April 2, 2001-- For the American teenager, the automobile has become a symbol of freedom and a rite of passage to adulthood. But according to a new study, a newly minted driver's license also can be a passport to the hospital, or even the morgue.
In what they're calling a "landmark" study on teenage driving safety, pediatric researchers from the University of Utah in Salt Lake City have found that teen drivers are involved in a disproportionately high number of car crashes.
Using the resources of the university's Intermountain Injury Control Research Center and other state agencies, Natalie Cvijanovich, MD, and colleagues reviewed a four-year period (1992-1996) and identified some 217,000 Utah car crashes involving 500,000 passengers and their hospital records. Information on teenagers was extracted from the huge pool of information.
Among the findings, available in the April issue of Pediatrics:
- Teen drivers were more likely to be involved in a car accident than adults, but in general, the crashes were less severe.
- Eleven percent of teen car crashes occurred between 11 p.m. and 6 a.m., but a disproportionate amount, 19%, were fatal.
- The risk of hospitalization or death in an accident increased "substantially" more for teens than adults when additional passengers were in the car.
- Teen drivers were more than twice as likely to be held accountable for a car crash.
- Teen drivers wore seatbelts less often than adults, especially when passengers were present.
- During the study period, 158 people died in car crashes, about 25% of them teens.
During the study period, there were no seatbelt requirements and no restrictions limiting nighttime driving or the number of passengers teens could carry.
Cvijanovich, a pediatrician specializing in intensive care, says her experience with teens suffering terrible automobile injuries motivated her to do the research. "Probably the head injuries are the worst, because they change people forever. That's the hardest for the families. They lose the child that they knew, even if they survive," she tells WebMD.
And though more teens may survive crashes -- because "age is in their favor as far as their health goes" -- Cvijanovich says that the toll is still tremendous.
In this study, the total hospitalization cost of treating all the victims involved in teen crashes was more than $20 million, not to mention the trauma, time lost from school, and rehabilitation.
The Utah researchers anticipate that the disturbing results can be used to support graduated driver licensing, whereby teens earn full driving privileges over time. The program includes supervised driving, as well as nighttime and passenger restrictions.
In fact, Cvijanovich says that graduated driver licensing programs could increase teen survival rates by 25%.
A nighttime driving restriction could reduce nearly 20% of all fatal accidents, and required seatbelt use also would reduce fatalities and injuries, Cvijanovich and colleagues report. But limiting the number of passengers teens can tote around would have the most significant impact, they argue. "The presence of any passenger in a car ... driven by a teen driver increases by 70% the risk of a crash that results in a fatal or serious injury," the Utah team reports.
However, she opposes restricting the driving privilege until age 18 -- a solution many states have considered -- because that could be a hardship on rural families whose teens need cars.
The National Highway Traffic Safety Administration, which helped pay for the research, also supports teen driving limits.
"In Ontario, Canada, and New Zealand -- where graduated driver licensing is in effect -- crash deaths and injuries for teenage drivers have been reduced," NHTSA reported in a prepared statement.
Currently in the U.S., about 30 states curtail teen driving with some type of restriction. NHTSA says states such as Maryland and California have experienced a decline in teen driving deaths as a result of their programs.
Last year in Utah, following testimony by Cvijanovich, the legislature passed rules limiting late-night driving for teens and beefing up seat belt requirements. This year, they cut back on the number of passengers teens can ferry around in their cars. While there could be a federal statute requiring graduated driver licensing for teens, such matters usually are left to the states.
Cvijanovich admits there could be a built-in bias to her study because teens usually are considered bad drivers. Still, she feels the evidence is overwhelming.
"An inexperienced driver is much more likely to be distracted by other things happening in the car, whether it's just the radio playing or somebody talking to them. I'm sure there's a factor of showing off," Cvijanovich says. She notes that in general, teen boys have more accidents than teen girls.
As things stand now, unless things change, the federal government estimates that 7,500 teenagers will die annually in car crashes.