Characteristics of teens-with-teens fatal crashes in the United States, 2005–2010

BackgroundMore than 40% of fatal crashes of 16- and 17-year-old drivers occur when transporting teenagers. Characteristics of this predominant crash type and prevention possibilities are described, based on data from fatal crashes in the United States during 2005–2010.ResultsFifty-seven percent of 16- and 17-year old drivers in fatal crashes had at least one passenger. Most commonly, all passengers were ages 13–19 (42% of all drivers and 73% of those with passengers). Of fatal crashinvolved drivers with teenage passengers and no passengers of other ages, 56% had one passenger, 24% had two, and 20% had three or more. Most frequently, passengers were the same sex and within one year of the driver. Risk factors involving speeding, alcohol use, late-night driving, lack of a valid license, seat belt non-use, and crash responsibility were more prevalent with teenage passengers than when driving alone, and the prevalence of these factors increased with the number of teenage passengers. Many risk factors were most prevalent with passengers ages 20–29, although few crashes had this occupant configuration. Risk factors were least prevalent with a passenger 30 or older.DiscussionFatal crashes of 16- and 17-year-old drivers with teen passengers are a common crash scenario, despite passenger restrictions in 42 states and the District of Columbia during some or all of the study period. The proportion of these fatal crashes decreased slightly from 46% in 1995 (pre-GDL) to 43% in 2010 and showed no signs of decreasing during the six-year study period (range 41% to 43%).Practical applicationsExisting passenger restrictions are relatively weak and could be strengthened. Fatal crashes involving teen passengers, especially multiple passengers, are more likely to involve alcohol, late-night driving, driver error, and invalid licensure, so stepped-up enforcement of existing laws involving these behaviors might reduce the prevalence of such crashes.     

Teenage drivers: patterns of risk

PROBLEM: To determine patterns of risk among teenage drivers. METHOD: Review and synthesis of the literature. RESULTS: On most measures, crash rates during the teenage years are higher than at any other age, for both males and females. Risk among teenagers varies greatly by driving situation; it is particularly low in some situations (e.g., the learner period) and particularly high in others (e.g., right after licensure, late at night, with passengers present). In some of these high-risk driving situations, risk is elevated for drivers of all ages (e.g., late night driving), in others risk is elevated more for teens than adults (e.g., driving after consuming alcohol), and in others the risk is unique to teen drivers (e.g., having passengers). IMPACT ON RESEARCH, PRACTICE, AND POLICY: These varying patterns of risk form the basis for graduated licensing systems, which are designed to promote low-risk and discourage high-risk driving.     

Factors related to seat belt use among fatally injured teenage drivers

PROBLEM: In the United States, teenage drivers have a higher crash risk and lower observed seat belt use than other age groups. METHOD: Seat belt use was examined for teenage (16-19 years) drivers who were fatally injured in traffic crashes occurring in the United States during the years 1995-2000. Vehicle, driver, and crash factors potentially related to belt use were examined. State differences in belt use rates among fatally injured teenage drivers were related to states' observed belt use rates for all ages and other state-level variables. RESULTS: During 1995-2000, mean belt use was 36% among fatally injured teenage drivers and 23% among fatally injured teenage passengers. One of the strongest predictors of higher belt use for both drivers and passengers was whether the crash occurred in a state with a primary seat belt law. Belt use rates for 1995-2000 for fatally injured teenage drivers ranged from 20% or less in six states to more than 60% in two states. States with the highest use rates were those with strong primary belt use laws and those with high rates of observed belt use for all ages. Lower belt use among fatally injured teenage drivers was associated with increasing age; male drivers; drivers of SUVs, vans, or pickup trucks rather than cars; older vehicles; crashes occurring late at night; crashes occurring on rural roadways; single vehicle crashes; and drivers with BACs of 0.10 or higher. Teenage driver belt use declined as the number of teenage passengers increased, but increased in the presence of at least one passenger 30 years or older. IMPACT ON TRAFFIC SAFETY: It is suggested that to increase teenage belt use, states should enact strong primary belt use laws and mount highly publicized efforts to enforce these laws. Graduated driver licensing systems should incorporate strong provisions that require seat belt use by teenage drivers and passengers.     

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.     

California's graduated driver license law: Effect on teenage drivers' deaths through 2005

PROBLEM: While many researchers believe Graduated Driver Licensing (GDL) laws save lives by imposing restrictions and delayed licensure on drivers under age 18, longer term effects on older teenagers have not been studied. METHOD: The effects of California's strict GDL law on deaths of drivers ages 16-19 were analyzed for 1995-2005 using Incidence Rate Ratios (IRR) and Auto-Regressive Integrated Moving Average (ARIMA) time series analysis of Fatality Analysis Reporting System mortality data. RESULTS: The two methods yielded similar results. IRR analysis found California 16-year-old drivers subject to the GDL experienced a 15% fatality decline (95% CI, 0.70-0.99), while 18 year-old drivers experienced a 15% increase (95% CI, 1.02-1.27). ARIMA analysis found 16 year-old drivers experienced a near-significant 20% fatality decline (p=0.07), while 18 year-olds experienced a 24% increase (p=0.01). Unlicensed teenage drivers and older teen drivers driving alone and transporting teenage passengers suffered significant fatality increases. SUMMARY AND DISCUSSION: California's GDL may negatively affect older teenagers and other driver subpopulations and merits reevaluation.     

Progress in teenage crash risk during the last decade

OBJECTIVE: The purpose of the present study was to examine the most recent data on teenagers' fatal and nonfatal crashes in the United States to determine current crash rates as well as changes in crash rates during the past decade METHODS: Data for calendar years 1996 and 2005 were extracted for fatal crashes from the Fatality Analysis Reporting System and for police-reported crashes from the National Automotive Sampling System/General Estimates System. To calculate crash rates, population data were obtained from the Census Bureau, and mileage data were obtained from the 2001 National Household Travel Survey RESULTS: During 2001-02, the latest year for which mileage data are available, 16 year-old drivers had higher fatal and nonfatal crash rates per mile traveled than all but the very oldest drivers. However, fewer 16 year-olds typically are licensed to drive and they drive fewer miles per year than all but the oldest drivers. Thus, their fatal and nonfatal crash rates per population in 2005 were lower than among other teenagers and among drivers 20-29. During the past decade the most progress has been made in reducing crashes among the youngest drivers. Between 1996 and 2005 both fatal and police-reported crashes per population declined about 40% for 16 year-old drivers, compared with about 25% for 17 year-old drivers and 15-19% for 18 year-old drivers. The greatest reductions for 16 year-olds occurred in nighttime crashes, alcohol-related fatal crashes, and fatal crashes involving multiple teenage passengers. CONCLUSIONS: Substantial progress has been made in reducing fatal and nonfatal crashes per population among 16 year-old drivers. Although this study was not designed to examine the role of graduated licensing, the results are consistent with the increased presence of such laws, many of which restrict nighttime driving and driving with teenage passengers. IMPACT ON INDUSTRY: Restrictions on nighttime driving and driving with teenage passengers should be made a part of all states' graduated licensing systems. Historically, 16 year-olds have had the highest crash risk per licensed driver and per mile traveled. Given the dramatic reductions in per population crash rates among 16 year-olds, it is possible that their per mile and per licensed driver rates also have declined and may no longer be as elevated relative to other ages. However, shortcomings in the licensed driver data and a lack of recent mileage data hamper our ability to examine these issues. If we are to continue to provide a yardstick against which we can measure progress among the youngest drivers, immediate steps need to be taken to restore the availability of reliable exposure data.     

Encouraging compliance with graduated driver licensing restrictions

PROBLEM: Although graduated driver licensing (GDL) programs have reduced the high crash rates for 16-and 17-year-old drivers, research suggests that some teenagers fail to comply with restrictions on nighttime driving and carrying passengers. METHOD: A program to encourage compliance with GDL restrictions and seat belt requirements was implemented in Guilford County, North Carolina. The program combined increased enforcement with a multi-faceted publicity campaign drawing attention to the enforcement activity. A comparison community was studied to assess whether changes over time could be reasonably attributed to the program. RESULTS: Several measures indicate that greater enforcement did occur in the intervention community and that teenagers perceived the increase. However, self-reported data and direct observations of young drivers in the intervention and comparison communities showed the program resulted in only modest changes in compliance with GDL restrictions. DISCUSSION: The program put in place the mechanisms known to produce changes in driver behavior, but these may have been insufficient to alter the behavior of the minority of teenagers (and parents) who were not already complying with restrictions. However, the modest changes in young driver behavior plus the clear changes in both actual and perceived enforcement suggest that high visibility enforcement programs merit further use and evaluation in other communities, particularly those where compliance with GDL provisions is lower than in Guilford County.     

Characteristics of crashes and injuries among 14 and 15 year old drivers,by rurality

Purpose: Motor-vehicle crashes continue to be the leading cause of death for teenagers in the United States. The United States has some of the youngest legal driving ages worldwide. The objective of this study was to determine rates and factors associated with injury crashes among 14- and 15-year-old drivers and how these varied by rurality. Methods: Data for this cross-sectional study of 14- and 15-year-old drivers were obtained from the Iowa Department of Transportation from 2001 to 2013. Crash and injury crash rates were calculated by rurality. The relationship between crash and driver factors and injury was assessed using logistic regression. Findings: Teen drivers, aged 14 and 15 years, had a statewide crash rate of 8 per 1,000 drivers from 2001 to 2013. The majority of crashes occurred in urban areas (51%), followed by in town (29%), remote rural areas (13%), and suburban areas (7%). Crash and injury crash rates increased as level of rurality increased. The odds of an injury crash increased more than 10-fold with the presence of multiple other teens as passengers, compared to no passengers (OR = 10.7, 95% CI: 7.1–16.2). Conclusions: Although 14- and 15-year-old drivers in Iowa have either limited unsupervised (school permits) or supervised only driving restrictions, they are overrepresented in terms of crashes and injury crashes. Rural roads and multiple teen passengers are particularly problematic in terms of injury outcomes. Practical applications: Results from this study support passenger restrictions and teen driving interventions designed with a rural focus.     

Child passenger injury risk in motor vehicle crashes: a comparison of nighttime and daytime driving by teenage and adult drivers

INTRODUCTION: To examine the association between child passenger injury risk, restraint use, and crash time (day vs. night) for children in crashes of vehicles driven by teenage versus adult drivers. METHODS: Cross-sectional study involving telephone interviews with insured drivers in a probability sample of 6,184 crashes involving 10,028 children. RESULTS: Child passengers in teen nighttime crashes had an increased injury risk and an increased risk of restraint nonuse compared with those in teen daytime crashes. This increased injury risk can be explained by differences in the age of child passengers, collision type, and child passenger's restraint status associated with time of day. CONCLUSIONS: In order to limit the risk of injury to child passengers driven by teens, Graduated Driver Licensing (GDL) laws should include provisions restricting nighttime driving, as well as mandates for age-appropriate restraint for child passengers. Consideration should also be given for education in child passenger safety for novice teen drivers as part of the licensing process. IMPACT ON INDUSTRY: Results of this study can be used to support advocacy efforts by the automotive industry and others to promote nighttime driving restrictions on novice drivers. In addition, given that both driver groups were more likely to be involved in a single-vehicle collision during the night, technologies such as electronic stability control may offer opportunities for protection. Further reseach on specific circumstances of teen nighttime crashes is needed to inform industry efforts to improve visibility or vehicle operation under poor lighting conditions.     

National evaluation of the effect of graduated driver licensing laws on teenager fatality and injury crashes

ProblemAutomobile crashes remain a prominent cause of death and injury for teenagers in the United States. While it is generally agreed that graduated drivers licensing (GDL) influences crash rates, it is unclear which components have the strongest effect on any specific types of crashes.MethodWe analyze the relative effect of different stages of GDL on teenage fatal and injury crash risk via a negative binomial generalized linear model with random state effects. Overall, nighttime, and crashes with multiple teenage passengers are considered.ResultsThe strongest effects are seen by 16-year-olds, for which a strict permit stage is associated with a 58% reduction in fatal crash risk over a lenient permit stage. Similar reductions are seen for injury crashes. The intermediate stage, involving nighttime and passenger restrictions, is associated with a 44% reduction in fatalities but has relatively little effect on injury crashes. The strongest effects are generally seen for passenger crashes, followed by nighttime, and then overall crashes.Impact on IndustryThis study identifies stronger relationships between GDL and crash risk than has previously been discovered and captures the relative effects of permit and intermediate licensing restrictions, two high-level components of GDL which differ in intent and implementation.     

Temporal patterns of crashes of 16-to 17-year-old drivers in Fairfax County, Virginia

OBJECTIVE: To develop a better understanding of the frequency and characteristics of teenage driver crashes occurring during school commute times. METHOD: Data were obtained from police reports of crashes involving drivers ages 16-17 that occurred between September 2001 and August 2004 in Fairfax County, Virginia. Temporal patterns and other characteristics of crash involvement during the school year were examined, and crashes during school commute times were compared with those at other times. RESULTS: Teenage driver crash involvement spiked during weekday school commute times. Compared with other times, crashes during school commute times were significantly more likely to involve multiple vehicles but less likely to result in injuries or involve drivers who were male, made driving errors, or had been drinking alcohol. Crashes during school commute times were more likely to involve more than one teenage driver and occur close to schools. CONCLUSIONS: Crashes involving teenage drivers are prevalent during school commute times. Many of these crashes involve multiple teenage drivers and occur near schools. Schools and communities should consider programs and policies that reduce teenage driving to school and enhance the safety of teenagers that do drive.     

Passenger distractions among adolescent drivers

PROBLEM: Adolescents who drive with peers are known to have a higher risk of crashes. While passengers may distract drivers, little is known about the circumstances of these distractions among teen drivers. METHOD: This study used survey data on driving among 2,144 California high school seniors to examine distractions caused by passengers. RESULTS: Overall, 38.4% of youths who drove reported having been distracted by a passenger. Distractions were more commonly reported among girls and students attending moderate- to high-income schools. Talking or yelling was the most commonly reported type of distraction. About 7.5% of distractions reported were deliberate, such as hitting or tickling the driver or attempting to use the vehicle's controls. Driving after alcohol use and having had a crash as a driver were both significant predictors of reporting passenger-related distraction. CONCLUSION: Adolescents often experience distractions related to passengers, and in some cases these distractions are intentional. IMPACT ON INDUSTRY: These results provide information about teenage drivers who are distracted by passenger behaviors. In some cases, passengers attempted to use vehicle controls; however, it seems unlikely that this behavior is common enough to warrant redesign of controls to make them less accessible to passengers.     

Vehicles driven by teenagers in their first year of licensure

OBJECTIVE: to determine access to vehicles, vehicle ownership and its correlates, and types of vehicles driven by teenagers during their first year of licensure. METHODS: About 3,500 Connecticut teenagers and their parents recruited at DMV offices participated in a study aimed at persuading parents to impose and maintain driving restrictions on their sons and daughters. Telephone interviews with teens and parents, which included questions on vehicles driven, were conducted upon licensure and at intervals throughout the year. RESULTS: The majority of both male and female teens owned vehicles immediately upon licensure. Family income and number of vehicles in the family were associated with early ownership. A year later 74% owned vehicles. Small cars, which provide inferior crash protection, were the most popular vehicle; the percent driving small cars increased from 36% to 42% over the year. About 25% were driving SUVs, pickups, or sports cars, which may increase crash risk for young beginners. One year after licensure, only 35% of teens were driving midsize or large passenger cars, the types of vehicles recommended for them, and about one-third of these vehicles were 10 or more years old. Owners were more likely than non-owners to drive older and smaller vehicles, to drive more miles, do more risky driving, and to have more traffic violations and crashes. DISCUSSION: Many teenagers in Connecticut were driving vehicles that rank low in crash protection or may increase crash risk. Attention to the young driver problem has been focused primarily on managing driving risks through graduated licensing systems. More attention needs to be given to the vehicles teens drive, and how decisions about vehicle type and ownership are made. Parents exert control over what vehicles their sons and daughters drive, and may benefit from information on how to make choices that better balance cost, safety, and other factors that go into these decisions.     

Choice of teenagers' vehicles and views on vehicle safety: survey of parents of novice teenage drivers

Objective

To examine parental decisions about vehicles driven by teenagers and parental knowledge of vehicle safety.

Methods

About 300 parents were interviewed during spring 2006 in Minnesota, North Carolina, and Rhode Island while teenagers took their first on-road driving tests.

Results

Fewer than half of parents surveyed said teenagers would be the primary drivers of the chosen vehicles. Parents most often cited safety, existing family vehicle, and reliability when explaining the choices for their teenagers’ vehicles. About half of the vehicles intended for teenagers were small/mini/sports cars, pickups, or SUVs — vehicles considered less safe for teenagers than midsize/large cars or minivans. A large majority of vehicles were 2001 models or earlier. Vehicles purchased in anticipation of adding a new driver to the family were more likely to be the sizes/types considered less safe than vehicles already owned. Few parents insisted on side airbags or electronic stability control, despite strong evidence of their safety benefits. Even when asked to identify ideal vehicles for their teenagers to drive, about half of parents identified less safe vehicle sizes/types. Most parents knew that midsize/large vehicles are safer than small vehicles, and at least half of parents said SUVs and pickups are not safe for teenage drivers, citing instability.

Conclusions

The majority of parents understood some of the important criteria for choosing safe vehicles for their teenagers. However, parents actually selected many vehicles for teenagers that provide inferior crash protection.

Impact on industry

Vehicle safety varies substantially by vehicle size, type, and safety features. Many teenagers are driving inferior vehicles in terms of crashworthiness and crash avoidance.     

Graduated driver licensing restrictions: awareness, compliance, and enforcement in North Carolina

PROBLEM: This study examined the extent to which critical restrictions in North Carolina's graduated driver licensing (GDL) system are known, adhered to, and enforced. METHOD: Teenagers and their parents were recruited as they applied for either an intermediate or full license at 1 of 23 licensing offices. Telephone interviews were conducted with 900 teenagers and their parents. RESULTS: Awareness of North Carolina's night and passenger restrictions was very high among both parents and teenagers. Ten percent of teenagers reported violating the night restriction without their parents' knowledge, and 15% had done so with their parents' approval. Only 4% of parents reported allowing their teenagers to drive with more than one teenage passenger, but 19% of teenagers reported that they were allowed to do this. Violations of the passenger restriction without parental knowledge were more common than violations of the night restriction (22% vs. 10%, respectively). Among teenagers who violated restrictions without their parents' knowledge, most reported doing so only once or a few times. Teenagers expressed little concern about detection, although a majority reported driving more carefully to avoid police notice. Neither parents nor teenagers knew much about police enforcement of GDL restrictions. To obtain a sense of the views of law enforcement officers, informal interviews were conducted with 20 officers from five diverse communities and the state highway patrol. These officers were highly supportive of GDL but unfamiliar with many of the specific provisions. Moreover, enforcement of GDL restrictions did not appear to be a high priority. IMPACT ON INDUSTRY: There is a need to increase the belief among teens (and parents) that police are enforcing GDL restrictions in their community; law enforcement participation in well-publicized traffic safety enforcement efforts would likely produce this result.     

Vehicle choices for teenage drivers: A national survey of U.S. parents

IntroductionPrevious research has shown that many newly licensed teenagers in the United States are driving vehicles with inferior crash protection. The objective of this study was to update and extend previous research on U.S. parents' choices of vehicles for their teenagers.MethodTelephone surveys were conducted with parents in May 2014 using a random sample of U.S. households likely to include teenagers. Participation was restricted to parents or guardians of teenagers who lived in the household and held either an intermediate or full driver's license. Parents were interviewed about the vehicle their teenager drives, the reason they chose the vehicle for their teenager, and the cost of purchased vehicles.ResultsTeenagers most often were driving 2000–06 model year vehicles (41%), with 30% driving a more recent model year and 19% driving an older model year. Teenagers most often were driving midsize or large cars (27%), followed by SUVs (22%), mini or small cars (20%), and pickups (14%). Far fewer were driving minivans (6%) or sports cars (1%). Forty-three percent of the vehicles driven by teenagers were purchased when the teenager started driving or later. A large majority (83%) were used vehicles. The median cost of the vehicles purchased was $5300, and the mean purchase price was $9751.ConclusionsAlthough parents report that the majority of teenagers are driving midsize or larger vehicles, many of these vehicles likely do not have key safety features, such as electronic stability control, which would be especially beneficial for teenage drivers. Many teenagers were driving older model year vehicles or vehicle types or sizes that are not ideal for novice drivers.Practical applicationsParents, and their teenage drivers, may benefit from consumer information about optimal vehicle choices for teenagers.     

Graduated driver licensing research in 2004 and 2005

This is the second update of research on graduated driver licensing (GDL) and teenage drivers. It briefly summarizes research in progress and research published since the January 2004 update (Hedlund, J. & Compton, R. [2004]. Graduated driver licensing research in 2003 and beyond. Journal of Safety Research 35(1), 5-11). Research has been very active, especially on teenage driver risk factors, GDL program evaluations, the role of parents in managing and training their teenage drivers, and driver education. Results have strengthened the case for GDL, for nighttime and passenger restrictions, and for extended supervised driving practice.     

Naturalistic teenage driving study: Findings and lessons learned

IntroductionThis paper summarizes the findings on novice teenage driving outcomes (e.g., crashes and risky driving behaviors) from the Naturalistic Teenage Driving Study.MethodSurvey and driving data from a data acquisition system (global positioning system, accelerometers, cameras) were collected from 42 newly licensed teenage drivers and their parents during the first 18 months of teenage licensure; stress responsivity was also measured in teenagers.ResultOverall teenage crash and near-crash (CNC) rates declined over time, but were > 4 times higher among teenagers than adults. Contributing factors to teenage CNC rates included secondary task engagement (e.g., distraction), kinematic risky driving, low stress responsivity, and risky social norms.ConclusionsThe data support the contention that the high novice teenage CNC risk is due both to inexperience and risky driving behavior, particularly kinematic risky driving and secondary task engagement.Practical ApplicationsGraduated driver licensing policy and other prevention efforts should focus on kinematic risky driving, secondary task engagement, and risky social norms.     

Sixteen-year-old drivers in fatal crashes, United States, 2003

OBJECTIVE: Key features of graduated licensing were introduced in 46 states and the District of Columbia between 1993 and 2003. State evaluations consistently have reported positive overall effects and positive effects of nighttime and passenger restrictions. Sixteen year-olds are the main target of graduated licensing, and the present study investigated changes in their fatal crash involvement and crash characteristics that have taken place nationally during 1993-2003. By looking at 16 year-olds nationally, the study does not constitute a direct test of the effect of graduated licensing laws per se. METHODS: Data on fatal crashes were obtained from the Fatality Analysis Reporting System. Sixteen year-olds were compared with older drivers. RESULTS: During these years, the extent to which 16-year-old drivers were in fatal crashes decreased substantially compared with older age groups. The drop in the per capita crash rate for 16 year-olds was 26%. The major change was a reduction in crashes involving transporting young passengers, especially in jurisdictions with restrictions that target these crashes. There was no change in the proportion of fatal late-night crashes even in states restricting this activity. CONCLUSIONS: There has been some progress nationally in reducing the crash problem for 16 year-olds, but this still is a big problem. To achieve further progress, the gaps and weaknesses in present graduated licensing laws will need to be addressed.     

Does the Maryland graduated driver licensing law affect both 16-year-old drivers and those who share the road with them?

PROBLEM: To assess effects of the 1999 Maryland graduated driver licensing (GDL) law on both 16-year-old drivers and other road users. METHOD: Calculation and comparison of crash involvement rates and non-fatal injury rates pre-GDL (1996-1998) and post-GDL (2001-2003) by type of road user, per population, and per licensed driver, with adjustment for trends among 30-59-year-old drivers. RESULTS: Post-GDL, prevalence of licensure decreased 24% among 16-year-olds, and rates of 16-year-old drivers involved in crashes significantly decreased per 16-year-old population (corrected rate ratio (RRc) 0.82; 95% CI (0.71, 0.96)). A significant decrease also was observed for non-fatal injuries per 16-year-old population among 16-year-old drivers involved in crashes (RRc 0.63; 95% CI (0.41, 0.98)). Similarly, decreases, albeit not statistically significant, were observed among their passengers and other vehicle occupants. Per 16-year-old licensed driver, a slight non-significant increase was observed in crash involvement rates; non-fatal injury rates per 16-year-old licensed driver suggest decreased risk (non-significant) among 16-year-old drivers, their passengers, and other vehicle occupants. SUMMARY: Maryland's GDL delayed licensure and reduced crashes and non-fatal injuries among 16-year-old drivers per population. Trends in injuries among other road users involved in crashes with 16-year-old drivers were suggestive of a benefit from GDL, although observed decreases were not significant. Per licensed driver, findings were not significant, but suggested little change in crash involvement and decreased non-fatal injuries. Because one-third fewer 16-year-olds were licensed post-GDL, these results may suggest a selection effect in licensure. IMPACT ON INDUSTRY: Because Maryland had nighttime restrictions for new drivers before 1999, this study suggests other components of GDL are beneficial for drivers and possibly for other road users. States with weak GDL laws should strongly consider revising them.