Published September 25, 2026

An Iowa law that expanded roadway access for all-terrain vehicles (ATVs) and utility task vehicles (UTVs) was associated with increases in ATV/UTV crashes, severe injuries and deaths, and hospitalization costs, a University of Iowa study found.

In 2022, Iowa passed House File 2130, allowing ATVs/UTVs on secondary roads and state highways. Before the law, individual Iowa counties could choose whether to allow or restrict them on roadways.

Researchers analyzed ATV/UTV crashes before and after implementation of the law, using data from January 2020 through December 2024. Data sources included the Iowa Department of Transportation, a Level I trauma center, and statewide hospital admissions. The analysis assessed crash characteristics, patient injuries and outcomes, hospital care, and health care costs.

Luke Vaske, a summer research fellow in the Department of Surgery in the Carver College of Medicine who led the study, said, “For me, the most striking finding was that the fatality rate nearly doubled, indicating that the nature of those crashes is changing. In particular, the increase in roadway crashes, and potentially collisions with other vehicles, may be contributing to more lethal mechanisms of injury.”

Crash-related increases after Iowa House File 2130 

• Overall ATV/UTV crashes increased 40.7% from 241 before the legislation to 339 after the legislation.
• Fatal crashes increased from 6.2% to 11.8%.
• Crashes on concrete surfaces increased from 48.5% to 61.1%.
• Crashes on state routes increased from 1.7% to 7.1%.

Hospital-related increases

• Abdominal injuries increased from 12.9% to 26.1%, chest injuries from 27.4% to 37.7%, and upper-extremity injuries from 45.2% to 67.6%.
• Unplanned reoperations and intensive care unit admissions increased from 0.5% to 7.2%.
• Hospitalization costs increased from $38,021 to $50,820.

Injuries become more severe

Vaske said that before the law, crashes predominantly caused lower-extremity injuries, consistent with off-road rollovers and single ATV/UTV crashes. After the law, researchers observed more chest, abdominal, and upper-extremity injuries.

“While our study cannot establish the exact mechanism, I think this pattern may reflect a shift toward higher-speed roadway impacts and vehicle-to-vehicle collisions,” he said. That is concerning because an ATV or UTV is a relatively lightweight, off-road vehicle now sharing pavement with much larger and faster vehicles.”

ATVs/UTVs are built for off-roadway riding, not for use on roadways. Their high center of gravity, low-pressure tires, and different handling characteristics can make them less stable at higher speeds and during sudden maneuvers on roadways. A previous UI study found that riding ATVs on roadways increases the risk for serious injury and death.

From county ordinances to stateside access

In 2004, Iowa gave individual counties the authority to adopt ordinances permitting off-road vehicle (ORV) use on public roadways. Between 2011 and 2018, 45 of Iowa’s 99 counties passed ORV roadway ordinances.

Before the 2022 law, UI researchers investigated ATV/UTV crashes as more counties adopted ORV roadway ordinances. The pilot study, funded by the IPRC, found that crashes increased significantly in counties that allowed ATVs/UTVs on public roadways compared with counties that did not.

Preventing ATV/UTV crashes in Iowa

Vaske said the most important policy question is whether ATVs and UTVs should be allowed on paved roadways.

“At a minimum, restricting their use to appropriate unpaved or lower-speed roads could be considered,” he said.

Other measures, Vaske said, could include mandatory helmet and seatbelt use, along with improved statewide registration and real-time crash surveillance to help evaluate the impact of ATV/UTV laws.

A limitation of the study was that researchers did not have reliable statewide ATV and UTV registration data and therefore did not know whether crashes increased because more people were riding these vehicles.

“We couldn’t completely separate the effect of the legislation from the possibility that there were simply more ATVs and UTVs in use during the post-legislation period,” Vaske said.

The study, published in Injury Prevention, was titled “Price to pay for freedom to ride: deregulation of All-Terrain and Utility Task Vehicles operation is associated with increased crashes and healthcare costs in Iowa, USA – a retrospective cohort study.” Co-authors include Sadaf Akbari, Colette Galet, Patrick McGonagill, and Dionne Skeete, all from the Department of Surgery.