Shane Kuhn, 14, rides his ATV at the Gresham Badlands ATV Run in Wisconsin in 2009. (Cory Dellenbach/Shawano Leader/Associated Press)

Children who ride all-terrain vehicles are suffering amputations, spinal injuries and deaths, according to U.S. research, prompting calls for mandatory training.

In 2008, nearly 28 per cent of all ATV-related injuries involved children younger than 16, according to a study presented Wednesday at the American Academy of Orthopaedic Surgeons' annual meeting in New Orleans.

The study on ATV-related spine injuries in the U.S. from 1997 to 2006 looked at 4,483 children in the U.S. who were injured in ATV-related accidents.

The increase in ATV-related injuries places a greater demand on the health-care system such as time in hospital, said Dr. Kevin Shea, an orthopedic surgeon specializing in pediatrics who moderated a media briefing on ATV and motorcross sports injuries at the meeting.

"The current steps taken by the ATV and motorcycle vehicle industry are not enough," Shea said in a release.

"Developing and enforcing a mandatory safety training session before these vehicles can be operated may be an important first step."

Shea also called for riders, parents and the public to be better educated about the potential for serious injury.

Fractures, amputations treated

Among the children studied, 332 or 7.4 per cent had a spine injury. Of those injuries, 70 per cent occurred in children under age 16, said Dr. Jeffrey Sawyer, chief of pediatric orthopaedic trauma at Campbell Clinic-LeBonheur Medical Center in Memphis.

A second study looked at "rhinos" or multi-rider ATVs. Of 110 patients evaluated over two years, 29 injuries were multi-rider related, compared with 71 for single-rider ATVs, said Dr. Gregg Wendell Schellack, an orthopedic resident at at Loma Linda University in California.

Among multi-rider drivers, 44 per cent had severe, limb-threatening open factures while there were none among single-rider ATVS. Of the multi-rider injuries, 15 per cent resulted in limb amputations, compared with one per cent in single riders.

Quebec and the Maritime provinces mandate safety training courses for children to operate ATVs, but regulations vary from province to province:

• In Atlantic Canada, children must be at least 14 to operate ATVs, and close adult supervision is required until the driver is 16.
• In Quebec, the minimum age to operate a full-size ATV is 16, and children under 16 are permitted to operate only "youth-sized" ATVs approved by government legislation. Similar vehicle-size restrictions are in place in Newfoundland and Labrador.
• In Ontario, children under 12 are not supposed to operate ATVs on public property unless they are supervised by an adult, but there are no rules regarding use on private property, according to a 2009 report by the Ontario Medical Association. The report's authors called for children under 14 to be banned from driving all-terrain vehicles.

• In Manitoba, children can operate an ATV if they are supervised by a parent or other adult who is in clear view of the vehicle.

• Saskatchewan permits children aged 12 to 15 to operate an ATV on public or private property if they have passed an approved ATV training course and are supervised by an adult with a current permit and safety training.

• Last year, Alberta delayed passing a law that would make helmets mandatory for all-terrain vehicles on public land. The province's health-care agency says children under 16 shouldn't operate ATVs, and helmets should be worn at all times when riding.

• British Columbia has no provincial legislation for recreational use of ATVs.

The U.S. All-Terrain Vehicle Safety Institute, along with the major manufacturers and distributors of ATVs in the United States, have urged all riders to follow the warning labels on the vehicle and for parents to supervise riders under the age of 16.