Is legislation effective in reducing risks of all-terrain vehicle-related injuries? A systematic review.

Background: Over decades, governments have enacted policies and legislation mandating strategies to reduce the incidence and severity of all-terrain vehicle (ATV)-related injuries. We performed a systematic review to determine the efficacy of laws and policies in reducing these injuries.

Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 20 articles from the peer-reviewed literature were systematically selected. Associations between legislation/policy and changes or differences in injury numbers, rates or severity were queried.

Results: Data were available to examine age restrictions or child/youth-directed safety measures, use of helmets and vehicle-specific/engineering policies. Legislating age restrictions was associated with limited paediatric injury reduction in five of nine studies; sustained efficacy may require concurrent socialisation through media or regulated riding environments. Mandated helmet use was associated with reduced ATV-related mortality in five of six studies. However, the concurrent presence of other safety legislation precludes concluding the efficacy of helmet laws, alone. Legislation targeting vehicle design/engineering is limited, as are studies of their efficacy. A US federal decree for large-scale vehicle-related and industry-related changes was associated with a brief but dramatic decrease in ATV-related deaths; this reversed once the decree was lifted.

Conclusions: With the possible exception of helmet legislation, many laws aimed at reducing ATV-related injuries demonstrate little association with actual injury reduction. Most target changing individual behaviours and may be unsuccessful due to personal perceptions of low risk of injury. Enacting policies directed to industry, to address design and engineering interventions that can reduce risk during operation of these products, is more likely to result in substantive and sustained change.