Fatal Crash Involvement Research Articles

Empirical examination of interdependent relationship between usage of seatbelt restraint system and driver-injury severity of single-vehicle crashes in Thailand using a joint econometric analysis

Objectives The paper aims to examine the interdependent relationship between the usage of the seatbelt restraint system and severities of the driver-injury in single-vehicle crashes. Methods This paper developed a comprehensive joint econometric structure − a joint random parameters binary probit-binary probit model − that allows for the simultaneous examination of injury severity of the driver in a crash, and taking into account the fact that seat belt use can be endogenous to the outcomes of driver injury. The developed model is tested using data on drivers-injury severities involved in single-vehicle crashes in Thailand from 2012-2017. Results In terms of the interdependent relationship between seatbelt use status and driver-injury severities, the findings suggest that drivers who do not use seat belts may demonstrate more dangerous or aggressive driving behaviors (such as speeding), subsequently increasing their likelihood of involvement in severe or fatal crashes. Additionally, the result also shows that drivers who are involved in speeding-related crashes are less likely to wear a seatbelt and have a higher risk of sustaining severe and fatal injuries. The findings also reveal that in crashes, drivers who are young, or operating trucks are less likely to be wearing their seat belts. The study also indicates that severe and fatal crashes are associated with factors such as elderly drivers, alcohol involvement, unbelted drivers, fatigue, depressed medians, and barrier medians. Conversely, a crash in a U-turn area, driving a passenger car, pickup truck, or large truck, or colliding with a guardrail reduces the likelihood of severe and fatal injuries. Conclusions Neglecting the hidden endogenous effect in statistical analyses could result in an overestimation of the impact of seat belt usage on crash-injury outcomes. The findings of this study can provide valuable insights for relevant authorities aiming to improve driver safety.

Does past offending behaviors catch up with you? A study examining the relationship between traffic offending history and fatal crash involvement

Objective The aim of the current study was to compare the traffic histories of drivers fatally injured in a road traffic crash, to alive drivers of the same age and gender in order to determine if key markers of increased fatality-risk could be identified. Methods The case sample comprised 1,139 (82% male) deceased drivers, while the control sample consisted of 1,139 registered Queensland drivers (who were individually matched to the case sample on age and gender). Results Using a logistic regression model, and adjusting for age and gender, it was found that a greater number of offenses predicted greater odds of fatal crash involvement, with each increase in offense frequency category increasing ones’ odds by 1.98 (95% CI: 1.8, 2.18). When each offense type was considered individually, dangerous driving offenses were most influential, predicting a 3.44 (95% CI: 2, 5.93) increased odds of being in the case group, followed by the following offense types: learner/provisional (2.88, 95% CI: 1.75, 4.74), drink and drug driving (2.82, 95% CI: 1.97, 4.04), not wearing a seatbelt/helmet (2.63, 95% CI: 1.53, 4.51), licensing offenses (1.87, 95% CI: 1.41, 2.49), and speeding (1.48, 95% CI: 1.33, 1.66). In contrast, mobile phone and road rules offenses were not identified as significant predictors. Conclusion The findings indicate that engagement in a range of aberrant driving behaviors may result in an increased odds of future fatal crash involvement, which has multiple implications for the sanctioning and management of apprehended offenders.

Factors explaining pedestrian-involved fatality crashes on National Highways in India

Pedestrians continue to face high risk of getting involved in fatal and serious injury crashes all over the world. In many high-income countries, pedestrian involvement in fatal crashes occur mostly in urban areas. However, in many low- and middle-income countries in Asia and Africa, pedestrian involvement in fatal crashes occur on intercity highways too. This research analyses fatal pedestrian crash characteristics, and identifies probable contributory factors to pedestrian involvement in fatal crashes using logistic regression for two-, four-, and six-lane National Highways. The fatal pedestrian crash density is found to be the highest at 1.37 crashes/km/year on six-lane divided NH-1. The binary logistic regression estimation results for pedestrian involvement in the fatal crash model revealed that the predictors: “number of lanes” and “time of crash” are found to be significant at 95% level. The model results for the variable “number of lanes” highlights the need to study pedestrian crossing behaviour on highways in detail. The design standards for pedestrian crossing facilities in urban areas may not be suitable for National Highways in particular multi-lane highways. In-depth research is required to understand the suitability of various traffic calming measures and other possible interventions which can ensure pedestrian safety on highways.

Motorcycle antilock braking systems and fatal crash rates: updated results

Objective Antilock braking systems (ABS) prevent wheels from locking during hard braking and have been shown to reduce motorcyclists’ crash risk. ABS has proliferated in the United States fleet, and the objective of the current study was to update the effectiveness estimate for ABS with additional years of data and a broader variety of motorcycle types. Methods Motorcycle drivers involved in fatal crashes per 10,000 registered vehicle years during 2003–19 were examined for 65 motorcycle models offering ABS as an optional feature. Fatal crash rates for motorcycles with ABS were compared with rates for the same models without it. Results ABS was associated with a statistically significant 22% reduction in motorcycle driver fatal crash involvements per 10,000 registered vehicle years. Conclusion This finding adds to the growing literature demonstrating the safety benefits of motorcycle ABS.

Estimating Cannabis Involvement in Fatal Crashes in Washington State Before and After the Legalization of Recreational Cannabis Consumption Using Multiple Imputation of Missing Values.

The government of Washington state legalized recreational cannabis consumption in December 2012. We used data on all drivers involved in fatal crashes in Washington in the years 2008-2019 (n=8,282) to estimate prevalence in fatal crashes of drivers with ∆9-tetrahydrocannabinol (THC; the main psychoactive compound in cannabis) in their blood before and after legalization. However, nearly half of the drivers were not tested for drugs; we therefore used multiple imputation to estimate THC presence and concentration among them. We used logistic regression followed by marginal standardization to estimate the adjusted prevalence of THC-positive drivers after legalization relative to what would have been predicted without legalization. In the combined observed and imputed data, the proportion of drivers positive for THC was 9.3% before and 19.1% after legalization (adjusted prevalence ratio: 2.3, 95% confidence interval: 1.3, 4.1). The proportion of drivers with high THC concentrations increased substantially (adjusted prevalence ratio: 4.7, 95% confidence interval: 1.5, 15.1). Some of the increased prevalence of THC-positive drivers might have reflected cannabis use unassociated with driving; however, the increased prevalence of drivers with high THC concentrations suggests an increase in the prevalence of driving shortly after using cannabis. Other jurisdictions should compile quantitative data on drug test results of drivers to enable surveillance and evaluation.

Effects of the autonomous vehicle crashes on public perception of the technology

In March 2018, an Uber-pedestrian crash and a Tesla's Model X crash attracted a lot of media attention because the vehicles were operating under self-driving and autopilot mode respectively at the time of the crash. This study aims to conduct before-and-after sentiment analysis to examine how these two fatal crashes have affected people's perceptions of self-driving and autonomous vehicle technology using Twitter data. Five different and relevant keywords were used to extract tweets. Over 1.7 million tweets were found within 15 days before and after the incidents with the specific keywords, which were eventually analyzed in this study. The results indicate that after the two incidents, the negative tweets on “self-driving/autonomous” technology increased by 32 percentage points (from 14% to 46%). The compound scores of “pedestrian crash”, “Uber”, and “Tesla” keywords saw a 6% decrease while “self-driving/autonomous” recorded the highest change with an 11% decrease. Before the Uber-incident, 19% of the tweets on Uber were negative and 27% were positive. With the Uber-pedestrian crash, these percentages have changed to 30% negative and 23% positive. Overall, the negativity in the tweets and the percentage of negative tweets on self-driving/autonomous technology have increased after their involvement in fatal crashes. Providing opportunities to interact with this developing technology has shown to positively influence peoples' perception.

Continued trends in older driver crash involvement rates in the United States: Data through 2017–2018

Introduction: With the growing older adult population due to the aging baby-boom cohort, there was concern that increases in fatal motor-vehicle crashes would follow. Yet, previous analyses showed this to be untrue. The purpose of this study was to examine current trends to determine if previous declines have persisted or risen with the recent increase in fatalities nationwide. Methods: Trends among drivers ages 70 and older were compared with drivers 35–54 for U.S. passenger vehicle fatal crash involvements per 100,000 licensed drivers from 1997 to 2018, fatal and all police-reported crash involvements per vehicle miles traveled using the 1995, 2001, 2009, and 2017 National Household Travel Surveys, and driver deaths per 1,000 crashes. Results: Since the mid-1990s, fatal crashes per licensed driver trended downward, with greater declines for drivers ages 70 and older than for middle-aged drivers (43% vs. 21%). Fatal crash rates per 100,000 licensed drivers and police-reported crash rates per mile traveled for drivers ages 70–79 are now less than those for drivers ages 35–54, but their fatal crash rates per mile traveled and risk of dying in a crash remain higher as they drive fewer miles. As the economy improved over the past decade, fatal crash rates increased substantially for middle-aged drivers but decreased or remained stable among older driver age groups. Conclusions: Fatal crash involvements for adults ages 70 and older has recently increased, but they remain down from their 1997 peak, even as the number of licensed older drivers and the miles they drive have increased. Health improvements likely contributed to long-term reductions in fatal crash rates. As older drivers adopt vehicles with improved crashworthiness and safety features, crash survivability will improve. Practical Application: Older adults should feel confident that their independent mobility needs pose less risk than previously expected.

Older Driver Crash Involvement and Fatalities, by Age and Sex, 2000-2017.

Federal reporting of crash fatalities has limited age-by-sex stratification, but both age and sex are associated with driving reduction and cessation. We described older driver fatal crash involvement and fatalities using Fatality Analysis Reporting System data to calculate rates (per 100,000 licensed drivers, per 100,000 population) with age-by-sex stratifications. Nationally from 2000 through 2017, 110,422 drivers 65+ were involved in crashes resulting in at least one death within 30 days, and 67,843 of these older drivers died. Involvement and fatality rates per 100,000 licensed drivers in 2017 were lowest for females 65-69 (7.7 and 3.6, respectively) and highest for males age 85+ (34.3 and 25.5, respectively). Females had lower driver fatal crash involvement and fatality rates throughout the lifespan, even when rates generally decreased over time. Elaborating fatal crash trends and rates by age and sex helps to differentiate the public health burden of older driver crashes and fatalities.

Prevalence and predictors of road crash involvement among medical doctors in Malaysia: a cross-sectional study protocol

IntroductionMedical doctors are often subjected to long working hours with minimal rest in between the shifts. This has led to many fatal and non-fatal road crash involvement (RCI). This study...

Associations between self-rated personality traits and automobile fatality rates across small geographic areas

We explore how variation in fatal automobile crashes across small geographic areas is associated with geographic variation in self-rated psychological and behavioral characteristics. Specifically, estimates of ZIP-code-level automobile fatality rates were linked to a separate dataset comprising 2.8 million responses to a widely used self-report personality questionnaire. To control for an area's wealth and population density, associations were estimated at the slightly larger level of US Census ZIP Code Tabulation Areas (ZCTAs). Relationships were estimated using an intraclass adjustment method, where the estimated correlation between individual scores and ZCTA-level fatality rates was divided by the square root of the estimated within-ZCTA intraclass correlation. Further, the ZCTA-level correlation was estimated separately for each US state to examine the consistency of associations. Rates of fatal crash involvement tended to be higher in areas where respondents were more likely to describe themselves as being depressed, moody, and quarrelsome. Some relationships were less intuitive; for instance, rates of fatal crash involvement tended to be higher in areas where respondents described themselves as more helpful and as less easily distracted. However, many small-area-level associations between self-rated personality and fatality rates were found to be in the same direction across more states than expected by chance. This pattern indicates that even many of the less intuitive associations were often highly reliable and general, which has implications for identifying geographic areas with heightened automobile fatality risk.

Can young novice e-bike riders identify hazardous traffic situations? An exploratory study

IntroductionBetween 2013 and 2017, there has been a twenty-five-fold increase in the number of riders hospitalized as a result of an e-bike crash in Israel. Despite youngsters’ growing involvement in fatal and severe-injury e-bike crashes, their hazard-perception skills are yet to be methodically examined. We aimed to explore and map e-bike riders’ development of hazard-perception abilities in perceiving different types of hazard instigators. It was hypothesized that the ability to identify hazard instigators prior to their materialisation (i.e., unmaterialised hazards) develops with age and experience. MethodEighty-nine participants (inexperienced-youngsters, experienced-youngsters, inexperienced-adults and experienced-adults) took part in the experiment. Participants observed 10 short traffic-scenes clips taken from an e-bikes riders’ perspective and engaged in a hazard detection task. ResultsInexperienced-youngsters identified significantly less unmaterialised hazards than all the other groups; inexperienced-adults and experienced-youngsters identified approximately the same number of hazards; experienced-adults identified the most. Additionally, more verbal descriptions regarding unmaterialised hazards were suggested by experienced-adults than by all other groups. Findings suggest that with both age and experience, e-bikes riders’ hazard-perception performance tend to enhance. Moreover, participants' driving license status was found to play an important role in their performance. ConclusionsUnderstanding young, novice e-bike riders' shortcomings in evaluating traffic-situations contribute to the effort of producing intervention techniques that may increase their attentiveness towards unmaterialised hazards and lead towards reduction in their over-involvement in crashes. Implications for training, licensing and policy change recommendations are discussed.

Identifying Fatality Risk Factors for the Commercial Vehicle Driver Population

Commercial/large-truck fatal crash involvement by drivers of different age groups is a critical issue for the trucking industry. Escalating safety concerns related to these heavy vehicles serving the freight economy in the U.S. have an impact national freight reliability and economic growth. This study identifies major contributing factors leading to large-truck fatal crashes for four age groups of driver: <30, 30–49, 50–65, and 65+. The analysis in this study is based on five years (2012–2016) of Fatality Analysis Reporting System data and provides an overall picture of risk factors in large-truck fatal crashes. In total, 30 variables were found to be significant in the logit models, indicating varying risks associated with large-truck drivers of these four age groups. Model results indicate different risk factors associated with driver characteristics, spatial and temporal characteristics, vehicle and vehicle maneuvering characteristics, and environmental conditions at the time of the crashes. Identifying the risk factors for different age groups of drivers is important so proper countermeasures can be implemented from the perspective of human factors (e.g., safe speed choice, fatigue), roadway engineering (e.g., design of roadside barriers, radius of ramps), enforcement (e.g., presence of law enforcement personnel at critical locations), and emergency medical attention in remote areas. Considering the aging of the truck driver population in the U.S. and around the world, the findings of this study are vital to understand better the importance of safety in relation to large-truck fatal crashes.

Prescription opioids, alcohol and fatal motor vehicle crashes: a population-based case-control study

BackgroundThe prevalence of prescription opioid use among drivers has increased markedly in the past two decades. The purpose of this study is to assess the associations of prescription opioid use and alcohol use with the risk of fatal crash involvement in US drivers.MethodsWe performed a population-based case-control study using toxicological testing data from two national data systems. Cases (n = 3606) were drivers involved in fatal motor vehicle crashes selected from the Fatality Analysis Reporting System and controls (n = 15,600) were drivers participating in the 2007 and 2013 National Roadside Surveys of Alcohol and Drug Use by Drivers. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) of fatal crash involvement associated with prescription opioid use with and without the presence of alcohol.ResultsOverall, cases were significantly more likely than controls to test positive for prescription opioids (5.0% vs. 3.7%, p < 0.001), alcohol (56.2% vs. 7.1%, p < 0.0001), and both substances (2.2% vs. 0.2%, p < 0.001). Relative to drivers testing negative for prescription opioids and alcohol, the adjusted ORs of fatal crash involvement were 1.72 (95% CI: 1.37, 2.17) for those testing positive for prescription opioids and negative for alcohol, 17.92 (95% CI: 16.19, 19.84) for those testing positive for alcohol and negative for prescription opioids, and 21.89 (95% CI: 14.38, 33.32) for those testing positive for both substances. The interaction effect on fatal crash risk of prescription opioid use and alcohol use was not statistically significant on either additive or multiplicative scale.ConclusionsPrescription opioid use is associated with a significantly increased risk of fatal crash involvement independently of alcohol use. Concurrent use of prescription opioids and alcohol is associated with a 21-fold increased risk of fatal crash involvement.

The moderating effects of work safety climate on socio-cognitive factors and the risky driving behavior of truck drivers in Pakistan

Trucks involvement in fatal road crashes are considerably high and, literature evidenced that the risky driving behavior of truck drivers is the main cause. Therefore, the study investigates the impacts of socio-cognitive factors (attitude towards risky driving, locus of control and social norms related to driving) and work safety climate in forming the risky driving behavior of truck drivers in Pakistan. Data from 396 truck drivers are collected through a self-administered questionnaire. The results show that driver attitude and prevailing social norms both have a positive significant effect on risky driving behavior, while the work safety climate has a negative impact on risky driving behavior. The study distinctly defines the role of “work safety climate” in the context of the culture prevailing among truck drivers in Pakistan, and looks additionally at the moderating effects on socio-cognitive factors and risky driving behavior. Open communication and counseling by supervisors, their role modeling and placing of limits on risky driving behavior in fact have negative effects on the self-reported risky driving behavior of truck drivers. The study reveals that five of the nine factors have significant moderating effects on risky driving behaviors. The results also imply that improvements in the “work safety climate” of the trucking industry would help to control the socio-cognitive factors and risky driving behaviors, and may improve the road safety conditions in Pakistan.

Trends in the crash involvement of older drivers in Australia

Research from the USA and Great Britain indicates that the number of fatal crashes (as well as the rates of crashes of all levels of injury and property damage) involving older drivers declined between approximately 1997 and 2010 despite increases in the number of older drivers on the road and in their driving exposure. Differing results have been found in Australian research with the number of older driver fatalities having been steady and even slightly increasing between 2004 and 2013. The present study further examined trends in the crash involvement of older drivers in Australia to determine whether their involvement has been increasing or decreasing, and how this compares to trends for younger aged drivers. Crash, injury, population and licensure data were examined by age group for the years 2003–2012. There were increases in the population and licensure of drivers aged 65 years and older, while the total crashes, serious injuries, and fatalities remained steady for drivers aged 65–84 and increased for the oldest group (85+) between 2003 and 2012. Increasing trends were also found for drivers 85 and older for rates of serious or fatal injuries per head of population and per licensed driver. Population and licensure among younger age groups also increased but their crash numbers and crash rates remained steady or declined. The stable or slightly increasing fatal crash involvement of older drivers in Australia contrasts with the declining trends in the USA and Great Britain. Therefore, greater attention should be given to the road safety of older drivers in Australia.

Fatal crashes involving large numbers of vehicles and weather

IntroductionAdverse weather has been recognized as a significant threat to traffic safety. However, relationships between fatal crashes involving large numbers of vehicles and weather are rarely studied according to the low occurrence of crashes involving large numbers of vehicles. MethodBy using all 1,513,792 fatal crashes in the Fatality Analysis Reporting System (FARS) data, 1975–2014, we successfully described these relationships. ResultsWe found: (a) fatal crashes involving more than 35 vehicles are most likely to occur in snow or fog; (b) fatal crashes in rain are three times as likely to involve 10 or more vehicles as fatal crashes in good weather; (c) fatal crashes in snow [or fog] are 24 times [35 times] as likely to involve 10 or more vehicles as fatal crashes in good weather. If the example had used 20 vehicles, the risk ratios would be 6 for rain, 158 for snow, and 171 for fog. ConclusionsTo reduce the risk of involvement in fatal crashes with large numbers of vehicles, drivers should slow down more than they currently do under adverse weather conditions. Driver deaths per fatal crash increase slowly with increasing numbers of involved vehicles when it is snowing or raining, but more steeply when clear or foggy. Practical applicationsWe conclude that in order to reduce risk of involvement in crashes involving large numbers of vehicles, drivers must reduce speed in fog, and in snow or rain, reduce speed by even more than they already do.

Understanding the context of alcohol impaired driving for fatal crash–involved drivers: A descriptive case analysis

ABSTRACTObjective: The objective of this study was to understand the social context and circumstances surrounding alcohol-impaired driving prior to fatal crash involvement for drivers with an illegal blood alcohol concentration (BAC ≥ 0.05 g/100 ml or 0.00 g/100 ml for restricted license holders).Methods: Coroners' case reports investigating fatal crashes in South Australia over a 3-year period (2008–2010) were examined. The personal and crash characteristics of drivers with an illegal BAC were compared with those who had a legal BAC. For each driver with an illegal BAC, information was recorded including characteristics of last trip, location and social context of alcohol consumption, quantity and type of alcohol consumed, BAC level, presence of drugs, perceived alcohol intoxication, and alcohol dependence. Official traffic offense records were also obtained.Results: Of the 284 fatal crashes included in the study, 34% (n = 95) involved a driver or rider with an illegal BAC. Prior to the crash, alcohol was most frequently consumed by drivers in rural areas, within private homes, and was part of normal social activities. Drivers recorded a high level of alcohol impairment, with a mean BAC of 0.173 g/100 ml and a level of alcohol dependence that was above the Australian national average (7.4 vs. 3.9%). In addition, 23% of drivers were known to be experiencing psychological stress at the time of the crash. The results also confirm that drink driving recidivism continues to be a significant problem, with 44% of drivers recording at least one prior alcohol driving offense.Conclusions: Alcohol-impaired driving continues to be a leading cause of fatal crashes. The popularity of drinking at home, particularly in rural areas, has implications for police enforcement strategies and suggests that drink driving interventions that focus on community values and looking after friends might be beneficial. Importantly, the study highlights the need for a broader holistic approach to reduce the high levels of alcohol consumption and alcohol dependence underlying drink driving behavior.

Trends in teen driver licensure, driving patterns and crash involvement in the United States, 2006–2015

IntroductionThe Monitoring the Future (MTF) survey provides nationally-representative annual estimates of licensure and driving patterns among U.S. teens. A previous study using MTF data reported substantial declines in the proportion of high school seniors that were licensed to drive and increases in the proportion of nondrivers following the recent U.S. economic recession. MethodTo explore whether licensure and driving patterns among U.S. high school seniors have rebounded in the post-recession years, we analyzed MTF licensure and driving data for the decade of 2006–2015. We also examined trends in teen driver involvement in fatal and nonfatal injury crashes for that decade using data from the Fatality Analysis Reporting System and National Automotive Sampling System General Estimates System, respectively. ResultsDuring 2006–2015, the proportion of high school seniors that reported having a driver's license declined by 9 percentage points (11%) from 81% to 72% and the proportion that did not drive during an average week increased by 8 percentage points (44%) from 18% to 26%. The annual proportion of black seniors that did not drive was consistently greater than twice the proportion of nondriving white seniors. Overall during the decade, 17- and 18-year-old drivers experienced large declines in fatal and nonfatal injury crashes, although crashes increased in both 2014 and 2015. ConclusionsThe MTF data indicate that licensure and driving patterns among U.S. high school seniors have not rebounded since the economic recession. The recession had marked negative effects on teen employment opportunities, which likely influenced teen driving patterns. Possible explanations for the apparent discrepancies between the MTF data and the 2014 and 2015 increases in crashes are explored. Practical applicationsMTF will continue to be an important resource for clarifying teen driving trends in relation to crash trends and informing strategies to improve teen driver safety.

Interaction of marijuana and alcohol on fatal motor vehicle crash risk: a case\u2013control study

BackgroundConcurrent use of marijuana and alcohol in drivers is of increasing concern but its role in crash causation has not been well understood.Methods Using a case–control design, we assessed the individual and joint effects of marijuana and alcohol use on fatal crash risk. Cases (n = 1944) were drivers fatally injured in motor vehicle crashes in the United States at specific times in 2006, 2007 and 2008. Controls (n = 7719) were drivers who participated in the 2007 National Roadside Survey of Alcohol and Drug Use by Drivers.ResultsOverall, cases were significantly more likely than controls to test positive for marijuana (12.2% vs. 5.9%, p < 0.0001), alcohol (57.8% vs. 7.7%, p < 0.0001) and both marijuana and alcohol (8.9% vs. 0.8%, p < 0.0001). Compared to drivers testing negative for alcohol and marijuana, the adjusted odds ratios of fatal crash involvement were 16.33 [95% confidence interval (CI): 14.23, 18.75] for those testing positive for alcohol and negative for marijuana, 1.54 (95% CI: 1.16, 2.03) for those testing positive for marijuana and negative for alcohol, and 25.09 (95% CI: 17.97, 35.03) for those testing positive for both alcohol and marijuana.ConclusionsAlcohol use and marijuana use are each associated with significantly increased risks of fatal crash involvement. When alcohol and marijuana are used together, there exists a positive synergistic effect on fatal crash risk on the additive scale.

An evaluation of the effect of Ohio's graduated driver licensing law on motor vehicle crashes and crash outcomes involving drivers 16 to 20 years of age

ABSTRACTObjective: Nationally, motor vehicle crashes are the leading cause of death among youth ages 16 to 20 years. Graduated driver licensing (GDL) laws have been implemented to reduce motor vehicle crashes among teen drivers. Studies have shown decreases in teen crash rates and crash-related fatality rates following enactment of GDL laws. However, GDL laws typically apply to teens only until their 18th birthday; therefore, the effect, if any, that GDL laws have on youth drivers ages 18 to 20 years and whether these programs should be extended to include these older youth warrant further study. The objective of this study was to evaluate the effects of Ohio's 2007 revised GDL law on motor vehicle crashes and crash-related injuries for crashes involving teen drivers ages 16 to 20 years, with a focus on the effects on crashes involving drivers ages 18 to 20 years.Methods: Cross-sectional analysis of motor vehicle crashes involving drivers ages 16 to 20 years in Ohio in the pre-GDL (2004–2006) and post-GDL (2008–2010) periods was performed. Descriptive statistics and population-based crash rates for drivers and occupants ages 16 to 20 years were calculated, as well as rate ratios and 95% confidence intervals (CIs) comparing crashes in the pre-GDL and post-GDL periods.Results: Compared with the pre-GDL period, the post-GDL period was associated with lower crash rates for drivers age 16 years (relative risk [RR] = 0.94; 95% CI, 0.90–0.98), age 17 years (RR = 0.90; 95% CI, 0.88–0.93), age 18 years (RR = 0.95; 95% CI, 0.92–0.97), and ages 16–17 years combined (RR = 0.92; 95% CI, 0.90–0.95). Crash rate was higher for the post-GDL period for drivers age 19 years (RR = 1.04; 95% CI, 1.01–1.07), age 20 years (RR = 1.09; 95% CI, 1.05–1.13), and ages 18–20 years combined (RR = 1.02; 95% CI, 1.00–1.03).Conclusions: Unlike previous studies, this investigation used linked data to evaluate the outcomes of all occupants in crashes involving drivers ages 16–20 years. The post-GDL period was associated with lower crash, injury crash, and fatal crash involvement among drivers and occupants ages 16–17 years but higher overall crash involvement for drivers and occupants ages 19 years, 20 years, and 18–20 years combined. These findings support extending GDL restrictions to novice drivers ages 18 through 20 years to reduce crashes in that group.