doi:10. 1136/archdischild 2013 305715. A study from Nottingham based on the same database as that described above, concluded that children under 5 years old are more likely to fracture bones in their arms and legs if they were older than one, had older brothers or sisters, had young mothers or mothers with a history of alcohol misuse. These fractures were independently associated with younger maternal age and higher birth order. Source: Baker R, Orton E, Tata LJ, et al. Risk factors for long bone fractures in children up to 5 years of age: a nested case control study. Arch Dis Child Published Online First: 14 Nov 2014. doi:10. 1136/archdischild 2013 305715. Given the popularity of ATV riding among youth and the potential for serious injuries, 2–4 effective interventions to reduce ATV related injury among youth are needed. 31 Education based approaches to improving ATV safety behaviours among youth face multiple challenges.