"There should be some kind of legislation that restricts the use of these ATVs. Right now basically any child can drive an ATV with no license," Dr. Tae Sung Park of St. Louis Children's Hospital in Missouri told Reuters Health.

There are no federal regulations on ATV use, and only a few states have laws on the books regarding the recreational vehicles, Park and his team note in the July issue of the Journal of Neurosurgery.

To better understand the risks of ATV use for young people, the researchers looked at all pediatric patients admitted to the St. Louis Children's Hospital for ATV-related injuries between 1993 and 2003, a total of 185 patients.

Sixty-two suffered at least one neurological injury, including 37 skull fractures, 39 cases of bleeding in the brain, and 11 spinal fractures. Two-thirds of the patients required in-patient rehabilitation treatment, while two died of their injuries.

Missouri state law states that a person must be at least 16 to drive an ATV, and that drivers younger than 18 must wear a helmet. However, the group of patients Park and his team studied included drivers as young as four years old, and passengers as young as three. The average age for injured drivers was 12, while passengers' average age was nine. Just 22 percent of the injured drivers were wearing helmets.

Park and his team urge that federal laws be passed banning children younger than 16 from riding ATVs, and requiring all ATV drivers to wear helmets. Also, they write, single-rider ATVs should not carry passengers, and people should be required to complete training and certification before operating the vehicles.

"A commitment among government agencies, ATV manufacturers, and parents, with support from the medical community, will undoubtedly decrease the high morbidity and mortality rates associated with ATV-related accidents," they conclude.

SOURCE: Journal of Neurosurgery, July 2006.