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National Institute on Alcohol Abuse and Alcoholism
Division of Epidemiology and Prevention Research
Alcohol Epidemiologic Data System
SURVEILLANCE REPORT #71
TRENDS IN ALCOHOL-RELATED FATAL
TRAFFIC CRASHES, UNITED STATES, 1977–2003
Hsiao-ye Yi, Ph.D.1
Gerald D. Williams, D.Ed.1
Michael E. Hilton, Ph.D.2
1 CSR, Incorporated
Suite 1000
2107 Wilson Boulevard
Arlington, VA 22201
2 Division of Epidemiology and Prevention Research
National Institute on Alcohol Abuse and Alcoholism
5635 Fishers Lane, MSC 9304
Bethesda, MD 20892–9304
August 2005
U.S. Department of Health and Human Services
Public Health Service
National Institutes of Health
CSR, Incorporated, operates the Alcohol Epidemiologic Data System (AEDS) under Contract No. N01AA32007 for the Division of Epidemiology and Prevention Research, National Institute on Alcohol Abuse and Alcoholism
HIGHLIGHTS
This is the 20th annual surveillance report from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) on trends in alcohol-related fatal traffic crashes. Data in this series of reports are compiled from sources provided by the National Highway Traffic Safety Administration (NHTSA), the Federal Highway Administration (FHA), and the U.S. Census Bureau. The following are highlights from the current report that update trends in alcohol-related fatal traffic crashes through 2003:
Alcohol-Related Traffic Crash Fatalities
In 2003 12,766 persons died in alcohol-related traffic crashes, which constituted 29.9 percent of the total traffic crash fatalities. This proportion was slightly lower than in 2002.
The number of alcohol-involved drivers in fatal traffic crashes was 9,959 for male drivers and 1,717 for female drivers, representing a 3 percent and 0.8 percent decrease from 2002, respectively.
Alcohol-related traffic crash fatalities per 100 million vehicle miles traveled, 100,000 population, 100,000 registered vehicles, and 100,000 licensed drivers were 0.44, 4.39, 5.39, and 6.51, respectively, all with slight decreases from the 2002 rates.
In 2003 drivers continued to constitute the largest proportion of fatalities in traffic crashes, which was 71 percent among alcohol-related traffic fatalities and 59 percent among nonalcohol-related traffic fatalities.
Blood Alcohol Concentration (BAC) Testing and Results
The national BAC testing rate of drivers killed in traffic crashes was 72.5 percent in 2003, about the same as in 2002.
The percentage distribution of BAC values peaked at 0.10–0.19 for drivers ages 16 to 19 and at 0.20–0.24 for drivers ages 35 to 44. The peak was at 0.15–0.19 for all other age groups.
In 2003 about 77.9 percent of drivers with positive BAC results had BAC scores of 0.10 grams per deciliter (g/dl) or higher at the time of their crashes. If the legal BAC limit were lowered to 0.08 in all States, a total of 83.8 percent of the BAC-positive drivers would have been considered legally intoxicated.
Young Drinking Drivers
In 2003 4,175 deaths (including driver, passenger, and pedestrian deaths) were associated with young drinking drivers ages 16 to 24, representing a 2.7 percent decrease from 2002.
In 2003 2,240 drinking drivers ages 16 to 24 were killed in traffic crashes, representing a 2.7 percent decrease from 2002.
Young drivers ages 21 to 24 continued to have the highest proportion (33.3
percent) of alcohol involvement among all age groups.
INTRODUCTION
This 20th issue of the surveillance report on alcohol-related1 fatal traffic crashes is one in a series of surveillance reports prepared by NIAAA’s Alcohol Epidemiologic Data System (AEDS). These reports are designed to provide useful data to researchers, planners, policymakers, and other professionals interested in alcohol abuse and its associated illnesses and mortality.
(1 The terms “alcohol-related” and “alcohol-involved” are used interchangeably throughout this report.)
The 2003 mortality statistics show that “accidents (unintentional injuries)” were the number one cause of death for persons in the age groups of 1 to 4, 5 to 14, 15 to 24, and 25 to 44 in the United States; motor vehicle accident fatalities represented 35, 62, 73, and 49 percent of the deaths in this category for the four age groups, respectively. Overall, this category was the fifth leading cause of death in the United States in 2003; 42 percent of these deaths were due to motor vehicle accidents (Hoyert, Kung, and Smith 2005). From 1977 through 2003 about 40,000 to 50,000 people per year died in traffic crashes.
The Surgeon General’s Workshop on Drunk Driving (Office of the Surgeon General 1989) emphasized the need for accurate and timely epidemiologic data to address the Nation’s drinking and driving problem. Over the past 20 years, in addition to this series of reports, AEDS staff have periodically reported on various aspects of alcohol-related traffic fatalities (e.g., Aitken and Zobeck 1985; Grigson et al. 1985; Lowman et al. 1983; Malin et al. 1982; Malin and Verdugo 1984; Verdugo et al. 1983; Zobeck and Williams 1994; Zobeck et al. 1986, 1990, 1994). Data in this report are focused on general trends in alcohol-related traffic fatalities, BAC testing rates and results, and young drinking drivers involved in fatal traffic crashes.
DATA
The U.S. Department of Transportation’s Fatality Analysis Reporting System (FARS) is the major data source for this report. FARS contains data on all traffic crashes within the United States involving a motor vehicle traveling on a trafficway customarily open to the public and resulting in the death of a vehicle occupant or nonmotorist within 30 days of the crash. The system is operated by NHTSA in cooperation with each State. FARS collects detailed data on the conditions of a crash, the vehicle(s) involved, and the driver(s) and other person(s) involved. These data are obtained from each State’s existing documents (e.g., police accident reports, death certificates, and hospital medical records).
Denominators used in calculating fatality rates are taken from the following sources:
Population estimates—U.S. Census Bureau estimates of the U.S. population as of July 1 of each year (U.S. Census Bureau 1977–89, 2002, 2003, 2004, 2005).
Registered vehicles, licensed drivers, and vehicle miles traveled—FHA, for each year (Federal Highway Administration 1978–2004).
It should be noted that, beginning with the 2003 issue of this report, the 1990s population data used previously in this report series were replaced with the reestimated intercensal population data that bridge the 1990 and 2000 censuses (U.S. Census Bureau 2002). This resulted in minor changes, mainly slight decreases, in the calculated population rates (presented in tables 2 and 3) for the 1990s compared with reports published prior to 2003.
METHODS
Definition of Alcohol Involvement
The following two variables in FARS are used in this report to define alcohol involvement:
Officer’s judgment—The judgment of the investigating officer regarding the presence of alcohol in a person involved in a fatal crash.
BAC test—A finding from any one of several chemical tests that measure the amount of alcohol in the blood.
In this report, the definition of an alcohol-related traffic crash is based on the alcohol involvement of the driver. A traffic crash is considered to be alcohol-related if either it was judged as such by the investigating officer or the BAC test is positive (i.e., 0.01 g/dl or above) for at least one driver involved in the crash. A fatality is considered to be alcohol-related if the death occurs as the result of an alcohol-related crash.
In contrast to the definition used in this report, NHTSA defines a traffic crash as alcohol-related if either a driver or a nonmotorist has a measurable or estimated BAC of 0.01 g/dl or above. NHTSA uses statistical procedures to estimate unknown BAC values based on data from drivers with known BAC values (Klein 1986a, b; Subramanian 2002). Thus the methodology in this report for determining alcohol involvement in fatal crashes differs from that used by NHTSA in the following three respects: (1) two alcohol involvement variables are used to identify a crash as alcohol-related, (2) only drivers’ alcohol involvement is used to determine the nature of a crash, and (3) no estimation procedures are used for unknown BAC values. Therefore, caution must be used while comparing data from this report with data from the estimates made by NHTSA.
Fatality Measures
Frequencies and percentage distributions of traffic crash fatalities and BAC tests are calculated by sex and/or age group and presented in graphic and tabular form. In addition, the report includes rates based on associated risk factors.
The probability of having or being involved in a traffic crash depends on several factors (e.g., the amount of time a person spends on the road, the number of miles driven, vehicle speed, or type of vehicle driven). Four associated “risk factors”—vehicle miles traveled (VMT), the number of people in the population, the number of registered vehicles, and the number of licensed drivers—are used to express traffic crash fatalities as rates per these denominators. These rates place the raw frequencies within a context of associated risk factors, each of which is subject to change over time.
Finally, the measure of years of potential life lost (YPLL) is used to assess the human cost of traffic crash fatalities. In this report, YPLL is calculated by subtracting the age at death from age 65 for each death (for decedents under age 65 only) and then accumulating the total across all deaths.
In previous issues of this report, comparisons between 1977 (the beginning year of the surveillance data) and the latest data year were presented in some figures and tables. In order to make the comparisons more relevant to observing current trends, these comparisons have been changed to that between 2000 and the latest data year beginning with the current issue.
Limitations
Alcohol involvement rates presented in this report should be viewed as conservative estimates for the following reasons:
BAC tests are not administered consistently and routinely across jurisdictions;
AEDS does not impute a value when the BAC level is missing from FARS data; and
Only alcohol-involved drivers flag accidents as alcohol-related; thus
a traffic crash involving an alcohol-impaired pedestrian, without evidence
that the driver(s) had been drinking, would not be included in this enumeration
of alcohol-related crashes.
REFERENCES
Aitken, S.S., and Zobeck, T.S. Epidemiologic Bulletin No. 8: Trends in alcohol-related fatal motor vehicle accidents for 1983. Alcohol Health & Research World 9(4):60–62, 1985.
Federal Highway Administration. Highway Statistics. Washington, DC: Department of Transportation, 1978–2003.
Grigson, M.B.; Zobeck, T.S.; Williams, G.; and Bertolucci, D. Alcohol-related traffic fatalities during Christmas and New Year’s holidays—United States, 1977–1984. Morbidity and Mortality Weekly Report 34(4):737–738, 1985.
Hoyert, D.L., Kung, H.C., and Smith, B.L. Deaths: Preliminary data for 2003. National Vital Statistics Reports 53(15). Hyattsville, MD: National Center for Health Statistics, 2005.
Klein, T.M. A Guide to Using the Fatal Accident Reporting System BAC Distribution Files. Sigmastat, Report to National Highway Traffic Safety Administration, July 1986a.
Klein, T.M. A Method of Estimating Posterior BAC Distribution for Persons Involved in Fatal Traffic Accidents. Sigmastat, Final Report for the National Highway Traffic Safety Administration, July 1986b.
Lowman, C.; Verdugo, N.; Malin, H.; and Aitken, S.S. Patterns of alcohol use among teenage drivers in fatal motor vehicle accidents—United States, 1977–1981. Morbidity and Mortality Weekly Report 32(26):344–347, 1983.
Malin, H.; Trumble, J.; Kaelber, C.; and Lubren, B. Alcohol-related highway fatalities among young drivers—United States. Morbidity and Mortality Weekly Report 31(48):641–644, 1982.
Malin, H., and Verdugo, N. Epidemiologic Bulletin No. 3: Differences in alcohol involvement in fatal motor vehicle accidents related to age of drivers. Alcohol Health & Research World 8(3):56–59, 1984.
National Highway Traffic Safety Administration. Digest of State Alcohol-Highway Safety-Related Legislation, Twenty-first Edition. Washington, DC: Department of Transportation, March 2003.
Office of the Surgeon General. Surgeon General’s Workshop on Drunk Driving. Proceedings. Washington, DC: December 14–16, 1988. U.S. Department of Health and Human Services, 1989.
Subramanian, R. Transitioning to Multiple Imputation– A New Method to Impute Missing Blood Alcohol Concentration (BAC) Values in FARS. NHTSA Technical Report, DOT HS 809 403. Washington, DC: Department of Transportation, 2002.
U.S. Census Bureau. Current Population Reports. Population Estimates and Projections. Series P-25. Washington, DC: U.S. Census Bureau, 1977–89.
U.S. Census Bureau. Intercensal Estimates of the United States Resident Population by Age Groups and Sex, 1990–2000: Selected Month. Washington, DC: U.S. Census Bureau, September 13, 2002.
U.S. Census Bureau. Annual Resident Population Estimates of the United States by Age and Sex: April 1, 2000 to July 1, 2002. Washington, DC: U.S. Census Bureau, June 18, 2003.
U.S. Census Bureau. Annual Estimates of the Population by Sex and Five-Year Age Groups for the United States: April 1, 2000 to July 1, 2003. Washington, DC: U.S. Census Bureau, June 14, 2004.
U.S. Census Bureau. Annual Estimates of the Population by Sex and Five-Year Age Groups for the United States: April 1, 2000 to July 1, 2004. Washington, DC: U.S. Census Bureau, June 9, 2005.
Verdugo, N.; Malin, H.; and Lowman, C. Blood alcohol concentrations among young drivers: United States, 1982. Morbidity and Mortality Weekly Report 32(49):646–648, 1983.
Zobeck, T.S., and Williams, G.D. Evaluation Synthesis of the Impacts of DWI Laws and Enforcement Methods: Final Report. Prepared for Office of Policy Analysis, National Institute on Alcohol Abuse and Alcoholism, April 1994.
Zobeck, T.S.; Grant, B.F.; Stinson, F.S.; and Bertolucci, D. Alcohol involvement in fatal traffic crashes in the United States: 1979–90. Addiction 89:227–233, 1994.
Zobeck, T.S.; Williams, G.; and Bertolucci, D. Epidemiologic Bulletin No. 13: Trends in alcohol-related traffic fatalities, 1977–84. Alcohol Health & Research World 11(1):60–63, 1986.
Zobeck, T.S.; Williams, G.; Grant, B.; and Bertolucci, D. Epidemiologic Bulletin No. 24: Years of potential life lost and other trends in alcohol-related fatal traffic crashes, 1977–87. Alcohol Health & Research World 14(1):63–68, 1990.
Figure 1. Alcohol-related and nonalcohol-related traffic crash fatalities, United States, 1977–2003.
Figure 2a. Total and alcohol-related traffic fatality rates per 100 million vehicle miles traveled (VMT), United States, 1977–2003.
Figure 2b. Traffic fatality rates per 100,000 population, registered vehicles, and licensed drivers, United States, 1977–2003.
Figure 2c. Alcohol-related traffic fatality rates per 100,000 population, registered vehicles, and licensed drivers, United States, 1977–2003.
Figure 3a. Decedent’s role in nonalcohol-related traffic crash fatalities, United States, 2003.
Figure 3b. Decedent’s role in alcohol-related traffic crash fatalities, United States, 2003.
Figure 4. Percentage of drivers involved in fatal traffic crashes and given BAC tests, according to injury severity, United States, 1977–2003.
Figure 5. Percentage distributions of BAC among alcohol-involved drivers, according to age, United States, 2003.
Figure 6. Percentage of alcohol involvement among drivers in fatal traffic crashes, according to age, United States, 2000 and 2003.
Figure 7. Percentage of alcohol
involvement among young drivers ages 16 to 20 and drivers ages 21 and older
in fatal traffic crashes, United States, 1977–2003.
Table 1. Traffic crashes, traffic crash fatalities, and alcohol-related traffic crash fatalities, United States, 1977–2003.
Table 2. Total and alcohol-related traffic fatality rates per 100 million VMT and 100,000 population, registered vehicles, and licensed drivers, United States, 1977–2003.
Table 3. Years of potential life lost (YPLL) from total and alcohol-related traffic crashes, according to sex, United States, 1977–2003.
Table 4. Alcohol-related traffic crash fatalities, according to age, United States, 1977–2003.
Table 5. Decedent’s role in alcohol-related traffic crash fatalities, United States, 1977–2003.
Table 6. Drivers involved in fatal traffic crashes, according to sex and alcohol involvement, United States, 1977–2003.
Table 7. Drivers involved in fatal traffic crashes and given BAC tests, according to injury severity, United States, 1977–2003.
Table 8. Drivers involved in fatal traffic crashes and given BAC tests, according to State and injury severity, United States, 2000 and 2003.
Table 9. Drivers involved in fatal traffic crashes and given BAC tests, according to sex, age, and injury severity, United States, 2000 and 2003.
Table 10. Percentage distributions of BAC among alcohol-involved drivers, according to sex and age, United States, 2000 and 2003.
Table 11. Alcohol-related traffic crash fatalities associated with young drivers ages 16 to 24, according to decedent’s role, United States, 1977–2003.
Table 12. Traffic crash fatalities among young drivers and young drinking drivers ages 16 to 24, United States, 1977–2003.
Table 13. Driver’s alcohol involvement in fatal traffic crashes, according to sex and age, United States, 2000 and 2003.
Table 14. Alcohol involvement among young
drivers ages 16–20 in fatal traffic crashes, United States, 1977–2003.
Figure 1. Alcohol-related and nonalcohol-related traffic crash fatalities, United States, 1977–2003.
Data for figure 1 are presented in Table 1.
Figure 2a. Total and alcohol-related traffic fatality rates per 100 million vehicle miles traveled (VMT), United States, 1977–2003.
Data for figure 2a are presented in Table 2.
Figure 2b. Traffic fatality rates per 100,000 population, registered vehicles, and licensed drivers, United States, 1977–2003.
Data for figure 2b are presented in Table 2.
Figure 2c. Alcohol-related traffic fatality rates per 100,000 population, registered vehicles, and licensed drivers, United States, 1977–2003.
Data for figure 2c are presented in Table 2.
Figure 3a. Decedent’s role in nonalcohol-related traffic crash fatalities, United States, 2003.
d
Note: 103 decedents were excluded from this pie chart because their roles were unknown.
Figure 3b. Decedent’s role in alcohol-related traffic crash fatalities, United States, 2003.
d
Note: 2 decedents were excluded from this pie chart because their roles were unknown.
Figure 4. Percentage of drivers involved in fatal traffic crashes and given BAC tests, according to injury severity, United States, 1977–2003.
Data for figure 4 are presented in Table 7.
Figure 5. Percentage distributions of BAC among alcohol-involved drivers, according to age, United States, 2003.
Data for figure 5 are presented in Table 10.
Figure 6. Percentage of alcohol involvement among drivers in fatal traffic crashes, according to age, United States, 2000 and 2003.
Data for figure 6 are presented in Table 13.
Figure 7. Percentage of alcohol involvement among young drivers ages 16 to 20 and drivers ages 21 and older in fatal traffic crashes, United States, 1977–2003.
Data for figure 7 are presented in Table 14.
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