Medical screening of older drivers as a traffic safety measure - A comparative Finnish-Swedish evaluation study

OBJECTIVES: To evaluate the safety effect of age-related medical screening of older drivers by comparing the licensing laws and accident rates for older road users in Finland and Sweden. DESIGN: Post hoc comparison of Sweden and Finland with respect to three different risk variables. SETTING: Nationwide Swedish and Finnish accident, licensing, and population data from the year 1990 were provided for the present study by the local authorities responsible for tabulating these data. PARTICIPANTS: Data about all citizens born in 1960 or earlier, i.e., aged 30 years or more in the year of measurement, are included. MEASUREMENTS: Rates of police-reported private car accidents leading to personal injury, fatality rates of private car drivers and passengers, and fatality rates of unprotected road users. RESULTS: The age-related variation in private car accident and private car fatality trends was similar in both countries. Fatalities among unprotected road users (i.e., pedestrians, cyclists, and mopedists) increased more sharply with age among the older Finnish population than among the Swedish population. CONCLUSION: We found no safety-related reasons to implement age-related medical screening of older drivers of the kind practiced in Finland. On the contrary, by producing a modal shift toward a more risky mode of travelling, this screening may indirectly lead to higher fatality rates among older road users.