Quad bikes: tobacco on four wheels
Correspondence to: Tony Lower, Director, Australian Centre for Agricultural Health and Safety (University of Sydney), PO Box 246, Moree, NSW 2400; e-mail: firstname.lastname@example.org
Quad bikes are four-wheeled vehicles with straddle seats and handlebars; they are sometimes erroneously called all-terrain vehicles (ATVs).1,2 Quad bikes are now the leading cause of non-intentional farm injury deaths in Australia, with more than 160 fatalities from 2001 to 2012.3–5 Additionally, for each fatality there are about 40 hospital admissions and at least a further 40 ED presentations.6
Details on the epidemiological profile of Australian fatalities are available elsewhere,5 however, half the fatal incidents involved a rollover. In rollover events, the potential for the 250+ kg machine to entrap the rider is high, with death frequently resulting from crush injury and/or asphyxiation. Quad bikes have been heavily marketed by manufacturers as an essential farm ‘workhorse’ so it is unsurprising that the majority of quad deaths (65%) and rollover-related deaths (86%) occur on farms.5 Given these data and the inherent risks associated with rollovers, one would think that development of a crush protection device (CPD) or rollover protection system (ROPS) to protect riders would be an industry priority. Tragically, this is not the case.
Quad bikes are considered ‘plant’ under the Australian Model Work Health and Safety Regulations, which clearly state that risks posed by overturn need to be effectively controlled.7 Yet, despite this legal requirement and international success in reducing deaths from fitting ROPS to tractors,8 quad manufacturers continue to vehemently resist such moves.
The strident industry opposition in the face of mounting evidence to the contrary, is reflective of stances taken by other recalcitrant industries (alcohol, asbestos, food, tobacco) where vested interests work in contravention of public health outcomes.9 This editorial summarises the quad bike industry stance against CPDs/ROPS in Australia and aims to draw a direct comparison with tactics used by ‘big tobacco’.
United we stand
The starting point for the industry defence of its position is the formation of a lobby group representing the leading manufacturers. Both industries established grandiosely titled ‘institutes’ in the US (Tobacco Institute and Speciality Vehicle Institute of America – SVIA), with the Australian quad distributors being represented by the Federal Chamber of Automotive Industries (FCAI). These agencies provide a public front through which manufacturers direct unified comments.
The quad bike industry claims “… research by ATV manufacturers (primarily, the respective parent companies of the Distributors) to seek to identify and develop further safety enhancements for ATVs is ongoing.”10 Ironically, nothing appears to be further from the truth when it comes to the publicly available information provided by industry in relation to CPDs/ROPS. Despite debate regarding CPDs/ROPS since the mid-1980s and having R&D budgets in the billions annually, no individual company has submitted their engineering information to a public debate on this issue. Just like tobacco, quad manufacturers use their industry lobby group to outsource research to third parties. Big tobacco did this through the Tobacco Industry Research Committee; the SVIA has repeatedly used private agencies (e.g. Dynamic Research Inc.) to counter arguments relating to the efficacy of CPDs/ROPS.
By outsourcing research to purportedly independent agencies, the manufacturers have been able to distance themselves from claims of bias or impropriety. Further, as they do not release any of their company R&D data, potential litigation threats are mitigated. Parallels with big tobacco and what R&D information quad manufacturers hold is speculative, but as evidenced by the eventual revelation of the Minnesota papers in relation to tobacco, such industries are not adverse to withholding crucial information from the public when it threatens their commercial interests.11
Safety is our priority
Publicly, neither industry can be seen to be taking steps that are in opposition to better health and/or safety.12 Tobacco executives provided the Frank Statement to Cigarette Smokers in 1954, indicating there was no proof that tobacco was a cause of lung cancer and enunciating their products were not “… injurious to health” and that “We always have and always will cooperate closely with those whose task it is to safeguard the public health”.13 For quad bikes, the Australian representatives have touted that the research they rely upon is “… state-of-technology and is based upon published research and relevant portions of international research standards, as expected of a quality report. It confirms that rollover devices, and in particular so-called ‘crush protective devices’, should not be fitted to ATVs” and “The ATV industry will continue to put the safety of riders first by opposing the use of rollover devices in Australia.”14 More recently, this research has yet again been found to be invalid and was identified by an independent review to be a “… misrepresentation of the true results”.15 Notwithstanding this, manufacturers continue to present and defend these data.
As long as there was some lingering doubt about the evidence, the tobacco industry could fight any regulatory actions and stymie potential litigation. In a similar vein, this is why the quad bike industry is so interested in events unfolding in Australia, particularly independent testing on CPDs/ROPS, and is exemplified by an SVIA submission to an Australian discussion paper.16
Hold the line – set no precedents
Despite extreme safety concerns regarding quad bikes, the debate around CPDs /ROPS has meandered for several decades in the US. As the leading user of quad bikes (10 million plus), there are significant amounts of money to be made (or lost) based on sales and/or potential litigation action (more than 11,000 deaths).17
Australia and New Zealand played key international roles in leading the debate against the tobacco industry.18 Similarly, recent efforts in Australia and, to a lesser extent New Zealand, have challenged the prevailing wisdom that CPDs/ROPS increase risk.15 The Product Safety Commissioner in the US indicated in reference to Australia that: “We're going to be monitoring your activities closely, with the hope that what you learn can help us back here in the United States”.19
Just like ‘big tobacco’, quad manufacturers do not want a precedent set regarding the use of CPDs/ROPS. The level of resistance to engineering controls is so high that one manufacturer reported to its distributors in a Dealer Bulletin that a national forum convened by Safe Work Australia on engineering controls was “… an ambush by a large group of so-called safety representatives who have a fixed agenda”.20
Big tobacco's efforts to prevent an international precedent being established in Australia on plain packaging legislation exemplifies the behaviour. This included brazen media promotions raising the spectre of ‘nanny state’, also a recurring theme within quad safety. Big tobacco funded anti-plain-packaging campaigns in countries that are considering adopting the Australian laws (including New Zealand).
For quad manufacturers, a similar situation exists based on the omnipresent fear of litigation for marketing a product that they have known for more than two decades is not safe. To date, quad manufacturers have not commenced legal proceedings against the government, as did big tobacco on plain packaging. However, this may only be a matter of time, with major legal firms known to be working on a range of issues regarding quad bikes for the industry.
Creating public doubt
Just as the tobacco lobby attempted to discredit scientific discussion on passive smoking, quad manufacturers are repeating similar tactics.21 This has included questioning the terms of reference of a Federal Government Review on quad bike safety, which focused on engineering controls. Manufacturers argued this was inconsistent as all such previous efforts in the US had illustrated none of these could be adopted.22
Dubious attempts by the FCAI to validate the purported evidence included public media and written notifications to all quad distributors, relevant politicians in Federal and State jurisdictions, plus the launching of a specific ‘We won't have a bar of it’ website which proclaimed that “… without exception, that ROP and Crush Proof Devices installed on ATVs increase rather than decrease the liklihood (sic) of injury.” However, the Australian Competition and Consumer Commission (ACCC) found that the “… FCAI representations may have contravened the misleading and deceptive conduct provisions of the Competition and Consumer Act 2010”.23 Subsequently, the industry closed the website, only to re-launch it several months later with altered semantics but the same theme. As with ‘big tobacco’, it is clear that manufacturers continue to lobby government representatives and provide public information that is counter to the prevailing evidence base.
The attempts to misinform extended to the publication of a picture of quad bikes that had been involved in a 50,000 km round the world expedition. The two quad bikes had CPDs fitted for the entirety of the journey, apart from the 120 km trek from Newcastle to the finish line at Sydney's Opera House. Yamaha used doctored photos in the media of the quad bikes without CPDs and an accompanying press release stating “… the Yamaha ATV was not modified in any way for the operation”. This assertion was false and, along with the photo modifications, prompted ACCC intervention in regards to misleading or deceptive conduct and misleading characterisations regarding the performance of a product.24
Our Product is Perfect – People are the Problem
Tobacco muddied the waters by diverting attention away from the negative impacts of its product in whatever way it could. For environmental tobacco smoke (ETS), the industry ignored the added risks this posed, preferring to focus on the impacts of genetics and lifestyle on risks and subsequent health.25
Similarly, quad manufacturers consistently attempt to divert attention away from the safety of their product and instead focus on ‘misuse’, even entitling reports that attribute all overturns to misuse.26 The subtext is that it's not the product – which is “… perfect if it's used within the design parameters”27– it is solely the users that are at fault.
In this context of ‘blaming the user’, the manufacturers have repeatedly defined helmet use and training as the two principle prevention methods and have flatly rejected CPDs/ROPS.10,22,28 While no-one disclaims these elements play a role, the impact of the latter is highly equivocal. Irrespective of this, in relation to injury prevention, helmet use and training are at the lowest end of the hierarchy of risk controls. This contrasts with engineering controls, such as CPDs/ROPS, that are higher order and more effective.7 Given the poor stability of quad bikes and their “proneness to rollover”,2 prevention efforts must consider all potential levers.
Buyers for life
Quad manufacturers have also learnt lessons from tobacco in attracting a customer for life. There is significant investment in Australia to encourage the purchase of allegedly appropriate-sized quad bikes for children, even to the extent of free giveaways when a larger unit is purchased. What is less well publicised by the manufacturers is that there have been at least five recorded fatalities on these smaller quad bikes of children under 16 years, all of them wearing a helmet. Four of the five involved a rollover incident. This does not seen to perturb the industry: “Honda and other manufacturers build children's quad bikes and there's no real issue with the safety of those machines.”29
Thankfully, a more logical approach is evolving in Australia, with calls for all children under 16 years to be banned from operating these vehicles in a workplace.30 Although this does not go far enough for safety advocates, it is a strong reinforcement of the dangers posed by operation of these vehicles by children, whether it be for work or recreational purposes.
It is perplexing that in the face of the mounting evidence, the quad bike industry continues to hold steadfast in opposition to any kind of device that can limit death and serious injury in the event of a rollover. There does not appear to be any logical explanation for this apart from the fear of some form of litigation against the manufacturers.
Comparisons of the quad and tobacco industry tactics are compelling. As identified, the combination of rigid policy stances requiring irrefutable evidence of risk, social attitudes and interference by vested interests often result in policy makers having to wait unreasonable lengths of time before they can commit themselves to preventive action.9 As was the case for tobacco, the need for more accurate scientific information has sometimes been used as a reason for inaction. While Sir Richard Doll first established the link between tobacco and cancer in the 1950s, it took 20–30 years for concerted action to take place, during which time countless millions of people suffered. Put simply, we should not entertain in any way such a lag in this debate around CPDs/ROPS for quad bikes.
Inevitably, decisions that incorporate a mix of politics, values and economic interests will result in tensions. However, decisions should always be informed by the best available science, common sense and community values.31 There is no doubt that more research is needed on CPDs/ROPS, but based on current evidence and precautionary principles, fitting of suitably tested devices is warranted.32
The quad bike industry, through its current inaction on this issue, will undoubtedly be tarnished as yet another example of big business behaving badly. Public health advocates must continue to hold this industry, and others that behave in a similar manner by threatening public safety, to account.