scholarly journals State or market? How to effectively decrease alcohol-related crash fatalities and injuries

2020 ◽  
pp. jech-2019-213191
Author(s):  
Jose I Nazif-Muñoz ◽  
Brice Batomen ◽  
Youssef Oulhote ◽  
Jack Spengler ◽  
Arijit Nandi
Keyword(s):  
Motor Vehicle ◽  
Blood Alcohol Concentration ◽  
Drunk Driving ◽  
Interrupted Time Series ◽  
Alcohol Concentration ◽  
Traffic Fatalities ◽  
Government Interventions ◽  
Policy Interventions ◽  
Drunk Drivers ◽  
State Interventions

BackgroundIt is estimated that more than 270 000 people die yearly in alcohol-related crashes globally. To tackle this burden, government interventions, such as laws which restrict blood alcohol concentration (BAC) levels and increase penalties for drunk drivers, have been implemented. The introduction of private-sector measures, such as ridesharing, is regarded as alternatives to reduce drunk driving and related sequelae. However, it is unclear whether state and private efforts complement each other to reduce this public health challenge.MethodsWe conducted interrupted time-series analyses using weekly alcohol-related traffic fatalities and injuries per 1 000 000 population in three urban conglomerates (Santiago, Valparaíso and Concepción) in Chile for the period 2010–2017. We selected cities in which two state interventions—the ‘zero tolerance law’ (ZTL), which decreased BAC, and the ‘Emilia law’ (EL), which increased penalties for drunk drivers—were implemented to decrease alcohol-related crashes, and where Uber ridesharing was launched.ResultsIn Santiago, the ZTL was associated with a 29.1% decrease (95% CI 1.2 to 70.2), the EL with a 41.0% decrease (95% CI 5.5 to 93.2) and Uber with a non-significant 28.0% decrease (95% CI −6.4 to 78.5) in the level of weekly alcohol-related traffic fatalities and injuries per 1 000 000 population series. In Concepción, the EL was associated with a 28.9% reduction (95% CI 4.3 to 62.7) in the level of the same outcome. In Valparaíso, the ZTL had a −0.01 decrease (95% CI −0.02 to −0.00) in the trend of weekly alcohol-related crashes per 1 000 000 population series.ConclusionIn Chile, concomitant decreases of alcohol-related crashes were observed after two state interventions were implemented but not with the introduction of Uber. Relationships between public policy interventions, ridesharing and motor vehicle alcohol-related crashes differ between cities and over time, which might reflect differences in specific local characteristics.

4. Are a Blood Alcohol Concentration of 256mg/dl and Minimal Signs of Impairment Reliable Indications of Alcohol Dependence?

1994 ◽  
Vol 34 (3) ◽  
pp. 265-270 ◽  
Author(s):  
A W Jones
Keyword(s):  
Expert Witness ◽  
Blood Alcohol Concentration ◽  
Drunk Driving ◽  
Alcohol Concentration ◽  
Driving Under The Influence ◽  
Blood Alcohol ◽  
Lower Court ◽  
Dna Profile ◽  
Court Of Appeals ◽  
Driving Scenario

This article describes a drink-driving scenario where a woman was apprehended for driving under the influence (DUI) with a blood alcohol concentration (BAC) of 256mg/dl1 The correctness of this result was vigorously challenged by a medical expert witness for the defence, who was actually a specialist in alcohol diseases. Despite reanalysis to confirm the BAC as well as a DNA profile to prove the identity of the blood specimen, the woman was acquitted of the charge of drunk driving by the lower court. However, she was subsequently found guilty in the High Court of Appeals with a unanimous decision and sentenced to four weeks imprisonment. This case report illustrates some of the problems surrounding the use of expert medical evidence by the defence to challenge the validity of the prosecution evidence based solely on a suspect's BAC. In situations such as these, an expert witness should be called by the prosecution to clarify and, if necessary, rebut medical and/or scientific opinions that might mislead the court and influence the outcome of the trial.

Indication for the Assessment of Driver Fitness after Problematic Alcohol Consumption

2014 ◽  
Vol 60 (3) ◽  
pp. 139-147
Author(s):  
Caroline Reimann ◽  
Wolfgang Schubert ◽  
Michael Berg ◽  
Elke van der Meer
Keyword(s):  
Alcohol Consumption ◽  
Psychological Assessment ◽  
Blood Alcohol Concentration ◽  
Drunk Driving ◽  
Experimental Manipulation ◽  
Alcohol Concentration ◽  
Fitness To Drive ◽  
Legal Limit ◽  
Research Findings ◽  
Practice Methods

Objectives: The present review of literature examines the relationship of alcohol consumption and fitness to drive. The legal limit (1,6 ‰) for establishing fitness to drive by means of a medical-psychological assessment (MPA) in Germany is analyzed on the background of published empirical research to present recommendations for the improvement of the current legal situation and administrative practice. Methods: 103 published articles have been analysed (inclusion criteria: completeness, comprehensibility, and experimental manipulation of the blood alcohol concentration [BAC]). The number of alcohol-induced impairments is to be shown in a quantitative analysis. The qualitative analyses of the studies will reveal the impaired areas of psychological and medical functioning. Results: It appears that 97 % of the documented impairments occur at a maximum BAC of 1,1 ‰. Numerous skills are impaired by low doses of alcohol (e. g. attention, memory, perception). Conclusion: Alcohol-induced impairments arise at a BAC far below 1.6 ‰, which marks the legal limit for a medical-psychological assessment (MPA) after drunk driving in Germany. The BAC limit in the current ordinance for assigning a medical-psychological fitness assessment cannot be confirmed on the basis of research findings. A reduction of this BAC limit to 1,1 ‰ is proposed.

Trends in Cannabis Involvement and Risk of Alcohol Involvement in Motor Vehicle Crash Fatalities in the United States, 2000‒2018

2021 ◽  
pp. e1-e10
Author(s):  
Marlene C. Lira ◽  
Timothy C. Heeren ◽  
Magdalena Buczek ◽  
Jason G. Blanchette ◽  
Rosanna Smart ◽  
...  
Keyword(s):  
United States ◽  
Motor Vehicle ◽  
Blood Alcohol Concentration ◽  
The United States ◽  
Alcohol Concentration ◽  
Motor Vehicle Crash ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Vehicle Crash ◽  
Alcohol Involvement

Objectives. To assess cannabis and alcohol involvement among motor vehicle crash (MVC) fatalities in the United States. Methods. In this repeated cross-sectional analysis, we used data from the Fatality Analysis Reporting System from 2000 to 2018. Fatalities were cannabis-involved if an involved driver tested positive for a cannabinoid and alcohol-involved based on the highest blood alcohol concentration (BAC) of an involved driver. Multinomial mixed-effects logistic regression models assessed cannabis as a risk factor for alcohol by BAC level. Results. While trends in fatalities involving alcohol have remained stable, the percentage of fatalities involving cannabis and cannabis and alcohol increased from 9.0% in 2000 to 21.5% in 2018, and 4.8% in 2000 to 10.3% in 2018, respectively. In adjusted analyses, fatalities involving cannabis had 1.56 (95% confidence interval [CI] = 1.48, 1.65), 1.62 (95% CI = 1.52, 1.72), and 1.46 (95% CI = 1.42, 1.50) times the odds of involving BACs of 0.01% to 0.049%, 0.05% to 0.079%, and 0.08% or higher, respectively. Conclusions. The percentage of fatalities involving cannabis and coinvolving cannabis and alcohol doubled from 2000 to 2018, and cannabis was associated with alcohol coinvolvement. Further research is warranted to understand cannabis- and alcohol-involved MVC fatalities. (Am J Public Health. Published online ahead of print October 28, 2021:e1–e10. https://doi.org/10.2105/AJPH.2021.306466 )

“Nurse, I Only Had a Couple of Beers”: Validity of Self-reported Drinking Before Serious Vehicular Injury

2002 ◽  
Vol 11 (2) ◽  
pp. 106-114 ◽  
Author(s):  
Marilyn Sawyer Sommers ◽  
Janice M. Dyehouse ◽  
Steven R. Howe ◽  
Kathryn Wekselman ◽  
Michael Fleming
Keyword(s):  
Alcohol Consumption ◽  
Motor Vehicle ◽  
Blood Alcohol Concentration ◽  
Alcohol Concentration ◽  
Alcohol Intervention ◽  
Blood Alcohol ◽  
Traffic Crashes ◽  
The Mean ◽  
Reported Data ◽  
Vehicular Crashes

• Background Of the more than 40 000 Americans killed each year in vehicular crashes, 40% are involved in alcohol-related collisions. Although self-reported alcohol use has become an anchor for alcohol intervention after traffic crashes, clinicians are often skeptical about the truthfulness of self-reporting. • Objective To determine the validity of self-reported alcohol consumption of vehicular occupants hospitalized for a serious, alcohol-related injury. • Methods Non-alcohol–dependent subjects 18 years and older who were injured in motor vehicle crashes were interviewed. The self-reported number of standard drinks, time that drinking commenced, sex, and weight were used to calculate estimated blood alcohol concentration. This value was compared with the blood alcohol concentration measured at admission. • Results Of the 181 subjects, 60% provided sufficient data to calculate the estimated concentration. Seven men with admission concentrations of 10 mg/dL or more denied drinking. Among the 113 subjects with estimated concentrations who acknowledged drinking (excluding the 7 who denied drinking), the mean concentration at admission was 158.67 mg/dL, and mean estimated concentration was 83.81 mg/dL. According to multiple regression analyses, weight and number of drinks accounted for 3% of the variance in alcohol concentration at admission for women (R =0.174, F2,40 = 0.623, P = .54) and for 29% of the variance in men (R=0.543, F2,128 =26.71, P< .001). • Conclusions Most persons who drink before vehicular injury acknowledge drinking. Self-reported data from men generally reflect the overall trend of alcohol consumption but with systematic underreporting. Reports from women are less predictable.

The Tracometer as an Intoxication Warning Device

1987 ◽  
Vol 31 (7) ◽  
pp. 751-755 ◽  
Author(s):  
Y. Ian Noy
Keyword(s):  
Alcohol Intoxication ◽  
Blood Alcohol Concentration ◽  
Drunk Driving ◽  
Alcohol Concentration ◽  
Tracking Task ◽  
Alcoholic Beverages ◽  
Subsequent Test ◽  
Pursuit Tracking ◽  
Wide Range ◽  
Male Subjects

An experiment was conducted to investigate the feasibility of developing an in-vehicle skill-based drunk driver detection and deterrence system. The experiment compared two well-developed psychomotor test devices, the Tracometer and the Critical Tracking Task (CTT), for their ability to detect alcohol intoxication. The Tracometer employed a pursuit tracking task whereas the CTT employed a compensatory tracking task. Twenty male subjects, aged 19 − 30 were trained on the Tracometer and the CTT over a three day period. On two subsequent test days, they were treated with either placebo or alcoholic beverages designed to bring their peak Blood Alcohol Concentration (BAC) to 1.2% (1200 mg/L). On each day, the subjects were tested once before treatment and six times after treatment at hourly intervals as their BAC levels declined. The results indicate that the Tracometer was more sensitive than the CTT to the the effects of alcohol over a wide range of BAC levels. At a BAC level of .08%, performance on the Tracometer deteriorated by 16% whereas performance on the CTT deteriorated by only 7%. Using optimized pass/fail protocols, the Tracometer failed 60% of subjects with BAC in the range .08–1.0%, whereas the CTT failed 34%. At BAC levels above 1.0%, the Tracometer failed about 85% whereas the CTT failed 40%. These results clearly illustrate the potential of the Tracometer as a test of alcohol intoxication. Although the impetus behind the study was the development of drunk-driving countermeasures, the technology can be easily extended to include other applications.

scholarly journals Time-varying effect of drunk driving regulations on road traffic mortality in Guangzhou, China: an interrupted time-series analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiao-Han Xu ◽  
Hang Dong ◽  
Li Li ◽  
Zhou Yang ◽  
Guo-Zhen Lin ◽  
...  
Keyword(s):  
Road Traffic ◽  
Drunk Driving ◽  
Interrupted Time Series ◽  
Motor Vehicles ◽  
Average Risk ◽  
Time Varying ◽  
Traffic Fatalities ◽  
Interrupted Time Series Analysis ◽  
Intervention Measures ◽  
Daily Data

Abstract Background China has introduced a series of stricter policies to criminalize drunk driving and increase penalties since May 2011. However, there is no previous study examining the time-varying impacts of drunk driving regulations on road traffic fatalities based on daily data. Methods We collected 6536 individual data of road traffic deaths (RTDs) in Guangzhou from 2008 to 2018. The quasi-Poisson regression models with an inclusion of the intervention variable and the interaction of intervention variable and a function of time were used to quantify the time-varying effects of these regulations. Results During the 11-year study period, the number of population and motor vehicles showed a steady upward trend. However, the population- and motor vehicles- standardized RTDs rose steadily before May 2011, the criminalizing drunk driving intervention was implemented and gradually declined after that. The new drunk driving intervention were associated with an average risk reduction of RTDs (ER = -9.01, 95% eCI: − 10.05% to − 7.62%) during the 7.7 years after May 2011. On average, 75.82 (95% eCI, 54.06 to 92.04) RTDs per 1 million population annually were prevented due to the drunk driving intervention. Conclusion These findings would provide important implications for the development of integrated intervention measures in China and other countries attempting to reduce traffic fatalities by stricter regulations on drunk driving.

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