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The objective of this study was to summarize existing knowledge on the association between driving under the influence of alcohol and road safety outcomes and to assess factors that may explain why these estimates vary. Based on studies of the association between blood alcohol concentration (BAC) levels and crashes, we used multilevel metaregression to calculate summary effects of BAC level and analyze potential moderators of the association. Based on 60 studies and 393 effect estimates, we found that BAC level, outcome severity, use of hospital data, and geographical region contributed to heterogeneity in results. The effect of BAC on crash and injury risk and culpability is stronger at higher BAC levels and for more serious outcomes. The relationship between BAC level and outcome is approximately exponential. The relationship is stronger in studies from Nordic countries than in studies from other countries, possibly because of the relatively low level of drunk driving in these countries. Studies based on hospital data and studies using non-crash-involved control groups find smaller effects on average. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to assess the prevalence of drinking and driving on roadways in urban areas and highways in Cameroon, and to determine the associations between drinking and driving and socio-demographic factors.Methods: A cross-sectional study of motor vehicle drivers was performed on Fridays, Saturdays, and Sundays between May and September 2020 with three driver groups: (1) random motor vehicle drivers (including riders) on major highways, (2) drivers recruited at car stations in Yaoundé, and (3) at fuel stations in Douala. Alcohol was measured using breathalyzers, and a questionnaire collected socio-demographic data.Results: In total, 2402 motor vehicle drivers were asked to participate in the study and 1701 (70.8%) gave informed consent. The vast majority (98.6%) were men. Drivers aged 30-39 years constituted the largest age group on highways and in Yaoundé, whereas 18-29 years was the largest age group in Douala. The highest prevalence of alcohol was observed among drivers in Yaoundé, which included mainly clandestine taxi car drivers and motorcycle taxi riders, where about 30% had blood alcohol concentrations (BAC) above the legal limit of 0.08%. The proportion with BACs above the legal limit was about 6% among the drivers in Douala, which included mainly motorcycle taxi riders, and about 4% among drivers on highways.Conclusions: The findings indicate that drinking and driving is a major traffic safety problem on Cameroonian public roads, especially among motorcycle taxi riders and clandestine taxi drivers in towns, which represent the major mass transportation means in the country. Drinking and driving education and legislation should be better developed and enforced in order to reduce the number road traffic crashes. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this study was to estimate the number of crash deaths specifically attributable to alcohol-impaired driving, with a focus on various strategies for introducing vehicle-based solutions. If alcohol detection systems are standard in all new vehicles, how many lives could be saved in the near term, and how long will it take to essentially eliminate alcohol-impaired driving? Alternatively, if such systems are offered as an option, how many lives could be saved?Methods: Fatal crashes in the United States during 2015-2018 were classified by the highest driver blood alcohol concentration (BAC) and the corresponding age category of that driver. Based on the estimates of relative risk (RR) for a given driver group, eliminating alcohol in the driver's blood should lower risk by the attributable proportion, 1 - 1/RR. Multiplying this quantity by the number of deaths for the driver group yielded the estimated number of lives potentially saved if the BACs were reduced to zero.Results: Systems that restrict drivers with any BAC could prevent nearly 12,000 deaths per year, while systems that restrict BAC to less than 0.08 g/dL could prevent more than 9,000 deaths. Within 3 years of a mandate for vehicle-based alcohol detection systems, it is expected that the annual lives saved would be between 1,000 and 1,300. Within 6 years, it would be between 2,000 and 2,600 lives saved per year, and within 12 years it would be between 4,600 and 5,900 lives saved per year. A system required only for those convicted of alcohol-impaired driving could save between 800 and 1,000 lives per year. A system available only to fleets of vehicles could save between 300 and 500 lives per year.Conclusions: Vehicle-based interventions will not immediately solve the problem of alcohol-impaired driving, but they are an important component of the overall strategy. Even if required as standard equipment in all new vehicles, it will take 12 years before there are enough to reach more than half of their potential. If vehicle-based interventions are instead voluntary or introduced as options, then progress toward a solution will be much slower. [ABSTRACT FROM AUTHOR]

Objective: Road traffic injury (RTI) is one of the most significant public health problems in Thailand, especially during New Year and Songkran (Thai traditional New Year) holidays, which have the highest traffic density during the entire year. Drunk driving was reported to be one of the leading causes of RTI in Thailand. This study aimed to investigate the prevalence of patients with high blood alcohol concentration (BAC) and the association of BAC and specific organ injury during New Year and Songkran (Thai traditional New Year) holidays.Methods: A cross-sectional study was performed to analyze the database from the Thai Governmental Road Safety Evaluation Project. Patient data on RTIs were collected from 26 main provincial hospitals during the New Year Festival 2003 and 2004 and Songkran Festival in 2003. Patient characteristics, type of organ injured, and BAC levels were mainly analyzed.Results: During those long holidays, 2,642 RTI patients were identified, among whom 1,341 patients had high BAC levels. High BAC levels were associated with motorcycle users, male sex, middle age, teenagers, being riders or drivers, and not using protective devices. Moreover, high BAC levels were associated with brain injury.Conclusion: Excessive alcohol consumption and RTIs occurred on New Year and Songkran Festival in Thailand. Legislation should be strictly used during these long holidays to control driving under the influence of alcohol, particularly among motorcyclists. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to understand the social context and circumstances surrounding alcohol-impaired driving prior to fatal crash involvement for drivers with an illegal blood alcohol concentration (BAC ≥ 0.05 g/100 ml or 0.00 g/100 ml for restricted license holders).Methods: Coroners' case reports investigating fatal crashes in South Australia over a 3-year period (2008-2010) were examined. The personal and crash characteristics of drivers with an illegal BAC were compared with those who had a legal BAC. For each driver with an illegal BAC, information was recorded including characteristics of last trip, location and social context of alcohol consumption, quantity and type of alcohol consumed, BAC level, presence of drugs, perceived alcohol intoxication, and alcohol dependence. Official traffic offense records were also obtained.Results: Of the 284 fatal crashes included in the study, 34% (n = 95) involved a driver or rider with an illegal BAC. Prior to the crash, alcohol was most frequently consumed by drivers in rural areas, within private homes, and was part of normal social activities. Drivers recorded a high level of alcohol impairment, with a mean BAC of 0.173 g/100 ml and a level of alcohol dependence that was above the Australian national average (7.4 vs. 3.9%). In addition, 23% of drivers were known to be experiencing psychological stress at the time of the crash. The results also confirm that drink driving recidivism continues to be a significant problem, with 44% of drivers recording at least one prior alcohol driving offense.Conclusions: Alcohol-impaired driving continues to be a leading cause of fatal crashes. The popularity of drinking at home, particularly in rural areas, has implications for police enforcement strategies and suggests that drink driving interventions that focus on community values and looking after friends might be beneficial. Importantly, the study highlights the need for a broader holistic approach to reduce the high levels of alcohol consumption and alcohol dependence underlying drink driving behavior. [ABSTRACT FROM AUTHOR]

Objective: Drink driving is widely recognized as a major road safety problem. In Australia, health promotion messages encourage monitoring the number of standard drinks consumed prior to driving. This pilot research aimed to investigate commuting behavior and blood alcohol concentration (BAC) of diners, including intended drivers, at Sunshine Coast restaurants.Methods: Five hundred and forty-four diners (n = 260 males) consented to participate in a brief interview and to use a breathalyzer device to measure their BAC.Results: Forty percent of participants advised they don't drink and drive (34% of males, 45% of females; 67.25% of <17-20 years, 30.5% of 50-59 years), and of the remaining participants, 75% advised they count the number of their drinks (69% of males, 84% of females; 32% of <17-20 years, 82% of 50-59 years), while 10% of participants monitored their BAC by how they were feeling (12% of males, 6% of females). Thirty-seven percent of participants said it was easy/very easy to estimate their BAC (41% of males; 33% of females; 21% of <17-20 years, 43% of 50-59 years). The actual BAC was less than expected for 56% of participants, with one-third underestimating BAC and some intended drivers having an actual BAC in excess of the 0.05 limit.Conclusions: Given the proportion of diners who reported they count the number of drinks, or use feelings as a way to gauge BAC, coupled with the considerable proportion who underestimated their BAC, a safer public health message is to avoid driving if you intend to drink. In addition, targeted intervention for experienced drivers (and, arguably, drinkers) appears warranted, as every participant aged less than 21 years who stated he or she would drive home indeed had a zero BAC. Interestingly every female driver who stated she would be driving home also had a legal BAC, suggesting gender-specific intervention. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to explore the effects of the new traffic safety law on pedestrian mortality by exploring hazardous behaviors of pedestrians in terms of alcohol use and blood alcohol concentration (BAC).Methods: A retrospective autopsy study was performed, covering a 7-year period (from 2006 to 2012), including cases of fatally injured pedestrians who died at the scene of the incident. Blood samples obtained from the femoral vein during autopsy were analyzed for BAC. The entire sample was divided into 2 groups. The first included cases from 2006 to 2009, at which time the old traffic safety law was in force, and the second included cases from 2010 to 2012, under the new traffic safety law.Results: A total of 247 cases were examined, covering a 7-year period. The average age was 57.5 ± 19.7 years (median 61.0 years) with a significant male predominance of 147 men to 100 women. This predominance also applied to alcohol use (54 vs. 13). The results show a significant decrease in the total annual number of fatally injured pedestrians, starting from 2009, compared to previous years, reaching a low in 2010, one year after implementation of the new traffic safety law. In contrast, the proportion of alcohol-intoxicated pedestrians showed no significant difference in the years preceding and following the new traffic safety law, nor did the annual distribution of BAC or mean BAC before and after application of the new law.Conclusion: The present study indicates that the new traffic safety law has been quite effective in reducing pedestrian mortality. However, alcohol consumption and intoxication in pedestrians remains a fairly important factor in motor vehicle accidents involving pedestrians, because the proportion of pedestrians positive for alcohol, the proportion of severely intoxicated pedestrians with BAC > 1 g/L, and annual mean BAC have remained unchanged. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to determine the roadside prevalence of alcohol-impaired driving among drivers and riders in northern Ghana. The study also verifies motorists' perceptions of their own alcohol use and knowledge of the legal blood alcohol concentration (BAC) limit in Ghana.Method: With the assistance of police, systematic random sampling was used to collect data at roadblocks using a cross-sectional study design. Breathalyzers were used to screen whether motorists had detectable alcohol in their breath and follow-up breath tests were conducted to measure the actual breath alcohol levels among positive participants.Results: In all, 9.7% of the 789 participants had detectable alcohol, among whom 6% exceeded the legal BAC limit of 0.08%. The prevalence of alcohol-impaired driving/riding was highest among cyclists (10% of all cyclists breath-tested) followed by truck drivers (9%) and motorcyclists (7% of all motorcyclists breath-tested). The occurrence of a positive BAC among cyclists was about 8 times higher (odds ratio [OR] = 7.73; P < .001) and it was 2 times higher among motorcyclists (OR = 2.30; P = .039) compared to private car drivers. The likelihood for detecting a positive BAC among male motorists/riders was higher than that among females (OR = 1.67; P = .354). The odds for detecting a positive BAC among weekend motorists/riders was significantly higher than on weekdays (OR = 2.62; P = .001).Conclusion: Alcohol-impaired driving/riding in Ghana is high by international standards. In order to attenuate the harmful effects of alcohol misuse such as alcohol-impaired driving/riding, there is the need to educate road users about how much alcohol they can consume and stay below the legal limit. The police should also initiate random breath testing to instill the deterrence of detection, certainty of apprehension and punishment, and severity and celerity of punishment among drink-driving motorists and riders. [ABSTRACT FROM AUTHOR]

Objective: To identify the extent and nature of the problem and the main contributing factors to drink driving crashes; determine the current mechanisms in place, particularly in terms of legislation and its enforcement; and identify baseline data and relevant stakeholders. Methods: The situational assessment was based on the collection of secondary data from available reports and documents, in-depth interviews with key representatives at a central level, and field surveys in provinces. Results: Vietnam has experienced phenomenal growth in motor vehicles, especially motorcycles, in the last decade (400%). This initially led to an increase in deaths from road crashes, but since 2006 the number has stayed fairly level according to police statistics. However, comparisons with health data suggest that the number of deaths is much higher and there are clearly a number of problems with the relevant data systems. Data on the percentage of drivers exceeding legal limits are not available, but police statistics indicated that drinking alcohol was a contributory factor in 7 percent of motor vehicle crashes. This is likely to be an underestimate, because the police and health services do not have the equipment to measure the blood alcohol concentration (BAC) levels of all drivers in crashes. Motorcycle riders and young people are in the high-risk groups. There are strict BAC limits starting at over zero and severe punishments for drunk drivers involved in serious crashes. However, the police do not have adequate manpower or equipment to conduct regular and frequent roadside checking for drivers who have been drinking. There have also been a number of education programs on road safety including drinking and driving, but these have not included sustained and intensive campaigns targeting the high-risk groups. The National Traffic Safety Committee (NTSC) is responsible for coordinating the relevant agencies but there is still a problem with lack of information sharing between agencies. Conclusions: This study completed a comprehensive situational assessment that examined the problem of drinking and driving and identified some of the weaknesses in the current prevention system. Vietnam currently has 2 international projects on road safety and it is hoped that these together with support from the International Center for Alcohol Policies (ICAP) Global Actions program will provide opportunities for strengthening drinking and drive prevention initiatives by improving the road crash and injury database, building the capacity of the key organizations, strengthening the coordination mechanisms, and implementing and evaluating trial drink-drive interventions. [ABSTRACT FROM AUTHOR]

Objective. According to the Norwegian Road Traffic Act, car drivers are not allowed to operate a vehicle with a blood alcohol concentration (BAC) above 0.2 g/kg. Depending on the size of the boat or ship, boat drivers/captains/first mates are not allowed to conduct the boat with a BAC above 0.8 g/kg when driving small boats (length less than 15 m) and above 1.5 g/kg when running larger vessels/ships. The new Sea Act of June 2005 states that captains/first mates cannot conduct a ship if he/she has a BAC above 0.2 g/kg. Our aim was to determine the current median BAC in a large population of car and boat drivers in Norway. Our other aim was to study if median BAC was higher in boat drivers than in car drivers who were suspected by the police to be impaired. Furthermore, we wanted to investigate if the BAC levels were differently distributed by gender or age within and between these two groups. Methods. The Norwegian Institute of Public Health analyzes blood samples from all car/boat drivers suspected of driving under the influence of alcohol and non-alcoholic drugs. In the present study, samples submitted between 01.05 and 01.09 in 2002-2004 were included. Drivers, who in addition tested positive for drugs or abuse substances other than ethanol were excluded. Results. There were 321 boat drivers and 3,061 car drivers who were suspected to be under the influence of ethanol only. The median BAC in boat drivers (1.76 g/kg [range 0.02-3.54]) was significantly higher compared to that in car drivers (1.54 g/kg [range 0.00-4.27]). In the car driver group, the mean BAC did not differ significantly between men and women. The median level of BAC was significantly higher in men than in women in the boat driver group (1.77 g/kg with CI 1.69-1.85 vs. 1.27 g/kg with CI 0.78-1.76). Conclusions. Alcohol impairment of car drivers is known to be considered the most important contributing cause of car crash injuries. Driving a boat may demand the same degree of performance skills as driving a car. The median BAC in apprehended boat drivers was considerably high in the present study. The median BAC was also high in car drivers despite strict legislation. The population of drivers of cars in our study, however, is from previous studies known to contain a large proportion of heavy drinkers. Less is known about the drinking habits in boat drivers, and caution is needed in generalizing from our results. However, our results indicate the possible need for stricter legislation and more frequent police control that will hopefully prevent serious accidents caused by ethanol drinking at sea. [ABSTRACT FROM AUTHOR]

Objective. To investigate the prevalence of alcohol problems in a representative sample of Swedish drivers suspected of drunk driving in comparison with control drivers and the general Swedish population in relation to mode and time of detection. Is the time of day or night or the detection mode important for the prevalence of alcohol problems and which are the best predictors for identifying alcohol problems among DUI offenders? Methods. Two thousand and one hundred drivers (169 females) suspected of DUI offence during 1997-2001 who agreed to respond to the AUDIT questionnaire (Alcohol Use Disorders Identification Test) and 785 control drivers (266 females) not suspected of DUI recruited at general traffic controls were investigated. Results. Both mode and time of detection were found to be important. The greatest impact on the prevalence of alcohol problems emanated from the predictors in the following order: high BAC; unlicensed driving; detection hours between 12.00 and 18.00, and age under 26 years. Age over 55 years and detection in general traffic controls were the two strongest factors negatively correlated to alcohol problems prevalence. The differences between regions with regard to alcohol problems incidence could only partly be explained by police routines and resources. Conclusions. Mode and time of detection affect the prevalence of DUI offenders with alcohol problems, and to a lesser degree also BAC level. Both the detection mode and the time of detection are significant for the proportion of identified DUIs with alcohol problems. Because the majority of committed DUI offenses are never identified, it is important to optimize the detection strategies of the police with the purpose of minimizing public damage and expenses. [ABSTRACT FROM AUTHOR]