Sex Differences in the Amount and Patterns of Car-Driving Exposure in Spain, 2014 to 2017: An Application of a Quasi-Induced Exposure Approach Mateos Granados, José Martín de los Reyes, Luis Miguel Rivera Izquierdo, Mario Jiménez Mejías, Eladio Martínez Ruiz, Virginia Ana Lardelli Claret, Pablo Car-driving exposure Gender differences Environmental factors Traffic epidemiology Quasi-induced exposure We wish to thank the Spanish Traffic Directorate (DGT) for granting access to their Spanish Register of Road Accidents with Victims. We designed a cross-sectional study in Spain, from 2014 to 2017. Our objective was to assess sex-related differences in the amount of driving exposure of car drivers, overall and stratified by the main environment-related driving conditions. We compared the sex distribution across three populations: (1) total number of person-years aged > 18 years; (2) total number of person-years aged > 18 years holding a valid car-driving license; and (3) total number of non-responsible car drivers involved in crashes with another offending driver, stratified by different environmental variables. The quasi-induced exposure approach was applied: the non-responsible drivers were considered as representative of the entire population of drivers on the road at the place and time at which the crash occurred. We calculated the female-to-male odds ratio (OR) by comparing population 2 versus 1, and population 3 versus 2. Finally, we performed separate regression models in population 3 for each environment-related variable as the dependent variable and driver’s age and sex as the independent variables. The female-to-male OR for the first comparison was 1.12, but values below 1 were found for extreme age groups. In the second comparison, an OR of 0.50 (0.49–0.51) was found, with progressively lower OR values as age increased. In population 3, women were found to drive less than men in environments known to be high risk (i.e., open roads, night-time, poor light conditions, and weekends). A significant gender gap exists in the amount and type of driving exposure. Although women obtain a driving license more frequently than men, they drive much less and tend to avoid high-risk environments. These results emphasize the need to incorporate a gender perspective in the development and implementation of road safety interventions. 2022-01-31T11:55:06Z 2022-01-31T11:55:06Z 2021-12-16 journal article Mateos-Granados, J... [et al.]. Sex Differences in the Amount and Patterns of Car-Driving Exposure in Spain, 2014 to 2017: An Application of a Quasi-Induced Exposure Approach. Int. J. Environ. Res. Public Health 2021, 18, 13255. [https://doi.org/10.3390/ijerph182413255] http://hdl.handle.net/10481/72561 10.3390/ijerph182413255 eng http://creativecommons.org/licenses/by/3.0/es/ open access Atribución 3.0 España MDPI