Abstract
Off-road vehicles (ORVs) are motorized vehicles engineered specifically for navigating rough terrain. They are often seen in rural, remote, and agricultural settings, but are widely used in Canada, primarily for recreation, and are responsible for a disproportionate number of severe injuries and deaths in the paediatric population. ORVs are becoming heavier and faster, and injuries associated with their use by children and adolescents are similar in severity to those sustained in motor vehicle crashes. However, while the automotive industry is bound by safety legislation, strict enforcement, and engineering and road strategies to prevent harm, there is no comparable regulatory framework for ORVs, leaving a gap in safety advancements. Based on a comprehensive literature search undertaken in February 2024, this statement provides an overview of the effects of ORV use by children and adolescents, factors influencing ORV crashes and resultant injuries, and recommendations for health care providers and governments to reduce preventable harms associated with ORVs in the paediatric population.