Alcohol intoxication in drivers in road traffic accidents and violations (original) (raw)
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Road Safety, Alcohol and Public Policy
Transportation Research Part E: Logistics and …, 2005
As one of the leading causes of death and injury that exact a high societal cost, motor vehicle highway crashes are a major public policy concern. The direct economic cost of global road crashes has been estimated conservatively at US$518 billion a year (Peden et al., 2004), with US$207 billion accruing to the European union countries and US$230 billion to the United States of America. Although there are many factors contributing to the frequency and severity of road crashes, drunk driving (also known as drink driving, driving while intoxicated, driving under the influence of alcohol) is among the principal reasons for crashes in many countries. Of the 38,252 fatal crashes in the US in 2003, for example, 40% were alcohol related, a percentage that has remained relatively stable over the past few years. Consistent with this, the National Highway Traffic Safety Administration, in a study based on 2000 US crash data, has estimated that alcohol related crashes imposed a $114.3 billion total cost on society. This Special Issue on Road Safety, Alcohol and Public Policy highlights recent work in highway safety that enlightens our understanding of the relationships that exist between alcohol consumption, driver regulations, and highway safety. The first two papers in the Issue, authored by Vollrath et al. and Mathijssen, respectively, focus upon alcohol related policies in Germany and the Netherlands whereas the next two papers explore the relationship between alcohol consumption and crash severity in New Zealand (Keall and Firth) and the state of Ohio in the United States (Traynor). In their paper, Noland and Karlaftis comparatively analyses alternative statistical methodologies commonly used in highway safety analyses. Each of these papers, although diverse in geographic scope (North American, European, and Australian continents), methodological approach, and policy orientation, provides additional insights on an aspect of alcohol and highway crashes that deepens our understanding of these events and will assist policy-makers charged with implementing highway safety interventions that are more efficacious in reducing the frequency, severity, and societal costs associated with alcohol related crashes. In the highway safety environment, rarely do researchers have an opportunity to analyse the effects of large natural experiments on a country-wide basis. But the reunification of East and West Germany, which led to a number of adjustments in the legal system, provided such an occasion. One significant change for East German motorists was a relaxation of the legal blood alcohol concentration (BAC) limit with no change in the legal limit for West German motorists. Combining the results of roadside breath alcohol tests administered to drivers with other data collected from three roadside surveys conducted from 1992 through 1994 in an East German region and a comparable West German region, Vollrath, Kruger, and Lobmann analyse the immediate, short term, and longer term effects of raising the BAC
Traffic accidents, deaths and alcohol consumption
Applied Economics, 2009
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The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers' products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. The World Health Organization does not warrant that the information contained in this publication is complete and correct and shall not be liable for any damages incurred as a result of its use. The named editors alone are responsible for the views expressed in this publication. Designed by minimum graphics. Cover by Tushita Graphic Vision. Typeset and printed in Switzerland. Contents Foreword vii Preface ix Contributors xiii Acknowledgements xvii iv • WORLD REPORT ON ROAD TRAFFIC INJURY PREVENTION Country estimates Trends in road traffic injuries Global and regional trends Trends in selected countries Projections and predictions Motorization, development and road traffic injury Profile of people affected by road traffic injuries Types of road user Occupational road traffic injuries Sex and age Socioeconomic status and location Other health, social and economic impacts Health and social impacts Economic impact Data and evidence for road traffic injury prevention Why collect data and build evidence on road traffic injuries? Sources and types of data Data linkages Analysis of data Data issues and concerns Other issues Limitations of the data sources used in this chapter Conclusion References CONTENTS • v Risk factors influencing injury severity Lack of in-vehicle crash protection Non-use of crash helmets by two-wheeled vehicle users Non-use of seat-belts and child restraints in motor vehicles Roadside objects Risk factors influencing post-crash injury outcome Pre-hospital factors Hospital care factors Conclusion References Chapter 4. Interventions A road traffic system designed for safe, sustainable use Foreword Every day thousands of people are killed and injured on our roads. Men, women or children walking, biking or riding to school or work, playing in the streets or setting out on long trips, will never return home, leaving behind shattered families and communities. Millions of people each year will spend long weeks in hospital after severe crashes and many will never be able to live, work or play as they used to do. Current efforts to address road safety are minimal in comparison to this growing human suffering. The World Health Organization and the World Bank have jointly produced this World report on road traffic injury prevention. Its purpose is to present a comprehensive overview of what is known about the magnitude, risk factors and impact of road traffic injuries, and about ways to prevent and lessen the impact of road crashes. The document is the outcome of a collaborative effort by institutions and individuals. Coordinated by the World Health Organization and the World Bank, over 100 experts, from all continents and different sectors-including transport, engineering, health, police, education and civil society-have worked to produce the report. Road traffic injuries are a growing public health issue, disproportionately affecting vulnerable groups of road users, including the poor. More than half the people killed in traffic crashes are young adults aged between 15 and 44 years-often the breadwinners in a family. Furthermore, road traffic injuries cost lowincome and middle-income countries between 1% and 2% of their gross national product-more than the total development aid received by these countries. But road traffic crashes and injuries are preventable. In high-income countries, an established set of interventions have contributed to significant reductions in the incidence and impact of road traffic injuries. These include the enforcement of legislation to control speed and alcohol consumption, mandating the use of seatbelts and crash helmets, and the safer design and use of roads and vehicles. Reduction in road traffic injuries can contribute to the attainment of the Millennium Development Goals that aim to halve extreme poverty and significantly reduce child mortality. Road traffic injury prevention must be incorporated into a broad range of activities, such as the development and management of road infrastructure, the provision of safer vehicles, law enforcement, mobility planning, the provision of health and hospital services, child welfare services, and urban and environmental planning. The health sector is an important partner in this process. Its roles are to strengthen the evidence base, provide appropriate pre-hospital and hospital care and rehabilitation, conduct advocacy, and contribute to the implementation and evaluation of interventions. The time to act is now. Road safety is no accident. It requires strong political will and concerted, sustained efforts across a range of sectors. Acting now will save lives. We urge governments, as well as other sectors of society, to embrace and implement the key recommendations of this report.
Driver intoxication and risk for fatal crashes in South Africa: A 3-year review
South African Medical Journal, 2021
Burden of alcohol-related crashes Globally, alcohol is implicated as a significant contributor to the enormous burden of injury-related mortality and morbidity from road traffic crashes, including associated psychosocial and mental health consequences of such crashes. [1] In Australia, 30% of all fatally injured drivers had blood alcohol concentrations (BACs) at or above the legal limit of 0.05 g/100 mL; in Canada 38.3% of all fatally injured drivers had BACs >0.08 g/100 mL; in China 34% of all fatal road crash victims had BACs between 0.02 and 0.08 g/100 mL; [2] in Europe 25% of all road fatalities had BACs above the various country limits; and in the USA 29% of all traffic fatalities had BACs ≥0.08 g/100 mL. [3] In South African (SA) drivers, a review of various studies that included selected driver samples in various geographical and clinical settings indicates prevalence estimates of driver intoxication between 33% and 69%. [4] Beyond drivers, the impact of alcohol intoxication on all road users in SA has been reported by the South African Road Traffic Management Corporation (RTMC) and other research as far-reaching and profound for families, communities and the economy. [5,6] In 2018, the cumulative cost for all road crashes in the country was estimated at ZAR166 billion, with alcohol considered a significant contributor to the total burden of crashes. However, despite the estimated likely impact of alcohol in road fatalities, there is somewhat limited and variable SA research on the extent of alcohol's contribution to the country's fatal crash burden. This lack has a constraining impact on developing and implementing the policy, prevention and control programming deemed necessary to mitigate such crashes and their consequences for individuals, families and society. Alcohol intoxication and driver risk behaviours Behavioural risk factors are the most commonly reported risks associated with road traffic crashes and injuries, [7] with alcoholimpaired driving a leading behavioural risk factor, along with others relating to excessive and inappropriate driving speeds, inadequate or inappropriate use of safety restraints and devices, driver distraction, and drug-impaired driving. [8] In SA, human behavioural risk factors are estimated to contribute to 89% of road traffic crashes. [9] Psychologically, drinking and driving has been associated with sensation-seeking, and it is also a predictor of other risky driving behaviours, such as speeding, unsafe lane changes and passing other vehicles, tailgating or short following distances, and failure to This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.
The Bulletin of Legal Medicine
Previous studies have revealed a relationship between the driving under the influence of alcohol (DUIA) and/or driving under the influence drugs (DUID) and the increased risk of death and injury in traffic accidents. The aim of this study was to investigate of blood alcohol concentration (BAC) of drivers after involved in a traffic accident or for suspected for drunkenness in the roadside traffic control in the Turkey's four major cities. Methods: In this study, we retrospectively reviewed the laboratory registrations in university hospitals in four big cities of Turkey (Van, Manisa, Diyarbakır and Samsun) for BAC for five years (from 1 January 2015 to 31 December 2019) of the drivers. Results: In 342 cases (7.1%), BACs were above the cutoff value (0.01 g/100 mL). Of the cases sent for alcohol determination, 11.3% were women and 88.7% were men, and their mean age was 35.3±13.1. In 342 alcohol positive cases, BACs were above 0.101% in 58.8% of cases. BAC positivity of the cases was 9.4% in Manisa, 6.3% in Van, 5.3% in Samsun, and 5% in Diyarbakır. BAC was found to be positive in 4.4% (n=24) of females and 7.4% (n=318) of males (p<0.05). Conclusion: This study is one of the limited number of multicentre studies in this field; it was concluded in the study that zero tolerance should be for drunk driving in traffic, the deterrence of fines should be increased, and roadside screening tests should be used more widely.
Alcohol, psychoactive substances and non-fatal road traffic accidents - a case-control study
BMC Public Health, 2012
Background: The prevalence of alcohol and other psychoactive substances is high in biological specimens from injured drivers, while the prevalence of these psychoactive substances in samples from drivers in normal traffic is low. The aim of this study was to compare the prevalence of alcohol and psychoactive substances in drivers admitted to hospital for treatment of injuries after road traffic accidents with that in drivers in normal traffic, and calculate risk estimates for the substances, and combinations of substances found in both groups. Methods: Injured drivers were recruited in the hospital emergency department and drivers in normal conditions were taken from the hospital catchment area in roadside tests of moving traffic. Substances found in blood samples from injured drivers and oral fluid samples from drivers in moving traffic were compared using equivalent cut off concentrations, and risk estimates were calculated using logistic regression analyses. Results: In 21.9% of the injured drivers, substances were found: most commonly alcohol (11.5%) and stimulants eg. cocaine or amphetamines (9.4%). This compares to 3.2% of drivers in normal traffic where the most commonly found substances were z-hypnotics (0.9%) and benzodiazepines (0.8%). The greatest increase in risk of being injured was for alcohol combined with any other substance (OR: 231.9, 95% CI: 33.3-1615.4, p < 0.001), for more than three psychoactive substances (OR: 38.9, 95% CI: 8.2-185.0, p < 0.001) and for alcohol alone (OR: 36.1, 95% CI: 13.2-98.6, p < 0.001). Single use of non-alcohol substances was not associated with increased accident risk. Conclusion: The prevalence of psychoactive substances was higher among injured drivers than drivers in normal moving traffic. The risk of accident is greatly increased among drivers who tested positive for alcohol, in particular, those who had also ingested one or more psychoactive substances. Various preventive measures should be considered to curb the prevalence of driving under the influence of psychoactive substances as these drivers constitute a significant risk for other road users as well as themselves.
Transportation Research Procedia, 2020
The blood alcohol concentration (BAC) limit has an effect not only on the prevalence of drivers under the influence of alcohol (DUI), but also on the occurrence and severity of road accidents. Most researchers in this field agree that reducing the alcohol limit leads to a decreased number of alcohol-related road accidents. Alcohol limit is a consequence of various political and legal factors. Depending on the driver category and country, the limit of alcohol concentration amounts up to 0.8 mg/ml. Alcohol affects drivers differently depending on their age, driving experience, etc. Thus, each alteration of alcohol concentration limit raises the issue of effects resulting from such a change. In 2009, in Serbia the alcohol concentration limit was reduced from 0.5 mg/ml to 0.3 mg/ml, as well as to 0 mg/ml for novice drivers, professional drivers and motorcyclists. After several years of application of more stringent alcohol limits, a research was conducted in order to identify the effects of reduced alcohol limit on involving DUI drivers in road accidents. The studies dealt with the influences of zero tolerance on novice drivers and motorcycle riders, as well as with the effects of reduced alcohol limits on other drivers and their involvement in road crashes. In order to study the influence of alcohol limits thus reduced, the researchers considered the relationship between the involvement of DUI drivers in road accidents in the years before and after the change in the permissible alcohol limit. The results of this study can be valuable for further development of the legislation related to alcohol concentration limits.
The Contribution of Alcohol to Serious Car Crash Injuries
Epidemiology, 2004
Background: Alcohol impairment of drivers is considered the most important contributing cause of car crash injuries. The burden of injury attributable to drinking drivers has been estimated only indirectly. Methods: We conducted a population-based case-control study in Auckland, New Zealand between April 1998 and July 1999. Cases were 571 car drivers involved in crashes in which at least 1 occupant was admitted to the hospital or killed. Control subjects were 588 car drivers recruited on public roads, representative of driving in the region during the study period. Participants completed a structured interview and had blood or breath alcohol measurements. Results: Drinking alcohol before driving was strongly associated with injury crashes after controlling for known confounders. This was true for several measures of alcohol consumption: for self-report of 2 or more 12-g alcoholic drinks in the preceding 6 hours compared with none, the odds ratio (OR) was 7.9 (95% confidence interval ϭ 3.4 -18); for blood alcohol concentration 3 to 50 mg/100 mL compared with Ͻ3 mg/100 mL, the OR was 3.2 (1.1-10); and for blood alcohol concentration greater than 50 mg/100 mL compared with Ͻ3 mg/100 mL, the OR was 23 (9 -56). Approximately 30% of car crash injuries in this population were attributable to alcohol, with two-thirds involving drivers with blood alcohol concentration in excess of 150 mg/100 mL. Equal proportions of alcohol-related injury crashes were attributable to drivers with blood alcohol concentrations of 3 to 50 mg/100 mL as those with levels of 51 to 150 mg/100 mL. Conclusion: Evidence about the proportion of crashes attributable to drivers at different blood alcohol concentrations can inform the prioritization of interventions that target different groups of drivers. These data indicate where there is the most potential for reduction of the injury burden.
Alcohol and road safety: investigation and legal aspects
Al Ameen Journal of Medical Sciences, 2018
Background: Ethanol (commonly phrased as Alcohol), in spite of presence of so many 'recreational drugs', is the most common drug exploited throughout the world. Objectives: This study explored the deleterious role of alcohol, effect of its consumption and their legal implications in a systematic manner. Method: To assess the toxic role of alcohol with the effects of its consumption and their legal implications a systematic review was done through an extensive search in the books, indexed literature and website-based reports, 14 reported literatures were identified of alcohol use. Results: Alcohol acts as a central nervous system depressant of specialised and sensitive cells of cerebral cortex. Its adverse effects like decrease in cognitive and psychomotive skills are well documented, with special regard to driving performance. In presence of lacunae in the implementation of legal enforcements alcohol related road safety has to be research interest to reduce this preventable ...