The relationship between alcohol consumption patterns and car, work, sports and home accidents for different age groups

The purpose of this study was to examine the relationship between alcohol consumption patterns and car, work, sports and home accidents for different age groups. A secondary analysis of data from a randomized household survey of 10385 Canadians was conducted. Overall, alcohol consumption patterns were significantly associated with car collisions, work and sports accidents for younger age groups (i.e. 15-24 and 25-34), but this relationship was not significant for the older age groups.     

Factors associated with alcohol and drug use among traffic crash victims in southern Brazil

Objective

To investigate the prevalence of and factors associated with alcohol- or drug-related traffic crashes (TC) in a sample of TC victims who were admitted to the two emergency rooms of Porto Alegre in southern Brazil.

Methods

A cross-sectional study with consecutive samples was used. Victims of non-fatal TCs (as drivers, passengers or pedestrians) who had presented at emergency rooms during the 45 days of data collection were selected. Subjects participated in a structured interview, were breathalyzed and underwent salivary drug testing. A multinomial logistic regression model was used to verify factors associated with alcohol or drug use.

Results

Of the 609 victims who participated in the interview, 72% were male, and the median age was 29 years (interquartile range 23.0–40.0 years). The drivers were mostly men (p < 0.001), with a higher binge drinking rate (p = 0.003) and marijuana use (p = 0.005) than seen in pedestrian and passengers. The prevalence of a positive blood alcohol concentration (BAC) ranged from 7.8% among the drivers to 9.2% among the pedestrians (p = 0.861), and the cannabis prevalence was 13.3% among the drivers. The variables associated with an alcohol-related accident were binge drinking in the prior 12 months (OR 2.4; CI 95% 1.1–5.1) and coming from a party/bar (OR 8.7; CI 95% 2.8–26.7). Alcohol abuse or dependence increased by 5.2-fold the chance of another substance-related TC.

Conclusion

The large number of individuals found in TC-related emergency room visits in a short time frame is evidence of the Brazilian epidemic of TC. The data showed that alcohol abuse or dependence also increases the risk of intoxication by other drugs, and they point to alcohol and drug use as a major problem requiring specific TC-related public policies and law enforcement.     

Impact of distracted driving on safety and traffic flow

Studies have documented a link between distracted driving and diminished safety; however, an association between distracted driving and traffic congestion has not been investigated in depth. The present study examined the behavior of teens and young adults operating a driving simulator while engaged in various distractions (i.e., cell phone, texting, and undistracted) and driving conditions (i.e., free flow, stable flow, and oversaturation). Seventy five participants 16–25 years of age (split into 2 groups: novice drivers and young adults) drove a STISIM simulator three times, each time with one of three randomly presented distractions. Each drive was designed to represent daytime scenery on a 4 lane divided roadway and included three equal roadway portions representing Levels of Service (LOS) A, C, and E as defined in the 2000 Highway Capacity Manual. Participants also completed questionnaires documenting demographics and driving history. Both safety and traffic flow related driving outcomes were considered. A Repeated Measures Multivariate Analysis of Variance was employed to analyze continuous outcome variables and a Generalized Estimate Equation (GEE) Poisson model was used to analyze count variables. Results revealed that, in general more lane deviations and crashes occurred during texting. Distraction (in most cases, text messaging) had a significantly negative impact on traffic flow, such that participants exhibited greater fluctuation in speed, changed lanes significantly fewer times, and took longer to complete the scenario. In turn, more simulated vehicles passed the participant drivers while they were texting or talking on a cell phone than while undistracted. The results indicate that distracted driving, particularly texting, may lead to reduced safety and traffic flow, thus having a negative impact on traffic operations. No significant differences were detected between age groups, suggesting that all drivers, regardless of age, may drive in a manner that impacts safety and traffic flow negatively when distracted.     

The role of parental alcohol consumption on driving under the influence of alcohol: results from a longitudinal, nationally representative sample

Purpose

Many studies have examined the role of peer and parental alcohol use on drinking behaviors among adolescents. Few studies, however, have examined parental influences on driving under the influence (DUI) of alcohol. The current study uses data from a longitudinal study to examine the role of parental alcohol use during adolescence on the risk for DUI among young adult men and women.

Methods

Data were derived from 9559 adolescents and young adults who participated in the National Longitudinal Study of Adolescent Health (Add Health) Waves I and III. Survey logistic regression was used to examine the relationship between multilevel risk and protective factors and self-reported DUI. Analyses were stratified by gender and frequency of parental alcohol consumption to understand the role of parental alcohol use on risk for DUI among their youth.

Results

Risk and protective factors for DUI were very similar among men and women. Parental alcohol use significantly predicted DUI among women (OR = 1.39, p < 0.01) and men (OR = 1.33, p < 0.05). When parents did not report alcohol use, peer alcohol use significantly increased risk for DUI for both women (OR = 1.26, p < 0.05) and men (OR = 1.31, p < 0.001). When parents reported alcohol use, however, peer alcohol use was not a significant independent predictor.

Conclusions

Findings suggest remarkable similarities in risk and protective factors for DUI across gender groups. For men and women, parental alcohol consumption was a risk factor for DUI. Peers’ alcohol use predicted DUI only when parents did not use alcohol.     

Acceptance of drinking and driving and alcohol-involved driving crashes in California

BackgroundAlcohol-impaired driving accounts for substantial proportion of traffic-related fatalities in the U.S. Risk perceptions for drinking and driving have been associated with various measures of drinking and driving behavior. In an effort to understand how to intervene and to better understand how risk perceptions may be shaped, this study explored whether an objective environmental-level measure (proportion of alcohol-involved driving crashes in one’s residential city) were related to individual-level perceptions and behavior.MethodsUsing data from a 2012 cross-sectional roadside survey of 1147 weekend nighttime drivers in California, individual-level self-reported acceptance of drinking and driving and past-year drinking and driving were merged with traffic crash data using respondent ZIP codes. Population average logistic regression modeling was conducted for the odds of acceptance of drinking and driving and self-reported, past-year drinking and driving.ResultsA non-linear relationship between city-level alcohol-involved traffic crashes and individual-level acceptance of drinking and driving was found. Acceptance of drinking and driving did not mediate the relationship between the proportion of alcohol-involved traffic crashes and self-reported drinking and driving behavior. However, it was directly related to behavior among those most likely to drink outside the home.DiscussionThe present study surveys a particularly relevant population and is one of few drinking and driving studies to evaluate the relationship between an objective environmental-level crash risk measure and individual-level risk perceptions. In communities with both low and high proportions of alcohol-involved traffic crashes there was low acceptance of drinking and driving. This may mean that in communities with low proportions of crashes, citizens have less permissive norms around drinking and driving, whereas in communities with a high proportion of crashes, the incidence of these crashes may serve as an environmental cue which informs drinking and driving perceptions. Perceptual information on traffic safety can be used to identify places where people may be at greater risk for drinking and driving. Community-level traffic fatalities may be a salient cue for tailoring risk communication.     

The effects of a new traffic safety law in the Republic of Serbia on driving under the influence of alcohol

The aim of the study presented here has been to see what the effects of the new traffic safety law are, 2 years into its initial implementation, on driving under the influence of alcohol. Until the end of 2009, the legal limit for blood concentration for drivers in Serbia was 0.5 g/l; however, the new traffic safety law stipulates the new limit to be 0.3 g/l. A retrospective autopsy study was performed over a 6-year period (from 2006 to 2011) whose sample covered cases of fatally injured drivers who had died at the scene of the incident, before being admitted to hospital. A total of 161 fatally injured drivers were examined for their blood alcohol concentration. The average age for these drivers was 40.2 ± 15.4 years, with a significant male predominance of 152 men to 9 women (χ² = 152.000, p < 0.001). This study has shown no decrease in the ratio of drivers under the influence of alcohol vs. all drivers (Pearson χ² = 4.415, df = 5, p = 0.491), nor in the number of drivers under the influence of alcohol (Pearson χ² = 6.629, df = 5, p = 0.250), nor a decrease in the mean blood alcohol concentration in drivers (1.72 ± 0.87 vs. 1.68 ± 0.95 g/l, t = 0.177, df = 80, p = 0.860). The conclusion of this study is that the new law has had a limited effect on driving under the influence of alcohol, which still remains one of the major human factors, responsible for road-traffic crashes in Serbia.     

The effects of health status, distress, alcohol and medicinal drug use on subsequent motor vehicle injuries

Objective

The purpose of this study was to examine the effects of health factors and substance use on subsequent motor vehicle collision (MVC) injuries of three different age groups, using the longitudinal dataset from the Canadian National Population Health Survey (NPHS) for the years 1994–2002.

Methods

Path analysis technique was used to determine the relations between MVC injury and four risk factors: binge drinking; health status; distress; and medication use. The three demographic variables, age at ‘baseline’, sex, and immigration status were added into the model as control variables. Three age groups were examined: young = 12–29.9; middle-aged = 30–59.9 and old = 60–85 years of age. The total sample size was 16,093.

Results

A lower percentage of males, older persons, immigrants, and non-binge drinkers reported a subsequent MVC injury, as did respondents reporting better health and lower distress scores. Medication use was associated with higher subsequent MVC injuries. Path analysis found that among younger individuals, the variable binge drinking, was the only significant risk factor associated with subsequent injuries. In contrast, among middle-aged individuals, the variable medication use, was the only statistically significant risk factor for subsequent injuries. No variables were significant risk factors of injuries for older individuals.

Conclusions

Various demographic and risk factors were found to influence injuries among a nationally representative sample of Canadians. Reported binge drinking among young individuals and medication use among middle-aged individuals were found to be risk factors for subsequent MVC injury. These findings support the need for continued focus on alcohol, drugs and traffic safety.     

Primary prevention of drink driving by the large-scale use of alcolocks in commercial vehicles

Alcolocks are commercial breath test devices that prevent a motor vehicle from starting when a driver's blood alcohol concentration (BAC) is elevated. This report is an evaluation of the experiences and BAC data from the first use of alcolocks in commercial vehicles as a primary prevention strategy. In most applications, the alcolock is imposed only after an impaired driving conviction. This study, implemented in Sweden, estimates drink driving on a large scale in a variety of commercial vehicles. Officials from 118 companies were interviewed representing 3689 alcolock-equipped vehicles used by 9614 professional drivers, an 80% compliance rate. In a contrast group of 230 transport businesses without alcolocks the interview compliance rate was 57%. Survey results probed motivation for and experience with alcolocks. Analysis of BAC test patterns showed alcohol consumption among employees through prevalence estimates of drink-driving attempts at the rate of BAC> or =the legal limit 0.020%. Before alcolock installation, 64% of the employers suspected alcohol problems among their employees and their motive for installing alcolocks (cost averaged 1700 euro/vehicle) was to improve the transport quality. Several companies had technical problems with the alcolocks; but 98% recommended that other companies install alcolocks. Among 600, heavy vehicles, 0.19% of all starts were prevented by elevated BAC; most during weekends and mornings. Daytime Saturday and Sunday mornings 0.72% of the drivers had elevated BAC. CONCLUSIONS: The prevalence of drink driving among professional drivers is probably similar to that among drivers in general. Alcolocks would improve the safety margin and reduce public risk. Provided that the entire fleet of trucks, buses, and taxis in Sweden had installed alcolocks that would correspond to about half a million drink driving trips being prevented every year.     

Drug use and fatal motor vehicle crashes: A case-control study

Drugged driving is a serious safety concern, but its role in motor vehicle crashes has not been adequately studied. Using a case-control design, the authors assessed the association between drug use and fatal crash risk. Cases (n = 737) were drivers who were involved in fatal motor vehicle crashes in the continental United States during specific time periods in 2007, and controls (n = 7719) were participants of the 2007 National Roadside Survey of Alcohol and Drug Use by Drivers. Overall, 31.9% of the cases and 13.7% of the controls tested positive for at least one non-alcohol drug. The estimated odds ratios of fatal crash involvement associated with specific drug categories were 1.83 [95% confidence interval (CI): 1.39, 2.39] for marijuana, 3.03 (95% CI: 2.00, 4.48) for narcotics, 3.57 (95% CI: 2.63, 4.76) for stimulants, and 4.83 (95% CI: 3.18, 7.21) for depressants. Drivers who tested positive for both alcohol and drugs were at substantially heightened risk relative to those using neither alcohol nor drugs (Odds Ratio = 23.24; 95% CI: 17.79, 30.28). These results indicate that drug use is associated with a significantly increased risk of fatal crash involvement, particularly when used in combination with alcohol.     

The outcome from legalizing Sunday packaged alcohol sales on traffic accidents in New Mexico

We attempt to disentangle the effect on alcohol-related accidents and fatal crashes when New Mexico lifted its ban on Sunday packaged alcohol sales on July 1, 1995. Using crash incidents between January 1990 and December 2005, from data maintained by the Division of Government Research in New Mexico, we estimate a negative binomial model that controls for unobservable factors affecting overall accidents. One of these factors is an increase in New Mexico's speed limits in 1996. We find no statistically significant increase in total alcohol-related accidents or alcohol-related fatal crashes on Sundays after the repeal of the ban.     

Stuck in the 70s: The role of social norms in distracted driving

Successful campaigns to end distracted driving must understand prevailing social norms for behaviors such as texting and phoning while driving. The current work examined this issue by asking younger drivers to read car crash scenarios and rate the responsibility of the driver for the crash, and to levy fines and assign jail time, as a function of whether the driver was attentive, had been drinking, or was distracted by phoning or texting. In the first experiment, ratings were performed in the absence of injunctive norm information (laws against drunk and distracted driving). In the second experiment, injunctive norm information was included. Impaired drivers were viewed as more responsible in both experiments, with texting drivers viewed as the most responsible. However, drunk drivers received the most fines and jail time. When compared to data from the 1970s, the results show that anti-drunk driving campaigns have changed how younger drivers view drunk driving, but that norms have not yet changed for distracted driving, despite consistent results showing they know the risk of driving distracted. Implications for social norm distracted driving campaigns are discussed.     

Economic development's effect on road transport-related mortality among different types of road users: a cross-sectional international study

The relationship between a country's stage of economic development and its motor vehicle crash (MVC) mortality rate is not defined for different road users. This paper presents a cross-sectional regression analysis of recent national mortality in 44 countries using death certificate data provided by the World Health Organization. For five types of road users, MVC mortality is expressed as deaths per 100,000 people and per 1000 motor vehicles. Economic development is measured as gross national income (GNI) per capita in U.S. dollars and as motor vehicles per 1000 people. Results showed overall MVC mortality peaked among low-income countries at about US$ 2000 GNI per capita and at about 100 motor vehicles per 1000 people. Overall mortality declined at higher national incomes up to about US$ 24,000. Most changes in MVC mortality associated with economic development were explained by changes in rates among nonmotorized travelers, especially pedestrians. Overall MVC rates were lowest when pedestrian exposure was low because there were few motor vehicles or few pedestrians, and were highest during a critical transition to motorized travel, when many pedestrians and other vulnerable road users vied for use of the roadways with many motor vehicles.     

Predictors of driving after alcohol and drug use among adolescents in Valencia (Spain)

Background

Driving under the influence of alcohol and drugs has been identified as a risk factor for road traffic crashes. We have assessed the prevalence and predictor factors for driving after alcohol and drug use by adolescents.

Methods

A cross-sectional survey involving 11,239 students aged 14–18 years from 252 private and public schools in the Valencia region of Spain was conducted. The prevalence and predictors of driving after alcohol use, alcohol and drug use, or drug use during the previous 6 months were measured.

Results

Of the students who reported driving (20%), 45.1% indicated driving after alcohol and drug use. The consumption of various drugs was higher among students who drove a vehicle compared with those who did not. The likelihood of driving after consuming alcohol, or alcohol and drugs, increased in line with the number of standard drink units per week, reports of any lifetime alcohol- or drug-related problems, and poor family relationship. In addition, masculine gender and early alcohol use increased the likelihood of driving after consuming alcohol.

Conclusions

Driving after alcohol and drug use is quite prevalent among adolescents in the Valencia region of Spain. There is a need for implementation of targeted policies for adolescents. This should focus on education and information on alcohol/drug use and driving.     

The effects of cannabis and alcohol on simulated arterial driving: Influences of driving experience and task demand

This study compared the effects of three doses of cannabis and alcohol (placebo, low and high doses), both alone and in combination, on the driving performance of young, novice drivers and more experienced drivers. Alcohol was administered as ethanol (95%) mixed with orange juice in doses of approximately 0, 0.4 and 0.6 g/kg. Cannabis was administered by inhalation of smoke from pre-rolled cannabis cigarettes (supplied by the National Institute of Drug Abuse, USA). Active cigarettes contained 19 mg delta-9-THC. Using a counterbalanced design, the simulated driving performance of 25 experienced and 22 inexperienced drivers was tested under the nine different drug conditions in an arterial driving environment during which workload was varied through the drive characteristics as well as through the inclusion of a secondary task. High levels of cannabis generally induced greater impairment than lower levels, while alcohol at the doses used had few effects and did not produce synergistic effects when combined with cannabis. Both cannabis and alcohol were associated with increases in speed and lateral position variability, high dose cannabis was associated with decreased mean speed, increased mean and variability in headways, and longer reaction time, while in contrast alcohol was associated with a slight increase in mean speed. Given the limitations of the study, it is of great interest to further explore the qualitative impairments in driving performance associated with cannabis and alcohol separately and how these impairments may manifest in terms of crash characteristics.     

Influences during adolescence on perceptions and behaviour related to alcohol use and unsafe driving as young adults

OBJECTIVE: To investigate whether aggression, parent and peer influences, and previous traffic-related experiences at ages 15 and 18 impacted on (a) differences between the perceived safe and estimated legal alcohol consumption limit, and (b) driving while impaired (DWI) behaviour at age 21. METHOD: The study population was a birth cohort involved in a longitudinal investigation of health and development. At the ages of 15 and 18, study members completed questionnaires assessing parent and peer attachment, experience travelling with an alcohol impaired adult or youth, aggression, and previous crash experience. At age 21, study members were questioned about how much alcohol they perceived they could drink and still drive safely, and whether they had driven after 'perhaps consuming too much alcohol'. For each participant their legal alcohol consumption limit was estimated using their height and weight. Path analysis was used to determine whether variables measured at ages 15 and 18 predicted differences between the perceived safe and estimated legal alcohol consumption limit and driving while impaired, both measured at age 21. RESULTS: Insufficient females drove while impaired at age 21, who also had complete data on all other variables, to conduct path analysis for this outcome. For males, aggression at ages 15 and 18, travelling with an impaired youth at age 18, and previous crash experience at age 18 predicted DWI behaviour at age 21. Only aggression at age 15 predicted the difference between perceived safe and estimated legal alcohol consumption limit for the males. For females, aggression at ages 15 and 18, and travelling with an impaired adult at age 15 predicted the difference between perceived safe and estimated legal alcohol consumption limit. CONCLUSION: The results show that aggressive behaviours and adult and/or youth modelling of drink driving behaviours in mid- to late-adolescence are related to differences between perceived safe and estimated legal alcohol consumption limit for both genders and driving while impaired for males.     

The observed effects of teenage passengers on the risky driving behavior of teenage drivers

The association between teenage passengers and crash risks among young drivers may be due to risky driving behavior. We investigated the effect on two measures of risky driving in the presence of young male and female passengers. Vehicles exiting from parking lots at 10 high schools were observed and the occupants were identified by gender and age (teen or adult). At a nearby site, the speed and headway of passing traffic were recorded using video and LIDAR technology. Teenage drivers drove faster than the general traffic and allowed shorter headways, particularly in the presence of a male teenage passenger. Both male and female teenage drivers allowed shorter headways (relative to no passenger or a female passenger) in the presence of a male teenage passenger, while the presence of a female teenage passenger resulted in longer headways for male teenage drivers. Overall, the observed rate of high risk driving (defined as speed > or =15 mph or more above the posted speed limit and/or headway of < or =1.0 s) for the teen male driver/male passenger condition was about double that of general traffic. In conclusion, the presence of male teenage passengers was associated with risky driving behavior among teenage drivers.     

Effects of enforcement intensity on alcohol impaired driving crashes

Background

Research measuring levels of enforcement has investigated whether increases in police activities (e.g., checkpoints, driving-while-intoxicated [DWI] special patrols) above some baseline level are associated with reduced crashes and fatalities. Little research, however, has attempted to quantitatively measure enforcement efforts and relate different enforcement levels to specific levels of the prevalence of alcohol-impaired driving.

Objective

The objective of this study was to investigate the effects of law-enforcement intensity in a sample of communities on the rate of crashes involving a drinking driver. We analyzed the influence of different enforcement strategies and measures: (1) specific deterrence – annual number of driving-under-the-influence (DUI) arrests per capita; (2) general deterrence – frequency of sobriety checkpoint operations; (3) highly visible traffic enforcement – annual number of traffic stops per capita; (4) enforcement presence – number of sworn officers per capita; and (5) overall traffic enforcement – the number of other traffic enforcement citations per capita (i.e., seat belt citations, speeding tickets, and other moving violations and warnings) in each community.

Methods

We took advantage of nationwide data on the local prevalence of impaired driving from the 2007 National Roadside Survey (NRS), measures of DUI enforcement activity provided by the police departments that participated in the 2007 NRS, and crashes from the General Estimates System (GES) in the same locations as the 2007 NRS. We analyzed the relationship between the intensity of enforcement and the prevalence of impaired driving crashes in 22–26 communities with complete data. Log-linear regressions were used throughout the study.

Results

A higher number of DUI arrests per 10,000 driving-aged population was associated with a lower ratio of drinking-driver crashes to non-drinking-driver crashes (p = 0.035) when controlling for the percentage of legally intoxicated drivers on the roads surveyed in the community from the 2007 NRS. Results indicate that a 10% increase in the DUI arrest rate is associated with a 1% reduction in the drinking driver crash rate. Similar results were obtained for an increase in the number of sworn officers per 10,000 driving-age population.

Discussion

While a higher DUI arrest rate was associated with a lower drinking-driver crash rate, sobriety checkpoints did not have a significant relationship to drinking-driver crashes. This appeared to be due to the fact that only 3% of the on-the-road drivers were exposed to frequent sobriety checkpoints (only 1 of 36 police agencies where we received enforcement data conducted checkpoints weekly). This low-use strategy is symptomatic of the general decline in checkpoint use in the U.S. since the 1980s and 1990s when the greatest declines in alcohol-impaired-driving fatal crashes occurred. The overall findings in this study may help law enforcement agencies around the country adjust their traffic enforcement intensity in order to reduce impaired driving in their community.     

Drug and alcohol use among drivers admitted to a Level-1 trauma center

The purpose of this research was to determine the incidence and prevalence of drug use, alcohol use, and the combination of drug and alcohol use among motor vehicle crash (MVC) victims admitted to a Level-1 trauma center. In a 90-day study, nearly two-thirds of trauma center admissions were victims of motor vehicle crashes. Blood and urine was collected from 168 MVC victims of whom 108 were identified as the driver in the crash. Toxicology results indicated that 65.7% of drivers tested positive for either commonly abused drugs or alcohol. More than half of the drivers tested positive for drugs (50.9%) other than alcohol, with one in four drivers testing positive for marijuana use. About one-third of those using drugs had also been drinking, but alcohol was detected in only 30.6% of all injured drivers. Within the total MVC patient pool, passenger drug/alcohol use was equivalent to the driver population; however, injured pedestrians had higher rates of alcohol only than other MVC victims. There were no significant differences in drug and alcohol use between MVCs and trauma admissions of other causes. Of the patients with positive toxicology results, less than half (42%) were referred for evaluation for substance abuse disorders.     

The contribution of alcohol to night time crash risk and other risks of night driving

Many studies show that driving at night is more risky in terms of crash involvements per distance travelled than driving during the day. The reasons for this include the more prevalent use of alcohol by drivers at night, the effects of fatigue on the driving task and the risk associated with reduced visibility. Although the consumption of alcohol prior to driving occurs most commonly at night, drink-driving is not inherently a night time risk factor. This study decomposes the New Zealand risk of driving at night into risk associated with alcohol and risk associated with inherently night time factors. The overall risk associated with alcohol use by drivers was shown to decrease with increasing age for the most risky situation analysed (male drivers on weekend nights). Given the levels of drinking and driving on weekend nights, the overall effect of alcohol was shown to contribute almost half of weekend night time risk for drivers aged under 40 on lower volume roads, but to contribute little to overall risk on higher-volume roads, consistent with other research showing that higher-volume roads are not favoured by drinking drivers. Risk at night relative to risk during the day (excluding risk associated with drinking and driving) was shown to decrease with age. Roads with illumination at night are less risky at night relative to during the day than roads without illumination. The risks estimated in this paper reflect the behaviour of the road users studied and their prevalence on the roads under the conditions analysed.