Health and relicensing policies for older drivers in the European union.

BACKGROUND

The number of older drivers is increasing rapidly in the developed world. Many states of the European Union (EU) have initiated legislation to screen older drivers for age-related disease, despite evidence that screening may be harmful or have no positive effect.

METHODS

We reviewed the current situation in the EU by sending a questionnaire to the Driver and Vehicle Licensing Agency in each member state.

RESULTS

All fifteen countries replied. Regular medical screening occurs in ten. European Council Directive 91/439/EEC forms the basis for national guidelines on medical fitness to drive, but these are not specific for age-related illness, and interpretation of the directive varies between countries. Specific guidelines are not available in all countries for the age-related conditions of dementia, stroke, and Parkinson's disease. In nine countries a medical colleague is available for consultation in difficult cases. Drivers are required to report illness to the Driver and Vehicle Licensing Agency only in the United Kingdom. In six countries, there is mandatory reporting by physicians of conditions which may pose a risk to driving.

CONCLUSIONS

There is considerable heterogeneity within the EU on the processes of older driver screening. This diversity may facilitate research into the effect of different policies on safe mobility of older people. If changes in the screening process are considered, further knowledge is needed on issues such as older driver exposure and valid measures of safe mobility for the EU. More evidence-based research is required to help policy makers frame future guidelines and legislation, so as to promote safe mobility of older people.