A recent study in Journal Emergency Medical Trauma Acute Care (JEMTAC), the latest open access, peer reviewed journal available on QScience.com, shows that all terrain vehicle (ATV) use is increasing at a rapid pace in Qatar, and finds that without proper safety regulations it is causing mortality and serious disability. Headed by Dr Mushrek Alani from the Section of Trauma Surgery at Hamad Medical Corporation (HMC) and a team of doctors including Dr Ahmad Zarour, Dr Ammar Almadani, Dr Abubaker Al-aieb, Dr Hazim Hamzawi and Dr Kimball I. Maull, a review was conducted of patients injured in ATV crashes in Qatar. The findings include recommendations  that can be implemented to reduce injuries. 

All terrain vehicles are four-wheeled motorized means of transport also known as quad bikes, the riding of which has become a popular form of recreational sports in Qatar. The interest in quad bikes has increased enormously over recent years, and trailers carrying one or more quad bikes are a common sight on the roads of Qatar, especially on the weekends.

The study shows that during a recent 10 month period, 56 patients were reported as injured seriously enough in quad bike crashes to require admission to a medical facility and were prospectively entered into a study-specific database. The lack of awareness of the injury potential for this popular recreational activity has escalated the risk of injury, and the absence of safety programs and regulations has further aggravated the problem. During this period three patients died and 19 patients were significantly disabled, head, face and musculoskeletal were the most common injuries. No protective equipment was used in 88% of crashes, and most injuries occurred at recreational sites.

The study identified the main sources of injury as collisions and rollovers. Collisions may be with fixed objects, with another quad bike or with other vehicles. Rollovers may occur side-to-side or backward, a common occurrence when ascending hills or dunes or doing “wheelies”.  Brandenburg et al identified distinct injury causes based on age, demonstrating that children were more likely to be injured in collisions or in lateral rollovers while adults were most commonly injured in backward rollovers. Additionally, the increase in size, speed, and power of ATVs in recent years has raised the risks for all.

The study found that labeling of ATVs as unsuitable for young drivers if over 90cc, is often in place, but is not universally applied. There are no required quad bike safety measures in Qatar. By contrast, in the United States, safety laws regarding ATV use have been enacted in 44 states.

While the increase in accidents is rising rapidly in Qatar the study offers recommendations to prevent accidents.  Their recommendations emphasized safety initiatives which consist of proper safety equipment, including helmets designed and approved for off-road vehicles, and limiting access to off-road environments. Driving quad bikes on roads or highways is dangerous. Most quad bikes have fixed rear axles which do not allow the inner rear wheel to rotate freely when turning, causing sudden release of torque which, on firm surfaces, promotes lurching and loss of control.

In Qatar, the failure to address this emerging menace to safety continues to lead to serious injuries among our youth and young adult population. The observation that most of these injuries occur at specified recreational sites, where safety measures could be monitored and enforced, suggests that a well designed safety oriented injury prevention program could be successful. This initiative is long overdue. According to the study accidents can be prevented by requiring helmet use specifically by children (protective equipment by regulation), plus certain restrictions on registration, age of operator, and carrying passengers. 

Children should not ride ATVs designed for adults. Most childhood deaths and serious impairments come from children riding ATVs designed for adults. Other educational messages relate to eliminating alcohol and other drug use which impair reaction time and judgment, two essential skills for safe ATV operation.

JEMTAC, operated by Hamad Medical Corporation, moved its publishing operations to QScience.com earlier this month. Arend Küster, Managing Director of QScience.com said “It is a wonderful honor for us to be able to host this journal. We are happy to be working with Hamad Medical Corporation on this, and other journals, and we hope bring this important work in emergency medicine to the attention of the international medical community through QScience.com.”

For free access to full text, visit: https://www.qscience.com/content/journals/10.5339/jemtac.2012.1