From 1977 to 1981, data from the Fatal Accident Reporting System (FARS)* show that the overall proportion of drivers with measurable blood alcohol concentrations (BACs)** steadily increased (Figure 1). The percentage of 16- to 19-year-old drivers (defined as "teenage") tested who had positive BACs rose from 20% in 1977 to 28% in 1981--an 8% increase. Comparable increases occurred among young adult (20-24 years of age) and adult drivers (25 years of age or older). During this same time period, the percentage of drivers reported to have a BAC test (including persons whose reported BAC was zero) also increased--e.g., the proportion of teenage drivers with reported BAC test results increased 9%.

In 1981, BAC results showed that 21% of the 8,790 teenage drivers involved in fatal motor vehicle accidents had been drinking alcoholic beverages. However, the extent of alcohol use among drivers involved in fatal motor vehicle accidents varied markedly depending on the driver's sex and age, number of vehicles involved, time of day, and day of the week the accident occurred. More single vehicle fatal accidents (SVFAs) than multiple vehicle fatal accidents (MVFAs) have been estimated to involve drivers with high BAC levels (1). In 1981, 28% of the 4,199 teenage drivers involved in SVFAs had positive BACs, in comparison with 14% of the 4,591 teenage drivers involved in MVFAs.

A more detailed analysis of teenage and other drivers involved in SVFAs is illustrated in Figure 1 and shown in Table 2. Five times as many male drivers as female drivers were involved in SVFAs in 1981. Teenage male drivers involved in SVFAs were as likely as adult male drivers to have been drinking an alcoholic beverage. Approximately 29% of each group had positive BACs. Fewer teenage female drivers than male drivers were involved in alcohol-related SVFAs, although 23% of the former had positive BACs. Sixteen percent of adult female drivers involved in SVFAs had positive BACs.

The greatest risk of involvement in an alcohol-related SVFA for all male drivers was at night on weekends: 35% of teenage male drivers, 40% of young adult male drivers, and 37% of adult male drivers involved in SVFAs at such times had positive BACs. In contrast, across the three age groups of females analyzed, 24%-35% of those involved in SVFAs on weekday nights had positive BACs, compared with 25%-31% of those involved in SVFAs on weekend nights. A higher proportion of male drivers involved in SVFAs on weekday nights were more likely to have a positive BAC, with percentages ranging from 30-36 across the three age groups examined.

Results of two national probability surveys (2,3) confirm the FARS findings. In these surveys, a larger proportion of young adult drivers generally reported alcohol use than did teenage or adult drivers. Although the survey data indicate that alcohol use among teenagers is a widespread national problem, proportionately more people in their twenties report higher levels of alcohol use and problems related to it than do members of any other age group. The FARS data demonstrate that the risk of a fatality from an alcohol-related motor vehicle accident is high for teenagers and that the risk of fatality further increases in the 20-24 year age group. Reported by C Lowman, PHD, N Verdugo, MA, H Malin, MA, S Aitken, DPA, Alcohol Epidemiologic Data System, Div of Biometry and Epidemiology, National Institute of Alcohol Abuse and Alcoholism; Div of Surveillance and Epidemiologic Studies, Epidemiology Program Office, CDC.

Editorial Note

Editorial Note: Interpretations based on the FARS data cannot be relied upon strictly, because of the data's incompleteness. However, these findings could indicate 1) that an increase in the number of drivers using alcohol before being involved in a fatal crash led to an increase in the number of drivers suspected of alcohol use and, therefore, given a BAC test or 2) that the increase in the number of drivers who use alcohol and then drive is an artifact of improved BAC testing and reporting. The findings in Figure 1 indicate that the 1981 BAC data are more complete than FARS data for earlier years and, therefore, may be more representative of patterns of alcohol use.

Recent FARS data indicate a rapid decrease of 15% in the total number of fatal accidents in the period 1980-1982, with the major decrease occurring in 1982. After adjusting the 1980-1982 data for population changes in specific age groups, the decrease in fatalities is 5% greater among 15-19 year olds than among other age groups (4). One interpretation of the 1981 FARS data suggested that loss of work and discretionary income related to the recession may have had a greater impact on the ability of teenage drivers to afford to operate a motor vehicle and to purchase alcoholic beverages than on older drivers (5). Data on changes in mortality rates lend support to this theory; death rates from traffic fatalities among 16-19 year olds decreased from 50/100,000 persons in 1979 to 43/100,000 in 1981 (6). If subsequent analyses show that economic factors influence these events, numbers of fatal motor vehicle accidents may increase with economic recovery and growth.

References

1. Cerrelli EC. Alcohol in fatal accidents: national estimates--U.S.A. NHTSA Technical Note. Washington, D.C.: National Highway Traffic Safety Administration, Research and Development, 1983.

2. Rachal JV, Guess LL, Hubbard RL, et al. The extent and nature of adolescent alcohol and drug use: the 1974 and 1978 national sample studies. Adolescent drinking behavior, Vol. 1. Rockville, Md.: National Institute on Alcohol Abuse and Alcoholism, 1980. NTIS No. PB81199267.

3. Clark W, Midanik L. Alcohol use and alcohol problems among U.S. adults: results of the 1979 national survey. In: National Institute on Alcohol Abuse and Alcoholism. Alcohol consumption and related problems. Alcohol and Health Monograph No. 1. DHHS Pub. No. (ADM) 82-1190. Washington, D.C.: Supt. of Docs., U.S. Goverment Printing Office 1982:3-52.

4. Cerrelli EC. The 1982 traffic fatalities: early assessment. Washington, D.C.: National Highway Traffic Safety Administration, Research and Development, 1983.

5. Partyka S. The 1981 traffic fatality decrease: isolation of the affected population. Washington, D.C.: National Highway Traffic Safety Administration, Research and Development, 1983.

6. Malin HJ, Trumble J, Kaelber CT, Lubran B. Alcohol-related highway fatalities among young drivers--United States. MMWR 1982;31:641-4.

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