DES MOINES, Iowa (AP) - When she crashed on an all-terrain vehicle, Megan Cratsley was hurt so badly that doctors had to amputate much of her right arm, a life-altering surgery that launched the teenager on a personal mission to change New York traffic laws to protect other ATV riders.
The buzzy, open-air vehicles are supposed to be banned from roads in New York and many other states. But small communities across the nation are increasingly bending the rules under pressure from riders who want to go wherever they please, even though ATV manufacturers warn that the vehicles are unstable on flat terrain at high speed, and accidents on roads kill more than 300 riders each year.
The trend appalls public health officials and is opposed by the manufacturers.
"We've seen too many people die," said Jen Kruzicke-Cratsley, Megan's mother, who lives near Buffalo, New York, and joined in her daughter's legislative efforts to make ATVs safer.
ATV enthusiasts acknowledge the vehicles can be dangerous if not driven properly, but they say the risks are overstated.
Thirty-five states allow local jurisdictions to authorize ATVs on some roads or road shoulders, according to a study by the Consumer Federation of American. While no one tracks how many local governments have offered ATVs access to local roads, the number is rising, as are ATV sales.
In Iowa, at least 17 counties allow all-terrain vehicles on public roads, and a state official said that number could climb to 30 counties by next fall. It's a similar trend in Minnesota, where at least a dozen counties permit some ATVs on roads, and in Indiana, where about half of counties do so.
West Virginia and Montana allow ATV use on most roads other than highways. Utah lawmakers voted in 2015 to allow street-legal ATVs on the shoulders of all roads except interstate freeways.
In New York, ATVs are banned from public roads except for small stretches between off-road riding areas. Yet small communities often grant unrestricted access if riders demand it, said Peter Bauer, executive director of the group Protect the Adirondacks, which often fights such efforts.
ATV manufacturers say the vehicles are designed only for off-road use. Many models have a higher center of gravity than cars. That design allows them to roll easily across uneven ground but also makes them more likely to topple over at high speed. They also have low-pressure tires that can make handling difficult on paved, dirt or gravel roads.
Studies show that more than half of fatal ATV crashes happened on roads. From 2003 to 2013, that number ranged from a high of 377 road deaths in 2008 to 301 in 2003.
Charles Jennissen, an emergency room doctor at the University of Iowa hospital in Iowa City, has studied the issue and travels around the state to discourage officials from legalizing ATVs on public roads. He's losing far more fights than he's winning.
The biggest issue is speed, Jennissen said. The most powerful all-terrain vehicles can travel 80 or 90 mph, but it's nearly impossible to reach these speeds except on roads, so riders race down rural lanes without realizing the risk.
"We see lots of accidents that are totally preventable," Jennissen said. "It's devastating to families and devastating to communities, and they don't need to happen."
Riders say manufacturers' warnings are more about limiting liability than averting serious danger. They regard opening up public roads as a common-sense move that carries little risk and can spur desperately needed economic growth in rural areas by attracting riders and increasing vehicle sales.
Michael Rygh, who co-owns an ATV shop in Algona, Iowa, said a recent decision to open up Kossuth County roads to the vehicles has already boosted sales. He's confident accidents will be rare.