All-terrain vehicles are anything but child's play, according to the largest study ever conducted of ATV injuries in children.

“Our experience shows that children’s use of ATVs is dangerous and should be restricted,” said Dr. Chetan C. Shah, a radiology fellow at the University of Arkansas for Medical Sciences and Arkansas Children’s Hospital, in a news release. “There is nothing ‘recreational’ about a trip to the emergency room,” Shah noted.

ATVs, designed for off-highway use, can weigh up to 600 pounds and travel up to 75 miles per hour. While the American Academy of Pediatrics recommends that children under the age of 16 be prohibited from operating ATVs, no laws are in place in most states. ATV accidents are seldom reported because the vehicles are unlicensed and typically operated off-road or on private land, the study noted.

“The question is a little like asking, ‘How can we make motorcycle use safer for five-year-olds?’” said Shah. “The problem is that five-year-olds should not be using motorcycles under any circumstances.”

Shah and his colleagues studied 500 children and teens admitted to Arkansas Children’s Hospital following ATV accidents over a span of eight years. The injuries ranged from head injuries, spinal injuries, broken bones and amputations. There were six fatalities and several cases of long-term disabilities. The fatalities represent only the children who died at the hospital, not those who died at the accident site.

“The youngest patient in our series was a six-month-old infant who was riding with his mother. His thigh bone was fractured,” said Shah. “Other patients included a two-year-old who was driving a ‘child-size’ ATV and had traumatic amputation of four toes, and another two-year-old driver who was found unconscious beside a flipped ATV. She had a severe brain hemorrhage that left her with permanent disability,” he said.

The findings were presented this week at the annual meeting of the Radiological Society of North America.