title: Comparison of two methods to assess the effect of age and sex on the risk of car crashes.
abstract: BACKGROUND
  This study was designed to compare two methods (direct measurement of exposure and quasi-induced exposure) for assessing the effect of age and sex on the risk of being involved in a car crash in Spain.
  
  
  METHODS
  Spanish crash rates (per 10,000,000 driver-km) for age and sex groups of drivers aged 18-64 years old were obtained for 2004-2007, using information from the Spanish General Traffic Office (census of reported car crashes) and the Spanish Household Survey on Alcohol and Drugs (estimate of the mean km driven for each car driver). The rate ratios estimated by direct exposure estimates were compared to those obtained with the quasi-induced exposure method, which compares the age and sex of responsible and non-responsible drivers involved in the same clean collision (in which only one of the drivers committed a driving infraction).
  
  
  RESULTS
  Both methods detected an increased risk of involvement in a crash for the youngest (18-20 years) and the oldest drivers (60-64 years), compared to middle-aged drivers (45-49 years). However, the rate ratios obtained with the quasi-induced method for the youngest group (2.0 for men, 1.6 for women) were much lower than those obtained with crash rates (13.4 for men, 5.7 for women). Both methods detected a similar increase in the risk of involvement of male drivers compared to women in the youngest age group. This excess risk for men was maintained with increasing age up to 45-49 years when the quasi-induced method was used. However, direct comparisons of crash rates revealed an increased risk of involvement in women compared to men of the same age from 25-29 years onward.
  
  
  CONCLUSIONS
  Both direct measurement of driving exposure and the quasi-induced exposure method detected some well-known patterns of risk associated with driver's age and sex. However, factors that could explain important differences between the two methods deserve attention, especially those related with the excess risk for the youngest drivers as well as sex-related risk.
authors.affiliation: Department of Preventive Medicine and Public Health, Facultad de Medicina, Universidad de Granada, Avenida de Madrid, 11, 18012 Granada, Spain. lardelli@ugr.es
authors.forename: Pablo
authors.initials: P
authors.lastname: Lardelli-Claret
authors.forename: Juan de Dios
authors.initials: Jde D
authors.lastname: Luna-del-Castillo
authors.forename: Eladio
authors.initials: E
authors.lastname: Jiménez-Mejías
authors.forename: José
authors.initials: J
authors.lastname: Pulido-Manzanero
authors.forename: Gregorio
authors.initials: G
authors.lastname: Barrio-Anta
authors.forename: Miguel
authors.initials: M
authors.lastname: García-Martín
authors.forename: José Juan
authors.initials: JJ
authors.lastname: Jiménez-Moleón
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001334:Automobile Driving / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012306:Risk; D018570:Risk Assessment / Q000379:methods*; D012737:Sex Factors; D013030:Spain; D055815:Young Adult