In the coming years, Europe is facing a significant shift in the age distributions of populations. Currently, elderly make up 18% of the European population. However, due to the decline in birth rates, the ageing of the baby-boom generation and the increased longevity; 24% and 28% of the population will be aged * 65 years in 2030 and 2050 respectively. Due to these demographic changes, more elderly will actively participate in traffic. An increased proportion of elderly road users in traffic will bring a significant increase in the number of elderly road users who are at risk of being involved in road accidents. While at the moment one road traffic fatality out of five is aged 65 or over in Europe, it is expected that by 2050 one road traffic fatality out of three will be an older person which is an increase of 13%. Therefore, the aim of the “Risks and countermeasures for road traffic for the elderly in Europe” project (in short: ElderSafe) funded by the European Commission DG MOVE is to provide an action plan containing recommendations for the most promising measures to be taken at the EUlevel in the light of developing a proactive strategy to enhance the road safety of the elderly in the (near) future. This strategy is developed by: *Assessing the main trends and road safety risks for all older road user groups; *Providing an overview and analysis of various countermeasures, including ITS, aimed at increasing road safety for all older road user groups. The following categories of older road users are identified in this study: *Car drivers; *Car passengers; *Cyclists; *Pedestrians; *Powered two-wheelers (mopeds and motorcyclists) (PTW); *Public transport users. Risk factors can make a considerable contribution to crashes or injuries. The risk factor analysis revealed that the road safety problem of elderly road users has three dimensions, not independent of each other: exposure, accident risk and injury risk. Within these three dimensions, the following thirteen risk domains for elderly road users in Europe are identified: 1. Exposure *Urban roads; *Rural roads; *Transportation mode: car driver, car passenger, PTW-user, pedestrian, cyclist and public transport user. 2. Accident risk *Illnesses/functional limitations; *Medication; *Risk taking/distraction; *Self-regulation. 3. Injury risk *Fragility. However, it is not always straightforward to reduce or eliminate the negative effects of certain risk domains since interventions in some risk domains may receive a strong public support or result in greater safety benefits. Therefore, the following risk domains require prior attention because they have the strongest impact on the reduction of serious traffic casualties among the elderly, and because they receive a strong support by the public in terms of countermeasures: 1. Fragility 2. Illnesses and functional limitations 3. Urban roads 4. Pedestrian (i.e. walking as a transportation mode) 5. Medication Unless there is a fundamental reconsideration of the road traffic system to guarantee that the safety and mobility needs of elderly road users are met, the risk associated with older road users will aggravate in light of the expected demographic changes. Therefore, measures targeting these risk factors are of great interest to the safety of elderly road users and should be a key priority of any policy. In order to meet the safety and mobility needs of elderly road users in the (near) future a comprehensive and proactive strategy is required which will encompass policy at EU, national, regional and local levels and includes a package of measures composed of: *Infrastructural interventions; *Education & training; *Licensing & enforcement; *Vehicle & ITS technologies. The key policy priority in the (near) future is that this package of measures should be based on a “design for all” approach. This approach takes the specific needs, opportunities and limitations of different road users into account. As a result, these measures will not only enhance the road safety and mobility of the elderly; younger road users will also benefit from an age-friendly design. Creating and providing a safe road environment can significantly improve the safety and mobility of elderly road users. Additionally, improvements in infrastructure and road design can realize immediate safety benefits and cost-effective results. Several interventions in road design have the potential to improve the safety of elderly road users, however, only a handful seems to address the most important risk factors of elderly people. It is recommended: *To separate vulnerable road users from motorized traffic and/or introduce low design speeds in areas with many vulnerable road users. *To develop self-explaining and forgiving roads in urban and rural environments. *To reduce conflicts between VRU’s and vehicles and between vehicles at intersections in urban networks. *To use protected-only operations at signalized intersections in urban areas. *To develop standards in the area of age-friendly road design. The safety benefits of educational and training programs are difficult to assess. However, creating a better awareness among the elderly of health and medical conditions and functional abilities that affect their driving, age-related vulnerability, and the adoption of self-regulation strategies will remain a key policy priority in the (near) future. Therefore, it is recommended to: *Train elderly in recognizing their deficits and to adjust their behaviour accordingly which will result in more effective self-regulation of older road users and improved road user behaviour. *Inform older road users about their increased age-related fragility and about the importance of using protection devices. These information initiatives should be combined with a practical training aimed at the correct usage of these protection devices. *Introduce standardized medical protocols to systematically assess the influence of age-related illnesses, functional limitations and prescribed medication on driving abilities. The results of these tests permit to design tailored-made educational and training initiatives to meet the individual needs and requirements of the older road user. As the number of elderly people will increase in the future, most will have a driving license, access to a car and will prefer to drive in old age. Therefore, future older driver programmes should support continued driving for as long as drivers are capable to meet specific medical and safety criteria. In that respect, programmes entailing gradual license restrictions provide promising prospects to fulfil the elderly’s safety and mobility needs. Therefore, it is recommended to: *Create a uniform arrangement across the Member States concerning the decision on fitness to drive. The decision with respect to driving cessation and/or restrictions should not be based on age nor on the diagnosis of any particular diseases, but on a judgement of health and functional abilities required for safe driving. *Establish specialised and certified mobility centres with multidisciplinary professionals (driving instructors, psychologists, physicians,…) to perform medical and driving tests and to provide individually tailored trainings. *Stimulate the development of a community-based referral system involving physicians, health care professionals, police, friends and families of older drivers and older drivers themselves to identify high-risk drivers, encourage them to test their driving abilities and provide tailored solutions. *Inform (older) unfit drivers to participate in voluntary driver assessments such as online checklists or tests to raise awareness about the effects of functional limitations on driving abilities. *Train licensing agencies to help maintain safe driving for as long as possible and assisting drivers in the transition to non-driving besides only focusing on identifying at-risk drivers. *Provide guidelines for health care professionals, licensing agencies and law enforcers to refer/report drivers for license screening and testing and provide immunity for those reporting. *Encourage research institutes to produce scientifically sound criteria (neuropsychological tests, medical tests and driving tests) to evaluate driving Interventions within the area of vehicle and ITS technologies provide potential to enhance the safety of elderly road users since advanced vehicle technologies or driver assistance systems can help the elderly to stay mobile in a safe way by assisting them to compensate for their age-related functional declines. Currently, these technologies are developed without applying a user-centered approach for older drivers. Therefore, it is time to design an age-friendly vehicle. It is recommended to: *Develop better active vehicle safety standards for older and more vulnerable road users by including the elderly within the design process. *Introduce a standardized testing procedure to systematically asses the usability and effectiveness of advanced vehicle technologies for older drivers. This should be done by including elderly safety in EuroNCAP testing. *Educate and train older people on the correct usage of active safety technologies (elderly-adapted ADAS technologies). *Encourage the further development of crash avoidance systems, such as intersection and lane change assistants and active pedestrian protection systems. *Explore the potential benefits and drawbacks of (semi-) automated driving in extending the driving life of older road users by offering assistance to compensate for functional limitations. Furthermore, fully automated vehicle technologies will create safety benefits for older drivers as the sensory, cognitive and psychomotor abilities of the driver can be compensated for by these vehicles. As a result, elderly will stay mobile. Furthermore, driving automation technologies encompass six levels ranging from no automation to full automation. In that respect special attention should be paid to the older driver when the technology is situated in the intermediate level of market introduction (i.e. level 2 ‘partial automation’ and level 3 ‘conditional automation’) since these technology levels still require that the driver is capable to intervene if necessary. Therefore, it needs to be carefully analyzed and monitored to what extent older drivers are still capable to quickly intervene in the driving task if this is required. Infrastructural interventions, education & training initiatives, licensing restrictions and vehicle & ITS technologies can only compensate for reduced fitness to drive to a certain degree. Furthermore, mobility, health and well-being are intertwined since the loss of mobility is connected with declines in life quality, functional independence and physical and mental health. Therefore, elderly safety and mobility should be balanced equally in the development of an elderly transport safety strategy. Thus, maintaining the mobility of elderly who quit or are forced to cease driving will be a key policy priority in the (near) future. This should be realized by providing alternative transport options and services. These measures must be taken now in order to cope with the expected increases in the elderly population. Therefore, all policy levels and key stakeholders must work together to support the elderly by: *Expanding and improving conventional public transport services adapted to the elderly’s travel patterns. *Offering safe, affordable, reliable, accessible transportation alternatives to elderly people before they are forced to cease driving. *Training and informing elderly people about how to use these alternative transport options and services. *Health care workers, licensing agencies, friends and families of older drivers should help the older driver to prepare the transition from car driving to lifeafter-car. Finally, the older road user himself should have an open mind about his life-afterdriving and should also consider life-decisions that can positively affect mobility into old age such as relocating to urban areas. Additional to the specific actions by countermeasure area, the ElderSafe project formulates the following recommendations for action with respect to the overall road safety policy for elderly road users. A multi-actor approach is necessary to keep older road users safe and mobile. Health care workers: *To increase their own knowledge and awareness about age-related deficits or medication that may have an impact on road user safety; *To pro-actively share information and discuss about such risks with the older road user; *To offer possibilities and motivate the participation in self-assessment and voluntary testing for the early detection of driving deficits; *Train elderly in recognizing their deficits and to adjust their behaviour accordingly which will result in more effective self-regulation of older road users and improved road user behaviour; *Inform older road users about their increased age-related fragility and about the importance of using protection devices. These information initiatives should be combined with a practical training aimed at the correct usage of these protection devices. Vehicle technology and manufacturing sector: *To design and inform older road users about effective vehicle safety technologies to better protect the (older) vulnerable road user; *To design smart vehicle safety technologies adapted to the needs and individual characteristics of different driver groups, such as the higher physical vulnerability of the older driver and passengers (i.e. design for all); *Educate and train older people on the correct usage of active safety technologies (elderly-adapted ADAS technologies); *To systematically assess the usability of advanced vehicle technologies for older drivers. Local and regional governments: *To design education and awareness campaigns aimed at improving the awareness of age-related, illness-related deficits and prescribed medication and their potential effects on road user safety; *To provide safe, easy-to-use and comfortable transportation alternatives for (older) road users who are no longer able to drive; *To create self-explaining and forgiving road infrastructure, both in urban and rural environments; *To organize and promote possibilities for voluntary driver self-assessment and training; *To formulate guidelines to separate vulnerable road users from motorized traffic and/or introduce low design speeds in areas with many vulnerable road users. Clear regulations should also be developed and applied in situations where this is not possible; *To inform and train elderly road users in refresher courses on (new) traffic rules and modern road infrastructure concepts such as shared space, selfexplaining and forgiving roads; *To establish specialised and certified mobility centres with multidisciplinary professionals (driving instructors, psychologists, physicians, etc.) to perform medical and driving tests and provide individually tailored trainings; *To develop a community-based referral system involving physicians, health care professionals, police, friends and families of older drivers and older drivers themselves to identify high-risk drivers, encourage them to test their driving abilities and provide tailored solutions; *To implement fitness-to-drive issues in the formal medical training of physicians and other health professionals; *To provide standardized training and education for health care professionals, law enforcers and licensing personnel on fitness-to-drive; *To provide guidelines for health care professionals, licensing agencies and law enforcers to refer/report drivers for license screening and testing and provide immunity for those reporting. Research institutes: *To better understand the accident circumstances in which older road users are involved and propose effective countermeasures; *To produce scientifically sound criteria (neuropsychological tests, medical tests, driving test) to evaluate driving abilities (including compensation behaviour) and risks; *To explore the impact of innovative transportation means such as electric vehicles, pedelecs (e-bikes) and intelligent bikes on elderly safety; *To explore the exposure patterns of elderly road users; *To evaluate the effectiveness of countermeasures to improve older road user safety; *To explore the prediction of non-fitness to drive in order to establish testing standards by differentiating safe from at-risk driving. Insurance sector: *To stimulate older road users to participate in awareness raising, educational and/or driver training activities, e.g. by offering financial incentives. European Commission: *To create additional awareness about older road user safety at different governmental levels (EU, national, regional, local); *To stimulate Member States to address older road user safety in their national mobility plans; *To exchange information on best practice countermeasures to increase older road user safety; *To stimulate scientific research in the area of older road user safety; *To include (older) vulnerable road user safety in vehicle safety testing standards; *To monitor that interventions aimed to increase the safety and mobility of elderly road users are not discriminatory; *To promote urban road safety policies within sustainable urban mobility plans; *To develop stronger policies for traffic safety of pedestrians and other VRUs; *To explore the potential benefits and drawbacks of (semi-) automated driving for older road users; *To increase the importance of (elderly) road safety elements in the guidelines for holistic urban management; *Add a recommendation to the Driving License Directive to include education/training/ awareness initiatives within the national licensing policies; *To encourage health programmes that help reduce fragility; *To introduce a standardized testing procedure to systematically asses the usability and effectiveness of advanced vehicle technologies for older drivers. This should be done by including elderly safety in EuroNCAP testing; *To create a uniform arrangement across the Member States concerning the decision on fitness to drive. The decision with respect to driving cessation and/or restrictions should not be based on age nor on the diagnosis of any particular diseases, but on a judgement of health and functional abilities required for safe driving; *To create a uniform arrangement across the Member States with respect to license renewal policies; *To introduce standardized medical and driving protocols with respect to license restrictions, license renewal and license screening and testing. The older road user himself: *To be aware about the potential problems and increased accident risks associated with ageing; *To (learn to) compensate for potential age- or medical related perceptualmotor deficits that may affect one’s safety; *To have an open mind about possibilities offered for self-assessment or voluntary driver testing, or to discuss one’s personal situation with family and/or health care professionals (doctor, occupational therapist, pharmacist); *To prepare the transition from driving to life-after-car. (Author/publisher)
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