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Our discovering that identical proportions of male and feminine youth said riding in any case once during the past year confirms findings from other recent studies of North American youth. 10 ,11 However, neither of the 2 old experiences mentioned frequency of riding by gender. Campbell et al12 pronounced that 38% of male riders and 18% of female riders rode ‘a lot’. This sample of greater exposure among young males may help explain their greater occurrence of ATV associated injury and death. 3 ,4 ,13 ,14Inconsistent helmet use by young ATV riders is a long standing, well documented problem. 10–12 ,14–19 For example, more than half of riders aged 8–18 years in three rural states stated never or almost never dressed in a helmet. 11 ,16 ,17 We found that the most common riders had the bottom consistent helmet use, with 8 of 10 youth who rode at least six times during the past year not always dressed in a helmet. Helmet non use among youth is of certain fear because young ATV riders have a better chance of crashing than adults5 ,18 and the likelihood of dying or sustaining a serious non fatal worrying brain injury in an ATV crash is substantially higher among unhelmeted ATV riders. 18–21 Although in 2012 31 US states had a helmet requirement for ATV riders, these policies include a variety of qualifiers equivalent to when and by whom helmets has to be worn, and exceptions for age requirements if a toddler is supervised by an adult, riding on private belongings, or has a security certificate. 22 Effectiveness studies of such state imposed policies in cutting back accidents and deaths among young riders have produced equivocal outcomes. 13 ,20 ,23–25 Enforcement of these guidelines is limited partly as a result of many states’ laws pertain only to the use of ATVs on public lands, and in line with a 2008 ATV owners’ survey received by the US Government Accountability Office, nearly 80% of ATV riding among riders of all ages occurs on inner most belongings.

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