Legislation may be needed to protect children from dying or being injured on quad bikes, a new study says.
The study, published in the New Zealand Medical journal today, looked at 218 cases where children younger than 16 had been hospitalised after suffering an injury caused by an ATV (all terrain vehicle) accident between 2000 and 2006.
Sixteen of those children died and six were left with a permanent disability.
Current New Zealand guidelines recommend children under the age of 12 never ride an adult sized ATV and that ATVs should not carry passengers.
Children aged 12-15 may operate an adult sized ATV if they have the size and strength to ride it safely and follow other restrictions.
More than half the children injured, 133, were aged under 12 and 32 were five years and younger.
Children were driving in 116 cases and were the passenger in 61.
It was clear guidelines about children riding on adult sized ATVs were widely ignored, the study's authors Kate Anson, Elizabeth Segedin and Peter Jones said.
If current guidelines had been followed two thirds of the injuries may not have happened.
"It is possible many parents are unaware of the dangers and at the very least guidelines should be made available at the point of purchase."
The vehicle rolled in 31 cases, the child fell in 105 cases and was injured because of a collision in 59 cases.
The majority of injuries suffered were head, soft tissue and orthopaedic injuries.
A helmet was worn by in just 30 cases.
The study showed a link between reduced risk of head injury and use of a helmet and recommended all children riding ATVs wear full face motorcycle style helmets.
"ATVs are potentially lethal and have the capacity to inflict significant harm. It is clear that it is not appropriate for a young child to ride an adult sized ATV due to the risk of serious injury or death.
"Public debate is needed as to whether education or legislation is the answer."
The authors said although enforcement of legislation in a rural setting might be a challenge, it would "at least inform and set a standard both to the point of sale and to parents and may be required to protect children from life threatening injuries".
The study also asked healthcare workers to advocate for children's safety by improving detail on clinical notes, particularly whether a helmet was worn or not as this was not stated in 62 percent of cases.
Few children were confirmed to be riding child-sized ATVs and there was no evidence to suggest children riding smaller ATVs had fewer accidents or less severe injuries, the study said.
Legislation dictates children aged six-11 may ride a vehicle under 70cc and children aged 12-15, 70-90cc. There were no vehicles considered suitable for children under six.
Michael Shepherd said in the journal's editorial it seemed likely legislation would be required to restrict the use of adult-sized ATVs to adults and to prohibit carrying passengers.
"While legislation may initially be regarded as a restriction on essential rural activities, it should be viewed in the context of other legislation that guide's children's activities."
Children younger than 14 cannot be left alone and children younger than 16 cannot get a gun licence.
While there were some children who were capable of doing these things at a younger age the legislation was aimed at the safety of all children, Mr Shepherd said.
ATVs demand an active riding technique where strength, movement and weight shifting are required to ensure stability and control.
Many children lack the strength or weight as well as the skills and judgement to safely operate one.
Most ATVs were not designed for passengers, who restrict the driver's mobility and added weight, which made the ATV harder to control and more prone to tipping over.
