change
N (rate/100,000) N (rate/100,000)
Male 1,935 (0.16) 6,215 (0.55) 221% (344%)
Female 291 (0.02) 1,016 (0.09) 249% (450%)
Totals 2,226 (0.09) 7,231 (0.32) 225% (356%)
* Helmkamp, Am J Pub Health, 2001
** Helmkamp et al, Pub Health Reports, 2012
4. Table 1. ATV-related Death Rates by Helmet Use Requirement, U.S. 2000-2007
− 38%
Gender
5. Table 1. ATV-related Death Rates by Helmet Use Requirement, U.S. 2000-2007
− 38% − 23%
Gender
Gender ∆ (female-to-male):
Helmet +650% (0.08 --- 0.52)
No Helmet +582% (0.11 --- 0.64)
6. Table 1. ATV-related Death Rates by Helmet Use Requirement, U.S. 2000-2007
− 100%
7. Table 1. ATV-related Death Rates by Helmet Use Requirement, U.S. 2000-2007
− 100% − 42%
Age (1-14) ∆ (female-to-male):
Helmet +282% (0.11 --- 0.31)
No Helmet +200% (0.22 --- 0.44)
9. Table 2. ATV-related Death Rates by Training and Licensure Requirements, U.S. 2000-2007
− 25%
10. Table 2. ATV-related Death Rates by Training and Licensure Requirements, U.S. 2000-2007
− 25% − 13%
Gender ∆ (female-to-male):
Training +663% (0.08 --- 0.53)
No Training +600% (0.10 --- 0.60)
11. Table 2. ATV-related Death Rates by Training and Licensure Requirements, U.S. 2000-2007
− 58%
12. Table 2. ATV-related Death Rates by Training and Licensure Requirements, U.S. 2000-2007
− 58% − 35%
Age (1-14) ∆ (female-to-male):
Training +258% (0.12 --- 0.31)
No Training +221% (0.19 --- 0.42)
13. Table 2. ATV-related Death Rates by Training and Licensure Requirements, U.S. 2000-2007
− 24%
14. Number and rate of death has increased significantly in both genders over the past 20 years
Males account for nearly 90% of deaths and have rates significantly higher than females
Some age groups are at higher risk; 1-14 and ≥65
Helmet and training requirements have slightly mitigated rates in states that have them, but
legislative policies have not impacted the growing number of deaths
Do enforcement of regulations and requirements play a role?
Could a ‘graduated driver license’ approach be feasible in developing safety skills for young
operators?
15. Contact information
Jim Helmkamp
NIOSH – Western States Office
Denver Federal Center
PO Box 25226
Denver, Colorado 80225
E-mail: jhelmkamp@cdc.gov
Phone: 303-236-5943
Notes de l'éditeur
Thanks again for the opportunity to share ideas and strategies with the Commission and the many stakeholders who have gathered here yesterday and today.As these pictures show, ATV riding is very often a family activity -- intended to be fun and safe – but sometimes it is neither!While millions of men, women, and children ride ATVs in a very safe and responsible manner, hundreds are killed and tens of thousands are injured annually – through bad luck, unfortunate circumstances, unsafe behavior, lack of appropriate skills and training, faulty equipment, and a variety of other reasons – ATVs can be fun and safe if we identify, understand, and address their inherent dangers.
During my brief presentation, I will share some data on numbers and rates and highlight some broad gender differences.I will also present some results from a recent paper in the July/August issue of Public Health Reports where I compared ATV fatality rates by states with and without helmet use and training and licensure requirements; I will examine gender and age-specific rate differences. Please keep in mind that the population-based rates you will see are fairly small – say compared to rates for motor vehicle deaths, cancer, and heart disease. What is important is the rate differentials or the magnitude of difference between genders and age groups. We typically use population based rates, because there is a genuine lack of good exposure data on how many ATVs there are, where they are used, and by whom.
First, let’s set the stage of how numbers and rates have changed from the 1990s to the 2000s. Overall, the number of ATV deaths increased 225% from 2,226 during the earlier period to 7,231 in the 8 years from 2000-2007;The number of female deaths increased at a slightly greater proportion than males. Males accounted for about 86-87% in both periods.Male rates increased 3.4 fold and female rates 4.5 fold.
The next series of slides on rate differences by Helmet Use Requirements are somewhat busy, but I will highlight the important points. Note that information from the District of Columbia is incorporated into this collective data, so the total number of states shown is 51.Here, rates among females were collectively 38% lower in the 32 states with helmet use requirements compared to the 19 states without requirements.
The rate among males was collectively 23% lower in the states with helmet legislation. Looking at the lower highlighted box, we see that the rate among males was 6.5 X higher than for females in helmet states and 5.8 X higher in no helmet states.
Looking at the youngest females, the collective rate is 100% less in 32 states requiring helmets compared to the 19 states with no helmet laws.
And 42% less for the youngest male victims in the helmet states.There are also gender rate differentials in the youngest victims as shown in the box at the bottom of the slide – but less so than we observed overall for all males and females.
The oldest male victims in the 32 states requiring helmets died at a rate 50% lower than their counterparts in the other 19 states not requiring helmets.
Shifting to a comparison of rates in states with and without training and licensure requirements, females in the 33 states that did have requirements had a collective rate 25% lower than females in the other 18 states.
And rates among males was collectively 13% lower in the 33 states requiring some level of training and licensure compared to the 18states with no such requirements.Again, rates were some 6.5 X higher among males in both categories of states, as shown in the box at the bottom of the slide.
Among the youngest females, those in the states with training requirements had a collective rate 58% lower than the youngest females in the states without such requirements.
Among the youngest male victims, the rate difference was 35% between the two categories of states.Again, the collective rate among these males was about 2.5 times higher than the rate among their female counterparts in both states that required or did not require some level of training and licensure.
The rate among the oldest male victims was some 24% lower in the 33 states requiring training and licensing.
So what can we conclude from the data we have reviewed…First, the number and rate of ATV-related death has increased dramatically in both genders over the past 20 years. Males account for the overwhelming majority of deaths and at rates significantly higher than females. The youngest and oldest drivers are at highest risk.Finally, while fatality rates are consistently lower in states with Helmet and Training and Licensure requirements, these policies don’t seem to have made any overall impact on the sharply increasing number of deaths. So, one might ask how does the enforcement and variability of regulations and requirements play a role? AND could a ‘graduated driver license” approach be considered?