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

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 )

Advancing Indian Nations’ Motor Vehicle Crash Reporting

The American Indian population is at high risk for motor vehicle (MV) crash injury. Although this is preventable, the majority of these indigenous populations lack fundamental data needed to understand these events and implement effective countermeasures. This cross-case study sets a framework by exploring Indian nations’ crash reporting systems (CRS) and the potential to fill this information void. An inventory process conducted with four tribes produced a pragmatic approach that tribes can refine to fulfill local objectives for accountability, sovereignty, and system integrity. Enormous benefits can be derived from a reliable CRS. The study shows that electronically documenting MV crash event data is plausible with commitment from tribes and support from other stakeholders.

Increase in Motor Vehicle Crash Severity: An Unforeseen Consequence of COVID-19

Introduction The 2019 coronavirus (COVID-19) pandemic led to stay-at-home (SAH) orders in Pennsylvania targeted at reducing viral transmission. Limitations in population mobility under SAH have been associated with decreased motor vehicle collisions (MVC) and related injuries, but the impact of these measures on severity of injury remains unknown. The goal of this study is to measure the incidence, severity, and outcomes of MVC-related injuries associated with SAH in Pennsylvania. Materials & Methods We conducted a retrospective geospatial analysis of MVCs during the early COVID-19 pandemic using a state-wide trauma registry. We compared characteristics of patients with MVC-related injuries admitted to Pennsylvania trauma centers during SAH measures (March 21-July 31, 2020) with those from the corresponding periods in 2018 and 2019. We also compared incidence of MVCs for each zip code tabulation area (ZCTA) in Pennsylvania for the same time periods using geospatial mapping. Results Of 15,550 trauma patients treated during the SAH measures, 3486 (22.4%) resulted from MVCs. Compared to preceding years, MVC incidence decreased 10% under SAH measures with no change in mortality rate. However, in ZCTA where MVC incidence decreased, there was a 16% increase in MVC injury severity. Conclusions Stay-at-home orders issued in response to the COVID-19 pandemic in Pennsylvania were associated with significant changes in MVC incidence and severity. Identifying such changes may inform resource allocation decisions during future pandemics or SAH events.

Motor Vehicle Crash Testing Regulations for More Inclusive Populations

There is a stark disparity in motor vehicle crash deaths and injuries between male and female drivers. Female drivers are 13% more likely to be killed than their male counterparts in similar motor accidents. However, vehicle safety test practices do not account for diverse body proportions when assessing safety outcomes. Vehicle crash testing standards only require testing of two variations of adult-sized crash test dummies: a 50th percentile male and a 5th percentile female. Automotive companies are not required to test safety outcomes in crash test model’s representative of average female proportions or of non-average body sizes and physiological compositions. Current crash test standards are regulated by the National Highway Traffic Safety Administration (NHTSA) under the US Department of Transportation. This memo proposes three actions for the NHTSA and the Department of Transportation to address disparities in vehicle safety outcomes: 1) update safety standard requirements to include a 50th percentile female crash test dummy, 2) implement a federal tax incentive program for companies to include a greater diversity of vehicle occupant models, and 3) allocate funds for research and development of virtual crash testing models. These proposed initiatives seek to raise the minimum safety requirements and prioritize wider representation of vehicle occupants to improve parity in vehicle safety outcomes.