All-terrain vehicles (ATVs) are fun, but they are also deadly. More than 254,000 ATV-related injuries were treated in hospitals and doctors' offices in the year 2000, according to the U.S. Consumer Product Safety Commission (CPSC). They cost the United States more than $6.5 billion in medical, legal and work loss expenses.

ATVs are especially dangerous for children. Children under 16 accounted for approximately 40 percent of the total ATV-related injuries and deaths in 2000. Few states require a license to operate an ATV and there are no nationally mandated safety standards. With their large, soft tires and high center of gravity, ATVs can reach speeds of up to 50 mph or more. Almost 60 percent of accidents involving ATVs result from tipping and overturning.

The American Academy of Orthopaedic Surgeons (AAOS) considers ATVs to be a significant public health risk.

To help reduce the numbers of injuries and deaths, particularly among young people, the AAOS recommends that:

• All ATV operators should be licensed and undergo a hands-on training course. According to the CPSC, inexperienced drivers in their first month of using an ATV have 13 times the average risk of injury.
• The minimum age for operating an ATV on or off the road should be at least 16 years old.
• ATVs should be used during daylight hours only.
• ATVs should be used by only one person at a time, no riders.

The CPSC reminds parents that ATVs are not toys. Children under 12 years of age should not operate any ATV. Younger children do not have adequate physical size and strength to control these vehicles. Nor do they have the thinking, motor, and perceptive skills to operate a vehicle safely. Children under 16 years of age should not operate ATVs that have an engine size of 90 cc or greater.

Here are some other safety tips for ATV use. Following these guidelines could help reduce your risk of injury.

• Read all instruction manuals and follow the manufacturers' recommendations for use, maintenance, and pre-use checks.
• Never operate an ATV on pavement or on a public road. Almost 10 percent of injuries and over 25 percent of deaths occurred while the ATV was on a paved road.
• Always wear protective gear. Helmets are especially important in reducing the risk of head injury. Protective gloves and heavy boots can also help reduce injuries.
• Do not operate at excessive speeds or after dark. ATVs are difficult to control and collisions with other vehicles can result in severe injuries or death.
• Do not operate an ATV if you have taken drugs or alcohol. According to the CPSC, 30 percent of all fatal ATV accidents involved alcohol use.
• Never operate a 3-wheeler.