Rural-urban differences in ATV-related hospitalisations among children, adolescents and adults in Canada from 2002 to 2019: a population-based descriptive study.

BACKGROUND

The aim of this study was to describe differences and trends in all-terrain vehicle (ATV)-related hospitalisations for urban and rural-dwelling youth in Canada.

METHODS

We conducted a cross-sectional study of patients admitted for an ATV-related injury to hospitals in Canada between 2002 and 2019. The primary exposure was rural residence. Rural-urban comparisons were stratified by age: children (<16 years), adolescents (16-20 years) and adults (≥21 years). The primary outcome was annual prevalence of any hospitalisation; secondary outcomes were head, fracture, crush and spinal cord injuries.

RESULTS

Among 34 390 patients, 83% (n=28 487) were male; 17% (n=5846) were children and 14% (n=4815) were adolescents and 47% lived rurally. The population-adjusted annual hospitalisation rates ranged from 4 to 9/100 000 for children to 8 to 21/100 000 for adolescents and 4 to 8/100 000 for adults. The rate difference for being hospitalised for an ATV-related injury was higher for rural dwelling children (17.29; 95% CI 16.54 to 18.04) and adolescents (38.10; 95% CI 16.18 to 40.02) compared with urban dwelling peers. Rate ratios (RRs) for ATV-related hospitalisations were fivefold higher among rural-dwelling children (RR: 5.62; 95% CI 5.33 to 5.92) and adolescents (RR: 5.22; 95% CI 4.93 to 5.53), compared with urban-dwelling peers. The RRs were highest for ATV-related crush (RR: 10.54; 95% CI 5.80 to 19.15) and spinal cord injuries (RR: 5.24; 95% CI 3.35 to 8.19) for rural-dwelling adolescents.

DISCUSSION AND

CONCLUSIONS

In Canada, ATV-related hospitalisations among rural children and adolescents are fivefold to sixfold higher than among their urban peers. These differences in hospitalisation rates may be related to greater time spent riding ATVs among rural youth.