Picture a summer afternoon shattered by the wail of an ambulance, a scene that unfolded over 93,200 times in 2022 alone as ATV injuries continue their relentless climb across America.
Key Takeaways
- In 2022, there were an estimated 93,200 emergency department visits for ATV-related injuries in the US, a 5% increase from 2021.
- From 1982 through 2022, ATVs were involved in over 4 million emergency room-treated injuries, averaging 83,000 per year.
- The rate of ATV-related injuries treated in US emergency departments rose from 8.92 per 100,000 population in 2001 to 12.18 per 100,000 in 2010.
- Children under 16 accounted for 22% of all ATV injury ER visits in 2022.
- Boys aged 10-14 had the highest ATV injury rate at 213.4 per 100,000 from 1990-2003.
- 36% of pediatric ATV injuries involved children under 12 years old in 2001-2012 data.
- Adults aged 30-49 had 28% of all ATV injury ER visits in 2022.
- Males accounted for 81% of adult ATV injuries treated in 2010-2019.
- From 2000-2009, adults 18+ comprised 73% of 1,073,000 ATV injuries.
- Head and neck injuries made up 19% of all ATV ER-treated injuries in 2022.
- Upper extremity fractures accounted for 28% of ATV injuries in children 2000-2009.
- Torso injuries from ATV rollovers comprised 37% of hospitalized cases 2001-2010.
- ATV crashes caused 1,321 deaths in 2021, highest since 1985.
- From 1982-2022, over 16,000 ATV-related fatalities reported in the US.
- Annual ATV fatalities averaged 669 from 2018-2022, up 25% from prior decade.
ATV injuries remain a serious and persistent public health problem in the United States.
Adults
- Adults aged 30-49 had 28% of all ATV injury ER visits in 2022.
- Males accounted for 81% of adult ATV injuries treated in 2010-2019.
- From 2000-2009, adults 18+ comprised 73% of 1,073,000 ATV injuries.
- Adult ATV injury rate peaked at ages 25-34 with 18.2 per 100,000 in 2001-2010.
- 45% of adult ATV ER visits in 2018 involved alcohol or drug impairment.
- From 1990-2010, adult males had ATV injury rates 6 times higher than females.
- Adults on utility ATVs had 2.1 times higher injury rates than sport models.
- In 2022, 72,000 adult ATV injuries required emergency treatment.
- 34% of adult ATV fatalities involved alcohol, per 1985-1997 NHTSA data.
- Adult ATV rollover injuries accounted for 52% of severe cases in 2008-2017.
- From 2001-2012, adult injury ER visits rose 35% to 78,900 annually.
- Males aged 45-54 had the second-highest adult ATV injury rate at 14.5 per 100,000.
- 67% of adult ATV injuries occurred off-road on private property.
- Helmet non-use in adults led to 42% higher head injury rates in 2015 study.
- From 2016-2020, adults 18-39 averaged 38,000 ATV ER visits yearly.
- Adult females saw a 50% increase in ATV injuries from 2000-2010.
- 29% of adult ATV injuries in 2007 were torso injuries from rollovers.
- Rural adult residents had 3.8 times higher ATV injury hospitalization rates.
- From 2009-2018, adult males 30-49 had 25% of all ATV ER injuries.
- Alcohol was a factor in 25% of adult ATV crashes requiring hospitalization 2005-2013.
- Adults over 40 comprised 35% of ATV fatalities from 1997-2014.
- 56% of adult ATV injuries involved vehicles 400cc or larger.
- In 2019, 70,500 adult ER visits for ATV injuries, mostly males.
Adults Interpretation
The statistics paint a clear and grim portrait: ATV injuries are overwhelmingly an adult male problem, fueled by powerful machines, rural terrain, alcohol, and a dangerous disregard for helmets, with middle-aged men ironically trading the safety of their sedans for the peril of a off-road rollover.
Fatalities
- ATV crashes caused 1,321 deaths in 2021, highest since 1985.
- From 1982-2022, over 16,000 ATV-related fatalities reported in the US.
- Annual ATV fatalities averaged 669 from 2018-2022, up 25% from prior decade.
- 92% of ATV fatalities involved males, per 2000-2009 CPSC data.
- Children under 16 accounted for 22% of 13,700 ATV deaths 1982-2013.
- Helmet non-use contributed to 37% of all ATV fatalities 1994-2004.
- Rollovers caused 58% of ATV fatalities from 1985-1997.
- Alcohol was involved in 23% of ATV fatalities ages 16+ in 1997-2014.
- 743 ATV deaths in 2020, a 20% increase despite COVID lockdowns.
- Head trauma was the cause of death in 45% of pediatric ATV fatalities.
- From 2003-2015, 2,600 child ATV deaths, 70% on public roads.
- Fatality rate per 10,000 ATVs registered was 3.9 for youth models 2000-2004.
- 78% of fatal ATV crashes involved single vehicles, mostly rollovers.
- Adult males 30-49 had highest fatality rate at 5.2 per 100,000 riders.
- From 2010-2019, ATV deaths rose 15% to 650 annually.
- 35% of fatalities occurred on paved roads, illegal for most ATVs.
- Non-helmeted riders had 5 times higher fatality risk from head injuries.
- 1,008 ATV fatalities in 2019, 40% involving large displacement engines.
- Chest compression caused 28% of deaths in ATV rollovers per autopsy studies.
- Youth passengers under 16 were 4 times more likely to die in ATV crashes.
- From 1982-2005, 5,500 child ATV deaths, averaging 210 yearly.
- 27% of ATV fatalities resulted in multiple organ failure post-trauma.
- Fatality odds ratio was 1.8 higher for riders over 400lbs vehicle weight.
- 15% of ATV fatalities involved collisions with automobiles on roads.
Fatalities Interpretation
ATV safety is tragically, statistically, a story of men—often intoxicated, usually helmetless, frequently on paved roads illegal for their vehicles—flipping machines they’ve overloaded and killing themselves, their young passengers, and a staggering, avoidable number of children along the way.
Incidence Rates
- In 2022, there were an estimated 93,200 emergency department visits for ATV-related injuries in the US, a 5% increase from 2021.
- From 1982 through 2022, ATVs were involved in over 4 million emergency room-treated injuries, averaging 83,000 per year.
- The rate of ATV-related injuries treated in US emergency departments rose from 8.92 per 100,000 population in 2001 to 12.18 per 100,000 in 2010.
- Between 2000 and 2009, there were 1,073,000 ATV-related injuries reported, with a 42% increase over the decade.
- In 2018, approximately 76,000 people were treated in US hospital emergency departments for injuries associated with ATVs.
- ATV injury rates per 100,000 registered vehicles increased by 22.5% from 2000 to 2010 among children under 16.
- From 2010-2019, annual ATV emergency visits averaged 87,500, with peaks at 101,800 in 2012.
- In rural areas, ATV injury hospitalization rates were 3.2 times higher than in urban areas in a 2005-2013 study.
- National Electronic Injury Surveillance System data shows 2.2 million nonfatal ATV injuries from 1990-2010.
- ATV-related injury rates for children aged 5-9 peaked at 15.6 per 10,000 in 2007.
- From 2001-2012, ATV injuries increased 31% nationally, from 76,000 to 99,900 ER visits.
- In West Virginia, ATV injury rates were 18.9 per 100,000 from 2001-2005, highest in Appalachia.
- US Consumer Product Safety Commission estimates 105,000 ATV injuries in 2007 alone.
- Pediatric ATV injuries accounted for 27% of all recreational vehicle injuries in ERs from 1990-2003.
- From 2016-2020, ATV ER visits averaged 82,400 annually, with a low of 69,400 in 2020 due to COVID.
- Injury incidence rate for ATV riders was 292 per 100,000 rider-years in a 2015 Canadian study.
- NEISS data from 2008-2017 shows 845,000 ATV-related injuries treated in US EDs.
- Annual ATV injury rate per 10,000 vehicles was 1,200 for youth models from 2000-2009.
- In Kentucky, ATV crash injuries increased 250% from 1997 to 2007.
- From 1985-1997, ATV injuries doubled from 54,000 to 108,000 annually.
- 2021 saw 88,400 ER-treated ATV injuries, up 27% from 2019 pre-pandemic levels.
- ATV injury hospitalization rates were 4.6 per 100,000 in 2010-2014 Canadian data.
- US military personnel had 1,057 ATV injuries from 2003-2007, rate of 11.5 per 10,000.
- From 1997-2006, farm-related ATV injuries averaged 15,800 annually.
- NEISS-AIP data 2000-2004: 544,800 nonfatal ATV injuries, 76% male.
- Injury rates for ATVs were 50% higher than motorcycles per vehicle mile in 2010 study.
- In 2019, 91,800 ATV-related injuries required ER treatment in the US.
- Pediatric ATV injury rates tripled from 1993-2003, reaching 98 per 100,000 children.
- From 2009-2018, ATV ER visits increased by 15%, to 95,200 annually.
- Regional data shows Southern US states had 2.5 times higher ATV injury rates than Northeast.
Incidence Rates Interpretation
Behind the roar of the engine, the statistics tell a sobering story: this isn't a rugged adventure; it's a predictable and escalating public health crisis that we, for decades, have stubbornly refused to treat with the seriousness it demands.
Injury Types
- Head and neck injuries made up 19% of all ATV ER-treated injuries in 2022.
- Upper extremity fractures accounted for 28% of ATV injuries in children 2000-2009.
- Torso injuries from ATV rollovers comprised 37% of hospitalized cases 2001-2010.
- 42% of ATV-related spinal injuries were thoracic or lumbar fractures per 1990-2003 data.
- Lower extremity injuries occurred in 22% of ATV ER visits, often open fractures.
- Traumatic brain injuries represented 11% of all ATV hospitalizations 2005-2013.
- Clavicle fractures were the most common upper extremity injury at 15% in rollovers.
- Internal organ injuries occurred in 18% of severe ATV crashes, mostly spleen/liver.
- Facial lacerations and contusions made up 8% of pediatric ATV injuries.
- Pelvic fractures from ATV crashes had a 25% mortality rate in adults.
- 31% of ATV injuries involved sprains/strains, primarily ankles and wrists.
- Concussions accounted for 14% of head injuries in helmeted vs 29% non-helmeted riders.
- Crush injuries to extremities were 12% of farm-related ATV incidents.
- Cervical spine injuries occurred in 7% of ATV rollover victims.
- Dental injuries were reported in 5% of pediatric ATV facial traumas.
- Rib fractures dominated torso injuries at 48% in adult ATV crashes.
- Open wounds comprised 16% of all ATV extremity injuries treated in ERs.
- Skull fractures occurred in 9% of non-helmeted pediatric head injuries.
- Shoulder dislocations were 11% of upper body injuries in ATV collisions.
- Abdominal injuries required surgery in 23% of severe pediatric cases.
- Lacerations to the head/neck were 25% more common without helmets.
- Femur fractures had the longest hospital stays, averaging 12 days in ATV injuries.
- Contusions/abrasions were 35% of minor ATV injuries in 2019 data.
- Vertebral burst fractures seen in 6% of high-speed ATV crashes.
- Hand/finger injuries comprised 9% of all extremity traumas from ATVs.
Injury Types Interpretation
It seems the ATV, in its relentless quest to diversify our suffering, offers a grim, full-body catalog of injuries where no bone, organ, or piece of skin is left unconsidered.
Long-term Outcomes
- Long-term disability affected 12% of severe ATV injury survivors, mostly spinal.
- 22% of hospitalized ATV patients required ICU admission, avg 7 days.
- Post-ATV TBI patients had 35% higher risk of chronic neurological deficits.
- 18% of pediatric ATV fracture patients needed surgical intervention.
- ATV injury survivors had 2.5 times higher healthcare costs over 5 years.
- Helmet laws reduced severe head injury outcomes by 39% in states with mandates.
- 41% of spinal cord injured ATV victims remained paralyzed long-term.
- Readmission rates for ATV torso injuries averaged 14% within 30 days.
- Chronic pain reported in 52% of adult ATV extremity fracture survivors.
- Mortality within 1 year post-ATV hospitalization was 8% for ages 40+.
- Functional recovery poor in 29% of pediatric TBI from ATVs after 2 years.
- ATV crash victims had 3-fold increase in PTSD diagnosis at 6 months.
- Orthopedic complications like non-union in 11% of femur fractures from ATVs.
- Reduced quality of life scores in 67% of severe ATV injury survivors.
- 25% of ATV head injury patients developed epilepsy within 5 years.
- Rehabilitation costs for ATV spinal injuries averaged $250,000 per case.
- 16% recurrence of ATV injuries among prior victims within 3 years.
- Visual impairments persisted in 9% of facial trauma ATV survivors.
- Opioid dependence developed in 21% of chronic pain ATV patients.
Long-term Outcomes Interpretation
These statistics paint a grim portrait of ATV crashes, where a moment’s thrill often cashes in with a lifetime of paralysis, pain, and bankruptcy, proving that the only thing tougher than these machines is surviving what they do to you.
Pediatrics
- Children under 16 accounted for 22% of all ATV injury ER visits in 2022.
- Boys aged 10-14 had the highest ATV injury rate at 213.4 per 100,000 from 1990-2003.
- 36% of pediatric ATV injuries involved children under 12 years old in 2001-2012 data.
- From 2000-2009, 15% of all ATV injuries were in children under 16, totaling 160,900 cases.
- Pediatric ATV hospitalization rates for ages 5-9 were 7.3 per 100,000 in 2001-2010.
- 27,000 children under 16 were injured in ATV crashes in 2009 alone.
- Children aged 11-15 represented 44% of youth ATV fatalities from 1982-2013.
- In a 1997-2006 study, 62% of injured child ATV riders were passengers.
- Head injuries occurred in 21% of pediatric ATV ER visits from 1990-2006.
- 78% of child ATV fatalities involved no helmet use in CDC 1985-1997 data.
- From 2003-2007, 12% of pediatric ATV injuries were severe enough for hospital admission.
- Boys under 16 had 2.5 times higher ATV injury rates than girls from 2001-2010.
- 40% of child ATV injuries occurred on public roads, illegal for youth models, 2000-2009.
- Pediatric ATV injury peak age group 10-14 years saw 5,800 ER visits in 2018.
- From 2010-2019, children under 16 comprised 23% of 875,000 total ATV ER injuries.
- 65% of fatally injured child ATV riders were passengers under 16 years old.
- In 2022, 21,300 pediatric ATV injuries treated in ERs, mostly ages 12-15.
- Helmet use reduced pediatric head injury risk by 64% in ATV crashes per 2005 study.
- 30% of child ATV injuries involved rollovers, highest mechanism for ages 5-9.
- From 1997-2014, youth ATV fatalities averaged 140 per year, 76% male.
- Children on adult-sized ATVs had 4.5 times higher injury rates than appropriately sized.
- 55% of pediatric ATV ER visits in 2007 were for extremity fractures.
- Pediatric ATV injury rates were highest in summer months, 45% June-August.
- 18% of child ATV injuries resulted from collisions with fixed objects.
- From 2009-2018, pediatric share of ATV injuries stable at 22-25% annually.
Pediatrics Interpretation
We have a clear, long-term pattern where youth ATV use consistently produces a predictable and significant injury toll, revealing that despite decades of data, we haven't yet translated concern into effective prevention.