Pediatric Off-Highway Vehicle Injuries and Fatalities: Exploring Risks, Prevention, and Safety.

Pediatric off-highway vehicle (OHV) injuries-including those from all-terrain vehicles (ATVs), utility terrain vehicles (UTVs), dirt bikes, golf carts, and snowmobiles-are a preventable public health issue. Between 2018 and 2020, children younger than 16 years of age accounted for 27% of the 500 000 OHV-related injuries reported by the US Consumer Product Safety Commission. In this review, ATVs were the most frequently involved, with head and neck injuries (56%) and fractures (21%) being the most cited. UTV crashes resulted in severe fractures (45%) and amputations (4%), whereas snowmobiles carried a high risk of internal organ injuries (33%). Golf carts, often misperceived as low risk, caused head and neck trauma in 79% of reported cases. Clear evidence supports protective measures, such as helmet mandates, age restrictions, and parental supervision, and their impact on reducing injury and mortality rates. Helmet noncompliance remains alarmingly high, ranging up to 96%, further exacerbating the risk of traumatic brain injuries. Addressing this preventable crisis requires urgent action. Strengthening safety legislation, increasing public awareness, and educating health care providers on risk mitigation are critical steps in reducing pediatric OHV-related injuries and fatalities. Regulations must be made consistent and enforced appropriately. Without decisive intervention, preventable injuries will continue to claim young lives at an unacceptable rate.