Graduated licensing laws and fatal crashes of teenage drivers: a national study.

OBJECTIVES: The objective of the current study was to quantify the effects of the strength of US state graduated driver licensing laws and specific licensing components on the rate of teenage driver fatal crash involvements per 100,000 teenagers during 1996-2007. The strengths of state laws were rated good, fair, marginal, or poor based on a system developed previously by the Insurance Institute for Highway Safety. METHODS: Analysis was based on quarterly counts of drivers involved in fatal crashes. Associations of overall ratings and individual licensing components with teenage crash rates were evaluated using Poisson regression, with the corresponding fatal crash rate for drivers ages 30-59 controlling for state- or time-dependent influences on crash rates unrelated to graduated licensing laws. RESULTS: Compared with licensing laws rated poor, laws rated good were associated with 30 percent lower fatal crash rates among 15- to 17-year-olds. Laws rated fair yielded fatal crash rates 11 percent lower. The longer the permit age was delayed, or the longer the licensing age was delayed, the lower the estimated fatal crash rates among 15- to 17-year-olds. Stronger nighttime restrictions were associated with larger reductions, and reductions were larger for laws limiting teenage passengers to zero or one than laws allowing two or more teenage passengers or laws without passenger restrictions. After the effects of any related delay in licensure were accounted for, an increase in the minimum learner's permit holding period showed no association with fatal crash rates. An increase in required practice driving hours did not appear to have an independent association with fatal crash rates. CONCLUSIONS: Graduated licensing laws that include strong nighttime and passenger restrictions and laws that delay the learner's permit age and licensing age are associated with lower teenage fatal crash rates. States that adopt such laws can expect to achieve substantial reductions in crash deaths.

The effects of minimum legal drinking age 21 laws on alcohol-related driving in the United States.

OBJECTIVE: To examine trends in alcohol consumption and alcohol-related crashes among people younger than 21 in the United States and to review evidence on the effects of minimum legal drinking age (MLDA) laws. METHODS: Trends in alcohol-related crashes and alcohol consumption among young people were examined, and studies on the effects of lowering and raising the drinking age were reviewed. RESULTS: MLDA laws underwent many changes during the 20th century in the United States. Since July 1988, the MLDA has been 21 in all 50 states and the District of Columbia. Surveys tracking alcohol consumption among high school students and young adults found that drinking declined since the late 1970 s, and most of the decline occurred by the early 1990 s. These were the years when states were establishing, or reinstating, a MLDA-21. Among fatally injured drivers ages 16-20, the percentage with positive BACs declined from 61% in 1982 to 31% in 1995, a bigger decline than for older age groups; declines occurred among the ages directly affected by raising MLDAs (ages 18-20) and among young teenagers not directly affected (ages 16-17). Almost all studies designed specifically to gauge the effects of drinking age changes show MLDAs of 21 reduce drinking, problematic drinking, drinking and driving, and alcohol-related crashes among young people. Yet many underage people still drink, many drink and drive, and alcohol remains an important risk factor in serious crashes of young drivers, especially as they progress through the teenage years. Stepped-up enforcement of MLDA and drinking and driving laws can reduce underage drinking. Recent efforts to lower MLDAs to 18 and issue licenses to drink upon completion of alcohol education have gained local and national media attention. There is no evidence that alcohol education can even partially replace the effect of MLDA-21. CONCLUSIONS: The cause and effect relationship between MLDAs of 21 and reductions in highway crashes is clear. Initiatives to lower the drinking age to 18 ignore the demonstrated public health benefits of MLDAs of 21. IMPACT ON INDUSTRY: Lowering the drinking age to 18 will increase highway crash deaths among young people.

Long-term effects of handheld cell phone laws on driver handheld cell phone use.

OBJECTIVES: As of October 2009, seven U.S. states and the District of Columbia (D.C.) ban driving while talking on a handheld cell phone. Long-term effects on driver handheld phone use in D.C., New York State, and Connecticut were examined. METHODS: The percentage of drivers talking on handheld cell phones was measured over time with daytime observation surveys in the jurisdictions with bans and comparison jurisdictions without bans. Trends were modeled using Poisson regression to estimate differences between actual rates and rates that would have been expected without a ban. RESULTS: The D.C. ban immediately lowered the percentage of drivers talking on handheld cell phones by 41 percent. Nearly 5 years later, the rate was 43 percent lower than would have been expected without the ban. Use in Connecticut declined 76 percent immediately after the ban; 3.5 years later, use was 65 percent lower than would have been expected without the ban. In New York, use declined 47 percent immediately after the ban; 7 years later, use was 24 percent lower than expected without the ban. Fifteen months after the laws took effect, compliance in New York was lower than in D.C., and the difference appeared due to more intensive enforcement in D.C. However, this linkage is no longer clear because enforcement in New York picked up such that 2008 levels of enforcement appeared comparable in D.C. and New York, whereas enforcement in Connecticut lagged behind. In all three jurisdictions, the chance that a violator would receive a citation was low, and there were no publicized targeted enforcement campaigns. CONCLUSIONS: Jurisdictional bans have reduced handheld phone use and appear capable of maintaining reductions for the long term. However, it is unknown whether overall phone use is lower because many drivers may have switched to hands-free devices. Further research is needed to determine whether reduced handheld cell phone use has reduced crashes.

Effects of a college community campaign on drinking and driving with a strong enforcement component.

OBJECTIVES: A program of publicized intensive enforcement of minimum drinking age law and drinking and driving laws was implemented in a college community. The effects on driving at various blood alcohol concentrations (BACs) were evaluated, particularly for drivers ages 16-24 targeted by the program. METHODS: Objective measures of driver BACs were collected through nighttime roadside surveys before and during the program in the experimental college community and a comparison college community. Logistic regression models estimated the program's effects on the likelihood of driving at various BAC thresholds in the program community, after accounting for BAC patterns in the comparison community. RESULTS: Relative to the comparison community, consistent reductions in driving at various BAC levels (positive BAC and BAC at least 0.02, 0.05, or 0.08%) were achieved in the experimental community. Reductions were greatest for 16- to 20-year-olds (from 66% for positive BAC to 94% for BAC > or = 0.05%), followed by 21- to 24-year-olds (from 32% for positive BAC to 71% for BAC > or = 0.08%) and drivers 25 and older (from 23% for positive BAC to 53% for BAC > or = 0.08%). All reductions for 16- to 20-year-olds were significant (p < 0.05), and all except the reduction for BAC > or = 0.08 percent were significantly greater than the corresponding reductions for drivers 25 and older. Reductions for 21- to 24-year-olds were significant for BACs at least 0.02, 0.05, and 0.08 percent, but they were not significantly greater than the corresponding reductions for drivers 25 and older. Although large, reductions for drivers 25 and older were not significant, based on 95 percent confidence intervals. CONCLUSIONS: A college community program with a strong enforcement component produced substantial reductions in drinking and driving among teenagers and young adults and smaller reductions among older adults. It is hoped that this will encourage colleges and communities to incorporate enforcement into interventions directed at alcohol use among young people.

Short-term effects of a teenage driver cell phone restriction.

On December 1, 2006, North Carolina began prohibiting use of any mobile communication device by drivers younger than 18. The current study examined the effects of the law on teenage drivers' cell phone use. Teenage drivers were observed at high schools in North Carolina 1-2 months before and approximately 5 months after the law took effect. The proportion of teenagers using cell phones did not change significantly (11.0% before the law took effect, 11.8% after). Cell phone use among teenage drivers at high schools in South Carolina, an adjacent state without a teenage driver phone ban, was stable at about 13%. Interviews were conducted with parents and teenagers in North Carolina both before and after the law took effect. In post-law interviews, teenagers were more likely than parents to say they knew about the cell phone restriction (64% vs. 39%), but support for the ban was greater among parents (95% vs. 74%). Only 22% of teenagers and 13% of parents believed the law was being enforced fairly often or a lot. Although the proportion of teenagers who reported using phones while driving declined somewhat following the law, about half admitted they used their phones, if they had driven, on the day prior to the interview. Overall, the findings suggest that North Carolina's cell phone restriction had little to no effect on teenage drivers' use of cell phones shortly after the law took effect.

Relationship of dynamic seat ratings to real-world neck injury rates.

OBJECTIVES: The Insurance Institute for Highway Safety assigns consumer safety ratings to passenger vehicle seats based on laboratory sled tests that simulate rear-end collisions. The purpose of this research was to determine how well these ratings correlate to driver neck injury risk in real-world crashes. METHODS: Insurance claims for cars and SUVs struck in the rear by the front of another passenger vehicle were examined for evidence of driver neck injury. Logistic regression was used to compare neck injury rates for vehicles with different seat ratings while controlling for other important variables. RESULTS: Driver neck injury rates were 15% lower for vehicles with seats rated good compared with vehicles with seats rated poor. Rates of driver neck injuries lasting 3 months or more were 35% lower for vehicles with seats rated good compared with vehicles with seats rated poor. CONCLUSIONS: Seat/head restraints that perform better in dynamic sled tests have lower risk of neck injury than seats that rate poor, especially when considering long-term injuries. However, the relationship of dynamic seat ratings to neck injury rates is not linear. Further research is needed to determine whether the criteria for rating seats can be amended so as to be more uniformly predictive of real-world neck injury.

Work schedules of long-distance truck drivers before and after 2004 hours-of-service rule change.

OBJECTIVES: Federal rules regulate work hours of interstate commercial truck drivers. On January 4, 2004, a new work rule was implemented, increasing daily and weekly maximum driving limits and daily off-duty requirements. The present study assessed changes in long-distance truck drivers' reported work schedules and reported fatigued driving after the rule change. Associations between reported rule violations, fatigued driving, and schedule as well as other characteristics were examined. METHODS: Samples of long-distance truck drivers were interviewed face-to-face in two states immediately before the rule change (November-December 2003) and about 1 year (November-December 2004) and 2 years (November-December 2005) after the change. RESULTS: Drivers reported substantially more hours of driving after the rule change. Most drivers reported regularly using a new restart provision, which permits a substantial increase in weekly driving. Reported daily off-duty and sleep time increased. Reported incidents of falling asleep at the wheel of the truck increased between 2003 (before the rule change) and 2004 and 2005 (after the change); in 2005 about one fifth of drivers reported falling asleep at the wheel in the past month. The frequency of reported rule violations under the old and new rules was similar. The percentage of trucks with electronic on-board recorders increased significantly to almost half the fleet; only a few drivers were using automated recorders to report rule compliance. More than half of drivers said that requiring automated recorders on all large trucks to enforce driving-hour limits would improve compliance with work rules. Based on the 2004-2005 survey data, drivers who reported more frequent rule violations were significantly more likely to report fatigued driving. Predictors of reported violations included having unrealistic delivery schedules, longer wait times to drop off or pick up loads, difficulty finding a legal place to stop or rest, and driving a refrigerated trailer. CONCLUSIONS: Reported truck driver fatigue increased after the new rule was implemented, suggesting that the rule change may not have achieved the goal of reducing fatigued driving. Reported violations of the work rules remain common. Because many trucks already have electronic recorders, requiring them as a means of monitoring driving hours appears feasible.

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.

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.

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.

Longer-term effects of Washington, DC, law on drivers' hand-held cell phone use.

OBJECTIVES: To determine whether the substantial short-term declines in drivers' use of hand-held phones achieved in the District of Columbia (DC) were sustained 1 year after a ban. METHODS: Drivers' daytime hand-held cell phone use was observed in DC and nearby areas of Virginia and Maryland, states without bans. Observations were conducted several months before the ban, shortly after, and 1 year later. The number of vehicles observed in all three surveys combined was 51,945 in DC, 36,796 in Maryland, and 43,033 in Virginia. RESULTS: The rate of talking on hand-held phones declined significantly from 6.1 percent before the law to 3.5 percent shortly after; when measured 1 year later, use was 4.0 percent, still significantly lower than baseline. Based on increases in rates of talking on hand-held phones in Maryland and Virginia, longer-term phone use in DC was estimated to be 53 percent lower than would have been expected without the ban. Declines in DC were identified for drivers of vehicles registered in all three jurisdictions. CONCLUSIONS: In DC, there was an initial decline of about 50 percent in drivers talking on hand-held cell phones following a ban, and this decline was sustained about 1 year later. After a similar ban in New York, there was an initial decline in phone use comparable with the initial decline in DC, but the decline a year after the New York ban took full effect was only about 21 percent and not statistically significant. The potential difference in sustained effectiveness for the DC ban may reflect tougher enforcement in DC. Even if full compliance with hand-held phone bans can be achieved, the risks from drivers' use of hands-free phones will remain.

Cell phones and driving: review of research.

OBJECTIVE: The research literature on drivers' use of cell phones was reviewed to identify trends in drivers' phone use and to determine the state of knowledge about the safety consequences of such use. METHODS: Approximately 125 studies were reviewed with regard to the research questions, type and rigor of the methods, and findings. Reviewed studies included surveys of drivers, experiments, naturalistic studies (continuous recording of everyday driving by drivers in instrumented vehicles), studies of crash risk, and evaluations of laws limiting drivers' phone use. RESULTS: Observational surveys indicate drivers commonly use cell phones and that such use is increasing. Drivers report they usually use hand-held phones. Experimental studies have found that simulated or instrumented driving tasks, or driving while being observed, are compromised by tasks intended to replicate phone conversations, whether using hand-held or hands-free phones, and may be further compromised by the physical distraction of handling phones. Effects of phone use on driving performance when drivers are in their own vehicles are unknown. With representative samples of adequate size, naturalistic studies in the future may provide the means to document the patterns and circumstances of drivers' phone use and their effects on real-world driving. Currently, the best studies of crash risk used cell phone company billing records to verify phone use by crash-involved drivers. Two such studies found a fourfold increase in the risk of a property-damage-only crash and the risk of an injury crash associated with phone use; increased risk was similar for males and females, younger and older drivers, and hands-free and hand-held phones. A number of jurisdictions in the United States and around the world have made it illegal for drivers to use hand-held phones. Studies of these laws show only limited compliance and unclear effects on safety. CONCLUSIONS: Even if total compliance with bans on drivers' hand-held cell phone use can be achieved, crash risk will remain to the extent that drivers continue to use or switch to hands-free phones. Although the enactment of laws limiting drivers' use of all phones is consistent with research findings, it is unclear how such laws could be enforced. At least in the short term, it appears that drivers' phone use will continue to increase, despite the growing evidence of the risk it creates. More effective countermeasures are needed but are not known at this time.

Effects of Washington, D.C. law on drivers' hand-held cell phone use.

OBJECTIVE: To assess the effects of Washington, D.C. law prohibiting drivers' use of hand-held cell phones on such use. METHODS: Daytime observations of drivers were conducted at signalized intersections in D.C. in March 2004, several months before the law took effect on July 1, 2004, and again in October 2004. As a comparison, observations also were conducted in areas of Virginia and Maryland located close to the D.C. border. Maryland and Virginia placed no limitations on drivers' phone use. Use was observed for 36,091 vehicles in D.C., 25,151 vehicles in Maryland, and 28,483 vehicles in Virginia. RESULTS: The rate of talking on hand-held cell phones among drivers in D.C. declined significantly from 6.1% before the law to 3.5% after. Phone use declined slightly in Maryland and increased significantly in Virginia so that, relative to the patterns of hand-held phone use in the two states, phone use in D.C. declined 50%. Hand-held phone use in D.C. declined comparably among drivers of vehicles registered in all three jurisdictions. D.C. police issued 2,556 citations and 1,232 warnings for cell phone violations during July-November 2004. There were spates of media coverage when the law was passed and when it took effect. CONCLUSIONS: D.C.'s law prohibiting drivers' hand-held phone use had a strong effect on such use among drivers in D.C. Without ongoing publicized enforcement of the law, long-term compliance may be difficult to achieve.