Driver licenses as a measure of older drivers' exposure: a methodological note.

The limitations of the number of driver licenses as an estimate of driving exposure were demonstrated by comparing Finnish and Swedish driver licensing practices, licensing rates and accident rates of older drivers. In Sweden, there is no screening for older license holders, and most of them keep their licenses for life. In Finland, there is a heavy and costly medico-legal control system for older license holders, leading to both screening and self-screening. Consequently, in the two countries, the numbers of driver licenses do not reflect the numbers of active older drivers in the same manner. This difference affects the comparative accident statistics: with respect to population, Finland and Sweden have similar age trends in accidents risk, but with respect to the number of driver licenses, the Finnish older drivers seem to have a higher risk of accident than the Swedish ones. It is concluded that if group comparisons of accident risk are presented using the number of driver licenses as an estimate of exposure, the licensing legislation and practice should affect all the groups in an identical manner for the comparison to be valid.