KIDS and quad bikes are a dangerous mix, according to the latest report into quad bike deaths and injuries.
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Last year, 21 quad bike-related deaths were recorded in Australia and 15 of those occurred on a farm.
Six of the deaths happened in NSW, 11 in Queensland, two in Victoria, one each in Tasmania and Western Australia, and none in the Northern Territory.
Seventeen of those who died were male and half of the deaths were due to the quad bike rolling over.
The high number was above the 10-year average of 13 cases.
In 2012, 18 deaths were recorded, 10 of them on a farm, while 23 deaths were recorded in 2011, 18 of them on farms.
The Australian Centre for Agricultural Health and Safety compiled the study of media reports in 2013.
Centre director Tony Lower recommended riders wore helmets and avoided carrying passengers.
He also recommended roll bars be installed and warned children of any size to stay away from the vehicles.
"The fatal mix of kids and quads was also reflected by two cases involving children under 16 years, both of which occurred on farms," Dr Lower said.
He said a further 78 injuries were serious enough to result in press coverage.
"These are often life-changing incidents such as spinal and brain injuries," he said.
"We know this significantly underestimates the true burden as a comprehensive study published in the Medical Journal of Australia in 2013 identified for each quad death there are about 40 hospital admissions plus at least a further 40 emergency department presentations.
"We believe the non-fatal cases reported in the media are simply the tip of the iceberg."
Dr Lower welcomed the efforts of some manufacturers to control risks of rollovers by improving vehicle design and advocating for crush protection devices to be fitted.
"However, more needs to be done to enhance the safety of the estimated 220,000 quad bikes already in operation across Australia, while at the same time there is a responsibility for operators to ensure the safe use of the vehicles," he said.
Dr Lower said in most cases, quad bikes were not the safest vehicle for a particular task on a farm.
"However, given the high rate of rollover incidents, if a quad is still to be used, then a suitably tested crush protection device should be fitted," he said.
"This is an increasingly common approach for many farmers and businesses that use quads and recognise their danger.
"Keeping children off quads of any size, not carrying passengers and wearing a helmet are also important preventive actions."