title: State-specific ATV-related fatality rates: an update in the new millennium.
abstract: OBJECTIVE
  We compared state-specific all-terrain vehicle (ATV) fatality rates from 2000-2007 with 1990-1999 data, grouping states according to helmet, training, and licensure requirements.
  
  
  METHODS
  We used the CDC WONDER online database to identify ATV cases from 2000-2007 and calculate rates per 100,000 population by state, gender, and age.
  
  
  RESULTS
  ATV deaths (n=7,231) occurred at a rate of 0.32 per 100,000 population. Males accounted for 86% of ATV-related deaths at a rate that was six times that for females (0.55 vs. 0.09 per 100,000 population, respectively); 60% of the male deaths occurred in the 15- to 44-year age group. With the exception of the two oldest age categories, rates were consistently higher in the no-helmet-law group. Both the number and rate of ATV-related deaths increased more than threefold between 1990-1999 and 2000-2007. West Virginia and Alaska continue to have the highest ATV fatality rates (1.63 and 2.67 ATV deaths per 100,000 population, respectively).
  
  
  CONCLUSIONS
  Helmet-use requirements seem to slightly mitigate ATV-related death, but training requirements do not. For policy to be effective, it must be enforced.
authors: National Institute for Occupational Safety and Health, Western States Office, Denver, CO 80225-0226, USA. jch4@cdc.gov
authors: James C
authors: JC
authors: Helmkamp
authors: Mary E
authors: ME
authors: Aitken
authors: James
authors: J
authors: Graham
authors: Corey R
authors: CR
authors: Campbell
mesh_terms: D000063:Accidents, Traffic / Q000401:mortality*; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000413:Alaska / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006260:Head Protective Devices / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D008004:Licensure / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015541:Off-Road Motor Vehicles / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D014903:West Virginia / Q000453:epidemiology; D055815:Young Adult