Six-wheel models often have a small dump bed, with an extra set of wheels at the back to increase the payload capacity. They can be either four-wheel drive (back wheels driving only), or six-wheel drive. In 2011 LandFighter was founded, "the first Dutch/European ATV brand". The largest part of production takes site in Taiwan, to European standards; the ATVs are finally assembled in the Netherlands. Safety has been a major issue with ATVs due to the high number of deaths and injuries associated with them and the negligible protection offered by the machine. The modern breed of ATVs was introduced in the early 1970s and almost immediately realized alarming injury rates for children and adolescents. Based on analysis of the National Trauma Data Bank, ATVs are more dangerous than dirt bikes, possibly due to crush injuries and failure to wear safety gear such as helmets. They are as dangerous as motorcycles, based on mortality and injury scores. More children and women are injured on ATVs, who also present a lower rate of helmet usage. Many common injuries can be prevented with the use of proper protective equipment. Most ATV manufacturers recommend at least a suitable DOT-approved helmet, protective eyewear, gloves and suitable riding boots for all riding conditions. Sport or aggressive riders, or riders on challenging terrain (such as those rock crawling or hillclimbing), may opt for a motocross-style chest protector and knee/shin guards for further protection. Proper tires (suited to a particular terrain) can also play a vital role in preventing injuries. Fatal accidents typically occur when the vehicle rolls over. In the United States, statistics released by the Consumer Product Safety Commission (CPSC) show that in 2005, there were an estimated 136,700 injuries associated with ATVs treated in US hospital emergency rooms. In 2004, the latest year for which estimates are available, 767 people died in ATV-associated incidents. According to statistics released by CPSC, the risk of injury in 2005 was 171.5 injuries per 10,000 four-wheel ATVs in use. The risk of death in 2004 was 1.1 deaths per 10,000 four-wheelers in use. Focus has shifted to machine size balanced with the usage of ATVs categorized by age ranges and engine displacements—in line with the consent decrees. ATVs are mandated to bear a label from the manufacturer stating that the use of machines greater than 90 cc by riders under the age of 12 is prohibited. This is a 'manufacturer/CPSC recommendation' and not necessarily state law.