All-terrain vehicles (ATVs) on the road: a serious traffic safety and public health concern.

On-road all-terrain vehicle (ATV) crashes are frequent occurrences that disproportionately impact rural communities. These crashes occur despite most states having laws restricting on-road ATV use. A number of overall risk factors for ATV-related injuries have been identified (e.g., lack of helmet, carrying passengers). However, few studies have determined the relative contribution of these and other factors to on-road crashes and injuries. The objective of our study was to determine whether there were differences between on- and off-road ATV crashes in their demographics and/or mechanisms and outcomes of injuries.