Against the background of the aging population, the question of the fitness and safety of older drivers has been widely discussed. Research from various countries has indicated that licensing policies are not evidence based and tests that are commonly used to assess the fitness to drive show at best very low correlations with accident rates. Chronological age per se seems to be, in the case of mature drivers, at best only a weak predictor of safe driving performance. Yet, licensing policies based on chronological age are widely used and many countries have chosen to invest in age-based testing of driving fitness. More evidence based policies have been called for, both out of ethical and economic reasons. In the present report, the different driver licensing policies in the 27 EU countries are described and their effects are assessed based on evaluation studies. The mapping of licensing policies in Europe (Chapter 2) indicates considerable heterogeneity of existing policies. Six out of 27 countries, most of them in Central Europe, issue unlimited licences, and the licences issued by the remaining 21 countries vary greatly. In some countries licenses have to be renewed every 10 years, while in other countries the license has to be renewed for the first time at a specific age. In most cases the intervals become shorter with increasing age. Most of the countries that issue licenses require medical examinations (with limited validity) to renew the license. The methods used to assess the fitness to drive vary with regard to the testing procedures and the medical professionals involved, but general practitioners have a dominating role. There is also a considerable heterogeneity regarding the direct costs paid by the licensee in connection with license renewal. In Chapter 3 the effects of older driver screening and licence renewal policies are evaluated through a literature review. There is no evidence supporting the assumption that general age-based assessments have any safety benefits. However, the review of evaluation studies identified possible safety benefits of more specific measures, namely in-person renewal (as opposed to renewal by mail) and restricted driving. These effects were, however, all found in American studies and it is not clear whether all of them can simply be transferred to the European context. The few existing European evaluation studies all conclude that aged-based licence renewal is associated with negative safety effects for older people, because it triggers a shift from the car to unprotected modes of transport. In addition, driving cessation is associated with negative mobility and health related effects. Older drivers are a safe group of drivers and a general screening of the whole population of older drivers does also not appear as a reasonable societal investment. In sum, age-based screening implies large societal and private costs and decreases transport safety on a system level. To take away the licence would only appear justified if it was possible to reliably identify unsafe drivers. Existing measures, however, fail in that respect. Apart from the negative consequences for the older person who has to cease driving, the relatives, who have to take care for the older persons’ future transport needs are also concerned. Finally, the GPs, when in charge of this decision, often find themselves in an ethical dilemma. In the future, more older people will hold a license and keep driving until an advanced age. Based on the results it is recommended to shift the focus from restricting their mobility to prolonging older persons’ safe driving careers (Chapter 4). This should be supported by soft policy measures as well as technological advances up to autonomous cars. In addition, different kinds of mobility services have to be provided to ensure a high level of mobility after driving cessation. Taking into account the increasing heterogeneity of older road users, the various measures should be designed for and addressed to different target groups of older road users. (Author/publisher)
Samenvatting