University of Iowa Hospitals and Clinics works to quell ATV injuries, accidents

Common injuries related to not wearing helmets, multiple passengers

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SOLON — To 49-year-old John Stratton, getting in an off highway vehicle (OHV) accident always has been a matter of when.

In his nearly 35 years of experience using dirt bikes and all-terrain vehicles for recreation, Stratton — who also serves as the president of the Lakeview Off Road Rider's Club in Solon — said he's been in a handful of them.

"It's inevitable and sometimes it's not a matter of if you're going to crash, it's a matter of when you're going to crash," Stratton said. "The majority of accidents I've had, I just got up and walked away, but I attribute that to the proper safety gear."

Stratton said he wears a helmet, special boots, a chest protector, knee braces and elbow guards every time he rides.

But Iowa doesn't require him to by law, and not everyone walks away from an ATV or other OHV accident. In fact, injuries and deaths from ATVs increased so much in recent years that the University of Iowa Hospitals and Clinics runs a whole program focused on safety and injury prevention.

ATV injuries in Iowa

Though ATVs have been a growing cause of death and injury to people of all ages, Pamela Hoogerwerf, community outreach and injury prevention coordinator for patient and family centered services at UIHC, said recent data shows nearly one in three ATV accidents involve riders under 16.

She said the hospital tends to see a spike in injuries in the fall, when people begin using them for occupational reasons on their farms. There are now more ATVs than there are tractors in Iowa, she said.

People working with the Kohl's Keeping Kids safe program — which is a partnership between Kohl's Department stores and UIHC — have spoken to roughly 7,000 Iowa middle school children and have learned that 85 percent of them have been on an ATV, either driving it themselves or riding as a passenger, Hoogerwerf said.

Of those 85 percent, Hoogerwerf said 55 percent indicated they had been in some sort of ATV crash, meaning they hit something, fell off or rolled over.

"What's injuring them most on these things, obviously is the lack of helmets," Hoogerwerf said. "There are a lot of head injuries, and so we certainly hit the helmet-safety message as much as we can."

UIHC also sees a lot of injuries caused by putting more than one person on an ATV, Hoogerwerf said. Though the seats on many ATV models are long and look as if they're meant for more than one person, doing so can throw off the balance of the vehicle and make it more likely to rollover, she said.

Each year, more than 700 deaths and 400,000 injuries are caused by ATVs in the United States. Just over one month ago, the IowaDNR reporteda 19-year-old man died in Cedar County when his ATV rolled on top of him while he was removing tree stands.

Even though there isn't currently a lobbying effort for ATV helmet laws, Hoogerwerf said she believes parents would welcome such regulations.

"When we talk to parents about anything related to regulation, they are usually open for it because it's easier for them to say 'it's the law' versus 'this is my rule,'" Hoogerwerf said. "It's an easier battle for them."

Greg Olson, 36, said he's been riding ATVs for about 30 years, but didn't start wearing a helmet until he was 22.

"I feel like I have a lot to live for, I don't want to crack my noggin," Olson said, as he stood out on the Lakeview OHV course on Sunday with his eight-year-old daughter beside him. "I also feel more secure wearing it."

How accidents happen

Because ATVs are designed to ride on rough terrain, they have a high clearance and high center of gravity. That requires the driver to shift his or her weight when making turns or going up inclines, said Gerene Denning, director of emergency medicine research at UIHC and a member of the ATV Injury Task Force.

Most other four-wheel vehicles have a lower center of gravity and better stability, she said, adding that people who are not using ATVs for recreational purposes tend to use them in a safer manner.

"There are distinct differences when people are using them for agriculture. When someone sees them as more of a work vehicle, they tend to use them more conservatively at lower speeds and those sorts of things," said Denning, "whereas recreationally I think people tend to think of them as toys and maybe don't fully appreciate the dangers of using them."

Denning said the program is studying both recreational and occupational uses of ATVs.

Charles Weinert, 43, said he comes down to the Lakeview OHV Park to ride his three-wheeler every other weekend from the Quad Cities and he always wears his safety gear.

"You don't take them as a joke, you respect it," Weinert said, minutes before heading back out to ride. "It's a lot of weight with a lot of power. When they come over, they come over hard."

Legislation and rules

The Iowa DNR has developed rules and regulations for people who use OHVs and ATVs at DNR-designated parks that include requiring riders to wear helmets, prohibiting them from riding double on vehicles meant for one person and riding recklessly. Stratton said that's helped to greatly reduce the amount of in-park injuries.

The Lakeview OHV park, which Stratton and other members of the club run for the DNR, also has taken some extra precautions — such as installing a helicopter landing area, color coding trees in the park so riders can easily identify where they are, and adding a perimeter trail that's readily accessible by emergency responders — to ensure the park is safe.

Iowa law does not require ATV users to wear a helmet or other safety gear while riding. The law does, however, require ATV riders 12 to 17 who wish to ride on public land and ATV parks to have a valid ATV safety certificate.

ATV users also are prohibited from carrying a passenger on an ATV, or riding double. Anyone over 18 years of age is allowed to drive on designated public land or ATV parks without a valid ATV certificate.

ATVs also are prohibited on roadways or highways unless the use fits the requirements for an agricultural exemption or is on a designated trail approved by the county board of supervisors. Lawmakers are considering expanding ATV use in Iowa that would allow people to operate them on secondary roads across the state.

While supporters of a law change have said it would ensure the rules are uniform to all 99 counties and could bring money to the state through registration fees and increased tourism, those against the law have claimed the use of ATVs on roadways is unsafe and would lead to more injuries and deaths.

"The ATV tires are low pressure, which makes them bouncy and the have kind of a knobby tread, but the problem with that is that when they go on other surfaces and when you get to higher speeds, then what happens is they have very unpredictable interactions with the roadway surface," Denning said. "So maybe one tire will grab which will cause the vehicle to grab the surface, or maybe they'll do the opposite and cause you to slide and lose control."


To stay safe, health care officials with UIHC recommend that ATV riders:

  • Wear a helmet at all times
  • Ride an appropriately sized ATV
  • Ride one person at a time
  • Complete an ATV safety course
  • Tell someone where they are riding
  • Wear protective gear, such as gloves and slip-resistant boots
  • Do not use drugs or alcohol 

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