Background All-terrain vehicles are used in a variety of industries and occupations.

Objective To estimate the societal economic burden associated with occupation-related ATV fatalities among civilian persons more than 17 years of age in the USA from 2003–2006.

Methods ATV death data were obtained from the Bureau of Labor Statistics' annual Census of Fatal Occupational Injuries. Costs were estimated using a model employing a cost-of-illness method developed by the National Institute for Occupational Safety and Health.

Results From 2003–2006, 129 occupation-related ATV deaths occurred among persons >17 years of age in the USA, nearly doubling from 20 deaths in 2003–39 deaths in 2006. The collective lifetime cost of the deaths was $103.6 million (M) with a 4-year mean of $803 100 and a 4-year median of $772 100. Decedents aged 35–54 years accounted for one-third of the deaths (n=41) at a cost of $50.1 M. Montana had the most deaths (13). Fifty-two per cent of the deaths were overturns costing $48.3 M. Eighty-four (65%) of the deaths were workers in agricultural production at a cost of $62.3 M.

Significance Short-term investment in prevention measures, such as training and helmets for workers, could provide lasting dividends by preventing occupation-related ATV deaths and reducing their economic impact.