Table 5 Extrinsic risk factors related to quadbike riding

EXTRINSIC RISK FACTORS For Crash, Injury or Death due to Quadbike use

Vehicle design

Vehicle design—low ground clearance [utility vehicle Honda vs sport vehicle Polaris]

Rollover

Sports vehicle Polaris has a greater distance from its foot-peg to the seat, keeping the rider's legs more extended during sitting position. This gives less space to bounce or vertical buffering during a bump, increasing the risk of injury

Mattei et al., 2011, USA

Vehicle track—width

Static tilt angle for lateral rollover

An increase in track width by 20 mm resulted in a stability of more than 32°

Edlund et al., 2020, Sweden

Seat design accommodating for passenger

Forward flip, lateral rollover

QB with two riders is more unstable and more likely to roll in both flip forward and lateral rollover accidents

Thorbole et al., 2012, USA

Rollover protection system

Crush protection zone during three types of rollover

Installation of Quadbar, Lifeguard, and Air-Quad systems increases the crush protection zone in case of a rollover, thus reducing the risk of injury to the trapped rider

Khorsandi et al., 2019, USA

Rollover protection system—Quadbar use

Simulated injury, asphyxiation

Risk/benefit percentage for injury in unhelmeted rider = 492%[95% CI 255%, 788%]; p < 0.001

Zellner et al., 2014, USA

Engine size >  = 350 cc, when compared to < 350 cc

Outcome injury severity score

Injury outcome score among those riding with engine size >  = 350 cc was 6.4 (p < 0.05) higher than those riding with engine size < 350 cc

Butts et al., 2015, USA

Age, not height used as a determinant for QB size selection

Pediatric rider QB misfit

Older children [12–15 years] fitting adult sized QB better than youth sized QB. Young drivers (12–15 years) not meeting size parameters of youth-sized QB [taller children], 6–11 year old not meeting size parameters of adult QB

Bernard et al., 2010, USA

Pediatric QB with engine size greater than 90 cc

Injury

Pediatric QB users were more likely to have experienced a crash when engine displacement is more than 90 cc (p < 0.01)

Campbell et al., 2010, USA

Oversteer speed > 40kmph

Rider displacement and rollover

A 100-mm hump on paved roads can displace the rider from seated position when turning at a high speed

Hicks et al., 2017, Australia

Legislation and implementation

Minimum age limit 16 years for driving QB—Canada

Hospitalization

Decreased hospitalization rate after introduction of legislation, but not supported statistically

McLean et al., 2014, Canada

Non-enforcement, violating state laws (Florida, USA)

Mortality rate

Significant difference in mortality rate (p = 0.045) between violators and non-violators of state laws of minimum age of 16 years, use of helmet and not driving on public roads

Winfield et al., 2010, USA

States with QB safety certification and licensing laws

Pediatric mortality rate

There is no significant difference between high mortality states and other states with regard to safety certification, licensing laws. p < .61 and p < 0.07

Upperman et al., 2003, USA

2010 Massachusetts ORV law for children

Hospitalization

ORV law (banning QB use for those under 10 years, limited use by 10–13 to events under parent supervision and engine size less than 90 cc) saw 41% drop (p < 0.001) in rates of inpatient hospitalization for 0–17 year age-groups after its implementation in 2010

Flaherty et al., 2017, USA

2010 Massachusetts ORV law for children

Emergency department visit

33%, 50%, 39% decline in emergency department visits in 0–9 years; 10–13 years; 14–17 years age-group with p < 0.001. There was a net 28.5% drop in emergency department visit after the law implemented in 2010 with p < 0.001

Flaherty et al., 2017, USA

Environment and terrain

Uneven terrain

Rollover

A retrospective analysis showed greater risk of injuries when driving on uneven terrain with odds ratio = 32.9 (6.6–221.5)

Brandenburg et al., 2007, USA

Unfamiliar terrain

Injury

This qualitative study highlights farmer perception of greater risk of injury when they travel on unfamiliar terrain

Clay et al., 2015, New Zealand

Type of crash—rollover

Death

Retrospective analysis of severe trauma due to QB showed greater risk of death due to rollover when compared to collision RR = 2.75 (1.13–6.70)

Krauss et al., 2010, Canada

Type of crash—ejection

Death

Retrospective analysis of severe trauma due to QB showed greater risk of death due to ejection when compared to collision RR = 4.28 (1.7–10.32)

Krauss et al., 2010, Canada

Rural residence

Death

Riders residing in rural areas were at greater risk of death, when compared to urban residents with RR = 1.019 (1.007–1.031)

Rodgers, 2008, USA

Farm vehicle ownership

Injury

A survey showed youth living in a farm had greater risk of injury if they owned a vehicle when compared to those who did not, with OR = 4.04 (2.08–7.86)

Burgus et al., 2009, USA

Vehicle driven in public spaces vs organized riding parks

Crash (pediatric)

Children had lower risk of crash when driving in organized recreational parks than on public spaces (p < 0.01, chi-square test)

Denning et al., 2013, USA

Vehicle driven in public spaces vs organized riding parks

Head injury GCS < 15

Children had greater risk of head injury when riding in public spaces than when compared to organized recreational parks (p < 0.0001, Fisher exact probability)

Denning et al., 2013, USA

QB crash occurring in recreational parks

Death

Records of severe QB trauma showed higher risk of mortality when QB was driven in recreational parks when compared to home or occupational settings with RR = 3.66 [IQR, 2.52–5.32]; p < 0.000

Krauss et al., 2010, Canada

QB crash occurring in state highways and paved surfaces

Death

Records of severe QB trauma showed higher risk of mortality when QB was driven on state highways and paved surfaces when compared to home or occupational settings with RR = 2.56 [IQR, 1.73–3.80]; p < 0.000

Krauss et al., 2010, Canada