Purpose. To estimate the costs of recreational boating injuries in the United States.

Data and Methods. We applied previously developed cost-estimating methods, similar to those used by the Department of Transportation, to boating-related injury cases in national and state mortality and medical discharge data sets. We grouped the costed cases by injury diagnosis into Boating Accident Reporting Data (BARD) diagnosis categories and merged the resulting average costs by severity level (fatal, hospital-admitted, non-admitted) onto BARD case counts adjusted for under-reporting. Cost categories included medical, work-loss (both wages and household production), and quality of life.

Results. In 2002, injuries resulting from recreational boating accidents generated $3.6 billion in costs, or about 1% of all transportation-related injury costs. The cost of the average medically treated boating injury was about $114,000 – nearly twice that of other transportation-related injuries. Boating injuries are more likely than injuries from most other causes to result in death or hospital admission, which accounts for their expense.

Conclusions. Boating injuries tend to be severe, and they impose significant societal costs.