Rios A, Wald M, Nelson SR, Dark KJ, Price ME, Kellermann AL. Annals of Emergency Medicine. 2006;47:361-369.

INTRODUCTION

Fatal motor vehicle crashes involving young drivers continue to be a concern for trauma nurses who respond and provide advanced resuscitation measures in an attempt to stave off unsuccessful outcomes.

ABSTRACT

This study reviews the impact that the Teenage and Adult Drivers Responsibility Act has had on fatal crash rates of various age groups of drivers 51/2 years before and after the law was enacted in Georgia. The researchers analyze fatal crash rates among drivers, factoring in such variants as alcohol involvement, speed, and time of day when the crash occurred. Overall, the fatal crash rate of 16-year-old drivers was 37% lower in the postenactment study period than in the preenactment study period, alcohol-related crashes decreased more than 60%, and speed-related crashes decreased by 50%. However, the law had little sustainable effect on the fatal crash statistics as the teenagers aged. There was no significant decline in fatal crashes for older teenagers or young adults. The researchers then compared the Georgia outcomes to the same cohort in 3 neighboring states to determine if any other historical factors may have altered the outcomes. Georgia's results surpassed those of the neighboring states.

Limitations of significance to the study included the inability to obtain enforcement data, voluntary use of seat belts, and lack of correlation to high school attendance and/or graduation rates. The authors failed to include the legal drinking age, which may have significant correlative influence on the data. There was no mention of the injuries, fatal or otherwise, to the occupants of the vehicles. There was no operational definition for "other historical effects." Lastly, no explanation was provided for the rational behind allowing no more than 3 passengers younger than 21 years who were not members of the driver's immediate family to ride in the car. This portion of the law implies that there may be more than 3 passengers younger than 21 years in the car if they are immediate family members. Analysis of fatal crashes where immediate family members were passengers is warranted to determine if they could be a confounding factor in fatal crashes. (42 references)

COMMENTARY

Tough driver responsibility acts have an impact upon young driver's habits, as evidenced by the decline in fatal crashes for 16-year-olds. Risk-taking behaviors such as drinking and driving and high rates of speed remained unaffected by the law. Trauma nurses need to understand that teenage risk taking remains undeterred by the enactment of new laws. The article demonstrated that education, supervision, and law affected the youngest teenagers in the study, but when independence rose commensurate with age, so did risk taking. This article would be useful for trauma nurses who provide community prevention education. The data suggest that older adolescents and college-age young adults should be the focus of ongoing efforts for programs such as Emergency Nurses Care, Students Againts Drunk Driving, and trauma nurse lectures. Many trauma nurses are involved in high school risk-taking prevention programs, but it is time to develop new educational strategies and continue the message on the college campus.