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BACKGROUND AND AIMS Sobriety checkpoints are an effective strategy to reduce alcohol-impaired driving, motor vehicle crashes, injuries, and fatalities. The aim of this study was to identify the geographic extent over which individual sobriety checkpoints affect alcohol-impaired driving. DESIGN, SETTING, PARTICIPANTS Spatial ecological panel analysis using geolocated breath test data from the Queensland Police Service, Australia, for January 2012 to June 2018. Data were aggregated over 338 weeks within 528 Statistical Area level 2 (SA2) units (n=178,464 SA2-weeks) and 84 Statistical Area level 3 (SA3) units (n=28,392 SA3-weeks). SA2 units in Queensland contain a mean population of 8,883.5 (standard deviation (SD)=5,5018,3) and encompass 468.9 roadway kilometers (SD=1,490.0); SA3 units contain a mean population of 57,201.6 (SD=29,521.6) and encompass 2,936.0 roadway kilometers (SD=7,025.0). MEASUREMENTS Independent measures were the density of sobriety checkpoints conducted per 500 roadway kilometers within local and spatially adjacent space-time units. The dependent measure was the rate of tests that detected breath alcohol concentration (a proxy for Blood Alcohol Concentration [BAC]) greater than the legal maximum value of 0.05% for fully licensed drivers in Queensland. Bayesian hierarchical spatial negative binomial models related sobriety checkpoints to the rate of breath tests with BAC≥0.05% within and between space-time units. FINDINGS One additional sobriety checkpoint conducted per 500 roadway kilometers was associated with 2.5% reduction in the rate of breath tests with BAC≥0.05% within local SA2 units (incidence rate ratio (IRR)=0.975; 95% credibility interval (CrI): 0.973, 0.978), and with 5.5% reduction in the rate of breath tests with BAC≥0.05% within local SA3 units (IRR=0.945; 95%CrI: 0.937, 0.953). Associations were attenuated towards null in spatially adjacent units and in temporally lagged units (e.g., SA3-weeks; adjacent lagged 1 week: IRR=0.969; 95%CrI: 0.937, 1.003). CONCLUSIONS Individual sobriety checkpoints appear to be associated with reductions in nearby alcohol-impaired driving. Relationships decay after approximately 1 week and beyond local areas containing approximately 60,000 residents and 3,000 kilometers of roadway.

Background Half of the offenders convicted of impaired driving in the United States are sentenced to install alcohol ignition interlock devices (IIDs), which prevent them from starting their vehicles if they have been drinking. No research has yet explored offenders' patterns of alcohol consumption and driving under the influence of alcohol (DUI) from the time before the arrest to the time period after the IID is installed. This study aims to fill that gap in knowledge. Methods Using the Timeline Follow-back interview procedure, we assessed the daily drinking of 153 convicted DUI offenders' self-reported total alcohol consumption and rates of self-reported driving after drinking over 4 phases: before DUI arrest, between arrest and IID installation, during the phase on the interlock, and after the interlock is removed. Because information about behaviors in each period was not available for every participant, comparisons were made using paired-sample contrasts. Results Compared with before the arrest, total alcohol use decreased by 50% in the 4-month phase following arrest and before IID installation, though it did not change much afterward. The frequency of drinking and driving decreased sharply after the arrest (-82%), with further decrease upon installation of the interlock (-58%, p = 0.05). The frequency of drinking and driving after the IID was removed returned to preinstallation drinking and driving status (+58%, p = 0.01). Conclusions Participants made significant adjustments to their drinking behavior by adhering to the traditional DUI driving restrictions in the postarrest phase. Although installation of an IID was not associated with a significant change in drinking, it further reduced the frequency of drinking and driving. Evaluations of the IID experience should take into account information on an individual's drinking and DUI behaviors not only before the IID was installed, but before the individual was arrested.

BACKGROUND AND AIM: In Canada, the minimum legal drinking age (MLDA) is 18 years in Alberta, Manitoba and Quebec, and 19 in the rest of the country. Given that public-health organizations not only have recommended increasing the MLDA to 19 years, but also have identified 21 years as ideal, the current study tested whether drivers slightly older than the MLDA had significant and abrupt increases in alcohol-impaired driving (AID) crimes,compared with their counterparts just younger than the MLDA. DESIGN: Regression-discontinuity approach. SETTING: Canada. SAMPLE: AID criminal incidents by drivers aged 15 to 23 years (female, n = 10,706; male, n = 44,973). MEASUREMENTS: Police-reported AID incidents from the Canadian 2009-2013 Uniform Crime Reporting Survey. FINDINGS: Significant gender-by-MLDA effects supported gender-specific models. Compared with males slightly younger than the MLDA, those just older had abrupt increases in AID incidents of 42.8% (95% CI = 20.4%-66.3%, P CONCLUSION: Release from drinking-age restrictions appears to be associated with increases inalcohol-impaired driving offenses among young drivers in Canada, ranging from 28%-43% among males and 19%-40% among females. This article is protected by copyright. All rights reserved. Language: en

Background and Objective The college student population is one of the heaviest drinking demographic groups in the US and impaired driving is a serious alcohol-related problem. The objective of this study is to better understand the relationship between alcohol-related behaviors and “plans to get home” among a sample of college students. Methods We conducted four anonymous field studies to examine associations between breath alcohol concentration (BrAC) levels, Alcohol Use Disorders Identification Test (AUDIT-C) classification, and plans for getting home among a sample of bar-attending college students (N = 713). Results, Discussion and Conclusions The vast majority of participants in our sample (approximately 95%) were not intending to drive and the average BrAC% of those intending to drive was .041. Our one-way ANOVAs indicated that (1) participants classified by the AUDIT-C as not having an alcohol problem had a significantly lower BrAC% than those classified as having a potential problem and (2) participants planning to drive had a significantly lower BrAC% than those with a plan that did not involve them driving and those without a plan to get home. Although it is encouraging that most of our sample was not intending to drive, it is important to continue to attempt to reduce impaired driving in this population. Scientific Significance This study helps college health professionals and administrators to better understand the relationship between alcohol-related behaviors and plans to get home among college students. (Am J Addict 2015;XX:XX –XX)

Emergency physicians are confronted daily with the care of traumatically injured patients. A considerable proportion of blunt trauma cases are due to motor vehicle crashes. While men have historically been overrepresented in crash-related injuries and deaths, unfavorable trends for women in alcohol-impaired driving crashes have emerged. This extended commentary with in-depth review presents an examination of the evolving role of sex and gender in alcohol-impaired driving and its outcomes.

BACKGROUND: The traditional outcome measure of the Dutch on-the-road driving test is the standard deviation of lateral position (SDLP), the weaving of the car. This paper explores whether excursions out-of-lane are a suitable additional outcome measure to index driving impairment. METHODS: A literature search was conducted to search for driving tests that used both SDLP and excursions out-of-lane as outcome measures. The analyses were limited to studies examining hypnotic drugs because several of these drugs have been shown to produce next-morning sedation. RESULTS: Standard deviation of lateral position was more sensitive in demonstrating driving impairment. In fact, solely relying on excursions out-of-lane as outcome measure incorrectly classifies approximately half of impaired drives as unimpaired. The frequency of excursions out-of-lane is determined by the mean lateral position within the right traffic lane. Defining driving impairment as having a ΔSDLP > 2.4 cm, half of the impaired driving tests (51.2%, 43/84) failed to produce excursions out-of-lane. Alternatively, 20.9% of driving tests with ΔSDLP CONCLUSIONS: Excursions out-of-lane are neither a suitable measure to demonstrate driving impairment nor is this measure sufficiently sensitive to differentiate adequately between differences in magnitude of driving impairment. Copyright © 2014 John Wiley & Sons, Ltd. Language: en

In industrialized countries one-fifth of all traffic accidents can be ascribed to sleepiness behind the wheel. Driver sleepiness can have many causes, including the use of medicinal drugs or prolonged driving. The present study compared the effects of prolonged highway driving at night with driving impairment caused by alcohol. A cross-over balanced design tested 14 healthy young men who drove three sessions during night-time on the open road. The driving sessions were of 2, 4 and 8 h (03:00-05:00, 01:00-05:00 and 21:00-05:00 hours) duration. Standard deviation of lateral position (SDLP, cm), measuring the weaving of the car in the last driving hour of each session, was the primary parameter. Only 2 h of continuous nocturnal driving were sufficient to produce driving impairment comparable to a blood alcohol concentration (BAC) of 0.05%; after 3 h of driving impairment corresponds to a BAC of 0.08%. In conclusion, a maximum of two continuous nocturnal driving hours should be recommended.

Keywords: Enforcement intensity; Fatal crashes; High visibility enforcement; Impaired driving; Sobriety checkpoints

In this paper I attempt to assess empirically the effects of Canadian impaired driving legislation enacted between 1976 to 1992. On average, penalties for impaired driving have limited impact on impaired driver fatalities. Instead, trends in impaired driver deaths are significantly correlated with the enactment of mandatory seatbelt legislation across provinces. Specifically, the implementation of mandatory seatbelt laws for drivers is significantly associated with a 27 per cent drop in impaired driver fatality rates. These findings suggest that more lives might be saved by focusing on initiatives aimed at enhancing vehicle safety.

Background: This study compared four sets of US low-risk drinking guidelines (two interpretations of the US Dietary Guidelines and two variations of the NIAAA physicians’ guidelines) in terms of adherence and how well they predicted five different alcohol-related outcomes. Methods: Using data from a nationally representative sample of 17,542 US adults 21 years of age and over who drank 12 or more drinks in the past year, this study assessed the sensitivity, specificity, overall accuracy, positive and negative predictive values, and odds ratios of the various drinking guidelines (specifically, of having exceeded them with different degrees of frequency) as predictors of alcohol dependence, impaired driving, liver disease, peptic ulcer, and hypertension. Results: The proportions of past-year regular drinkers exceeding the four sets of guidelines varied from 20.9%, whose average intake exceeded the weekly limits, to between 21.0% and 42.7% who exceeded the daily guidelines at least once a week, and to between 69.2% and 94.2% who ever exceeded the daily limits in the year preceding the interview. Sensitivity and odds ratios were highest for the ever exceeding the Dietary Guidelines daily limits, intermediate for ever exceeding the two variations based on the NIAAA physicians’ guidelines, and lowest for exceeding the Dietary Guidelines interpreted as weekly limits. The opposite pattern was observed for specificity and overall predictive accuracy. When frequently exceeding the daily limits was considered, their sensitivity declined but their specificity and positive predictive value increased. Conclusions: If sensitivity and specificity are deemed equally important, the NIAAA physicians’ guidelines incorporating both daily and weekly limits seem to do the best job of balancing these dimensions in the prediction of a variety of alcohol-related outcomes.

The objective of the current study was to assess the separate and combined effects of marijuana and alcohol on actual driving performance. Eighteen subjects were treated with drugs and placebo according to a balanced, 6-way, crossover design. On separate evenings they were given weight calibrated Delta(9)-tetrahydrocannabinol (THC) doses of 0, 100 and 200 mg/kg with and without an alcohol dose sufficient for achieving blood alcohol concentrations (BAC) of 0.04 g/dl while performing a Road Tracking and Car Following Test in normal traffic. Main outcome measures were standard deviation of lateral position (SDLP), time driven out of lane (TOL), reaction time (RT) and standard deviation of headway (SDH). Both THC doses alone, and alcohol alone, significantly impaired the subjects performances in both driving tests. Performance deficits were minor after alcohol and moderate after both THC doses. Combining THC with alcohol dramatically impaired driving performance. Alcohol combined with THC 100 and 200 mg/kg produced a rise in SDLP the equivalent of that associated with BAC=0.09 and 0.14 g/dl, respectively. Mean TOL rose exponentially with SDLP. Relative to placebo mean RT lengthened by 1.6 s under the combined influence of alcohol and THC 200 mg/kg. Changes in SDH ranged between 0.9 and 3.8 m. Low doses of THC moderately impair driving performance when given alone but severely impair driving performance in combination with a low dose of alcohol. Copyright 2000 John Wiley & Sons, Ltd.

Clock drawing is recommended by medical and transportation authorities as a screening test for unsafe drivers. The objective of the present study was to assess the usefulness of different clock drawing systems as screening measures of driving performance in 122 healthy and cognitively impaired older drivers. Clock drawing was measured using four different scoring systems. Driving outcomes included global ratings of safety and the error rate on a standardized on-road test. Findings revealed that clock drawing was significantly correlated with the driving score on the road test for each of the scoring systems. However, receiver operator curve analyses showed limited clinical utility for clock drawing as a screening instrument for impaired on-road driving performance with the area under the curve ranging from 0.53 to 0.61. Results from this study indicate that clock drawing has limited utility as a solitary screening measure of on-road driving, even when considering a variety of scoring approaches.

We examined the effects of rules to govern drinking, individual feedback on blood alcohol concentration (BAC), and public posting of group data on impaired driving on the incidence of impaired driving. Level of impairment was determined from breath samples taken from tavern patrons. Following baseline, an intervention package consisting of (a) cards to guide patrons in pacing their drinking to stay under the legal limit, (b) individual feedback on BAC, and (c) posted group feedback on the percentage of patrons driving while impaired the preceding week was introduced in two taverns. Results indicated that the intervention package did not reduce the percentage of impaired drivers departing either tavern. The addition of a brief intensive police enforcement program directed at impaired driving produced a short-term reduction in impaired driving.

Ross's (1975) assessment of the Scandinavian drinking-and-driving laws was a pivotal paper in the international literature because, in many ways, Norway and Sweden offer a critical test of the "tough approach" to deterring alcohol-impaired drivers. The present review raises some methodological and philosophical questions about Ross's approach to the Scandinavian data and examines four types of indirect evidence for deterrence in Norway and Sweden. While no conclusive evidence for deterrence could be identified, there was internal consistency in the pattern of circumstantial evidence pointing to a workable system of external restraints and internal controls in Scandinavia; and this pattern of evidence contrasted sharply with that obtained in the U.S.