Traffic accident rates among finnish out-patients

A questionnaire was administered to 765 rheumatoid arthritic, 715 tuberculous, and 1050 psychiatric outpatients concerning their use of alcohol and drugs, driving habits, and traffic accident involvement. The same questionnaire was administered to 587 controls. The driving populations of all groups were matched as to their age, and living district. The main finding of the study was that, as the traffic exposure was controlled, the non-drug treated patients were not involved in accidents more often than the controls. In the psychiatric out-patient group, drug use was linked with an increased accident rate. Heavy use of alcohol was linked with increased traffic exposure in the present study. The combined use of alcohol and drugs tended to increase one's involvement in accidents.     

Alcohol and drugs in fatally and non-fatally injured motor vehicle drivers in northern Sweden

Alcohol and drugs are important risk factors for traffic injuries, a major health problem worldwide. This prospective study investigated the epidemiology and the presence of alcohol and drugs in fatally and hospitalized non-fatally injured drivers of motor vehicles in northern Sweden. During a 2-year study period, blood from fatally and hospitalized non-fatally injured drivers was tested for alcohol and drugs. The study subjects were recruited from well-defined geographical areas with known demographics. Autopsy reports, medical journals, police reports, and toxicological analyses were evaluated. Of the fatally injured, 38% tested positive for alcohol and of the non-fatally 21% tested positive; 7% and 13%, respectively, tested positive for pharmaceuticals with a warning for impaired driving; 9% and 4%, respectively, tested positive for illicit drugs. The most frequently detected pharmaceuticals were benzodiazepines, opiates, and antidepressants. Tetrahydrocannabiol was the most frequently detected illicit substance. No fatally injured women had illegal blood alcohol concentration. The relative proportion of positively tested drivers has increased and was higher than in a similar study 14 years earlier. This finding indicates that alcohol and drugs merit more attention in future traffic safety work.     

An assessment of the 1982 traffic fatality decrease

United States traffic fatalities dropped dramatically from 49,301 in 1981 to an estimated 43,721 in 1982. Fatalities are at their lowest level in 20 yr, and fatalities per mile of travel are the lowest ever recorded. A decrease of similar magnitude occurred only in 1974, when the oil crisis, the national 55 mph speed limit, and depressed economic conditions disrupted the nation's driving habits. In 1982 the potential explanations are more difficult to observe and test. This paper examines several factors which may have contributed to the 1982 changes, including alcohol programs, occupant restraint use, demographic shifts, economic conditions, and travel patterns. Each factor's effect is assessed, though available data do not permit precise quantification. Implications of these findings for 1983 and beyond are discussed.     

The severity of drunken driving as perceived by drunken drivers

Men convicted of drunken driving rated this particular offence as significantly less serious than men from a control group who had no convictions for drunken driving offences. Instead of shame and guilt feelings preventing the person from committing further acts of drunken driving, prosecution and court appearance seems to have a detrimental effect on the offender's attitudes to this type of criminal behaviour.     

What do Israeli Jewish and Arab adolescents know about drinking and driving?

This article describes a study, which is the first in Israel to investigate knowledge concerning drinking and driving among a large group of 2408 adolescents of four religions in the north of Israel, in the winter of 1995. The article analyses the results by referring to general scores and to five areas in the “drinking and driving” domain: legal blood alcohol concentration (BAC) limit, minimal number of drinks prohibited by the law before driving, common myths, main effects of alcohol on driving ability and youth vulnerability. The article emphasizes differences between the Jewish group and the non-Jewish (Arab) group. The average score of the sample was 2.06 (out of 5). Jews received the highest score (2.30) and Moslems got the lowest score (1.45). No differences were found among those who had a driving license and those who had not, and between the group of respondents from the north of Israel and a sample of participants from the center of the country. Lack of knowledge was revealed especially concerning knowledge about the BAC limit and youth vulnerability. Arabs tended to exaggerate the amount of drinks allowed to be consumed before driving according to the law, to hold common myths more than Jews and to get lower scores concerning alcohol main effects on driving skills. However, they tended to be more aware than Jews to youth vulnerability.     

The effect of alcohol, THC and their combination on perceived effects, willingness to drive and performance of driving and non-driving tasks

Background

Driving under the influence of drugs (DUID) is one of the main causes of car accidents. Alcohol and marijuana are the most popular drugs among recreational users. Many classify these drugs as “Light” drugs and therefore allow themselves to drive after consuming them.

Objective

The study had two main objectives: 1) to investigate the effect of alcohol (BAC = 0.05%), THC (13 mg) and their combination on driving and non-driving tasks. 2) to investigate the extent to which people are willing to drive based on their subjective sensations and their perceived effects of the drugs.

Method

7 healthy men and 5 healthy women, ages 24-29, all recreational users of alcohol and marijuana, completed 5 experimental sessions. Sessions included: drinking and smoking placebo, drinking alcohol and smoking placebo, drinking placebo and smoking THC, drinking alcohol and smoking THC, drinking placebo and smoking placebo 24 hours after drinking alcohol and smoking THC. Three types of measures were used: subjective perceptions (with questionnaires), performance parameters of the driving and non-driving tasks (arithmetic task and a secondary target detection task) and physiological changes (heart rate).

Results

Overall, the combination of alcohol and THC had the most intense effect after intake. This effect was reflected in performance impairments observed in the driving and non-driving tasks, in the subjective sensations after intake, and in the physiological measures. Despite significant differences in the size of the effects after the various treatments, there were no differences in the distances subjects were willing to drive while under the influence on each of the treatments.     

Effects of THC on driving performance, physiological state and subjective feelings relative to alcohol

BACKGROUND: The effects of marijuana or THC on driving has been tested in several studies, but usually not in conjunction with physiological and subjective responses and not in comparison to alcohol effects on all three types of measures. OBJECTIVE: To assess the effects of two dosages of THC relative to alcohol on driving performance, physiological strain, and subjective feelings. METHOD: We tested the subjective feelings and driving abilities after placebo, smoking two dosages of THC (13 mg and 17 mg), drinking (0.05% BAC) and 24 h after smoking the high dose THC cigarette, while monitoring physiological activity of the drugs by heart rate. Fourteen healthy students, all recreational marijuana users, participated in the study. RESULTS: Both levels of THC cigarettes significantly affected the subjects in a dose-dependent manner. The moderate dose of alcohol and the low THC dose were equally detrimental to some of the driving abilities, with some differences between the two drugs. THC primarily caused elevation in physical effort and physical discomfort during the drive while alcohol tended to affect sleepiness level. After THC administration, subjects drove significantly slower than in the control condition, while after alcohol ingestion, subjects drove significantly faster than in the control condition. No THC effects were observed after 24 h on any of the measures.     

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.     

Parental and offspring assessment of driving capability under the influence of drugs or alcohol: Gender and inter-generational differences

The current study set to examine whether there are inter-generational and gender-based differences between family members self-assessing their ability to drive under normal conditions and while under the influence of either alcohol or drugs. Participants were 135 young-adults and both their parents, consisting 45 family triads, who received self-assessment questionnaires relating to their driving skills in various road scenarios. Each family triad was randomly assigned to one of three groups: either requested to base the assessments on normal driving conditions, or under the influence of either drugs or alcohol, thus forming a control group, and two experimental groups (alcohol and drugs), respectively.The findings indicate the assessments of both the alcohol and drugs groups were more severe than those of the control group. The alcohol group assessments were less strict than the drug group assessment (non-significantly). Inter-generational differences indicated that the parents’ driving-skills assessments were lower than those of their offspring, corresponding with previous findings (Elkind, 1967, Finn and Bragg, 1986).A significant within-subject interaction has been found between the respondent's gender and familial relations regarding the self-assessment of driving skills: male respondents assessed better driving skills compared to the self estimates of both parents (which did not significantly differ). In contrast, female respondents’ estimates did not differ from their fathers’ and both fathers’ and daughters’ estimates were significantly higher than that of the mothers in each family.     

Substance use and social,health and safety-related factors among fatally injured drivers

Objective

The aim of this study was to examine different socio-demographic, health and safety-related factors, and psychoactive substance use among fatally injured drivers in road traffic accidents in Finland during 2006–2008.

Methods

An accident information register maintained by the Traffic Safety Committee of Insurance Companies (VALT) of the Finnish Motor Insurers’ Centre was used as basic data, and the basic data were complemented with further toxicological analytical information retrieved from autopsy reports from the Department of Forensic Medicine, Helsinki University. The data included all the drivers (n = 556) who were driving a motor vehicle and who died in a road traffic accident in Finland during 2006–2008.

Results

Of all the 556 fatally injured drivers 43% (n = 238) had psychoactive substance findings. 51% (n = 121) of substance positive drivers had a finding for alcohol only, the rest had a finding for one or more illicit/medicinal drugs impairing driving ability, and possibly also alcohol. Fatally injured drivers with alcohol findings were significantly younger (mean age 34 years) than sober drivers (mean age 44 years) or drivers with findings for drugs (mean age 45 years). Socio-demographic background did not differ substantially among drunken/drugged and sober drivers, although drivers with alcohol findings had a slightly lower education and socioeconomic position. Previous substance abuse problems were highly prevalent among drivers with substance findings and mental or both mental and physical health problems were more common among drivers with drug findings. The non-use of safety equipment and driving at a high speed were more common among fatally injured drivers with substance findings.

Conclusions

Substance abuse and mental health problems, as well as reckless driving behavior were more pronounced among fatally injured drivers with substance findings when compared to sober drivers. Thus, prevention and early intervention concerning substance abuse, mental health problems and DUI are essential. Improved traffic safety cannot be achieved by means of traffic policy only, but integration with other policies, such as health and social policy should be strengthened.     

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.     

Reduction of the blood alcohol concentration limit in Norway—Effects on knowledge,behavior and accidents

From January 1, 2001, the legal blood alcohol concentration (BAC) limit in Norway was reduced from 0.5 to 0.2 g/l. A before-and-after telephone survey concerning the effects of the reduced BAC limit was carried out. 3001 driver's license holders were interviewed before and after the amendment. The percentage of drivers claiming that they will drink no alcohol before driving has increased from 82 to 91 percent, thus the distinction between driving a motor vehicle and drinking alcohol has become clearer. Drivers influenced by alcohol and involved in accidents have on the average much higher BACs than 0.5 g/l. Statistics on alcohol-related accidents are not available for the years before and after the legal amendment, but single-vehicle night-time and weekend personal-injury and fatal crashes are used as surrogate measures. There are no significant decreases in these proxies from the six years before to the six years after the reductions of the legal limit.     

Retail alcohol monopolies, underage drinking, and youth impaired driving deaths

OBJECTIVE: To explore associations of state retail alcohol monopolies with underage drinking and alcohol-impaired driving deaths. DATA: Surveys on youth who drank alcohol and binge-drank recently and their beverage choices; census of motor vehicle fatalities by driver blood alcohol level. METHODS: Regressions estimated associations of monopolies with under-21 drinking, binge drinking, alcohol-impaired driving deaths, and odds a driver under 21 who died was alcohol-positive. RESULTS: About 93.8% of those ages 12-20 who consumed alcohol in the past month drank some wine or spirits. In states with a retail monopoly over spirits or wine and spirits, an average of 14.5% fewer high school students reported drinking alcohol in the past 30 days and 16.7% fewer reported binge drinking in the past 30 days than high school students in non-monopoly states. Monopolies over both wine and spirits were associated with larger consumption reductions than monopolies over spirits only. Lower consumption rates in monopoly states, in turn, were associated with a 9.3% lower alcohol-impaired driving death rate under age 21 in monopoly states versus non-monopoly states. Alcohol monopolies may prevent 45 impaired driving deaths annually. CONCLUSIONS: Continuing existing retail alcohol monopolies should help control underage drinking and associated harms.     

Drugs related to motor vehicle crashes in northern European countries: a study of fatally injured drivers

The aim of this study was to find which drugs and drug combinations were most common in drivers who died, in particular, in single vehicle crashes where the responsibility for the crash would be referred to the driver killed. The study included all available blood samples from drivers, who died within 24 h of the accident, in the years 2001 and 2002 in the five Nordic countries (total population about 24 million inhabitants). The samples were analysed for more than 200 different drugs in addition to alcohol, using a similar analytical programme and cut-off limits in all countries. In three countries (Finland, Norway and Sweden) blood samples were available for more than 70% of the drivers, allowing representative prevalence data to be collected. 60% of the drivers in single vehicle crashes had alcohol and/or drug in their blood samples, compared with 30% of drivers killed in collisions with other vehicles. In single vehicle accidents, 66% of the drivers under 30 years of age had alcohol and/or drugs in their blood (alcohol only – 40%; drugs only – 12%; alcohol and drugs – 14%). The drugs found were mostly illicit drugs and psychoactive medicinal drugs with warning labels (in 57% and 58% respectively of the drivers under 30 with drugs present). Similar findings were obtained for drivers 30–49 years of age (63% with alcohol and/or drugs). In drivers aged 50 years and above, killed in single vehicle crashes (48% with alcohol and/or drugs) illicit drugs were found in only one case, and psychoactive medicinal drugs were detected less frequently than in younger age groups. In 75% of single vehicle crashes, the driver was under 50 years. Thus, the majority of accidents where the drivers must be considered responsible, occurred with drivers who had recently used alcohol, or drugs, alone or in combination. The drugs involved were often illicit and/or psychoactive drugs with warning labels. Therefore a large proportion of single vehicle accidents appear to be preventable, if more effective measures against driving after intake of alcohol and drugs can be implemented.     

Alcohol, illicit and non-illicit psychoactive drug use and road traffic injury in Thailand: A case-control study

The objective of this study was to determine the relationship between alcohol use, psychoactive drug use and road traffic injury (RTI). A case-control study was conducted among drivers in Bangkok, Thailand. Two hundred cases and 849 controls were enrolled between February and November 2006. Cases who sustained a RTI were matched with four controls recruited from petrol stations within a 1-km radius of the reported crash site of the case.A positive alcohol breath test (≥50 mg/dl), and positive tests for the presence of illicit (amphetamine, cocaine, marijuana) and non-illicit psychoactive drugs (antihistamine, benzodiazepine, antidepressants), using gas chromatography/mass spectrometry (GC/MS) were documented as primary measures.There were significantly higher odds of an alcohol breath test ≥50 mg/dl (adjusted odds ratio (OR) 63.6 (95% CI: 25.5-158.9)), illicit psychoactive drugs (adjusted OR 3.4 (95% CI: 1.7-6.6)) and non-illicit psychoactive drug (adjusted OR 3.1 (95% CI: 1.5-6.3)) among cases than controls.Even though driving under the influence of psychoactive drugs has been significantly linked to RTI, its contribution to road safety is much lower than driving under the influence of alcohol. With limited resources, the priority for RTI prevention should be given to control of driving under the influence of alcohol.     

Drugs related to motor vehicle crashes in northern European countries: A study of fatally injured drivers

The aim of this study was to find which drugs and drug combinations were most common in drivers who died, in particular, in single vehicle crashes where the responsibility for the crash would be referred to the driver killed. The study included all available blood samples from drivers, who died within 24 h of the accident, in the years 2001 and 2002 in the five Nordic countries (total population about 24 million inhabitants). The samples were analysed for more than 200 different drugs in addition to alcohol, using a similar analytical programme and cut-off limits in all countries. In three countries (Finland, Norway and Sweden) blood samples were available for more than 70% of the drivers, allowing representative prevalence data to be collected. 60% of the drivers in single vehicle crashes had alcohol and/or drug in their blood samples, compared with 30% of drivers killed in collisions with other vehicles. In single vehicle accidents, 66% of the drivers under 30 years of age had alcohol and/or drugs in their blood (alcohol only – 40%; drugs only – 12%; alcohol and drugs – 14%). The drugs found were mostly illicit drugs and psychoactive medicinal drugs with warning labels (in 57% and 58% respectively of the drivers under 30 with drugs present). Similar findings were obtained for drivers 30–49 years of age (63% with alcohol and/or drugs). In drivers aged 50 years and above, killed in single vehicle crashes (48% with alcohol and/or drugs) illicit drugs were found in only one case, and psychoactive medicinal drugs were detected less frequently than in younger age groups. In 75% of single vehicle crashes, the driver was under 50 years. Thus, the majority of accidents where the drivers must be considered responsible, occurred with drivers who had recently used alcohol, or drugs, alone or in combination. The drugs involved were often illicit and/or psychoactive drugs with warning labels. Therefore a large proportion of single vehicle accidents appear to be preventable, if more effective measures against driving after intake of alcohol and drugs can be implemented.     

The child support seat—A new type of protection system for the older child passenger

A protection system for the older child passenger consisting of a specially designed cushion has been allocated to 50 families. The parents completed a questionnaire and were interviewed following 3 months' and one year's use of the seats concerning their safety, comfort and handling qualities. These results are discussed as well as suggestions to manufacturers concerning the improvement of the system.     

Are bad drivers more impaired by alcohol? Sober driving precision predicts impairment from alcohol in a simulated driving task

The contribution of driver experience to risk for alcohol-related crashes is based on the tacit assumption that driver experience contributes to driver skill which could mediate the impairing effects of alcohol on driving performance. Surprisingly, few studies of alcohol effects on simulated driving performance have examined the role of driver skill as a mediator of the intensity of alcohol impairment. The present study examined the degree to which individual differences in driving skill mediated the intensity of impairment produced by a moderate dose of alcohol in a group of young adult drivers. Twenty-eight participants were familiarized with a simulated driving road test. After determining their baseline skill level, participants' driving performance was re-tested under either an active dose of alcohol (0.65 g/kg) or a placebo. Results showed that alcohol reduced driving precision, as evident by the increased within-lane deviation observed under the drug. Moreover, those individuals with poorer baseline skill levels showed the greater impairments in response to alcohol. The results highlight the importance of understanding interactions between driver skill level and the effects of alcohol and possibly other drugs.     

The effect of antipsychotic drugs on driving and driving related psychomotor functions

Despite the extremely widespread use of antipsychotic medications, there is little evidence from the surveys conducted to date, that this class of psychoactive medications is significantly implicated in vehicular crashes or deaths. In five major surveys of vehicular fatalities, in which drug and alcohol analyses were obtained, only two of over 800 victims studied involved detection of antipsychotic medications. It is clear that the acute administration of antipsychotics in normal individuals does induce sedation and performance decrements in visual-motor coordination and specific attentional behaviors, which have a deleterious effect on driving behavior. On the other hand, it should be emphasized that antipsychotics are rarely used on an acute basis and tolerance to the sedation and decreased alertness does occur during chronic treatment. Antipsychotic drugs have the capacity to potentiate the effects of alcohol, sedative hypnotics, narcotics and antihistamines; therefore, the combination of antipsychotics with these substances increases the impairment of driving behavior. There is an indication that the less sedating piperazine phenothiazines and the butyrophenones may have little or no effect on psychomotor performance, and antipsychotic drugs of these two subclasses may have a distinct advantage, at least in terms of driving performance, over the other more sedating drugs. Antipsychotic drugs are almost never used for recreational or abuse purposes; therefore, more central to the focus of this review is the effect that antipsychotics may have on the driving behavior of those seriously disordered mentally ill patients who require continued maintenance on these medications. There is good agreement in the literature which suggests that schizophrenic patients demonstrate improved psychomotor performance during chronic treatment with antipsychotic drugs.(ABSTRACT TRUNCATED AT 250 WORDS)     

A three-year prospective study of rearrests for driving under influence of alcohol or drugs

Fifty drunken drivers and 50 drivers with high blood drug concentrations arrested during the first four months of 1983 were selected for a study of rearrests for driving under influence of alcohol or drugs. Of the drugged drivers selected, 32 had been driving with high blood concentrations of diazepam (greater than 1.0 microM). 50% of these drivers were rearrested during the subsequent three years. The rearrest rate was low (6%) among those who had been driving with high blood concentrations of amphetamine (greater than 2.0 microM) or THC (greater than 0.010 microM). Among the drunken drivers arrested (BAC greater than 0.05%), the rearrest rate was 20%. The drivers were mostly rearrested for driving under the influence of alcohol.