Motor vehicle accidents remain the leading cause of death in youths from 16 to 20 years of age. The motor vehicle fatality rate of teenagers is higher than that of any other age group. Sixteen year old drivers are more than 20 times as likely to have an accident as the general population and 17 year old drivers are more than 6 times as likely to have an accident. For every adolescent killed in a motor vehicle crash, about 100 non-fatal injuries occur. The magnitude of the problem of young drivers is clear and physicians must become involved in counseling and other related programs to prevent this massive epidemic.
What are the main risk factors that account for the high incidence of adolescent related, motor vehicle accidents?
The adolescent’s overall judgment and decision making ability may not be fully developed. Furthermore, the adolescent, as a novice driver, lacks the experience and ability to perform many of the complex tasks of ordinary driving. It is well known that compared with experienced drivers, the adolescent is less proficient in detecting and responding to hazards, controlling the vehicle and integrating speed.
How does the risk taking behavior of adolescents affect their driving skills?
Adolescents have a great propensity for taking risks and these may be particularly influenced by emotions, peer group pressure and other stresses. The experimental use of alcohol and other drugs by adolescents puts them at particularly great risk. Alcohol has been implicated in about one-third of all fatal accidents involving teenagers. The combination of alcohol and marijuana is particularly popular and deadly. Furthermore, the low rate of safety belt use by teenagers increases their risk of injury. Between 10 and 20 years of age, safety belts are used in only 35% of cases.
How does night-time driving affect teenagers?
Night-time driving is inherently more difficult and challenging for novice drivers. As a group, teenagers drive fewer hours than adults, but they drive disproportionately more at night and have a much higher night-time accident fatality rate. A teenager is more than 4 times as likely to be killed while driving at night than during the day.
Should mandatory driver education and training classes be enforced in order to diminish teenage motor vehicle accidents?
Driver education programs teach the basic mechanics of operating a motor vehicle, traffic rules and relegation, safe driving practices, occupant safety, risks of drunk driving and other behavioral issues. However, they do not provide sufficient time to acquire enough road experience and they do not teach judgment. There has even been one study which has suggested that driver education classes may be counter productive leading to an increased accident rate because teenagers learn to drive sooner than they would have otherwise done. Driver education courses should be viewed as a stepping stone only towards becoming a more competent driver and additional one-on-one, behind the wheel training, must be demanded before the teenager is ready to drive alone.
Do graduated licensing systems address the problems of inexperience and risk taking by adolescents?
A sequential and graduated licensing system is thought to be the most optimal way of introducing the adolescent into the world of safe driving. The most optimal system is a three stage program involving a learner’s permit, an intermediate or provisional license and a regular driver’s license. Such a program already exists in most provinces but could be tightened up by requiring parents to supervise teenagers during high risk hours, to establish a night-time curfew, to establish “zero alcohol tolerance” for teenagers, to restrict the number of and/or ages of passengers, to require driver education and to impose other restrictions.
What can physicians do to address the issue of risks related to teenage driving?
During office visits, physicians can address risk factors, especially driving while impaired by alcohol or other drugs and night-time driving. The greatest risk for night-time accidents is between midnight and 5.00 a.m. In cities with night curfews, the teenage injury fatality rate has been reduced by 23%. Physicians should be encouraged to become involved in community efforts promoting such programs as alcohol-free social events, chauffeuring for high-risk events such as proms and parents-teen contracts. Physicians should encourage research and funding for motor vehicle accidents involving teenagers.
What can parents do to reduce motor vehicle accidents in their teenage children?
Parents should be encouraged to set good driving examples, (e.g. no drinking and driving, no speeding, and requiring all occupants to use safety belts). Parents should expect responsible driving behavior from their teenagers and impose strict penalties for irresponsible action. They should supervise novice drivers and ensure the mechanical safety of any car used by a teenager.
| PEARLS |
|---|
| Motor vehicle accidents are the leading cause of death in teens aged 16-20 years. |
| The two main risk factors include lack of driving experience and risk taking behavior. |
| Night-time driving, and the use of alcohol and drugs are a deadly combination. |
| Graduated licensing systems, driver education, and proper counseling by child advocates should help to reduce the magnitude of this problem. |
Reference: Pediatrics 1996, Vol 98(5), 987-990
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