title: Association of Graduated Driver Licensing With Driver, Non-Driver, and Total Fatalities Among Adolescents.
abstract: Graduated driver licensing systems typically require an extended learner permit phase, and create night-time driving or passenger restrictions for adolescent drivers. Restricted driving might increase the use of alternative transportation to replace driving and consequently increase crashes and injuries for passengers, bus riders, pedestrians, and bicyclists. This study examined whether graduated driver licensing increases non-driver fatalities among adolescents, and whether it reduces total traffic fatalities combining drivers and non-drivers.
  
  
  
  Longitudinal analyses were conducted using data from the 1995-2012 U.S. Fatality Analysis Reporting System. Adjusted rate ratios were estimated for being fatally injured in a crash according to: (1) presence/absence of a graduated driver licensing system; and (2) four levels of graduated driver licensing systems (absent, weak, medium, strong). Analyses were conducted in 2015.
  
  
  
  Among adolescents aged 16 years, graduated driver licensing was not associated with increased passenger fatalities (adjusted rate ratio, 0.96; 95% CI=0.90, 1.03) or pedestrian and bicyclist fatalities (adjusted rate ratio, 1.09; 95% CI=0.85, 1.39), but was associated with an 11% reduction in total traffic fatalities. Among those aged 17 years, graduated driver licensing was not associated with increased fatalities as passengers, pedestrians, or bicyclists, and was not associated with reduced total traffic fatalities.
  
  
  
  In general, graduated driver licensing systems were not associated with increased fatalities as passengers, pedestrians, bicyclists, and bus riders. Graduated driver licensing systems were associated with reduced total fatalities of adolescents aged 16 years.
authors.affiliation: Department of Epidemiology, West Virginia University, Morgantown, West Virginia; Injury Control Research Center, West Virginia University, Morgantown, West Virginia. Electronic address: mozhu@hsc.wvu.edu.
authors.forename: Motao
authors.initials: M
authors.lastname: Zhu
authors.affiliation: Injury Control Research Center, West Virginia University, Morgantown, West Virginia.
authors.forename: Songzhu
authors.initials: S
authors.lastname: Zhao
authors.affiliation: Department of Biostatistics, West Virginia University, Morgantown, West Virginia.
authors.forename: D Leann
authors.initials: DL
authors.lastname: Long
authors.affiliation: Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
authors.forename: Allison E
authors.initials: AE
authors.lastname: Curry
mesh_terms: D000063:Accidents, Traffic / Q000401:mortality / Q000706:statistics & numerical data*; D000293:Adolescent; D001334:Automobile Driving / Q000331:legislation & jurisprudence*; D005260:Female; D006801:Humans; D007858:Learning; D008004:Licensure / Q000592:standards / Q000706:statistics & numerical data*; D008297:Male; D014481:United States