As all-terrain vehicles continues to grow in popularity, so do the dangers to young people.

A study in Clinical Pediatrics found that over the course of 25 years, nearly 280,000 children under the age of 18 were treated in emergency rooms for ATV-related head and neck injuries — an average of 31 children a day.

Nearly half of the injuries were in children under the age of 12, who were more likely to suffer broken bones and be ejected from ATVs.

"Children in this age group simply should not be operating an ATV as it's not safe for them to do so," said Dr. Kris Jatana, pediatric neck and head surgeon at Nationwide Children's Hospital in Columbus, Ohio, and professor at Ohio State University.

Jatana said that while ATV age requirements and laws vary state by state, driving an ATV involves strength, coordination, sound judgment and quick decision making. These are similar skills needed to operate a car. Therefore, Jatana said ATVs should be restricted to older teens and adults.

In New Jersey, an operator must be at least 14 years old. If the operator is under 18, they must enroll in the ATV Safety Institute course.

Children as young as 8 years old can operate an ATV in North Carolina. In West Virginia, a child must be at least 18 years old without a safety certificate.

According to the Consumer Product Safety Commission, there were 3,232 children younger than 16 killed in ATV-related accidents between 1982 and 2016. Of those, 1,411 were younger than 12.

Jatana said that no matter the age requirement, these types of injuries are preventable. A helmet is critical — but it needs to be a motorcycle-type helmet for better protection. Other safety equipment includes protective gloves, close-toed shoes and goggles.

He also said that passengers should be prohibited because ATVs are not designed for passenger use. He said having a passenger can affect the ATV's balance, increasing the risk of a rollover and ejecting someone.

It's also important to remember that ATVs are meant for off-road use: They should not be operated on public roads and highways. The study found that children who were injured on a street or highway were one and a half times more likely to be admitted to the hospital with more serious injuries.

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