Graduated drivers licensing and traffic injury-attributable emergency department visits in Alberta, an interrupted time series study

• Alberta recently removed the advanced road test in licensing requirements. • An interrupted time series design was used to assess any increases in traffic injuries. • The licensure change resulted in immediate increases in some types of motor vehicle collisions. Graduated drivers licensing (GDL) programs are being simplified across Canada. In April 2023, Alberta removed advanced road testing for full (Class 5) licenses and lifted previous restrictions on alcohol use, nighttime driving, and passengers for learners (Class 7). As of June 25, 2023, ∼700,000 drivers gained full licensure without advanced testing. New Alberta drivers are younger, less restricted, and have higher motor vehicle collision (MVC) rates than other provinces. We used interrupted time series analysis with publicly available data from January 2022 to January 2025. Negative binomial regression was used to estimate immediate and longer-term effects of the policy change on emergency department (ED) visits due to MVCs, adjusting for age, gender, and seasonality, with subgroup analyses by road user type. Following the changes to GDL programming, drivers and passengers experienced modest increases in visit rates immediately after the intervention (driver IRR: 1.05, 95% CI: 1.00–1.11; passenger IRR: 1.11, 95% CI: 1.02–1.21). Motorcycle drivers showed larger increases, though estimates for motorcycle passengers were imprecise due to small sample size (motorcycle driver IRR: 1.40, 95% CI: 1.09–1.78; motorcycle passenger IRR: 1.49, 95% CI: 0.81–2.73). Removing GDL restrictions in Alberta led to immediate increases in MVC-related ED visits, particularly among motorcycle users, younger age groups, and males. Minimal ongoing trends suggest the effects were largely immediate and no statistically significant lasting impacts are noted. These findings highlight potential safety risks from relaxing licensing restrictions and the need for targeted interventions for high-risk groups as other provinces consider similar policy changes.