Association between older driver characteristics, on-road driving test performance, and crash liability

From May 1999, a new system for licensing older drivers was introduced in New Zealand. It included a practical on-road driving test with expanded scope, to be completed every two years from the time the driver turns 80. The relationship between crashes and test performance needed to be studied to inform the debate regarding the testing system. The population studied was all drivers who entered this licensing system during its first three years of operation. They were defined as crash involved if they were involved in an injury crash during the two years following their first licensure under the new system. Logistic regression was used to describe the risk of crash involvement in terms of driving test performance and other driver characteristics. Each driving test failure was associated with a 33% increase in the odds of crash involvement (95% CI 14% to 55%), controlling for age, gender, minor traffic violations, and whether the older driver lived with another licensed driver or not. Minor traffic violations in the two years following the driving test were associated with twice the odds of crash involvement. These results suggest that the new on-road driving test does identify older driver behaviors or limitations that are related to crash liability. It is anticipated that the results presented here will provide essential information for discussing older driver licensing systems, whose impact will grow in importance as the population of drivers ages.     

Improving older driver knowledge and self-awareness through self-assessment: the driving decisions workbook

PURPOSE: This study aims to assess whether the Driving Decisions Workbook, a self-assessment instrument for older drivers, increased self-awareness and general knowledge. This study also assessed perceptions regarding its usefulness, particularly as a tool for facilitating discussions within families of older drivers. A secondary purpose of the study was to determine if problems identified by drivers in the workbook related to problems they had with actual driving. DESIGN AND METHODS: The Driving Decisions Workbook was administered along with a questionnaire and a road test. A convenience sample of 99 licensed drivers aged 65 and above was used. RESULTS: After completing the workbook, about three fourths of the participants reported being more aware of changes that could affect driving. Fourteen percent reported that they had discovered a change in themselves of which they had not been previously aware. All respondents found the workbook to be at least a little useful and thought the workbook could help facilitate family discussions. Workbook responses were positively correlated with overall road test scores. Significant correlations were also noted between the road test and a majority of workbook subsection responses. IMPLICATIONS: This study indicates that the workbook may be a useful first-tier assessment instrument and educational tool for the older driver. It may encourage an older driver to drive more safely and/or to seek clinical assessment, and help in facilitating discussions about driving within their families.     

Using a driving simulator to identify older drivers at inflated risk of motor vehicle crashes

PROBLEM: To develop appropriate assessment criteria to measure the performance of older drivers using an interactive PC-based driving simulator, and to determine which measures were associated with the occurrence of motor-vehicle crash. METHOD: One hundred and twenty-nine older drivers residing in a metropolitan city volunteered to participate in this retrospective cohort study. Using the driving simulator, appropriate driving tasks were devised to test the older drivers, whose performances were assessed by 10 reliable assessment criteria. Logistic regression analysis was then undertaken to determine those criteria that influence the self-reported crash outcome. RESULTS: As expected, driving skill of older drivers was found to decline with age. Over 60% of the sample participants reported having at least one motor-vehicle crash during the past year. Adjusting for age in a logistic regression analysis, the cognitive abilities associated with the crash occurrence were working memory, decision making under pressure of time, and confidence in driving at high speed. SUMMARY: The findings of this retrospective study indicated those individuals at inflated risk of vehicle crashes could be identified using the PC-based interactive driving simulator. Prospective studies need to be undertaken to determine whether the driving simulator can predict future crash events. IMPACT ON INDUSTRY: This study demonstrated an economical driving simulator approach to screen out problematic or unsafe older drivers before a more detailed but expensive road test is considered.     

Medical referral and license disposition for drivers in Iowa

Introduction: Driver retirement and determination of fitness-to-drive are important aspects of reducing the risk of motor-vehicle collision for an older driver. A lack of information about the review process may lead to poor evaluation of drivers or an increased testing burden to referred drivers. Methods: This paper evaluates the license review process for the state of Iowa. We evaluated data from January 2014 to January 2018 and described the source of referral, testing process, and ultimate license disposition. Cox proportional hazards for competing risk were used to determine the risk of having a change in restrictions on the license and the risk of license denial. Results: 20,742 individuals were followed through the medical referral process. The most common source of referrals was licensing officials (39.7%). Drivers referred by licensing officials were less likely to be denied their license when compared to drivers from other sources (HR = 0.92 95%CI: 0.87–0.98); however, licensing official referrals were more likely to result in license restrictions compared to other sources (HR = 1.91, 95%CI: 1.82–2.00). Drivers referred by either law enforcement or a physician were more likely to ultimately have their license denied. Conclusions: Physician and law enforcement referred the drivers most likely to have their license denied. A smaller proportion of drivers were referred by physicians and law enforcement compared to licensing officials. Practical Applications: Licensing agencies should work with physicians and law enforcement to identify drivers who may need a review of their license. Comprehensive tracking of all medical referrals for a driver’s license review is important for individual states to understand the burden of their driver referral process and for identifying referral sources with a high proportion of referrals with no licensing change for targeted outreach and education.     

Age of licensure and monitoring teenagers' driving: survey of parents of novice teenage drivers

OBJECTIVE: To assess parental decision making regarding the timing of teenagers initiating driving and monitoring teenagers' driving after licensure. METHODS: About 300 parents were interviewed during spring 2006 in Minnesota, North Carolina, and Rhode Island, states with varying licensing provisions, while teenagers took their first on-road driving tests. RESULTS: States' differences in ages of obtaining learner's permits and licenses reflected different licensing laws, but most teenagers obtained permits and took road tests within the first few months after they became eligible. Common reasons for delaying obtaining permits were fulfilling driver education requirements and lack of readiness/immaturity. Insufficient practice driving most often delayed licensure. Among the parents interviewed, 33-49% believed the minimum licensure age should be 17 or older. Almost all parents planned to supervise teenagers' driving after licensure, and most wanted to know about speeding or distractions. When asked about in-vehicle devices to monitor teenagers' driving, 37-59% of parents had heard of them. Parents were least interested in using video cameras and about equally interested in computer chips and cell-phone-based GPS systems. Disinterest in monitoring devices most often was attributed to trusting teenagers or respecting their privacy. CONCLUSIONS: Licensing laws influence ages of initiating driving. Although many parents support licensing at 17 or older - higher than in all but one state - most teenagers initiate driving soon after reaching the minimum age. Parents plan to supervise teenagers' driving, and many say they are open to using in-vehicle monitoring devices. IMPACT ON INDUSTRY: Many parents support a minimum licensing age of 17 or older and would consider in-vehicle devices to extend their supervision of teenager's driving.     

Driver licensing,motor-vehicle crashes,and moving violations among older adults

IntroductionDriving is important for well-being among older adults, but age-related conditions are associated with driving reduction or cessation and increased crash risk for older drivers. Our objectives were to describe population-based rates of older drivers’ licensing and per-driver rates of crashes and moving violations.Methods: We examined individual-level statewide driver licensing, crash, and traffic citation data among all New Jersey drivers aged ≥ 65 and a 35- to 54-year-old comparison group during 2010–2014. Rate ratios (RR) of crashes and moving violations were estimated using Poisson regression.Results: Overall, 86% of males and 71% of females aged ≥ 65 held a valid driver’s license. Older drivers had 27% lower per-driver crash rates than middle-aged drivers (RR: 0.73, 95% CI: 0.73, 0.74)—with appreciable differences by sex—but 40% higher fatal crash rates (RR: 1.40 [1.24, 1.58]). Moving violation rates among older drivers were 72% lower than middle-aged drivers (RR: 0.28 [0.28, 0.28]).Conclusion: The majority of older adults are licensed, with substantial variation by age and sex. Older drivers have higher rates of fatal crashes but lower rates of moving violations compared with middle-aged drivers.Practical applications: Future research is needed to understand the extent to which older adults drive and to identify opportunities to further reduce risk of crashes and resultant injuries among older adults.     

Does longevity impact the severity of traffic crashes? A comparative study of young-older and old-older drivers

Introduction: This article analyzes the effect of driver’s age in crash severity with a particular focus on those over the age of 65. The greater frequency and longevity of older drivers around the world suggests the need to introduce a possible segmentation within this group at risk, thus eliminating the generic interval of 65 and over as applied today in road safety data and in the automobile insurance sector. Method: We investigate differences in the severity of traffic crashes among two subgroups of older drivers –young-older (65–75) and old-older (75+), and findings are compared with the age interval of drivers under 65. Here, we draw on data for 2016 provided by Spanish Traffic Authority. Parametric and semi-parametric regression models are applied. Results: We identified the factors related to the crash, vehicle, and driver that have a significant impact on the probability of the crash being slight, serious, or fatal for the different age groups. Conclusions: We found that crash severity and the expected costs of crashes significantly increase when the driver is over the age of 75. Practical Applications: Our results have obvious implications for regulators responsible for road safety policies – most specifically as they consider there should be specific driver licensing requirements and driving training for elderly – and for the automobile insurance industry, which to date has not examined the impact that the longevity of drivers is likely to have on their balance sheets.     

Characteristics and risks of drivers with low annual distance driven

OBJECTIVES: It has been noted by several authors that risk (defined only in terms of total expected numbers of crash involvements per total distance driven) paints a misleading picture of crash liability, particularly for the young and the old, as their high risk is associated with risky driving patterns typical of people who drive low annual kms. This article sets out to analyze these driving patterns of low-km drivers and to evaluate the risk of these patterns. As licensing programs tend to focus on young and old drivers, who tend to drive lower annual distances, income and employment data are also analyzed for low-km drivers. This is to provide a better picture for policy makers of the sort of people and the sorts of transportation requirements that their policies may affect. METHODS: Crash data and travel data were disaggregated by driver characteristics and by driving conditions (road type, day and night, weekend and weekday) and combined to form estimates of risk for typical driving patterns of driver groups. Characteristics of driving patterns and of the drivers themselves were derived for groups defined by age and by the amount of annual driving undertaken. RESULTS: Older drivers who drive less tend to have higher risk per km mainly due to their predominantly urban trips. Nevertheless, because older drivers on average manage to reduce their risk per distance driven by choosing driving patterns that are safer than the driving patterns of other age groups, the risk of older drivers as a group is not overestimated. CONCLUSION: Despite being quite different from one another, the low- and high-km driving patterns of younger drivers were found to impose identical risks.     

Effectiveness of mandatory license testing for older drivers in reducing crash risk among urban older Australian drivers

Most licensing jurisdictions in Australia maintain mandatory assessment programs targeting older drivers, whereby a driver reaching a specified age is required to prove his or her fitness to drive through medical assessment and/or on-road testing. Previous studies both in Australia and elsewhere have consistently failed to demonstrate that age-based mandatory assessment results in reduced crash involvement for older drivers. However studies that have based their results upon either per-population or per-driver crash rates fail to take into account possible differences in driving activity. Because some older people maintain their driving licenses but rarely if ever drive, the proportion of inactive license-holders might be higher in jurisdictions without mandatory assessment relative to jurisdictions with periodic license assessment, where inactive drivers may more readily either surrender or lose their licenses. The failure to control for possible differences in driving activity across jurisdictions may be disguising possible safety benefits associated with mandatory assessment. The current study compared the crash rates of drivers in Melbourne, Australia, where there is no mandatory assessment and Sydney, Australia, where there is regular mandatory assessment from 80 years of age onward. The crash rate comparisons were based on four exposure measures: per population, per licensed driver, per distance driven, and per time spent driving. Poisson regression analysis incorporating an offset to control for inter-jurisdictional road safety differences indicated that there was no difference in crash risk for older drivers based on population. However drivers aged 80 years and older in the Sydney region had statistically higher rates of casualty crash involvement than their Melbourne counterparts on a per license issued basis (RR: 1.15, 1.02-1.29, p=0.02) and time spent driving basis (RR: 1.19, 1.06-1.34, p=0.03). A similar trend was apparent based on distance travelled but was of borderline statistical significance (RR: 1.11, 0.99-1.25, p=0.07). Collectively, it can be inferred from these findings that mandatory license re-testing schemes of the type evaluated have no demonstrable road safety benefits overall. Further research to resolve this on-going policy debate is discussed and recommended.     

Cognitive failures, driving errors and driving accidents

INTRODUCTION: The impact of a driver's cognitive capability on traffic safety has not been adequately studied. This study examined the relationship between cognitive failures, driving errors and accident data. METHOD: Professional drivers from Iran (160 males, ages 18-65) participated in this study. The cognitive failures questionnaire (CFQ) and the driver error questionnaire were administered. The participants were also asked other questions about personal driving information. A principal component analysis with varimax rotation was performed to determine the factor structure of the CFQ. Poisson regression models were developed to predict driving errors and accidents from total CFQ scores and the extracted factors. RESULTS: Total CFQ scores were associated with driving error rates, but not with accidents. However, the 2 extracted factors suggested an increased effect on accidents and were strongly associated with driving errors. DISCUSSION: Although the CFQ was not able to predict driving accidents, it could be used to identify drivers susceptible to driving errors. Further development of a driving-oriented cognitive failure scale is recommended to help identify error prone drivers. Such a scale may be beneficial to licensing authorities or for developing driver selection and training procedures for organizations.     

Impact of medical fitness to drive policies in preventing property damage,injury, and death from motor vehicle collisions in Ontario,Canada

Introduction: Drivers with medical conditions and functional impairments are at increased collision risk. A challenge lies in identifying the point at which such risk becomes unacceptable to society and requires mitigating measures. This study models the road safety impact of medical fitness-to-drive policy in Ontario. Method: Using data from 2005 to 2014, we estimated the losses to road safety incurred during the time medically-at-risk drivers were under review, as well as the savings to road safety accrued as a result of licensing decisions made after the review process. Results: While under review, drivers with medical conditions had an age- and sex-standardized collision rate no different from the general driver population, suggesting no road safety losses occurred (RR = 1.02; 95% CI: 0.93–1.12). Licensing decisions were estimated to have subsequently prevented 1,211 (95% CI: 780–1,730) collisions, indicating net road safety savings resulting from medical fitness to drive policies. However, more collisions occurred than were prevented for drivers with musculoskeletal disorders, sleep apnea, and diabetes. We theorize on these findings and discuss its multiple implications. Conclusions: Minimizing the impact of medical conditions on collision occurrence requires robust policies that balance fairness and safety. It is dependent on efforts by academic researchers (who study fitness to drive); policymakers (who set driver medical standards); licensing authorities (who make licensing decisions under such standards); and clinicians (who counsel patients on their driving risk and liaise with licensing authorities). Practical Applications: Further efforts are needed to improve understanding of the effects of medical conditions on collision risk, especially for the identified conditions and combinations of conditions. Results reinforce the value of optimizing the processes by which information is solicited from physicians in order to better assess the functional impact of drivers’ medical conditions on driving and to take suitable licensing action.     

Other high-risk factors for young drivers--how graduated licensing does,doesn't,or could address them

PROBLEM: Young drivers, particularly those who are newly licensed, have a very high crash risk. This paper examines the risk factors underlying their high crash rates and assesses the extent to which existing graduated licensing programs address these risks and whether improvements to these programs should be considered. METHOD: Review and synthesis of the literature. RESULTS: The elevated risk among young drivers of being in an injury crash is the result of a number of factors found alone or in combination, such as risky driving, alcohol use, seat belt nonuse, driver distraction, fatigue, and vehicle choice. Nighttime and passenger restrictions, adopted widely in the United States, work by keeping drivers out of hazardous situations rather than by addressing risk factors directly. However, the risk factors remain in play in driving situations not specifically restricted by law. Although other graduated licensing components adopted around the world-more stringent exit tests (i.e., you need to pass a test to move to the next stage), hazard perception tests, and restrictions on speed, vehicle power, and roadway access-make sense based on the identified risk factors, they are not yet supported by research. Should research findings warrant it, consideration should be given to providing guidance to parents about how to keep their beginning drivers safe, including information on vehicle choice. IMPACT ON RESEARCH, PRACTICE, AND POLICY: Researchers should continue to monitor and to evaluate innovative approaches to reduce the crash risk of young drivers. The effectiveness of new approaches should be established before adoption on a wider scale takes place.     

Aggressive driving behaviour in young drivers (aged 16 through 25) involved in fatal crashes

IntroductionWe wished to determine the extent to which number of passengers, driver age, and sex were associated with aggressive driving actions (ADAs) in young drivers involved in a fatal crash.MethodsWe used U.S. fatal-crash data from Fatality Analysis Reporting System (FARS), 1991 –2008. Proxy measures of aggressive driving included ADA presence and speed differential (posted speed limit minus estimated travel speed). We examined the odds of an ADA and speed differential in young drivers (aged 16 to 25) by passenger status.ResultsCompared to driving alone young drivers (aged 16) had increased odds of an ADA between 14% (OR: 1.14; 95% CI: 1.07; 1.22) and 95% (OR: 1.95; 95% CI: 1.40; 2.74) when accompanied by one and five passengers, respectively. Further, carrying a higher number of passengers was a stronger predictor of speeding in younger drivers.ConclusionsThis study supports the use of graduated licensing approaches. Specifically, developing interventions to reduce aggressive driving appear imperative.Impact on IndustryWhile the results of our study support the use of graduated licensing approaches there is room for improvement. Our study indicates that tackling impaired driving is not sufficient to drastically reduce aggressive driving among the youngest drivers. Further research on young drivers is required to understand the influence of peers and the role of gender on driving behavior. Strategies to reduce aggressive driving behaviors among the youngest drivers may not only prevent crashes during their early driving careers but may also translate into a reduced crash risk over their lifetime.     

The provisional license: nighttime and passenger restrictions--a literature review

PROBLEM: Due to inexperience and inadequate driving skills, the road is a very risky place for young and beginning drivers, yet such experience and skills can only be built by increased driving and exposure to risks on the road. Graduated driver licensing (GDL) allows beginning drivers to get their initial driving experience under less risky conditions and gradually eases them into more complex driving situations. This paper reviews the literature exploring two key features of the intermediate licensing phase of GDL, nighttime driving restrictions and passenger restrictions. METHOD: Literature review. RESULTS: Nighttime driving restrictions have been shown to effectively reduce the number and rate of crash involvements on the part of teenage drivers. Data suggest that having passengers in the car increases the likelihood of a fatal injury in young drivers and that this risk increases with the number of passengers. Young drivers were more likely to cause a crash when accompanied by their peers. DISCUSSION: Nighttime driving and passenger restrictions are effective in decreasing injuries among teenage drivers and their passengers, especially in the context of a full GDL system. Several research questions remain to be answered in order to fully refine and optimize the impact of these provisional measures.     

The effect of extending graduated driver licensing to older novice drivers in Indiana

Introduction: Graduated driver licensing (GDL) systems have been shown to reduce rates of crashes, injuries, and deaths of young novice drivers. However, approximately one in three new drivers in the United States obtain their first driver’s license at age 18 or older, and thus are exempt from most or all provisions of GDL in most states. Method: In July 2015, the state of Indiana updated its GDL program, extending its restrictions on driving at night and on carrying passengers during the first 6 months of independent driving, previously only applicable to new drivers younger than 18, to all newly-licensed drivers younger than 21 years of age. The current study examined monthly rates of crashes per licensed driver under the affected conditions (driving at night and driving with passengers) among Indiana drivers first licensed at ages 18, 19, and 20 under the updated GDL system compared with drivers licensed at the same ages under the previous GDL system. We used Poisson regression to estimate the association between the GDL system and crash rates, while attempting to control for other factors that might have also influenced crash rates. We used linear regression to estimate the association between the GDL system and the proportion of all crashes that occurred under conditions restricted by the GDL program. Results: Results showed, contrary to expectations, that rates of crashes during restricted nighttime hours and with passengers were higher among drivers licensed under the updated GDL system. This mirrored a statewide increase in crash rates among drivers of all ages over the study period and likely reflected increased overall driving exposure. The proportions of all crashes that were at night or with passengers did not change. Practical Applications: More research is needed to understand how older novice drivers respond when GDL systems originally designed for younger novice drivers are applied to them.     

Older driver crash rates in relation to type and quantity of travel

It is a well-established phenomenon that, notwithstanding their overall good crash record, older drivers have a higher than average rate of involvement in injury crashes when the rate is calculated by dividing crash numbers by distance driven. It has been hypothesised that at least some of this higher crash rate is an artefact of the different nature of driving undertaken by many older drivers. For example, driving in congested urban environments provides more opportunities for collisions than driving the same distance on a motorway. However, there have been few opportunities to investigate this theory, as relevant data are difficult to acquire. High-quality data from the New Zealand Travel Survey (1997/1998) were combined with crash data to enable a statistical model to estimate the risk of driver groups under various driving conditions characterised by the type of road used, time of day, day of week, and season of year. Despite elevated crash risks per distance driven compared with middle-aged drivers for most road types, older drivers were as safe as any other age group when driving on motorways. Accounting for the fragility of older drivers and their passengers in the risk estimates for other road types, older drivers appeared to have daytime risks comparable to 25-year-olds and night-time risks as low as any other age group. The driving patterns of older drivers (in terms of when and where they drive) were estimated to minimize their risks in comparison with the driving patterns of other age groups. These results are of interest to both policy makers and transportation planners working against the background of inevitable increases in the number of older drivers as the population ages.     

The genesis of GDL

This paper discusses the early research that lead to graduated driver licensing, some of the educational principals on which it is based, obstacles to its acceptance, and some of the early efforts in the U.S. and elsewhere. EARLY RESEARCH: The research underlying the concept of graduated driver licensing was a 1971 North Carolina study that identified the overrepresentation of young drivers in crashes at night and when another young person was the right front passenger. EDUCATIONAL PRINCIPALS: Efforts to reduce the risk to young novice drivers applied what was known about learning. The concepts included distributed learning (i.e., over time) and progressing from simple to complex skills. A PROPOSAL: The proposed graduated licensing system based on learning principals included (a) initial experience under low risk conditions, (b) extended supervised practice, (c) gradual move to more complex conditions, and (d) harsher penalties for deliberate risk-taking. OBSTACLES: There were several most common objections raised against graduated licensing. Raising the licensing age decreased mobility. Some young drivers were "good" drivers. Enforcement is difficult. Fear of parental objections. Parents are not driver educators and some young people do not have an available parent. Administrative costs are too high. ACCEPTANCE: Driver educators were the first to see the benefits of a graduated system in the 1970s and 1980s. Toronto nearly adopted a graduated system in 1976. New Zealand was the first to adopt a graduated licensing system in 1984. Michigan in 1997 was the first state to require parental certification of extended supervised driving practice.     

Prevalence and characteristics of road traffic injuries among young drivers in Oman, 2009–2011

Objectives: Studies from different parts of the world have indicated that the impact of road traffic incidents disproportionally affects young adults. Few known studies have been forthcoming from Arabian Gulf countries. Within Oman, a high proportion of the population is under the age of 20. Coupled with the drastic increase in motorization in recent years, there is a need to understand the state of road safety among young people in Oman. The current research aimed to explore the prevalence and characteristics of road traffic injuries among young drivers aged 17–25 years.

Methods: Crash data from 2009 to 2011 were extracted from the Directorate General of Traffic, Royal Oman Police (ROP) database in Oman. The data were analyzed to explore the impact of road crashes on young people (17–25 years), the characteristics of young driver crashes, and how these differ from older drivers and to identify key predictors of fatalities in young driver crashes.

Results: Overall, young people were overrepresented in injuries and fatalities within the sample time period. Though it is true that many young people in crashes were driving at the time, it was also evident that young people were often victims in a crash caused by someone else. Thus, to reduce the impact of road crashes on young people, there is a need to generally address road safety within Oman. When young drivers were involved in crashes they were predominantly male. The types of crashes these drivers have can be broadly attributed to risk taking and inexperience. Speeding and nighttime driving were the key risk factors for fatalities.

Conclusion: The results highlight the need to address young driver safety in Oman. From these findings, the introduction of a graduated driver licensing system with nighttime driving restrictions could significantly improve young driver safety.