Doctors are calling for banning kids from using quad bikes after a six-year-old Australian girl was killed in a quad bike crash.
Her death brings the quad-bike toll across Australia to 115 in the last seven years.
In New Zealand, 2016 saw a record high for quad bike-related deaths with 14 people killed. WorkSafe NZ says quad bikes are involved in nearly a third of all work-related farm deaths.
Now the Australasian College of Surgeons is urging the New South Wales government to do more to prevent similar fatalities in the Australian state.
"Quad bikes and kids do not mix," Dr John Crozier says.
"We need effective controls to prevent these tragedies. These deaths can be prevented if restrictions are put in place that reflect the danger that these machines pose to young riders."
According to Accident Compensation Corporation figures, every year more than 100 children hurt themselves on off-road vehicles in New Zealand," RACS New Zealand trauma committee chair Li Hsee says.
"Of these, around one fifth will be hospitalised, and tragically, between three and six will die."
Dr Crozier says in Massachusetts there've been nearly no child deaths after a ban on under-14s riding quad bikes.
And it's not speeding around that causes the fatal crashes, he says. Even though quad bikes - or all-terrain vehicles - have four wheels, they have a high centre of gravity, making them unstable.
"Most injuries and deaths involve the bike rolling onto the rider and this can occur at low speeds," Dr Crozier says.
"Quad bikes are not toys; they leave very little room for rider error - a lack of judgement, a lack of skill, or even a lack of body mass and physical strength, can result in death or serious injury.
"This places children at a distinct disadvantage when operating these vehicles, and this is something the NSW Coroner recognised when she recommended a ban on under 16s riding quads in 2015.
"Surgeons are often on the front lines of these horrific injuries and we see first-hand the damage caused by quad bikes."
After a 2014 study on quad bike-related child deaths in New Zealand there were calls for roll bars, but there have been no new enforced safety measures.
Safekids, the ACC, Federated Farmers, WorkSafe NZ and quad bike manufacturers all strongly advise against the use of quad bikes by those less than 16 years of age.
Last year, a study of admissions to Starship Children's Hospital published in the New Zealand Medical Journal also supported a call for a ban on under-16s using quads.
New Zealand's Health Quality and Safety Commission's child and youth mortality review committee released a report in December 2014, which reviewed injuries and deaths in children in off-road accidents involving quad bikes, motorcycles and other agricultural vehicles from 2002 to 2012.
There were 33 children under 15-years-old killed in motorbike and quad bike-related incidents in that period.
NZN / Newshub.