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Various fitness drinks under the designation of "energy or power drinks" or "brain or athletic food" are very popular among young people. For those entrusted with rendering expert opinions that poses the question of whether consumption of these beverages is of any importance when a person's ability to drive or mental capacity has to be assessed, especially in combination with alcoholic beverages imbibed at the same time. In the case discussed here-both the 20-year-old car driver and his passenger suffered not inconsiderable injuries-an alcohol concentration of 1.2 per mille was found at the time a blood sample was taken. Furthermore, a caffeine content of 1.5 micrograms/ml was noted. A value also reached after drinking a cup of filter coffee. In contrast, values of 2 to 10 micrograms/ml are reached when caffeine is used for therapeutic purposes. Values of more than 15 micrograms/ml are considered toxic. The measured caffeine content was thus fully insignificant. The same also applies to the "active ingredients" (taurine, glucuronolactone) contained in the beverage "Red Bull". Another assumption that, namely, the effect of alcohol can be offset by such beverages could lead to a situation in which young people incorrectly assess their ability to drive after imbibing alcohol and fitness drinks. That is naturally given support by corresponding tributes by the manufacturers ("improves performance", "invigorates the mind and body").

1. The alcohol level regulation affects everyone who participates in public road, rail, shipping and air traffic. In legal terms a person participating in traffic is anyone who has a direct, physical influence on the traffic flow i.e. as a pedestrian, a vehicle driver, an aircraft captain or a train driver. Participation in any kind of traffic requires a physical, mental and psychological joint effort which is controlled by the central nervous system. The influence of alcohol drastically deteriorates driver performance to the detritment of traffic safety. In cases of traffic law determination of dangerous driving or in cases of the legal limitations of diminished or no responsibility, recognised discoveries in traffic medicine as well as blood alcohol research, psychiatry and statistics have played a significant role. The main medical-scientific used to determine the alcohol level regulation, in particular the borderline cases, essentially rely on on experiments (mainly driving experiments). These experiments are carried out with drivers under the influence of alcohol and who drive road vehicles, particularly motor vehicles. At present, no comparable, scientifically convincing research is available for the other groups of participants in traffic. Therefore, the determination of a universal alcohol level regulation including pedestrians and train drivers for example, can not be justified. Blood alcohol effect has been thoroughly researched, the metabolic reaction is well known, alcohol is easily quantifiable, its effect can be easily reviewed and is reproducible to a large extent. Therefore, due to existence of certain alcohol level values, legal conclusions can be drawn which affect all participants in traffic. The main issue is, that the blood alcohol level taken at the time of the accident is definite, regardless whether it was taken by means by a blood sample or by means of a statement of the amount of alcohol consumed. Whether or not the driving under the influence of alcohol falls under the category of "infringement of the law" or "criminal offence" depends largely on the abstract danger caused to the traffic. According to section 316 StGB a motorized or non-motorized driver under the influence of alcohol is considered to be unsafe if he/she is incapable of driving the vehicle safely for a long span of time or when sudden difficulties arise. It would apply if the alcohol has caused a personality change which would not enable the driver to drive safely despite wilfully trying. This applies respectively to drivers of vehicles that don't circulate on roads. 2. Currently, the following alcohol limit regulation applied in Germany: Criminal offences section 316, section 315 c section 1 no. 1 a StGB 1. Drivers of motor vehicles on the road--0.3 to 1.09/1000 and an additional error to due the consumption of alcohol--1.10/1000 (including the body's alcohol resorption effect) and more, with or without errors due to the consumption of alcohol. 2. Cyclists--0.3 to 1.59/1000 and an additional error due to the consumption of alcohol--1.60/1000 (including the body's resorption effect) and more, with oder without error due to the consumption of alcohol. 3. Carriage drivers, motorized wheelchair users--0.3/1000 and more and an additional error due to the consumption of alcohol. Section 316, Section 315 StGB 4. Train drivers, airplane pilots and persons in charge of ships--0.3/1000 and more and an additional error due to the consumption of alcohol. Author's opinion: airplane pilots, from 0.1/1000 even without an error due to the consumption of alcohol. Infringement of the law section 24 StVG--0.80 (including body's alcohol resorption effect) to 1.09/1000 without error due to the comsumption of alcohol. Sections 2, 69 a section 1 no. 1 StVZO pedestrians with or without special means of transport, animal leaders/animal drovers, pillion rider or passenger on a motor-bike--0.3/1000 and more and an additional error due to the consumption of alc

The Legislator's decision not to lower the 0.8 per mile alcohol level limit of the section 240 StVG runs counter to the tendency of fighting dring driving altogether. This decision was made despite the fact, that according to current medical science the risk limit lies at 0.4 per mile. It can't be justified by the "ultima ratio" principle which was introduced by the legislator for decision making. Much on the contrary, it suggests a development where considerations will no longer be applied only for the protection of the citizen. Here we can observe a continuation of the interpretation of the alcohol level limits which seem to simply serve as a means of ensuring a conviction. The economical analysis of the law is the theoretical background to this consideration which dominated by this process. This analysis does not take any further limitations of legislative powers into consideration with the exception of effectiveness, efficiency and its maximum use under the political and economic aspects. Therefore it allows the protection of the individual to be obscured by these maxims. However, lowering of the alcohol level risk limit to 0.4 per mile should not be insisted on, but instead there should be a call for the introduction of an alcohol ban altogether. This request could be justified with the lack of the legal basis of the alcohol level limits.

A retrospective study was undertaken to determine whether the degree of alcohol intoxication has an effect on the driving performance with regards to both the quantity and quality. A total of 625 accidents caused by drivers who were under the influence of alcohol were reviewed. They were divided into three groups according to the blood alcohol concentration (BAC):0.30 - 1.09 g/kg, 1.10 - 1.99 g/kg and2.00 g/kg. In order to exclude the influence of factors unrelated to alcohol, the groups were matched for age, sex, location of accident and the light and road conditions. This resulted in a total of 85 accidents in each group. The accidents were classified with reference to the "Register of causes of accidents" used in road accident statistics. The three groups differed significantly in their causes of accidents (p0.025), although those due to speeding dominated in each group. In the group with low BAC, the next most common accidents were the ones caused by failure to give way. In the group with medium BAC, rear-end collisions and accidents occurring during low speed manoeuvres were the second most common. In the group with highest BAC, the next most common causes of accidents were the leaving of the correct traffic lane unassociated with speeding.

A study of group comprising all road accidents caused by drivers of private cars who were under the influence of alcohol (BAC= 0.3 g/kg; X = 1.56 +/- 0.62 g/kg) that occurred in a defined area over the span of one calendar year (n = 625) was compared with a randomly selected control group of 718 road accidents in which the drivers had not been under the influence of alcohol. The drivers in the study group were marginally younger than the ones in the control group. However, there was no evidence of an alcohol related increase in the risk of an accident associated with younger age. The sex ratio in the study group corresponded to that, generally found amongst people driving under the influence of alcohol. In the study group there was no evidence of a restricted manner and extent of car use, based on the distances between the sites of the accidents and the offenders' homes. However, the proportion of accidents occurring out of towns was greater in the study group. Alcohol associated accidents occurred more frequently in the evenings and at night, which reflects habitual drinking patterns. Therefore these accidents occurred mainly in darkness and twilight. Surprisingly, unfavorable weather conditions such as rain or ice did not lead to an increase in accidents due to alcohol. In fact, in the study group, proportionally fewer accidents occurred on icy roads. Both injury to persons and damage to property were more severe in the study group. While no relationship between accident severity and blood alcohol concentration could be proven within the study group, the risk of death or severe injury was 3 to 4 times greater in this group than in the control group.

In order to be able to give an accurate legal judgement of a drink driving offense, the BAC at the time of the offense has to be determined. The calculation which may be necessary is based on the time of blood sampling and on the time of the offense. The authors examined records of 854 blood samples taken in the years 1979 and 1989 with regards to the times recorded. Blood sampling recorded on the hour or on the half hour could be found four times more frequently than would have been statistically expected. Blood sampling recorded to the nearest five or ten minutes were documented three times as often as those ending on the exact minute. Times of the offense were recorded at least ten times as often to the nearest five minutes. The rounding up of times could cause discrepancies of more than 0.01% when calculating the BAC at the time of offense.

The ethanol determination using the ADH/REA method (Abbott TDx-REA) is based on the principle of radiative energy attenuation (REA) applying the classic ADH-method. However, instead of measuring the extinction of the reaction product NADH, a chromogen formed by a coupled diaphorase reaction is measured. Serum, whole blood and urine are used for ethanol determination without prior treatment. The following analytical procedures such as sampling, addition of reagents and measuring are automated. Sample solutions of 100 to 200 microliters should be used. Daily calibration of the apparatus is recommended. Both precision and reproducibility meet the requirements of BAC-assays in forensic specimens. The results obtained by using gas chromatography and ADH/REA method show an excellent correlation (factor r = 0.9977). The ADH/REA method has proved to be a reliable assay procedure in routine determination of the BAC in forensic samples.

Driving ability of 34 males under minor influence of alcohol was tested at the ART 90 test unit of the Austrian Road Safety Board. Furthermore, 22 males not under the influence of alcohol, formed part of the sober control group. Some months previously, all volunteers had completed a driver aptitude test consisting of identical tests for all participants. Therefore a before-and-after analysis as well as a comparison of the different groups could be carried out by means of MANOVA. A high motivational level was guaranteed in the first tests as all test persons' driver qualification depended on the results of their driver aptitude tests. Months later they were invited to participate in this study on a voluntary basis. The second tests took place immediately after a social evening at which 8 volunteers were present at any one time. To create conditions as near to reality as possible, only alcohol that would be readily available to the public was served. An entertainer ensured an equally cheerful and relaxed atmosphere in both the experimental and control groups. Alcohol levels were measured by means of the Siemens breathalyser. Results show that as early as an average alcohol level of 0.67/1000 performance is significantly impaired: three times more errors in concentration tests, twice as many errors in reaction tests, twice as many observation errors in visual structuring and a considerable reduction of reactive stress tolerance. On the other hand quantitative dimensions of performance such as reaction time are not significantly impaired. In addition, the readiness to take risks increases with alcohol consumption as is shown by means of questionnaire.

During a drinking experiment 20 young male volunteers were asked to estimate the amount of their BAC and commented on their driving ability and their readiness to participate in road traffic. During the resorption phase the majority of the volunteers estimated their BAC too low, whereas in the early elimination phase most of their estimates were to high. The majority of the volunteers felt able to drive throughout the whole experiment which demonstrates an impairment of essential control functions as early as low to medium alcohol intoxication.

By evaluating 100 drinking experiments the formula put forward by Zink and Reinhardt for calculating the BAC at the time of the incident (maximum BAC = BAC at the time of blood sampling + 0.2/1000 per hour + 0.2/1000 added value for the first hour) was tested for its validity in cases when long time spans have to be taken into consideration. This evaluation showed that in cases of high BACs the elimination rate of ethanol during 8 or 9 was even higher than expected when the formula was applied. Even when increasing the additional value for the first hour to 0.3/1000, the calculated maximum BAC did not match the actual BAC measured in all cases.

The aforementioned case proves very convincingly that a very high dose of alcohol consumed within a short time span can be absorbed completely within 2 hours. Numerical models based on low to moderate alcohol consumption were lower than expected in cases of severe alcohol intake. The claim of alcohol consumption after an event can best be verified by means of a drinking experiment under intensive medical supervision.

We report about the allegedly new sobering up preparation called PARTY-PLUS, the ingredients of which resemble very much those of the inefficient "drink with a sobering up effect NEUKAMM-lemonade". In a drinking experiment Verum vs. Placebo (a light mineral water) the inefficiency of the alcohol elimination kinetics is proved once again, especially with regards to the extent of success suggested in advertising. Official bodies of administration of justice and legislation are called upon to oppose such doings of manufacturers and distributors more firmly. This is necessary because expected side effects and health hazards due to the high fructose contents are deliberately played down or concealed altogether.

The role played by alcohol in pyromania and arson was examined. We had a total of 103 arsonists, 95 of which were men and 8 women. 69 of the offenders had only started one fire, 34 had started more than one. 70 offenders were under the influence of alcohol at the time of the arson, 54 were alcoholics altogether. Adults were usually under the influence of alcohol, whereas adolescents were quite often not. Psychotics were generally not under the influence of alcohol. With regard to marital status, married arsonists showed the highest level of alcohol consumption. Offenders who started fires during the night were usually under the influence of alcohol, very drunk or even alcoholics. There were significant connections between the frequency and level of alcohol consumption and the number of previous convictions. Pyromania is classed as some form of psycho infantilism. In adults, it may be found in the form of an alcohol toxic regression in many different psychological disorders. However, it is found most commonly in unstable people with personality disorders.

While making investigations into microbiological literature, the following question was looked into: Are microorganisms able to generate methanol from the basic carbon frame of ethanol? Due to carbon monoxide dehydrogenase complexes some methanogens and acetate oxidisers are able to cleave the carbon bond of acetyl-CoA. Coenzyme bonded methyl groups (methyl-H4MPT, methyl-CoM, methyl-THF) are generated both by means of reduction (methano-genesis) and by means of oxidation (CO2 evolution) of the C2-unit. Usually these are looked at as precursors of methanol. Methanotrophs and certain methylotrophs are able to oxidise methane to methanol by means of oxigenase complexes. The C1-unit supplies coenzyme bonded CO; carbon monoxide can be reduced to methanol very effectively by several Clostridia. Both in vivo analysis of intestinal gases of alcoholised individuals and incubation experiments with certain intestinal groups with marked alcohol, might contribute in judging the real importance of the intestinal micro flora with regard to the problems of ethanol congeners.

Alcohol elimination was examined in 10 patients involved in accidents while intoxicated. The influence of trauma, particularly polytrauma resulting in haemorrhage shock and its therapeutic treatment were analysed. The blood alcohol concentrations were determined according to the usual forensic criteria (2 alcohol dehydrogenase and 2 gas chromatography measurements). Observation periods ranged from 3 hours 45 minutes to 12 hours 35 minutes, with blood being drawn at intervals ranging from 45 minutes to 185 minutes (on average 70 minutes). Results of two patients (delta 60 = 0.22/1000/h and 0.28/1000/h) who only had 3 venous drawn and results of a deceased patient from whom only four arterial samples could be obtained (beta 60 = 0.21/1000/h) were disregarded when working out the average values. The blood alcohol curve plateaued in the case of the deceased patient as well as in the case of a patient whose hepatic circulation was curtailed for approximately half an hour during surgery. The blood alcohol curves for the remaining patients for uniformly linear with beta 60 values between 0.17/1000/h and 0.21/1000/h (mean = 0.18/1000/h +/- 0.01) in arterial samples and 0.18/1000/h and 0.21/1000/h (mean = 0.18/1000/h +/- 0.01) in venous samples. Given our results and the existing literature, we feel that retrograde calculations of the BAC can be justified in patients with polytrauma, despite the small number of patients included in the study. Naturally, the usual forensic criteria have to be taken into account, as well as individual situations. Examples that can be mentioned here are liver failure or curtailment of hepatic circulation during surgery.

With the co-operation of a further 13 institutes and as a continuation of our own epidemiological-statistical survey, we recorded the total and relative distribution (frequency profile) of the blood alcohol concentration of car drivers for the 3rd quarter 1990 and the 1st quarter 1991. The participating institutes recorded almost 27,000 blood samples and compared them with results of the first part of the study (1989). The survey dealt separately with sex-, age- and time of day-distribution of drivers involved and not involved in road accidents. One of our repeatedly presented field research into the problem of "alcohol and road safety", once again, provided to be a useful method in the run-up to the unprejudiced alcohol test which we are striving for. We noticed characteristic changes in the frequency profiles of the old and the new counties (Bundesländer) in Germany in the 1st (1989) and the 2nd (1990/91) report of the study. The results of Police supervisory operations in the administrative district of Cologne have basically given useful indications as to their epidemiological-statistical value as evidence.

Women account for about 12% of all cases of drink driving in German cities. Little is known about their drinking behaviour and the extent of their alcohol misuse. In order that these questions may be clarified, three major studies were evaluated. In these studies, additional indicators for alcohol misuse such as GGT or methanol and acetone+isopropanol or indeed CDT, GGT, methanol and acetone+isopropanol were measured in blood samples. The results were compared with studies of the same kind on male car drivers. There were no significant differences in the ages of males and females. However, there were no differences at all regarding the frequency of the blood alcohol levels or the CDT. Indicators levels of chronic alcohol abuse, such als GGT levels above 70 U/L, methanol levels above 10.00 mg/kg or acetone+isopropanol concentrations above 9.00 mg/kg were approximately the same with women as they were with men. This demonstrates an increasing similarity amongst male and female DWI drivers regarding the drinking behaviour and alcohol abuse.

We report about the investigation of stored blood samples carried out at the Institute for Legal Medicine in Greifswald between 3. 10. 1990 and 3. 10. 1994. In 12 of the 13 checks carried out (92.3%) the blood alcohol and the control sample were found to be identical, in both the serological test and the DNA analysis. In one of the cases the accused could be excluded by means of 5 different systems. Merely 2 of the 13 orders came from our catchment area (East-Mecklenburg and Vorpommern). In 11 cases the checks were carried out on behalf of courts in the country of Brandenburg. Despite the low number of expert opinions, the stored blood sample is thought to be an indispensible piece of evidence.

Breath alcohol simulators with aqueous solutions of ethanol (equilibrators) are suitable for simulating the measuring process with a person, while testing different functions of an evidential breath analyser including the temperature measuring device. Therefore they are commonly used for random tests. They are unsuitable for an absolute calibration if the coefficient of solubility of ethanol can not be presumed. Absolute calibrations require the transformation of a known quantity of ethanol within a defined volume into a gaseous state. The concentration of the gas produced in such a way then has to be measured with the analyser to be tested and must be compared with the calculated value. A measuring device with a large volume piston pump was constructed for this purpose. The values of the solubility coefficient coincide with internationally used values.

Assessing the problem of "alcohol in road traffic" it becomes apparent that most offenders have high BACs (in excess of 1.6 per mille) and that they are repeating offenders. It can therefore be assumed that those people are drink-drivers, which means that, when assessing the offence, the offender's personality as a whole has to be taken into consideration. The DUI offenders themselves usually justify the offence by balming it on the circumstances of a given situation. On the basis of this discrepancy, the published study deals with the question of whether there are any differences between the way DUI offenders judge their personality and self concept and the way other people do. This also leads to the questions of whether the number of offences play a role or not. The self image of 60 male DUI offenders was rated by means of the Giessen test and the Frankfurt self concept scales "problem solving", "confidence in behaviour and decision making", as well as "judgement by others". For the outside judgement, 60 male volunteers were asked to judge DUI convicted drivers. It showed that the DUI convicted drivers assessed their personality to be no different than that of the average person. Their self concept was characterised by positive attributes. However, the outside judgement showed them to be less socially responsive, lacking self control, as well as rather dominant, depressive, reserved and rather inhibited in heterosexual relationships. The self judgement changes with an increasing number of offences, as does the outside judgement to an even greater extend. The latter turns into a more negative judgement. Regarding the self concepts, only the outside judgement proved to be more negative. The number of convictions didn't influence the DUI offenders' self estimation.

Statistical analysis of 46,972 recorded blood samples and the relevant BAC classification revealed the following points: 1. A correlation between the BAC level at the time of the first offence and the probability of a recurrence could not be proved. 2. Most recurrences took place within three years. 3. The probability of a recurrence rises with the number of offences.

In a case where a mix up of blood samples was claimed, an identity check was carried out by means of four single-locus-probes. DNA analysis produced identical profiles with two of the probes (MS 31 and MS 43). With the two other probes one matching and one differing fragment could be detected respectively (MS 1 and g3) In addition to the unambiguous statement "no identy", the DNA analysis proved that the tested blood samples must have been those of two closely related people, most probably of brothers and sisters. Attempted fraud can be assumed from these findings. Further investigations and additional DNA analysis which included a blood sample of the brother of the accused, revealed that the sample for the identity check had been taken from the brother and not from the accused himself.

Several thousand blood samples were taken from alcoholized drivers at the Blood Alcohol Examination Centre of the Institute of legal Medicine at Cologne University. These samples showed blood alcohol contents (BAC) as well as GGT, CDT, methanol, acetone and isopropanol levels which indicated alcohol addiction. The blood samples were selected by the drivers' ages and their BAC, but in some cases the GGT also played a role. In the majority of cases 1 or 2 parameters were measured. In 200 cases all four indicators were determined. The four parameters characterize a different problematic drinking behaviour. GGT characterizes chronic, long-term misuse, CDT characterizes occasional misuse, methanol characterizes current addicted drinking and acetone and isopropanol characterize metabolic disorders caused by alcohol. The importance of parameters is thoroughly discussed, also in relation to incorrectly measured positive values and the relation between alcohol consumption and -problems. Methanol values above 10 mg/kg, GGT activities above 100 U/l and CDT levels above 60 U/l provide sufficient proof of there being an alcohol problem which requires treatment. The levels of other indicators need not be above normal to determine this. The proportion of drivers under the influence of alcohol with problematic alcohol levels increases significantly when the BAC is above 2.0 per mille. However, there have been drivers with alcohol problems with lower BAC levels. DUI offenders addicted to alcohol are quite frequently over 40 years old. A correlation between the single indicators and the BAC is rarely found. If a correlation is to be found, it would be most likely with drivers whose BAC lies above 2.0 per mille. The mentioned indicators would detect an alcohol problem from the blood sample taken for the blood alcohol test. Alcohol problems may be detected and treated shortly after the DUI offence. This method is comparatively cheaper than medical-psychological-examinations as well as being based on objective and verifiable parameters.

The Institute for Legal Medicine in Hamburg carried out a retrospective analysis for identity checks of stored blood samples. A total of 70,597 blood alcohol examinations were carried out between 1984 and 1993. Identity checks were commissioned for 187 people (0.26% of the total of all blood samples). Amongst those, 33 cases of "non-identity" were established (17.6% of all checked blood samples). The results are compared to an earlier study by Kleiber over a span of 10 years--between 1974 and 1983. While the frequency of identity checks decreased, the cases of "non-identity" increased quite drastically in comparison. In the cases where "non-identity" could be detected, it was not a matter of blood samples getting mixed up. However, it was a matter of intentional, sometimes very cunning ploys by means of other people's IDs, forged IDs and impersonations. In these cases the later checking of the blood group systems proved to be important evidence in the criminal proceedings. This evidence would not be available if there were to be no blood alcohol tests.

Twenty young male volunteers carried out a drinking experiment during which they underwent the Romberg standing test and the Unterberger treading test. These tests were carried out three times each in a sober state, 25 minutes and 2 hours after alcohol consumption. The balance tests were recorded, evaluated and documented by means of a Cranio-Corpo-Graphy. The Romberg standing test proved to be the more sensitive indicator of impaired balance, even when only slightly under the influence of alcohol. Both the degree of anterior-posterior and of lateral swaying increased according to the BAC and decreased after the end of absorption. Only lateral swaying was similarly recorded with the Unterberger test.

1,000 blood samples from drivers tested for alcohol were screened specifically for active constituents and metabolites of medicines of the benzodiazepine class. 42 blood samples contained benzodiazepines and a total of eight different active constituents were detected. The active constituents of Valium, Vegesan or Tranxilium, Lexotanil and Seresta have to be dealt with primarily. In addition to benzodiazepine 35 samples showed an alcohol level of over 0.08%. This raised the question of whether the benzodiazepine level measured in the blood samples would intensify the effect of the alcohol. Four categories were formed in order to be able to compare the levels of the various benzodiazepines. According to this categorisation the benzodiazepine concentration was classed as very high in 4 cases, high in 7 cases, moderate in 26 cases and low in 10 cases.

Saccadic eye movements were registered under different ethanol concentrations (0 g/kg, 0.5 g/kg, 1.0 g/kg) using an infrared reflexion method. On the basis of photographic pictures conflict situations of a car driver were simulated. 12 young car drivers were exposed for 10 sec to four pictures, all under different ethanol concentrations. The eye movements were registered and analyzed by a computer. The amplitude of saccades, their number, duration and velocity as well as the points of fixation and the scanning of the pictures were qualitatively and quantitatively analyzed. All persons demonstrated deficits in all parameters under 1 g/kg blood ethanol concentration. Nearly all results were reduced under 0.5 g/kg in comparison to 0 g/kg situation. In conclusion, low dose ethanol influence the saccadic eye movements. On the other hand the study could demonstrate a new technique (infrared reflexion technique), which allows the qualitative and quantitative recording of the influence of ethanol as well as peripheral as cortical structures of the brain. The exposition to photographic pictures demonstrating dangerous traffic situations simulate real traffic situations and allows to transfer the laboratory results to real situations.

GGT and blood alcohol concentration (BAC) were measured of 2,655 male car drivers using alcoholized their cars during the year 1991 in the area of the city of Cologne. The results were evaluated statistically together with other parameters like age, time of taking blood sample and behaviour while drunken. BAC was 1.6% and more in 30.5% of all cases. Half of them had levels of 2.0% and higher. GGT in serum was increased (28 U/l) at 29.5% of the drivers, in 6% even above 100 U/l. 53% were younger than 31 years. Medium BAC and part of GGT higher than 28 U/l were remarkable lower in this group than at the older ones. 50% of all car drivers with blood alcohol levels above 2.0% have alcohol problems regarding GGT. Problem drinkers were found among the younger ones to an extent of 15%, but of 50% among the drivers older than 40 years. But also 25% of all with a BAC lower than 1.6% showed increased GGT levels. They remain undetected on account of the present instructions of MPA though there is a great danger repeating drunken driving. On the other side nearly 50% of those driving with an BAC of 1.6% or more are no driving drinkers regarding GGT but have to undergo MPA. The recommendation of the 30. German Traffic Courts Meeting in 1992 to determine other indicators of alcohol habituation in the blood samples taken after drunken driving like GGT and methanol should be taken in a corrected setting of the instructions. This would regard fairer the problems of an individual case. The connection of MPA with the height of BAC and other circumstances seen as indicators for extraordinary alcohol habituation is a wrong way and unnecessary if alcoholism markers are used like GGT, CDT and methanol.

Determination of blood alcohol concentration and water content were performed on blood specimens from 71 bodies. Two blood specimens were sampled from each body. First-specimens (short-time-specimens) were sampled from 0 to 9.6 hours postmortem, in mean 2.1 hours. Second-specimens (long-time-specimens) were sampled from 8.0 to 229.9 hours postmortem. The relation between the blood alcohol concentration and the blood water content in the two blood specimens (first and second) is described by a multiple regression equation. The equation gave as result: if the body had no signs of putrefaction, the difference in water content between the short-time-specimens and the long-time-specimens has a significant influence on the blood alcohol concentration. This was not the case if the body had visible signs of putrefaction. Then other factors influence the blood alcohol concentration more than the water content. Our study also indicates that if a blood alcohol determination is performed on whole blood, and the blood specimen was sampled shortly after death from a case of bleeding shock, a correction of the blood alcohol concentration should be done if the blood water content is higher than 82%.

Drinking experiments were performed by using a device-combination appreciated by the German National Institut of Health (BGA) as being evidential and proposed as prototype for the future practice of breath-alcohol analysis. Comparing the breath- (BrAC) and blood alcohol-concentrations (BAC), however, there were relevant deviations. Our evaluation of the facts published Schoknecht demonstrated nevertheless distinct divergences in comparison to the blood alcohol determination: A BAC-nominal of 1% gave divergences of the nominal up to 0.25% resulted from the measured BrAC-values of Schoknecht on corresponding conversion. The divergences are distinctly above those that are tolerated by legislation according to previous standards for the blood alcohol determination. Consequently it requires further checking in standardized experiments and field experiments in order to be able to judge the practice usefulness; furthermore such further checking would have to be implemented by unconcerned institutions. Basing on these experiments an evidential breath-alcohol analysis for forensic purposes has not been established yet.

In Austria, automobile drivers are obligated to undergo a breathalizer test if they are suspected of driving under the influence of alcohol. Drivers cannot be forced to take the test, but if they refuse, their conduct is then dealt with as a violation of civil law and is therefore punishable by law. If the Alcomat test yields an alcohol content of 0.4 ml/l, i.e. relevant amount, the suspect then has the right to demand that a blood test be carried out. If the authorities refuse to give him this test, then the suspect will not be held to have been in excess of the legal alcohol level by the civil authorities in the following proceedings. On the other hand, in a legal criminal proceeding, the suspect will then be found guilty of exceeding the legal alcohol level, if additional evidence--which must be examined by the judge within the framework of the free consideration of evidence (a principle recognized by Austrian law but not, for example, by American law)--suffices to show with relative certainty that the suspect exceeded the alcohol limit as defined in section 81 Z2StGB). If a blood test is completed and the results differ from those of the breathalizer, then the blood test results are used.

A crossover investigation of the ethanol concentration decline after oral and parenteral administration of ethanol respectively was performed with direct intra- and interindividual comparison. No significant differences in relation to the kind of administration were noted. An influence of the circadian rhythm on the rate of decline could be excluded. The low beta 60 values derived (average: 0.111 g/kg/h) can be explained by the long period over which the probands were denied food.

The pretest, which measures the alcohol content in one's breath, will remain necessary within the field of police work regardless as to whether this process will be recognized in the future as a means of reaffirming existing evidence. Inaccurate measurements, especially those which are lower than should be in the area of 0.08% and 0.11%, lead to inaccurate rulings, which in turn, directly influence traffic safety. After examining 682 breathalizer measurements, the Hamburg police department released the following information: even after having replaced the older Dräger AT 7310 with the newer AT 7410 breathalizer, larger discrepencies than those that had appeared in earlier examinations still occurred. There are too many inaccurate measurements which, in actuality, are overwhelmingly a result of the conditions surrounding police use of breathalizers. More detailed instructions describing proper application of these devices are, at present, more suitable for increasing the accuracy of the breathalizer measurements than the technical improvement of the instruments would be.

The canton of Vaud is one of the major wine-growing areas of Switzerland. The driving ban rate for drunk driving is the highest in the country. This is the result of the very important rise in the number of drivers intercepted by the police for drunk driving (accidentless cases), in the course of the last ten years (+260%). In order to find out what penal and administrative measures were taken against drunk drivers (those who did not commit an accident), a comparative retrospective study of the offenses committed in the area of Lausanne and in rural area of the canton of Vaud (La Broye) was undertaken. This study deals with the years of 1970 and 1989. In a parallel, the average blood alcohol concentration (BAC) value, relative distribution of the BAC (frequency profile), and the concordance between the doctor's medical examination and the suspect's BAC were studied. Our results demonstrate that only the urban area (Lausanne) showed a significant increase in the drunk-driving offenses without accident, resulting in a significant decrease in the average BAC value as well as a veering towards the left of the BAC frequency profile curve. The legal sanctions and the administrative measures diverge according to the different areas, the most striking fact is the lowering of the average term of imprisonment for second-time or multiple offenders in the study group of Lausanne. The results of the clinical examination undertaken by the doctor at the moment of the blood test have shown that there is often a difference between the clinical evaluation and the actual BAC: for a BAC of 2 to 3/1000, the objective clinical symptoms of drunkenness (Romberg, unstable gait, coordination troubles) are noticed in only half of the cases. As a result, the assessment is no longer based on objective criteria but on subjective criteria as well as on the life-style of a certain period. In conclusion it is our belief that the efforts made by the vaudois police (especially in urban areas) should be pursued further, since positive results are apparent. The Judiciary system should however rebalance the sanctions delivered to drunk-drivers, showing greater severity towards second-time or multiple offenders.

In this article a survey on the three Dutch Alcohol Courses is given, which are constructed as short information-projects. They all were first developed in Assen, but meanwhile one of them is in use everywhere in the Netherlands. While these courses are rather efficient in increasing knowledge and influencing attitudes of people, they are less successful in preventing recidivism. Nevertheless these courses are important supplements to the penal sanctions we use traditionally as they strengthen an integrated penal system that fits with modern democratic principles.

In the successor states of former Czechoslovakia, the law enforces the principle of 0.0% alcohol content in blood while operating a motorized vehicle. Those persons who break this law can be punished according to either section 201 StGB "Jeopardizing others while under the influence of addictive substances" or section 201 a StGB which regulates "drunk driving" instances. Various sanctions can also be imposed: 1) imprisonment; 2) confiscation of driver's license; 3) monetary fine. Within the judicial framework, driving while intoxicated, 0.1% alcohol content in blood, is absolutely forbidden, and in some cases, an alcohol content of 0.08% is sufficient to place the suspect under the same laws regulating 0.1% category. The alcohol content in the blood is usually determined by means of a blood or urine test.

About two years ago pharmacies in the Federal Republic of Germany began to offer motorists test sticks named "Alco Screen" in order to evaluate the concentration of alcohol in the saliva. According to the producers it should be a quick and simple method giving a high correlation between the alcohol level both in blood and saliva. As advertised, a drunken driver could estimate his own extend of alcohol impairment by himself. We checked the reliability of this method by comparing the alcohol level in the blood with the extend of colour change of the sticks in 20 adult volunteers engaged in drinking tests. 85% of them demonstrated distinct discrepancies. In most cases the saliva concentration estimated was too low. Those, depending on the result of this test kit, take a high risk of being misled and can probably assume sobriety in contrast to their actual state. A warning concerning this test is necessary.

For the processing and evaluation of a large number of data obtained in the course of blood alcohol determination the use of computerized systems is essential. By applying the software Skylight a data management program was developed under Windows. After entering the case data (name of the person involved, type of offence, time of accident and of blood sampling etc.) and BAC-values the evaluation of the data is automatically performed, e.g. calculation of the mean value, BACs at the time of event (minimum and maximum value). The user is guided by screen menus, which facilitate the entry of data. Reports are created by using predesigned formats retrieved from a report file. The data base system is installed on a local network. Access is permitted by password only to guarantee optimal security of the data.

After representing figures and facts about drinking behaviour and drinking-driving offences of the 45 mio. drivers in Germany counter-measures for DWI-offenders are dealt with. The proceedings practised so far are critically analysed and new approaches are discussed. Primarily reviewed are special preventive measures and here particularly the selection procedure usually applied in Germany, in which on demand of the driver licensing authorities the question is to be answered by expert opinions whether there is to be reckoned with driving under the influence in die future, too. It is pointed out that the expert opinions are not valid enough for making a distinct decision in an individual case. Validity coefficients obtained in evaluation studies lie between phi = 0 and .28, raising the expectancy value of 50% resulting by chance at best only on to 65%. Moreover the psychological interview is understandably burdened with faked answers of the explored person, in several cases increased by a specific, professionally managed preparation for the testing situation. As a way out of the dilemma expert opinions prognosticating driver behaviour should be waived in favour of making diagnoses and proposals for treatment. The timing of regranting the driver license is then only determined by the revocation period pronounced by the court and by the performance of the measures recommended by the experts and demanded by the licensing authority. As a support for such a procedure a more consistent and resolute administration of the judicial revocation of driver license with longer periods for repeaters should be provided. Besides there is necessary a wider range of rehabilitation programs for drivers with alcoholic problems.

Within the framework of a comparative cross-national study led by INRETS, France, in 1991/92, representative surveys of drivers were conducted in 15 European countries. The survey covered a wide spectrum of biographical driver data as well as opinions and attitudes to practically all subjects of road traffic. In this context, the "drinking and driving" subject was of special interest. A comparison was made between drivers from 10 countries with a legal BAC limit of 0.08% and drivers from 5 countries with a legal BAC limit of or under 0.05%. Drivers from countries with a legal BAC limit below 0.08% state more often that they never drive after drinking even a small amount of alcohol; have been stopped and breathalysed by the police on at least one occasion; expect to be stopped and breathalysed by the police on a typical journey. They further advocate more breath tests by the police in their country and harsher penalties for drivers found to be over the limit. Where low legal BAC limits are in force, they are accepted in most cases. The extent to which these basically positive attitudes may also be relevant on the traffic scene, cannot be answered based on this survey alone. It is common knowledge that opinions and attitudes represent only one determining factor of a whole complex of factors influencing behaviour.

A blood methanol test which was done in addition to routine diagnosis of the blood methanol level of persons with alcohol driving delicts in the past who were alcoholized during the medical-psychological investigation (MPU) produced differently significant cues for (pre) alcoholism in nearly all persons. As a result 15 out of 40 persons reached a blood methanol level of 10 mg% and more (24 more persons a level between 1.5 and 9.9 mg%). This is a clear indicator of pathological alcohol drinking. Persons with a breath alcohol concentration from 0.2 to 0.99/1000 showed an average blood ethanol concentration of less than 10 mg%, but above 1.5 mg%, where as those persons with an alcohol level above this limit had a blood methanol concentration significantly above 10 mg%. The arithmetical mean and the standard deviation were significantly elevated compared to the range of reference, an effect that didn't show as clearly with the median of the Gamma-glutamyltransferase (GGT). The mean corpuscular volume of erythrocytes (MCV) reacted less sensitively. The correlation between the five parametres (blood ethanol at the last alcohol driving delict, breath alcohol concentration, GGT, MCV, blood methanol) were all significantly positive with one exception: the correlation between the breath alcohol and the blood methanol level. Altogether the results support the hypotheses that the protective assertions of the subjects concerned are hard to believe, even those of persons with a lower blood alcohol level. An additional test of the blood methanol level should be done, however, with persons reaching an alcoholization between 0.2 and 1.0/1000 during the MPU.(ABSTRACT TRUNCATED AT 250 WORDS)

From 1980 to 1990 the number of female drunken drivers increases significantly from 5.33% to 7.87% in Germany. Women between 25 and 55 years old are overrepresented, especially the 35-45 aged. The number of women, who had been sentenced for the first time because of drunken driving significantly decreases from 12.75% in 1985 to 9.07% in 1990 within the total subpopulation of those who were medical-psychologically examined in Münster. The blood-alcohol-concentrations (BACs) of the women examined in Münster were analyzed. There were no differences in the average BACs and in the variance. In every year the examined women were part of the same population of people with similar problems. The average BACs are 2.04/1000 (1980), 2.2/1000 (1985) and 2.01/1000 (1990). The analysis of the results of the medical-psychological examinations shows no significant difference between men and women in 1990. In 1980, 1985 and 1990 there was no increase in negative judgements because of medical reasons, in 1980 only one woman was suggested to participate in a driver-improvement-course and in 1985 significantly less women were rejected because of psychological reasons. This was caused by a significant increase in positive judgements in the subgroup of those women, who had more than one drunken driving offence or other incidents. The results show, that those women examined in Münster belong to the group of people who drink alcohol in an excessive an abnormal way. The equal treatment of women and men by the examining psychologists can be regarded as justified. In respect to the different conditional structure responsible for abnormal drinking of women in comparison to men it is necessary to examine women and men in different ways.

Already as early as 1955 the German Federal Board of Health pointed out that the legal treatment of drunken drivers according to traffic (criminal) law regulations was not in accord with the proven effects of alcohol upon the human system and traffic safety. The Board of Health therefore recommended a revision of the regulation. The acceptable percent of alcohol in the blood of a driver should not exceed 0.08% while the said person is operating a motorized vehicle. Further, if a driver is found to be over the limit, he will be punished by law. This author has shown the extent to which policymakers have gone in attempting to pass laws which concur with recommendations resulting from scientific/medical research. Regarding this issue, it is especially disturbing that little attempt has been made to assimilate East German law into West German law.

After sniffing of glue solvents (mixture of aliphatic hydrocarbons: boiling fraction 60-90 degrees C, ethylacetate and toluene) a blood alcohol concentration of 1.96 permille was indicated with an instrument using the infrared wavelength of 3.4 micrometer for the spectrophotometrical determination of breath alcohol. Testing of the individual solvents with a simple manual procedure showed linear relationships between concentrations in breathing air and the false positive breath alcohol values. Aliphatic hydrocarbons predominantly are responsible for the false positive breath alcohol determination. With 500 micrograms/liter a value of nearly 1.5 permille can be produced (using the factor of 2100 for the calculation of the blood alcohol concentration from breath alcohol). With ethylacetate or toluene up to 1 milligram/liter 0.5 permille ethanol in the blood will erroneously be found. The problem of recognition of crossreactive other gases by the measurement at two wavelengths (3.4 and 9.2 micrometer) is discussed.

During a drinking experiment 12 persons were tested with two different breath-alcohol analysers. Both instruments fulfill essential requirements according to the expertise of the Federal Health Office concerning the forensic applicability of breath analysers. One instrument was equipped with different measuring systems (infrared system and fuel cell). The other instrument had only an infrared system and in each case two measurements were performed with this system. With both instruments breath temperature and breath volume were determined, so that the BrAC values could be compared after they were related to the reference temperature of 34 degrees C. Taking into consideration the course of BrAC as a function of time a measuring precision of all systems was found which can be characterized by a standard deviation of less than 0.01 mg/l.

We examined the period breath-alcohol values may be falsified owing to gasoline vapors with regard to the Alcomat currently used in routine tests. In a sober test person the breath-alcohol concentration was found to be 0.10/1000 24 min. after the inhalation of gasoline vapors, whereas the value measured after 28 min. was still 0.09/1000. 63 min. after the clothes had been moistened with gasoline, a breath-alcohol concentration of still 0.11/1000 could be identified immediately after inhalation.

The salivary ethanol concentration correlates very well with the serum level (r = 0.98) in samples which are obtained almost simultaneously from persons undergoing a traffic control. If ethanol was referred to the aqueous compartment the saliva/plasma ratio was about 0.85; this ratio was about 11% less than the theoretical one and remained constant over the entire concentration range applied. Saliva could be taken together with breath samples from traffic participants which are controlled for ethanol consumption. The advantage of saliva in favour of blood is that it can be obtained nearly simultaneously with the breath sample without the intervention of a physician and does not hurt the person under suspicion. Furthermore saliva is suited for the voluntary surveillance of former alcoholics who are willing to prove that they are able to live abstinently.

4.135 measurements of breath- and blood-alcohol concentration were performed by police in 1986 and 1987 using the Alcomat A 11 (wavelength 3.4 microns). Important conclusions from these measurements can be derived with regard to legal breath-alcohol limits. The parameter for judgement is the breath- to blood-alcohol concentration ratio. Extreme deviations which have to be considered as malfunctions were found only in 0.4% of all cases, despite of the fact that not all precautions for evidential measurements are fulfilled. The reasons for malfunction may result from faulty breath- or blood-alcohol determinations or may simply be errors of transfer. The frequency of relatively too high breath-alcohol values (e.g. by interfering substances) is nearly the same as of relatively too low values (e.g. by too small breath volume). It has to be considered that the requirements according to the expertise of the Federal Health Office for evidential breath-alcohol measurements are only fulfilled partly. Especially the influence of breath-temperature is disregarded although the influence on frequency distributions is important as the comparison with other measurements demonstrates. A further result shows that the frequency distribution of the breath- to blood-alcohol ratio does not depend on blood-alcohol values.

When breathalyser tests are used to detect whether a person in charge of a vehicle is incapable of activing due to the influence of alcohol. The difficulties which arise are not limited to the extent to which these modern methods are forensically sound but extend to the question whether it is legally permissible to implement random breathanalysing. It is doubtful whether a duty to take a breath test, as yet unrecognized by the law (cf. section 36 Abs. 5 StVO), would be in conformity with the constitution. According to the established case-law of the Constitutional Court nobody can be compelled to put himself in danger of incriminating himself under the criminal law by their own act (under the principle "nemo tenetur se ipsum accusare"), which in this case would be a hard and prolonged breath into a breathalyser. The author sets the strict legal limits within which random breathalysing may be enforced.