title: A population-based study of crashes involving 16- and 17-year-old drivers: the potential benefit of graduated driver licensing restrictions.
abstract: OBJECTIVE
  To evaluate the potential effectiveness of graduated driver licensing programs using population-based linked data for motor vehicle crashes (MVCs) that involved teenaged drivers (TDs).
  
  
  METHODS
  Utah crash, inpatient hospital discharge, and emergency department databases were analyzed and probabilistically linked. We computed hospital charges and compared violations, contributing factors, seatbelt use, and passengers for TDs (16-17 years old) relative to adult drivers (18-59 years old).
  
  
  RESULTS
  TDs comprised 5.8% of the study population, but were involved in 19.0% of MVCs. TD crashes resulted in $11 million in inpatient hospital charges and 158 fatalities. TD crashes were 1.70 times (95% confidence interval [CI]: 1.34, 2.04) less likely to result in fatal injury to drivers than were crashes that involved adult drivers, but TDs were 2.20 times (95% CI: 1.96, 2.47) more likely to receive citations. The following were findings of the study: 1) 11% of all TD crashes but 19% of fatal TD crashes occurred between 2200 and 0600 hours; 2) TDs used seatbelts less often than did adult drivers (79.1% vs 84.4%) and less often with passengers present (81.9% vs 75.0%; 3) TDs were 1.72 times (95% CI: 1.38, 2.14) more likely to be involved in crashes that resulted in seriously or fatally injured occupants when driving with passengers than when driving alone.
  
  
  CONCLUSIONS
  TDs are overrepresented in MVCs. TD crashes have a higher fatality rate at night, and TDs wear seatbelts less often than do adult drivers. Passengers affect TD crash characteristics. Graduated driver licensing programs that target state-specific characteristics of TDs may decrease morbidity and mortality.
authors.affiliation: Intermountain Injury Control Research Center, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA. natalie.cvijanovich@hsc.utah.edu
authors.forename: N Z
authors.initials: NZ
authors.lastname: Cvijanovich
authors.forename: L J
authors.initials: LJ
authors.lastname: Cook
authors.forename: N C
authors.initials: NC
authors.lastname: Mann
authors.forename: J M
authors.initials: JM
authors.lastname: Dean
mesh_terms: D000063:Accidents, Traffic / Q000401:mortality / Q000517:prevention & control / Q000706:statistics & numerical data*; D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D000328:Adult; D000367:Age Factors; D001333:Automobile Driver Examination / Q000331:legislation & jurisprudence*; D002940:Circadian Rhythm; D019992:Databases as Topic / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006753:Hospital Records / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010343:Patient Admission / Q000706:statistics & numerical data; D012044:Regression Analysis; D015599:Trauma Severity Indices; D014481:United States / Q000453:epidemiology; D014589:Utah; D014947:Wounds and Injuries / Q000191:economics / Q000453:epidemiology / Q000401:mortality