The Director of The Royal Children's Hospital Melbourne trauma service and paediatric surgeon, Dr Warwick Teague said children and quad bikes are a toxic mix, and legislation should be developed to put an age-based ban on children under the age of 16 from riding any quad bike.
"We see children disturbingly over-represented in both injury and fatality data, both within Victoria and across the nation," he said.
"Almost one in six of the people who have died as a result of quad bike trauma since 2001 have been children.
"More than 700 children under the age of sixteen presented to Victorian hospitals with quad bike trauma between 2006 and 2015, which is an average of one child injured on a quad bike every five days."
Quads not toys
Dr Teague said while manufacturers recommended children did not ride adult-sized quads, he believed children should not use any type of quad.
"In our experience and understanding as health practitioners, youth-sized quad bikes are not the safer or age-appropriate options they are presented to be," he said.
"We have seen children injured or killed while using a quad bike models specifically marketed as being suitable for use by children of their age.
"I would point out the injuries and deaths caused by both youth-sized quad bikes as and quad bikes classified for recreational use, and ask why would we accept these risks on behalf of our children."
When riding a quad bike, the margin between safety and catastrophe is too narrow to chance our children's life and health on it
Dr Teague, who is also an Associate Professor at the University of Melbourne, said there is both direct and adjunct research which supports that children are both physically and cognitively ill-equipped for quad bike use.
"We recognise that the safe use of a quad bike is both a physically and cognitively demanding task, and consider that these requirements are poorly met by children younger than 16 years of age," he said.
"Children are even less able to complete these complex tasks under duress, in which moment the child's ability to respond physically and cognitively may mean the difference between death and injury, severe injury and minor injury."
Zero death goal
Dr Teague said while safety ratings, operator protection devices, helmets and user training were all good steps to protect adult quad users, more needed to be done to save children's lives and protect their health.
"Even when we apply any or all of these good measures to the child age group, less than 16 years, we find it is insufficient to achieve our goal, our goal is 'towards zero'.
"Our goal is that zero children should die and zero children should be injured due to quad bikes."
To limit ourselves to a sticker or user manual to communicate the dangers of quad bikes to children is a grossly inadequate messaging strategy to affect change in a community or individual
Dr Teague said a zero fatality goal while ambitious, was achievable.
"We have seen this in US state of Massachusetts, where they introduced age-based quad bike restriction in 2010. Coined 'Sean's Law', in memory of 8 year old Sean Kearney who died following a quad bike roll-over, this law bans children under 14 years using quad bikes and legislates increased training and supervision for 14 to 17 year olds," he said.
"Between 2010 and 2017, Massachusetts saw only one child killed by a quad bike, that being in 2016, and quad bike injuries in children reduced by up to 50 percent."
"If we keep the children off the quad bikes they will stop being injured by them.
"Consideration of the evidence and the burden of injury and death that quad bikes bring children has bought me to the polarised stance of advocating for an age based ban, alongside the suite of informative and protective changes being considered for older quad bike users."
Warnings not enough
Dr Teague said the current status quo simply warning against children riding quads was insufficient.
"To limit ourselves to a sticker or user manual to communicate the dangers of quad bikes to children is a grossly inadequate messaging strategy to affect change in a community or individual," he said.
"The ongoing and widespread use of adult sized quad bikes by children shows this current strategy has been ineffective."
"It is of utmost importance that the law reflect and communicates the current understanding of best practice and risk mitigation, to reinforce with clarity a message of safety that is presently very confused, and this at the cost of children's health and lives."
Our goal is that zero children should die and zero children should be injured due to quad bikes
Dr Teague reflected that some industry and community messaging erroneously gives the impression quad bikes are stable vehicles, suitable for all terrains, and so a safer option than a than a two-wheeled motorbike.
"The compelling evidence of the Australian performed research on this matter suggests quad bikes are not at all suitable for 'all terrains'. It seems quads are suitable for low velocity travel over an even surface with no slope. However, quads can be over turned by a bump as low as 10 centimetres, and when used on steep or uneven terrain, their propensity to roll is unacceptably high.
"But yet people have the impression that quad bikes are stable and safe."
Dr Teague said it was important for parents to be educated about the risks inherent in childrens' use of quad bikes.
"In general terms, when a parent allows their or another's child to engage in an activity, this expresses their understanding and acceptance the activity is safe," he said.
"As parents, we don't choose dangerous moments to place our children in harm's way, we use car seats while they are small and insist the seat belt is worn once they outgrow the car seat options, we prevent exposure to poisons, and we don't let them play with guns.
"So when we allow our children to do other things, this is itself an expression that we have considered the risks on behalf of our children and say to them 'this is safe'."
Dr Teague said that without increased awareness of the risks posed by quad bikes, parents were at risk of trivialising the dangers."
"I have concerns about the recreational use of quad bikes. These are dangerous activities and deadly vehicles, and so not fit for that purpose," he said.
"Whether it is gamefication of quad bike use, glorification of misuse by videos depicting people doing silly things, or having introducing quads as toys for play, I worry that all these serve undermine the messaging that quad bike these are unsafe and not suitable for children."
Dr Teague encouraged parents to think specifically about the very real risks of death and injury to their children before allowing or encouraging them to use a quad bike.
"As parents, we rightly invest a lot of time helping our children to navigate an at times unsafe world, we teach them road safety, we teach them water safety, we teach them personal safety," he said.
"We correctly prepare our children to navigate this world so they can enjoy childhood in its fullness, and yet avoid unnecessary and unacceptable dangers. To get this balance right we cannot afford for them to receive mixed messaging, and the clarity of messaging must be maintained from the highest levels of government, to the most influential of users, to the conversations we have as families."
Not just farmers
Dr Teague said while often portrayed as such, quad bikes were not only an issue for farmers.
"The experience of The Royal Children's Hospital is that quad bike trauma in children is not an issue unique to one particular community, it is not just a farming problem or just a regional Australia problem," he said.
"Our geospatial mapping of quad bike trauma in Victorian children reveals the majority of these children are injured in inner regional or metropolitan locations.
"Irrespective of the setting of use, farms or otherwise, children are most often injured when using quad bikes for recreational activities.
"The robust measures to protect children from injuries in the work place, such as those of WorkSafe are very important, but depiction of quad trauma in children as only a 'farm work' problem makes to too easy to ignore where bigger prevention gains can be made, however unpopular these may be in some sectors.
"Children and quad bikes are a toxic mix."
Roll over protection
While the Federal Chamber of Automotive Industries and quad manufacturers such as Yamaha and Honda have said behavioural changes and personal protective equipment would cause a significant decrease in injury, Dr Teague said these moves alone are not sufficient.
"In general terms we fully support the concept legislation and regulation that would enshrine a suite of changes to protect quad users, which include safety ratings, behavioural changes, user protection, training and supervision.
"These are laudable next steps, but the experience and evidence before us suggests each of these are insufficient as stand alone gestures.
"User protection would include an evidence supported role for standard compliant helmets and operator protective devices."
Read more: ACCC calls for mandatory standards
Dr Teague said research conducted by the New South Wales University TARS Group supported the use of operator protective devices, as a mechanism to prevent serious injuries to the torso.
"The evidence is building in support of operator protective devices," he said.
Dr Teague acknowledged that working in the field of trauma created some bias in his opinions.
"The bias I carry is the bias created by exposure to terrible injury and to the loss of life and opportunity, the harsh first-hand experience of caring for children whose quad bike injuries have resulted in long term disability. I feel this bias adds more to my perspective than it skews," he said.
"Injury is the leading cause of death and disability in children in Australia over the age of one, so anything and everything we can do to reduce that loss of life and future opportunity is important.
"When riding a quad bike, the margin between safety and catastrophe is too narrow to chance our children's life and health on it."
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