Overview
Alcohol-related motor vehicle crashes kill someone every 31 minutes
and nonfatally injure someone every two minutes (NHTSA 2006).
But there are effective measures that can be taken to prevent
injuries and deaths from impaired driving.
Occurrence and
Consequences
-
During 2005,
16,885 people in the U.S. died in alcohol-related motor vehicle
crashes, representing 39% of all traffic-related deaths (NHTSA
2006).
-
In 2005,
nearly 1.4 million drivers were arrested for driving under the
influence of alcohol or narcotics (Department of Justice 2005).
That’s less than one percent of the 159 million self-reported
episodes of alcohol–impaired driving among U.S. adults each year
(Quinlan et al. 2005).
-
Drugs other
than alcohol (e.g., marijuana and cocaine) are involved in about
18% of motor vehicle driver deaths. These other drugs are
generally used in combination with alcohol (Jones et al. 2003).
-
More than half of
the 414 child passengers ages 14 and younger who died in
alcohol-related crashes during 2005 were riding with the drinking
driver (NHTSA 2006).
- In 2005, 48 children age 14 years and younger who were killed as pedestrians or pedalcyclists were struck by impaired drivers (NHTSA 2006).
Cost
Each year, alcohol-related crashes in the United States cost about $51 billion (Blincoe et al. 2002).
Groups at Risk
-
Male drivers
involved in fatal motor vehicle crashes are almost twice as
likely as female drivers to be intoxicated with a blood alcohol
concentration (BAC) of 0.08% or greater (NHTSA 2006). It is
illegal to drive with a BAC of 0.08% or higher in all 50 states,
the District of Columbia and Puerto Rico.
-
At all levels of blood alcohol concentration,
the risk of being involved in a crash is greater for young
people than for older people (Zador et al. 2000). In 2005, 16%
of drivers ages 16 to 20 who died in motor vehicle crashes had
been drinking alcohol (NHTSA 2006).
-
Young men
ages 18 to 20 (under the legal drinking age) reported driving
while impaired more frequently than any other age group (Shults
et al. 2002, Quinlan et al. 2005).
- Among motorcycle drivers killed in fatal crashes, 30% have BACs of 0.08% or greater (Paulozzi et al. 2004).
· Nearly half of the alcohol-impaired motorcyclists killed each year are age 40 or older, and motorcyclists ages 40 to 44 years have the highest percentage of fatalities with BACs of 0.08% or greater (Paulozzi et al. 2004).
-
Of the 1,946
traffic fatalities among children ages 0 to 14 years in 2005,
21% involved alcohol (NHTSA 2006b).
- Among drivers involved in fatal crashes, those with BAC levels of 0.08% or higher were nine times more likely to have a prior conviction for driving while impaired (DWI) than were drivers who had not consumed alcohol (NHTSA 2006).
Prevention Strategies
Effective measures to prevent injuries and deaths from impaired driving include:
-
Aggressively
enforcing existing 0.08% BAC laws, minimum legal drinking age
laws, and zero tolerance laws for drivers younger than 21 years
old in all states (Shults et al. 2002, Quinlan et al. 2005).
-
Promptly
suspending the driver's licenses of people who drive while
intoxicated (DeJong et al. 1998).
-
Sobriety
checkpoints (Elder et al. 2002).
-
Health
promotion efforts that use an ecological framework to influence
economic, organizational, policy, and school/community action (Howat
et al. 2004; Hingson et al. 2006).
-
Multi-faceted
community-based approaches to alcohol control and DUI prevention
(Holder et al. 2000, DeJong et al. 1998).
- Mandatory substance abuse assessment and treatment for driving-under-the-influence offenders (Wells-Parker et al. 1995).
Other suggested measures include:
-
Reducing the legal limit for blood alcohol
concentration (BAC) to 0.05% (Howat et al. 1991; National
Committee on Injury Prevention and Control 1989).
-
Raising state and federal alcohol excise taxes
(National Committee on Injury Prevention and Control 1989).
- Implementing compulsory blood alcohol testing when traffic crashes result in injury(National Committee on Injury Prevention and Control 1989).
CDC Research and Evaluation
Actions to decrease alcohol-related fatal crashes involving young drivers have been effective
Over the past 20 years, alcohol-related fatal crash rates have
decreased by 60 percent for drivers ages 16 to 17 years and 55
percent for drivers ages 18 to 20 years, according to a study from
the Centers for Disease Control and Prevention (CDC). However, this
progress has stalled in the past few years. To further decrease
alcohol-related fatal crashes among young drivers, communities need
to implement and enforce strategies that are known to be effective,
such as minimum legal drinking age laws and "zero tolerance" laws
for drivers under 21 years of age.
Related article:
Elder RW, Shults RA. Trends in alcohol involvement in fatal
motor vehicle crashes among young drivers – 1982-2001. MMWR
2002;51:1089–91.
Sobriety checkpoints reduce
alcohol-related crashes
Fewer alcohol-related crashes occur when sobriety checkpoints are
implemented, according to a CDC report published in the December
2002 issue of Traffic Injury Prevention. Sobriety checkpoints are
traffic stops where law enforcement officers systematically select
drivers to assess their level of alcohol impairment. The goal of
these interventions is to deter alcohol-impaired driving by
increasing drivers’ perceived risk of arrest. The conclusion that
they are effective in reducing alcohol-related crashes is based on a
systematic review of research about sobriety checkpoints. The review
was conducted by a team of experts led by CDC scientists, under the
oversight of the Task Force on Community Preventive Services—a
15-member, non-federal group of leaders in various health-related
fields. (Visit
www.thecommunityguide.org
for more information.) The review combined the results of 23
scientifically-sound studies from around the world. Results
indicated that sobriety checkpoints consistently reduced
alcohol-related crashes, typically by about 20 percent. The results
were similar regardless of how the checkpoints were conducted, for
short-term “blitzes,” or when checkpoints were used continuously for
several years. This suggests that the effectiveness of checkpoints
does not diminish over time.
Related article:
Elder RW, Shults RA, Sleet DA, Nichols JL, Zaza S, Thompson RS. Effectiveness of sobriety checkpoints for reducing alcohol-involved crashes. Traffic Injury Prevention 2002;3:266-74.
Stronger state DUI prevention activities
may reduce alcohol-impaired driving
Strong state activities designed to prevent driving under the
influence (DUI), including legislation, enforcement, and education,
may reduce the incidence of drinking and driving, according to a
study from the Centers for Disease Control and Prevention (CDC). For
the study, which was published in the June 2002 issue of Injury
Prevention, CDC analyzed data from the 1997 Behavioral Risk Factor
Surveillance System (BRFSS) national telephone survey, and the
Mothers Against Drunk Driving (MADD) Rating the States 2000 survey,
that graded states on their DUI countermeasures from 1996-1999.
Results showed that residents of states with a MADD grade of "D"
were 60 percent more likely to report alcohol-impaired driving than
were residents from states with a MADD grade of "A." MADD based the
grades on 11 categories of prevention measures, including DUI
legislation; political leadership; statistics and records
availability; resources devoted to enforcing DUI laws;
administrative penalties and criminal sanctions; regulatory control
and alcohol availability; youth DUI legislation; prevention and
education; and victim compensation and support.
The study also found that 4 percent of the residents who consume
alcohol reported they had driven after having too much to drink at
least once during the previous month. Men were nearly three times as
likely as women to report alcohol-impaired driving, and single
people were about 50 percent more likely to report alcohol-impaired
driving than married people or those living with a partner.
Related article:
Shults RA, Sleet DA, Elder RW, Ryan GW, Sehgal M. Association
between state-level drinking and driving countermeasures and
self-reported alcohol-impaired driving. Injury Prevention
2002;8:106–10.
Research identifies effective
interventions against alcohol-impaired driving
CDC and the Task Force on Community Preventive Services—an
independent, nonfederal panel of community health experts—published
systematic reviews of the literature for eight community-based
interventions to reduce alcohol-impaired driving. The reviews
revealed strong evidence of effectiveness for 0.08% blood alcohol
concentration (BAC) laws, minimum legal drinking age laws,
sobriety checkpoints, and mass media campaigns (under certain
conditions). They also found sufficient evidence of effectiveness
for lower BAC laws specific to young or inexperienced drivers (zero
tolerance laws), school-based education programs to reduce riding
with a drinking driver, and intervention training programs for
alcohol servers. They found insufficient evidence of effectiveness
to recommend the use of designated driver programs.
The systematic review of the effectiveness of 0.08% BAC laws for
drivers was helpful in establishing a 0.08% standard nationwide. The
review revealed that state laws that lowered the illegal BAC for
drivers from 0.10% to 0.08% reduced alcohol-related fatalities by a
median of 7 percent, translating to 500 lives saved annually. With
this evidence, the Task Force on Community Preventive Services
strongly recommended that all states pass 0.08% BAC laws. In October
2000, the President signed the Fiscal Year 2001 transportation
appropriations bill, requiring states to pass the 0.08% BAC law by
October 2003 or risk losing federal highway construction funds. As
of October 1, 2003, 45 states and the District of Columbia had
enacted 0.08% BAC legislation.
In June 2001, Tommy G. Thompson, Secretary of the Department of
Health and Human Services, awarded the Secretary’s Award for
Distinguished Service to the CDC researchers who conducted
systematic reviews for their contribution to the field. In September
2006, Mothers Against Drunk Driving (MADD) presented the Ralph W.
Hingson Research in Practice National President’s Award to the CDC
research team to recognize their important contributions to reducing
alcohol impaired driving.
Related articles:
Elder RW, Nichols JL, Shults RA, et al. Effectiveness of school-based health promotion programs for reducing drinking and driving and alcohol-involved crashes: a systematic review. American Journal of Preventive Medicine 2005;28(5S):288-304.
Ditter S, Elder RW, Shults RA, et al. Effectiveness of designated driver programs for reducing drinking and driving and alcohol-involved crashes: a systematic review. American Journal of Preventive Medicine 2005;28(5S):280-7.
Elder RW, Shults RA, Sleet DA, et al. Effectiveness of mass media campaigns for reducing drinking and driving and alcohol-involved crashes. American Journal of Preventive Medicine 2004;27:57-65.
Elder RW, Shults RA, Sleet DA, et al. Effectiveness of sobriety checkpoints for reducing alcohol-involved crashes. Traffic Injury Prevention 2002;3:266-74.
Shults RA, Elder RW, Sleet DA, Nichols JL, Alao MA, Carande-Kulis VG, et al. Reviews of evidence regarding interventions to reduce alcohol-impaired driving [published erratum appears in American Journal of Preventive Medicine 2002;23:72]. American Journal of Preventive Medicine 2001;21(4S):66–88.
References
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A, Zaloshnja E, Miller T, Romano E, Luchter S, et al. The Economic
Impact of Motor Vehicle Crashes, 2000. Washington (DC): Dept of
Transportation (US), National Highway Traffic Safety Administration
(NHTSA); 2002. Available from URL:
http://www.nhtsa.dot.gov/people/economic/
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DeJong W. Hingson R. Strategies to reduce driving under the influence of alcohol. Annual Review of Public Health 1998;19:359–78.
Department of Justice (US), Federal Bureau of Investigation (FBI). Crime in the United States 2005: Uniform Crime Reports. Washington (DC): FBI; 2005 [cited 2006 Nov 3]. Available from URL: http://www.fbi.gov/ucr/05cius/index.html
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Paulozzi LJ, Patel R. Changes in motorcycle crash mortality rates by blood alcohol concentration and age – United States, 1983 - 2003. MMWR 2004;53(47):1103-6.
Quinlan KP, Brewer RD, Siegel P, Sleet DA, Mokdad AH, Shults RA, Flowers N. Alcohol-impaired driving among U.S. adults, 1993-2002. American Journal of Preventive Medicine 2005;28(4):345-350.
Shults RA, Sleet
DA, Elder RW, Ryan GW, Sehgal M. Association between state-level
drinking and driving countermeasures and self-reported
alcohol-impaired driving. Inj Prev 2002;8:106–10.
Wells-Parker E,
Bangert-Drowns R, McMillen R, Williams M. Final results from a
meta-analysis of remedial interventions with drink/drive offenders.
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Zador PL, Krawchuk SA, Voas RB. Alcohol-related relative risk of driver fatalities and driver involvement in fatal crashes in relation to driver age and gender: an update using 1996 data. Journal of Studies on Alcohol 2000;61:387-95.
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