Quad bike safety and injury risk in the United Arab Emirates: insights from a mixed-methods study

Abstract Background Quad bike riding is increasingly popular in the Middle East, yet evidence on injury risk remains scarce. Addressing this under-reported public health challenge, our study offers novel insights into the UAE’s unique desert riding culture and traditions by characterizing injury risks alongside influences from families, peers, and regulators. Method The study used a mixed-methods design comprising a cross-sectional field survey and an in-depth qualitative inquiry. The aim was to characterize quad bike riding practices, injury patterns, and stakeholder influences in the United Arab Emirates. The survey included 134 resident recreational riders recruited through a three-stage location-based sampling strategy. We observed riders to document riding behaviours, followed by an interviewer administered questionnaire in Arabic or English. Descriptive statistics and logistic regression examined riding habits and injury risk factors. Guided by socio-ecological theory, the qualitative component used respondent-driven purposive sampling. Sixty-three participants included riders, parents, police officers, health professionals, and tour operators. Interviews continued to thematic saturation and analyzed using framework analysis. Results 45% of observed respondents reported injuries requiring medical attention; one quarter of injuries occurred at night. Riding on paved roads was strongly associated with injury requiring hospital admission (adjusted odds ratio 5.78), while consistent helmet use (adjusted odds ratio 0.27) and earlier initiation of riding (adjusted odds ratio 0.30) were associated with lower odds of severe injury. Qualitative findings suggested that higher helmet use among injured riders may be attributable to police counselling and increased parental supervision following injury. Young males who began riding with peers often described unsupervised night rides involving speed, stunts, and passenger carriage. In contrast, riders who began under close parental supervision reported gradual skill-building in controlled settings, alongside clear household rules about riding locations and behaviours. Conclusion Recreational quad bike riding in the United Arab Emirates involves a high burden of preventable injuries from behavioural and environmental risks. Stakeholders must implement urgent interventions like mandatory safety training, off-road club mentorship, strengthened paved-road enforcement, and social media campaigns targeting youth and families to promote safer practices.