Introduction: The presence of passengers can affect the driving behavior of motor-vehicle operators. Child passengers present unique motivations to drive more safely, as well as opportunities to distract drivers. Because motor-vehicle crashes are an important cause of premature childhood mortality, this study assesses whether adult drivers with child passengers are more or less likely to cause a fatal crash. Method: Data include fatal crashes involving one or two vehicles from 2007 to 2017 in the U.S. Fatality Analysis Reporting System. We apply methods developed by Levitt and Porter (2001) and Dunn and Tefft (2020)-the LPDT approach-to estimate the risk that adult drivers (21 years or older) with at least one child passenger (15 year or younger) cause a fatal crash relative to adults without child passengers. Results: Childhood crash exposure when traveling with an adult driver is low: 0.78 of vehicle miles trav-eled by adults included a child passenger. Nevertheless, adult drivers with child passengers were signif-icantly more likely to cause a fatal crash than adult drivers without child passengers. The estimated risk of causing a single-vehicle crash was 6.2 times higher among the full sample of adults, 7.2 times higher among female drivers, and 5.0 times higher among drivers 25-44 years old. Conclusions: Despite their rel-atively low crash exposure, child passengers are associated with much greater risk of causing a fatal crash. Practical Applications: This study not only informs about the need to develop interventions to remind parents and adult drivers of the risks associated with driving children, but also reminds research-ers about the enormous potential of the LPDT approach when applied to traffic safety issues.(c) 2022 National Safety Council and Elsevier Ltd. All rights reserved.
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