Young drivers' early access to their own car and crash risk into early adulthood: Findings from the DRIVE study.

INTRODUCTION: Car ownership at early licensure for young drivers has been identified as a crash risk factor, but for how long this risk persists is unknown. This study examined crash hazard rates between young drivers with their own vehicle and those who shared a family vehicle at early licensure over 13 years. METHODS: The DRIVE study, a 2003/04 survey of 20,806 young novice drivers in New South Wales, Australia was used to link to police crash, hospital and death records up to 2016. The first police-reported crash and crash resulting in hospitalisation/death was modelled via flexible parametric survival analysis by type of vehicle access at baseline (own vs. shared family vehicle). RESULTS: After adjusting for covariates, drivers with their own vehicle at early licensure had an almost 30 % increased hazard rate for any crash after one year (95 % CI:1.16-1.42) compared with those who only had access to a family car and this attenuated but remained significantly higher until year 7 (HR: 1.1, 95 % CI: >1.00-1.20). For crashes resulting in hospitalisation or death, an almost 15-times higher hazard (95 % CI: 1.40-158.17) was observed at the start of follow up, remaining 50 % to year 3 (95 % CI:1.01-2.18). CONCLUSIONS: Parents and young drivers should be aware of the increased risks involved in car ownership at early licensure. Development of poorer driving habits has been associated with less parental monitoring at this time. Graduated Driving Licensing educators, researchers and stakeholders should seek to address this and to identify improved safety management options.

Teen driver crash risk and associations with smoking and drowsy driving.

Motor vehicle crashes are the leading cause of death for young people in the United States. The goal of this study was to identify risk factor profiles of teen and young adult drivers involved in crashes. General demographic and behavioral as well as driving-related factors were considered. Analysis of a nationally representative telephone survey of U.S. young drivers ages 14 to 22 (N=900) conducted in 2005 was restricted to 506 licensed drivers (learners excluded). Statistically significant univariate associations between factors of interest and the primary outcome, crash involvement (ever) as a driver, were identified and included within a multivariate logistic regression model, controlling for potential demographic confounders. Aside from length of licensure, only driving alone while drowsy and being a current smoker were associated with having been in a crash. Gaining a better understanding of these behaviors could enhance the development of more customized interventions for new drivers.

Recent developments in young driver education, training and licensing in Australia.

Australian young driver education and training approaches have differed from the mandatory school-based programs found internationally; generally comprising voluntary programs conducted outside of licensing. This paper reports on recent developments pertaining to the pre-learner, learner, and provisional license stages. Given its important context, state-based graduated driver licensing systems are also reviewed. There has been a shift toward starting driver education younger (pre-learner), greater involvement of parents, and more school-based programs; many now conducted by licensing authorities. The majority of initiatives are yet to be evaluated, particularly relative to crash outcomes; however, some studies suggest other positive outcomes, including increased supervised practice and delayed licensure. Furthermore, the federal government is proceeding with plans for a national license-based program. Several jurisdictions have also announced the introduction of passenger and nighttime restrictions on provisional licenses. Together these initiatives offer promise of reductions in young driver-related fatalities and injuries in the very near future.

Risk factors for death among older child and teenaged motor vehicle passengers.

OBJECTIVE: To identify and prioritize risk factors for passenger death. DESIGN: Retrospective cohort captured in 2 databases: US census of fatal crashes (Fatality Analysis Reporting System) and US-representative sample of police-reported crashes (National Automotive Sampling System Crash Data System). SETTING: Crashes in 50 states and the District of Columbia from January 1, 2000, to December 31, 2005. PARTICIPANTS: A total of 45 560 passengers aged 8 to 17 years in crashes, representing 2 545 168 passengers (weighted). Main Exposures Age and sex of driver, vehicle and road type, restraint use, seating position, day of week, month, time of day, and speed limit. Outcome Measure Passenger fatality. RESULTS: Approximately 424 000 passengers (aged 8-17 years) annually were in tow-away crashes and experienced a fatality rate of 3.9 per 1000. Just more than three-quarters as many passengers (aged 8-17 years) were in crashes with 16- to 19-year-old drivers as with all adult drivers (those aged > or =25 years), with double the passenger fatality rate. For drivers aged 16 to 17 years, passenger fatalities doubled between passenger ages 11 to 12 years and increased to a peak at a passenger age of 16 years. Of crashes with child passenger fatality, 21.2% involved alcohol. In crashes with drivers younger than 18 years, the greatest risk factors for death for passengers aged 8 to 17 years were drivers younger than 16 years, restraint nonuse, and high-speed roads (> or =55 and 45-54 mph). CONCLUSIONS: While passenger risks because of restraint nonuse require continued attention, interventions must be developed to address risk because of travel on high-speed roads and riding with drivers younger than 16 years. For safety, child passengers and their parents should monitor these characteristics of the drive and the driver. Anticipatory guidance about passenger risks should begin by the age of 11 years.

National young-driver survey: teen perspective and experience with factors that affect driving safety.

BACKGROUND: Motor vehicle crashes are the leading cause of fatality and acquired disability in adolescents. Young, inexperienced drivers are overrepresented in crashes. OBJECTIVE: Our goal was to explore the adolescent perspective on driving safety to provide a better understanding of factors that influence safety and teenagers' exposure to driving hazards. METHODS: Adolescents generated, prioritized, and explained their viewpoint by using the teen-centered method. These viewpoints were obtained from a school-based nationally representative survey of 9th-, 10th-, and 11th-graders (N = 5665) from 68 high schools, conducted in spring 2006, that included teen-generated items. The main outcome measures were rating of risk and prevalence of witnessing driving hazards. RESULTS: Drinking while driving was ranked as the greatest hazard (87% of the respondents reported that it made a lot of difference), although only 12% witnessed it often. Ranked next as dangers while driving were text-messaging, racing, impairment from marijuana, and road rage. Sixty percent viewed inexperience as a significant hazard, although only 15% reported seeing it often. Cell phone use was viewed as a significant hazard by 28%, although 57% witnessed it frequently. Only 10% viewed peer passengers as hazardous, but 64% frequently observed them. Distracting peer behaviors, among other distractions, were viewed as more dangerous. Subpopulations varied in the degree they perceived hazards. For example, black and Hispanic adolescents viewed substance use while driving as less hazardous than did white adolescents but witnessed it more frequently. CONCLUSIONS: Adolescents generally understand the danger of intoxicated driving. However, some groups need to better recognize this hazard. Distractions take teenagers' focus off the road, but not all are viewed as hazardous. Although inexperience is the key factor that interacts with other conditions to cause crashes, adolescents do not recognize what merits experience. Future research is needed to explore how to help teens become safer drivers and how to make clinicians, families, and communities more effective in setting, promoting, and monitoring safety standards.

Child passenger injury risk in sibling versus non-sibling teen driver crashes: a US study.

Several international jurisdictions allow family exemptions to graduated driver licensing passenger restrictions. The objective of this research was to examine differences in injury risk to US child passengers in crashes involving sibling versus non-sibling teen drivers, and to compare outcomes with crashes involving adult drivers. Insurance claim and telephone survey data were collected on 16 233 child passengers (representing 289 329 children) in 17 US jurisdictions. There was a trend toward higher restraint non-use by child passengers in the non-sibling group than in the sibling group (9.6% vs 4.7%; p = 0.08). Children in the sibling group had a 40% lower risk of injury than those in the non-sibling group (adjusted OR 0.60, 95% CI 0.40 to 0.90); however, injury risk was higher in the sibling group than in children traveling with adults (adjusted OR 1.57, 95% CI 1.09 to 2.26). Child passengers riding with sibling teen drivers may be safer than those riding with non-sibling teens, but not as safe as those riding with adult drivers.