ATV accidents cost N.L. health system $1.6M in trauma care over 10 years
Study looked at nearly 300 cases where patients were treated at emergency departments in St. John’s
Research published this year casts a new spotlight on all-terrain vehicle accidents in Newfoundland and Labrador — the financial cost, the human cost, and potential ways to reduce the stream of riders and passengers that end up in the emergency room.
The study found that ATV-related accidents resulted in a bill of at least $1.6 million to the province's health-care system over a decade-long stretch between 2003 and 2013.
And that only includes the nearly 300 cases that ended up in the provincial trauma registry — patients who ended up being sent to emergency departments at hospitals in St. John's.
A lack of information in cases where patients were treated in rural areas likely contributed to those numbers being low-balled.
"I think the key word there is a minimum of $1.6 million," co-author Holly Black told CBC News.
"Unfortunately, we didn't have the information regarding surgeries incurred by patients that suffered ATV injuries, or ICU stays that were incurred, or even rehabilitation stays. So none of that was calculated in that $1.6 million cost."
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Co-author Desmond Whalen said the research began as an assignment for medical school that was only going to be shared with a few classmates at Memorial University.
But it turned into a project that took years to research and prepare for publication.
"We picked up this topic as something that we had to do, and as we started to delve a little more into it, we realized that it was a real problem in Newfoundland, and there were a lot of young people who were ending up with unnecessary injuries and deaths," Whalen told CBC News.
"We quickly realized that this is something we should probably put out there in the medical community for the broader public to have a look at."
The study's authors are calling for change — to legislation, and to education — to reduce the financial and human cost of these accidents.
Black is now working as a resident physician with the University of Manitoba's emergency program in Winnipeg.
Whalen is doing a Memorial University family medicine residency based out of Grand Falls-Windsor.
Their research mentors, Cathy MacLean and Peter Rogers, and another medical student, Sabrina Alani, were also co-authors of the study.
Among their findings:
- Between 1995 and 2013, the provincial health information agency reported a total of 1,286 patients requiring a hospital admission, with a steady increase in the annual incidence of ATV-related hospitalizations.
- Young men aged 16 to 20 years were the primary demographic injured — numbers that are comparable to similar studies.
- Over the 10-year study period, 16 per cent of those injured — roughly one in six patients — were under the provincial legal ATV operator age of 16 years.
- Just over half of the patients with ATV-related accidents in the trauma registry initially sought treatment at a health institution outside St. John's.
- Of the nine deaths in the trauma registry cases, only one person was confirmed to have been wearing a helmet. There were six deaths in which the patient was not wearing a helmet. For the other two, the use of a helmet was unknown. (Deaths that occurred at the scene of the accident were not included in their research data.)
The research found that there was "no significant change" in helmet use among injured riders after tougher legislation was introduced in Newfoundland and Labrador more than a decade ago.
"The legislation that was enacted in 2005 — that made stricter laws regarding helmet use and the age required to drive an ATV — (was) not effective in any way," Black said.
"There was no change in the population or the injury patterns before or after legislation was enacted."
The study found several possible reasons for that. Public knowledge of the laws in place might be lacking. The penalties might not be tough enough. And enforcement might be inadequate.
The legislation that was enacted in 2005 — that made stricter laws regarding helmet use and the age required to drive an ATV — (was) not effective in any way.- Holly Black
"When we look at how the public responds to that legislation, words on a page aren't going to prevent ATV injuries," Whalen said.
"If people don't know about the legislation, or it's not being enforced appropriately, then the legislation is — by our statistics — probably not working as well as it could."
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Last month, the minister in charge of ATV regulations said the province is now reviewing those rules.
"The child death review committee recently recommended a full review of the Motorized Snow Vehicle and All-Terrain Vehicles Act and regulations, and we intend to do just that," Service NL Minister Sherry Gambin-Walsh said in early November.
Call for more education
Black and Whalen have yet to discuss their work with the relevant government officials, but are open to doing so.
The researchers believe more education, done in different ways, could have a positive impact.
They are still working on exactly how that should happen — something complicated by the fact that they are both busy working as medical residents.
When we look at how the public responds to that legislation, words on a page aren't going to prevent ATV injuries.- Desmond Whalen
Whalen says there is an opportunity for family physicians, primary care providers, and emergency doctors to potentially play a role.
"When you've got a patient in front of you that you know is a high-risk person for an ATV injury maybe just take a couple of minutes to do that public health awareness campaign," he said.
Black says the answer may be in showing the real-life impacts of ATV-related accidents.
"I think that goes back to the sort of the emotional cost," she said.
"I think all you really need to do is is show them the one case where you have a really poor outcome. I personally have had acquaintances been involved in ATV injuries and accidents, and they've been very unfortunate, and I think it's changed a lot of behaviours in the people around me as a result."