West Virginia had the third highest number of ATV-related deaths and the highest death rate among all states from 1990-98. Adolescents were identified as a particularly high-risk ATV user group. Fatality data from the U.S. Consumer Product Safety Commission indicated that one-quarter (25 of 101) of the state's ATV-related deaths occurred among children 16 and younger. Only one victim was wearing a helmet at the time of their fatal crash and nearly 70% of the victims were males. The average years of potential life lost was 64.2. WV's adolescent death rate of 0.67 per 100,000 was 5 times higher than the national rate. Young ATV drivers exacerbate the inherent dangers associated with ATVs through poor judgment and risk-taking. Health care providers should utilize "teachable moments" to emphasize ATV safety to their young patients and their parents, but more importantly, adults must become role models by embracing and teaching practical preventive measures.