Nearly a decade ago, doctors in Nova Scotia thought they had found a way to protect children from being injured or killed on all-terrain vehicles.

The Canadian province banned children younger than 14 from operating any kind of ATV almost everywhere. The following year, the number of children hospitalized with injuries from ATV riding plummeted by half.

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A new vehicle with added safety features called the Sportsman Ace is being built at a Polaris plant in Milford, Iowa

But today, the celebrating is over.

The region's premier trauma unit treated nearly as many children this year for ATV-related injuries as it did the year before the 2005 ban took place. Dr. Natalie Yanchar, who led the campaign to get kids off ATVs, said the initiative didn't go far enough because families eventually went back to their old riding habits.

"Nothing is going to change unless we start changing the vehicles," said Yanchar, trauma surgeon at IWK Health Centre in Halifax.

Yanchar and other doctors are hoping ATV manufacturers will pursue design changes that would make ATVs safer, either voluntarily or through mandates from the U.S. government. Over the past decade, however, federal regulators and safety advocates have sought improvements that have gone largely nowhere, including seat belts and roll bars that are found on other recreational vehicles.

Every year, thousands of people are hurt or killed in ATV crashes across the country. Federal regulators and engineers who have studied the accidents say injury risks could be dramatically reduced with modest changes to design.

Some large models, for example, have seats so close to the controls that even a toddler can reach them. In 2012, a 3-year-old boy from North Branch, Minn., grabbed the throttle of an ATV while sitting on it with his two sisters. The ATV surged across a road and smashed into the side of a tool-and-die plant, breaking the boy's arm and fracturing the skull of his 6-year-old sister.

"You can't make them childproof, but we can make the vehicles substantially safer," said California engineer Randy Nelson, who has designed ATV parts and accessories for decades. "And you could do it without spending a lot of money."

Though it has the authority to order design changes, the U.S. Consumer Product Safety Commission negotiated agreements with the ATV industry over the past eight years that softened or eliminated at least 41 safety improvements the agency had sought, according to commission documents.

"We really have to come to grips with the design of the machines," said Robert Adler, a commissioner with the safety agency.

ATV companies have argued that such improvements aren't necessary. The key to ATV safety is for people to follow all of the industry warnings and guidelines, according to Polaris Industries, which is based in Medina and is the No. 1 ATV maker in North America.

"The most important piece of safety equipment that goes on any of our vehicles resides between the ears of the operator," said Mike Trihey, the company's senior off-road vehicle testing manager.

With the exception of Polaris, all other top ATV makers in the U.S. declined requests for interviews. They referred questions to the Specialty Vehicle Institute of America, an industry trade group.

Tim Buche, president of the group, said ATV makers have invested heavily in design and engineering. He cited his own evaluation of accident data in which he concluded that more than 90 percent of accidents happen because riders engage in at least one type of behavior that violates vehicle instructions.

"If there were design changes that should be made, they would be," Buche said.

Consumer advocates say that ATV riders are bound to make mistakes on a vehicle that comes with so many warnings and can be so physically challenging to operate. Car manufacturers, for example, have been more aggressive in making design changes that reduced rollovers and addressed other factors linked to accidents, said David Renfroe, a consulting engineer in Arkansas who recently helped Australia officials design a stability test for off-road vehicles.

ATV makers, Renfroe said, "have been slow in reacting to the danger."

How much speed do you need?

Some of the most contentious proposals have revolved around how fast ATVs should be allowed to go.

Eight years ago, the Consumer Product Safety Commission wanted the smallest child-size vehicles, which can be used by children as young as 6, to be designed with a limit of 10 miles per hour. A 15 mph ceiling was proposed for the next size up, tailored for children 9 and older.

Those proposals met with strong resistance from the industry, which argued that faster maximum speeds were necessary to make the vehicles attractive to young buyers. That was essential, the industry said, to keep kids off adult-sized ATVs that were too powerful for them.

"Children would get bored at some of the slower speeds," according to a report funded by ATV companies.

Federal regulators eventually backed off and approved speed limits ranging from 15 mph to 38 mph for three youth models, well above limits they were seeking.

ATV makers also resisted initiatives to cap the speed of ATVs designed for adults, which can reach 80 mph. In a 2011 letter to the agency, the seven major ATV makers — including Arctic Cat, Honda and Polaris – said speed limits would make the vehicles less attractive to customers and undermine their utility.

"These are off-road vehicles — why do they need to go 50, 60, 70 miles per hour?" said Charles Jennissen, an Iowa doctor who has led several studies on ATV design issues and riding habits. "You can't travel any off-road area going that fast."

In other cases, ATV manufacturers argued that safety enhancements could make the vehicles more dangerous. In 2011, for example, the seven big companies lobbied against seat belts and roll bars because the protective devices would encourage dangerous riding "due to a false sense of security," federal records show.

At the time, Adler said in filings that the safety commission had done nothing to advance safety. ATVs remain "the most dangerous discretionary use product for children within [our] jurisdiction," he said.

But the federal agency is undertaking a new review of ATV safety, and Adler said he expects significant progress will be made. The commission has allocated about $1 million to test the stability of ATVs. That's a crucial design issue linked to rollovers.

"I think we have a new direction," Adler said. "The commission is really determined to come to grips with overall ATV problems as we see it."

ATV designs scrutinized

In 60 percent of ATV accidents in 2010, the vehicle tipped over, according to a federal safety commission report. Most ATV models are about 48 inches wide and built high off the ground. That's a good design for navigating bumpy trails and undergrowth, but it makes the vehicle more susceptible to rolling over.

"If you made the vehicle a few inches wider, it increases the stability dramatically," said Nelson, the California ATV engineer. "That would mitigate a lot of these accidents."

Nelson contends that ATV companies don't want to expand the width of ATVs because they would no longer fit into most pickups. That would force many ATV owners to buy a trailer to move the machine, which could dampen sales, he added.

Polaris says it doesn't want to widen its ATVs because they would no longer fit on many public trails that limit ATV width to 50 inches. "Even without this restriction, though, it is not necessary to widen ATVs in order for them to be operated safely," said Paul Vitrano, vice president of government relations at Polaris Industries.

After studying 67 adult ATV models in 2013, medical researchers at the University of Iowa found that some companies make it too easy for children to reach the throttle. Polaris offered "significantly shorter" distances, with the controls just 3.3 inches away from the seat on some models, compared to 16.5 inches on an Arctic Cat vehicle.

"It just encourages children to ride those vehicles," said Jennissen, who led the study.

Troy Flicek and his 6-year-old son went riding on their Kawasaki 650 last year near their cabin in northern Minnesota. The boy was sitting in front, with his hands on the handlebars, Flicek said. Then Tyler decided to "show off in front of mommy." He grabbed the throttle, and the ATV zoomed past his wife, who was on another ATV. They crashed into a ditch. Tyler had a concussion, and Flicek broke two ribs.

"I put my boy in a situation I never should have," Flicek said. "But moving forward, they could definitely look at ways to set up these machines so they are less kid friendly."

The Iowa researchers also found wide variations in the length of the seat on adult ATVs. Investigators have blamed extra-long seats for many ATV crashes, saying the extra space improperly invites passengers and makes it harder to control the vehicle. Polaris typically had the longest seats among the eight companies surveyed, according to the report.

Vitrano said "there is no correlation" between the risk of injury and either seat length or the proximity to controls. Polaris seats are long so that riders can move their bodies on the vehicle as needed on turns and hills, he said.

"While the fundamental design of ATVs has been well settled for many years, Polaris continually enhances the safety and performance of its vehicles," Vitrano said.

The next generation

In a converted furniture factory in northern Iowa, Polaris is building a new off-road vehicle that safety advocates hope will revolutionize the industry.

Named after the company's bestselling ATV, the Sportsman Ace is an all-wheel-drive machine that was built to go anywhere an ATV can go. The company is investing $10 million in its Iowa plant, which is producing 150 Sportsman Ace vehicles each week.

Unlike ATVs, the Ace features a steering wheel and foot controls, making it harder for young children to operate. It also has a bucket seat, which discourages passengers. Those features are typically found in larger utility vehicles known as side-by-sides.

When driving the Ace, an operator is secured by a three-point harness and protected by a roll cage. ATV makers have said those safety enhancements could not be made to ATVs without hindering mobility and "degrading vehicle stability."

In promotional materials, some dealerships refer to the Ace as an ATV. Polaris, however, maintains that the Ace is in a category of its own, describing it as an "entirely new type of off-road vehicle."

Consumer advocates said they understand the company's reluctance to call the Ace an ATV because Polaris is still selling traditional ATVs that don't have the same equipment. Regarding safety, the best outcome would be for the Ace to emerge as a replacement for traditional ATVs, said Sean Kane, president of the Safety Institute, a nonprofit that monitors vehicle defects.

"It's a big deal," he said. "I really like the protection."

Polaris officials, however, maintain that the Sportsman Ace isn't necessarily safer than the company's other models. After all, Vitrano said, it can be misused like any other off-road vehicle.

"That is why we build them as safe as we can, and we make sure we emphasize how they are supposed to be used."

Next: Part 5: Dangerous terrain: ATVs and open roads

Go to Part 1: ATV thrills drive child injuries, deaths

Go to Part 2: States ignore federal ATV age limits

Go to Part 3: State to state, ATV rules are all over the map