Evaluation of Maryland's state police impaired driving reduction effort (SPIDRE)

Objective: Alcohol-impaired driving is a significant factor in fatal and serious injury-producing crashes in the United States and many other countries. In 2013, the State of Maryland implemented an anti-driving under the influence (DUI) enforcement program, called the State Police Impaired Driving Reduction Effort (SPIDRE). This enforcement effort consisted of a select team of 7 police officers from the Maryland State Police who engaged in high-intensity driving under the influence (DUI) enforcement. The purpose of this evaluation was to determine the impact of the SPIDRE program on impaired-driving crashes, DUI arrests, DUI adjudicative outcomes, and public perceptions of DUI enforcement.

Methods: Data from alcohol-related crashes, arrests, and adjudicative outcomes of those arrests were used, along with data obtained from public opinion and bar patron surveys, to compare counties where the SPIDRE program operated and non-SPIDRE counties where it did not. The evaluation period extended from 2010 to 2016 in monthly intervals. Autoregressive integrated moving average (ARIMA) methods were used for the data analyses of crashes and arrests.

Results: There was no significant reduction in alcohol-related crashes as reported by the police associated with the SPIDRE program. However, there was a statistically significant decrease in the ratio of single-vehicle nighttime to multiple-vehicle daytime crashes in the SPIDRE counties but not in any other counties, suggesting a positive effect using this surrogate measure of impaired-driving crashes. The specific comparison counties as well as the other non-SPIDRE counties in Maryland experienced a statistically significant decrease in DUI arrests during the evaluation period, whereas the SPIDRE counties did not show such a decrease. Further, the arrests made by the SPIDRE team resulted in a significantly higher rate of positive adjudicative outcomes than arrests made by non-SPIDRE officers in those counties where the SPIDRE team operated. There was no evidence that the public was more aware of DUI enforcement efforts in the SPIDRE counties than in the non-SPIDRE counties.

Conclusions: The SPIDRE program appeared able to prevent a downward trend in DUI arrests, experienced by the rest of the state, and achieved higher quality arrests resulting in more positive adjudicative outcomes. The way in which the SPIDRE team was deployed may have lacked sufficient duration and intensity (e.g., only 2–3 months of activity in any given county) to achieve a reduction in alcohol-impaired-driving crashes as reported by the police. It is recommended that the SPIDRE team increase its enforcement activities for at least 9–12 consecutive months in the county where they are employed.     

Delays in DUI blood testing: Impact on cannabis DUI assessments

Objective: This study examined the time from law enforcement dispatch to the first blood draw in cases of driving under the influence (DUI) vehicular homicide and a subset of DUI vehicular assault cases in Colorado in 2012. Laboratory toxicology results were also examined to understand the implications of delays in blood draws in cases of driving while under the influence of marijuana's delta-9-tetrahydrocannabinol (THC).

Methods: Colorado court records were reviewed and information regarding charges, presence of alcohol and/or drugs, time of law enforcement contact and blood draw, crash location, and other contextual factors were identified. The distributions of first blood draw times were studied by charge and by responding law enforcement agency. Toxicology data from a different cohort of DUI traffic arrests in Colorado and Washington were examined to determine the proportion of blood tests for THC that were above specified legal limits in those states.

Results: The average time from law enforcement dispatch to blood draw in cases of vehicular homicide and vehicular assault was 2.32 h (SD ± 1.31 h), with a range of 0.83 to 8.0 h and a median of 2.0 h. Data from DUI traffic arrests found that between 42 and 70% of all cannabinoid-positive traffic arrests tested below 5 ng/ml THC in blood, which is the legal limit in Colorado and Washington.

Conclusion: Given the current delays to blood testing in cases of arrests for vehicular homicide and vehicular assault in Colorado, many blood tests are unlikely to confirm that drivers who are impaired from smoking marijuana have THC levels above established legal limits.     

A comparison of overtime patrol stops made inside and out of cluster identified hotspots

Objective: The annual rate of impaired driving crashes in the United States has remained nearly constant over the last decade. While engineers, educators, enforcement, and emergency response personnel have worked diligently in their combined efforts to reduce the loss of life, there is still significant progress to be made. One area of recent interest is the use of data driven enforcement. The basis for data driven enforcement is the use of statistical clustering to identify geographic areas that represent the location of problem identification for various criminal or traffic offenses. In the case of impaired driving fatalities, the clustering represents locations with high rates of impaired driving crashes. Law enforcement officers and supervisors may allocate resources towards more specifically and efficiently addressing problem areas.

Methods: While data driven enforcement has been proven to be an effective tool in addressing crime and traffic safety problems, it has been a slow process for agencies to adopt data driven techniques. This study aims to explore the difference in traffic stops made inside and outside of hotspot identified areas. The study uses data from the Stark County Operating a Vehicle Impaired Task Force between 2013 and 2014.

Results: The analysis determined that stop occurring in hotspot defined areas are more likely to result in impaired driving arrests and seatbelt citations. Additionally it is found that the average cost of impaired driving arrests is significantly cheaper for stops occurring inside of hotspot areas.

Conclusion: Clustering as a means of directing law enforcement efforts are a way to increase the productivity and benefits of law enforcement agencies with limited finances or personnel. From this study it is seen that traffic stops made within defined cluster or hot spot areas are more effective in resulting in OVI arrests.     

Drinking and driving and perceptions of arrest risk among California drivers: Relationships with DUI arrests in their city of residence

Objective: Addressing drinking and driving remains a challenge in the United States. The present study aims to provide feedback on driving under the influence (DUI) in California by assessing whether drinking and driving behavior is associated with the DUI arrest rates in the city in which the driver lives; whether this is due to perceptions that one can get arrested for this behavior; and whether this differed by those drivers who would be most affected by deterrence efforts (those most likely to drink outside the home).

Methods: This study consisted of a 2012 roadside survey of 1,147 weekend nighttime drivers in California. City DUI arrest rates for 2009–2011 were used as an indicator of local enforcement efforts. Population average logistic modeling was conducted modeling the odds of perceived high arrest likelihood for DUI and drinking and driving behavior within the past year.

Results: As the DUI arrest rates for the city in which the driver lives increased, perceived high risk of DUI arrest increased. There was no significant relationship between either city DUI arrest rates or perceived high risk of DUI arrest with self-reported drinking and driving behavior in the full sample. Among a much smaller sample of those most likely to drink outside the home, self-reported drinking and driving behavior was negatively associated with DUI arrests rates in their city of residence but this was not mediated by perceptions.

Conclusion: The results of the present study suggest that perceptions are correlated with one aspect of DUI efforts in one's community. Those who were more likely to drink outside the home could be behaviorally influenced by these efforts.     

Impaired driving enforcement practices among state and local law enforcement agencies in the United States

IntroductionAlcohol-impaired driving (DUI) persists as a substantial problem, yet detailed data on DUI enforcement practices are rarely collected. The present study surveyed state and local law enforcement agencies about their DUI enforcement activities.MethodTelephone interviews were conducted with law enforcement liaisons in state highway safety offices. Officers from a nationally representative sample of municipal, county, and state law enforcement agencies were also interviewed about their agency's DUI enforcement activities, including the types of enforcement, frequency of use, and whether activities were publicized. Response rates were 100% among law enforcement liaisons, 86% among county agencies, 93% among municipal agencies, and 98% among state agencies.ResultsBased on the highway safety office survey, 38 states conducted sobriety checkpoints in 2011. Nationally, 58% of law enforcement agencies reported that they conducted or helped conduct sobriety checkpoints during 2011–12, with 14% of all agencies conducting them monthly or more frequently. The vast majority (87%) of agencies reported conducting dedicated DUI patrols. However, dedicated DUI patrols were less likely to be publicized than checkpoints. Less than a quarter of agencies reported using passive alcohol sensors to improve detection of alcohol-impaired drivers.ConclusionsResults show that 38 states conducted sobriety checkpoints in 2011, little changed from a previous survey in 2000. Despite evidence of effectiveness, many agencies do not conduct frequent, publicized DUI enforcement or use passive alcohol sensors.Practical applicationsThe survey suggests that there are several areas in which impaired driving enforcement could be improved: increasing the frequency of special enforcement, such as sobriety checkpoints and/or dedicated patrols; publicizing these efforts to maximize deterrent effects; and using passive alcohol sensors to improve detection of alcohol-impaired drivers.     

Associations between driving under the influence or riding with an impaired driver and future substance use among adolescents

Objective: Risky driving behaviors among adolescents, such as riding with a drinking or impaired driver (RWID) or driving while under the influence (DUI) of alcohol or drugs, are significant public health concerns. Few studies have examined associations of RWID and DUI with future substance use and problems after controlling for baseline substance use. Given that the DUI/RWDD event may be a teachable moment to prevent future consequences (e.g., when injured or arrested), it is important to understand how this risk behavior relates to subsequent use and problems. This study therefore examined characteristics of adolescents who reported DUI and RWID and assessed their risk of future alcohol and marijuana use and consequences 6 months later.

Methods: Participants were 668 adolescents aged 12 to 18 (inclusive) recruited at 1 of 4 primary care clinics in Pittsburgh and Los Angeles as part of a larger randomized controlled trial. They completed surveys about their health behaviors at baseline and 6 months after baseline. We examined baseline characteristics of adolescents who reported DUI and RWID and then assessed whether past-year DUI and RWID at baseline were associated with alcohol and marijuana use and consequences 6 months after baseline.

Results: Fifty-eight percent of participants were female, 56% were Hispanic, 23% were Black, 14% were White, 7% were multiethnic or other, and the average age was 16 years (SD?=?1.9). At baseline, participants who reported RWID or DUI were more likely to be older, report past-year use of alcohol and marijuana, and more likely to have an alcohol use disorder or cannabis use disorder versus those who did not report RWID or DUI, respectively. At 6-month follow-up and after controlling for baseline demographics and baseline alcohol use, RWID was associated with more frequent drinking episodes in the past 3 months and greater number of drinks in the past month when they drank heavily. DUI at baseline was associated with more frequent heavy drinking episodes and alcohol and marijuana consequences 6 months later.

Conclusions: RWID and DUI are significantly associated with greater alcohol and marijuana use over time. This study highlights that teens may be at higher risk for problem substance use in the future even if they ride with someone who is impaired. Prevention and intervention efforts for adolescents need to address both driving under the influence and riding with an impaired driver to prevent downstream consequences.     

The impact of retail beverage service training and social host laws on adolescents' DUI rates in San Diego County,California

Introduction: Driving under the influence (DUI) citations are still a serious concern among drivers aged 16–20 years and have been shown to be related to increased risk of fatal and nonfatal crashes. A battery of laws and policies has been enacted to address this concern. Though numerous studies have evaluated these policies, there is still a need for comprehensive policy evaluations that take into account a variety of contextual factors. Previous effort by this research team examined the impact of 20 minimum legal drinking age–21 laws in the state of California, as they impacted alcohol-related crash rates among drivers under 21 years of age while at the same time accounting for alcohol and gas taxes, unemployment rates, sex distribution among drivers, and sobriety checkpoints. The current research seeks to expand this evaluation to the county level (San Diego County). More specifically, we evaluate the impact of measures subject to county control such as retail beverage service (RBS) laws and social host (SH) laws, as well as media coverage, city employment, alcohol outlet density, number of sworn officers, alcohol consumption, and taxation policies, to determine the most effective point of intervention for communities seeking to reduce underage DUI citations.

Methods: Annual DUI citation data (2000 to 2013), RBS and SH policies, and city-wide demographic, economic, and environmental information were collected and applied to each of the 20 cities in San Diego County, California. A structural equation model was fit to estimate the relative contribution of the variables of interest to DUI citation rates.

Results: Alcohol consumption and alcohol outlet density both demonstrated a significant increase in DUI rates, whereas RBS laws, SH laws, alcohol tax rates, media clusters, gas tax rates, and unemployment rates demonstrated significant decreases in DUI rates.

Conclusions: At the county level, although RBS laws, SH laws, and media efforts were found to contribute to a significant reduction in DUI rates, the largest significant contributors to reducing DUI rates were alcohol and gas taxation rates. Policy makers interested in reducing DUI rates among teenagers should examine these variables within their specific communities and consider conducting community-specific research to determine the best way to do so. Future efforts should be made to develop models that represent specific communities who are interested in reducing DUI rates among drivers aged 16–20 years.     

Risk factors for the severity of injury incurred in crashes involving on-duty police cars

Objective: This article explores the risk factors associated with police cars on routine patrol and/or on an emergency run and their effects on the severity of injuries in crashes.

Methods: The binary probit model is used to examine the effects of important factors on the risk of injuries sustained in crashes involving on-duty police cars.

Results: Several factors significantly increase the probability of crashes that cause severe injuries. Among those causes are police officers who drive at excessive speeds, traffic violations during emergency responses or pursuits, and driving during the evening (6 to 12 p.m.) or in rainy weather. Findings also indicate some potential issues associated with an increase in the probability of crashes that cause injuries. Younger police drivers were found to be more likely to be involved in crashes causing injuries than middle-aged drivers were. Distracted driving by on-duty police officers as well as civilian drivers who did not pull over to let a police car pass in emergency situations also caused serious crashes.

Conclusions: Police cars are exempted from certain traffic laws under emergency circumstances. However, to reduce the probability of being involved in a crash resulting in severe injuries, officers are still obligated to drive safely and follow safety procedures when responding to emergencies or pursuing a car. Enhancement of training techniques for emergency situations or driving in pursuit of an offender and following the safety procedures are essential for safety in driving during an emergency run by police.     

Low-manpower checkpoints: can they provide effective DUI enforcement in small communities?

OBJECTIVE: Sobriety checkpoints can be effective in reducing alcohol-impaired driving. Checkpoints are underutilized, however, partially because police believe a large number of officers are required. This study evaluated the feasibility and impact of conducting small-scale checkpoints in rural communities. METHODS: Law enforcement agencies in two counties agreed to conduct weekly checkpoints for one year. Two nonadjacent counties did not undertake additional checkpoints. Evaluation included public-awareness surveys and roadside surveys (including blood alcohol concentration [BAC] measurements) of weekend nighttime drivers. RESULTS: Relative to drivers in the comparison counties, the proportion of drivers in the experimental counties with BACs >0.05% was 70% lower. Drivers surveyed at driver's license offices in the experimental counties after program implementation were more likely to report seeing or passing through a checkpoint and were more aware of publicity on driving under the influence (DUI) enforcement. CONCLUSIONS: Small rural communities can safely and effectively conduct low-staff sobriety checkpoints on a weekly basis. Such programs can be expected to result in large reductions in drivers operating at higher BACs.     

Factors associated with driving under the influence of alcohol

Objective: This study examined the risk factors of driving under the influence of alcohol (DUI) among drivers of specific vehicle categories (DSC). On the basis of this research, the variables related to DUI and involvement in traffic crashes were defined. The analysis was conducted for car drivers, bicyclists, motorcyclists, bus drivers, and truck drivers.

Method: The research sample included drivers involved in traffic crashes on the territory of Serbia in 2016 (60,666). Two types of analyses were conducted in this study. Logistic regression established the correlation between DUI and DSC and the The Technique for Order of Preference by Similarity to Ideal Solution (Multi-criteria decision making) method was applied to consider the scoring and explore the potential for the prevalence of DUI on the basis of 2 data sets (DUI and non DUI).

Results: The study results showed that driver error and male drivers were the 2 most significant risk factors for DUI, with the highest scores and potential for prevalence. The nonuse of restraint systems, driver experience, and driver age are the factors with a significant prediction of involvement in an accident and an insignificant prediction of DUI.

Conclusions: Following the development of the logistic prediction models for DUI drivers, testing of the model was conducted for 3 control driver groups: Car, motorcycle, and bicycle. The prediction model with a probability greater than 50% showed that 77% of car drivers were under the influence of alcohol. Similarly, the prediction percentage for motorcyclists and bicyclists amounted to 71 and 67%, respectively. The recommendation of the study is that drivers whose DUI probability is above 50% should be potentially suspected of DUI. The results of this study can help to understand the problem of DUI among specific driver categories and detect DUI drivers, with the aim of creating successful traffic safety policy.     

Sobriety checkpoints: evidence of effectiveness is strong, but use is limited

There is substantial and consistent evidence from research that highly publicized, highly visible, and frequent sobriety checkpoints in the United States reduce impaired driving fatal crashes by 18% to 24%. Although checkpoints are not conducted in 13 states for legal or policy reasons, there is strong evidence that if conducted appropriately, checkpoints would save lives in the other states. However, a recent survey of checkpoint use has demonstrated that despite the efforts of the U.S. Department of Transportation to encourage checkpoint use through publications, providing funds for equipment, and for officer overtime expenses, only about a dozen of the 37 states that conduct checkpoints do so on a weekly basis. The survey found that lack of local police resources and funding, lack of support by task forces and citizen activists, and the perception that checkpoints are not productive or cost effective are the main reasons for their infrequent use. This article discusses each of these problems and suggests a method for local communities to implement checkpoints without depending on state or federal funds. Low-staffing sobriety checkpoints conducted by as few as three to five officers have been shown to be just as effective as checkpoints conducted by 15 or more officers. A modified sobriety checkpoint program using passive alcohol sensors ("PASpoints") can be implemented by small- to moderate-sized communities in the United States to deter impaired driving. If implemented in a majority of communities, this strategy has a potential level of effectiveness similar to the high level achieved by several Australian states in their random breath-test (RBT) programs. The PASpoint system calls for a small group of three to five officers on traffic patrol duty to converge on a preset site and conduct a mini-checkpoint, returning to their standard patrol duties within two hours. Within this framework, the PASpoint operation would become a standard driving under the influence (DUI) enforcement technique regularly used within the community's jurisdiction. As a standard traffic enforcement activity, the cost would be covered by the normal enforcement budget.     

Spatial patterns of off-the-system traffic crashes in Miami–Dade County,Florida, during 2005–2010

Objective: The objective of this study is to analyze the spatial distribution of the vehicles involved in crashes in Miami–Dade County. In addition, we analyzed the role of time of day, day of the week, seasonality, drivers’ age in the distribution of traffic crashes.

Method: Off-the-system crash data acquired from the Florida Department of Transportation during 2005–2010 were divided into subcategories according to the risk factors age, time of day, day of the week, and travel season. Various spatial statistics methods, including nearest neighbor analysis, Getis-Ord hot spot analysis, and kernel density analysis revealed substantial spatial variations, depending on the subcategory in question.

Results: Downtown Miami and South Beach showed up consistently as hotspots of traffic crashes in all subcategories except fatal crashes. However, fatal crashes were concentrated in residential areas in inland areas.

Conclusion: This understanding of patterns can help the county target high-risk areas and help to reduce crash fatalities to create a safer environment for motorists and pedestrians.     

Driving under the influence of alcohol and the effects of alcohol prohibition—Case study in Serbia

Objective: The purpose of this study is to provide an overview of the prevalence of driving under the influence of alcohol (DUI) according to day of the week, specific roads (urban/rural), daytime or nighttime, and vehicle category. In addition, this study examines how the prohibition of selling alcoholic drinks in shops and supermarkets (not in restaurants) after 10 p.m. has affected the prevalence of DUI.

Method: Breath alcohol concentration (BrAC) was collected from all drivers through police checkpoints at 54 locations in Serbia. In this study, 17,945 drivers were tested in urban areas and 19,507 in rural areas. The relationship between DUI during the prohibition on alcohol sales in Belgrade and other large cities in Serbia was determined using logistic regression.

Results: On average, every 100th driver in traffic in Serbia was DUI (0.99%). This study shows that the 0 blood alcohol concentration (BAC) limit for motorcyclists does not have an influence on DUI. Moreover, motorcyclists represent the category with the highest share of DUI, with a statistically significantly larger difference compared to drivers of other vehicle categories. These results may be a consequence of the fact that a large number of drivers drive both motorcycles and other vehicle categories (cars or mopeds), so the different BAC limits for nonprofessional drivers may create confusion about the legal BAC limit.

Conclusions: This study suggests that the required legal BAC limit for nonprofessional drivers should be the same. The prohibition of selling alcoholic drinks in Belgrade after 10 p.m. does not decrease the prevalence of DUI.     

DUID prevalence in Colorado's DUI citations

IntroductionThere are limited studies that measure the prevalence of driving under the influence of drugs (DUID) based upon impairment measures because most prevalence studies are based on drug tests. The aim of this study was to provide the first estimate of DUID prevalence in Colorado using data collected by Colorado law enforcement officers in vehicular homicide (VH) and vehicular assault (VA) cases, and reported in court records.MethodsThe four research questions of this study were answered by completing independent t-tests or Mann–Whitney U tests, Pearson chi-square analyses or Fisher's exact tests, and Kruskal–Wallis tests.ResultsSeventy percent (119 out of 170) of the cases involved alcohol only and 30% (51 out of 170) involved drugs. Of the latter cases, 32 cases involved a combination of alcohol and drugs and 19 cases identified drugs only, with no alcohol. Marijuana was the most commonly cited drug (23 cases); however, it was the sole impairing substance identified in only three cases.ConclusionPolydrug use was very common among DUID cases, which makes it difficult to identify which drug or drugs caused the impairment responsible for the Driving Under the Influence citation. This study revealed tha (a) drugged driving is a frequent cause of DUI citations in cases charged with VH or VA; (b) that polydrug use, rather than marijuana, is the most common cause of drugged driving in Colorado; and (c) that current warrant procedures render blood test results meaningless in cases of marijuana-impairment.Practical applicationStates should collect and analyze DUID data to ensure legislators focus on the right DUID problems to improve biological testing for drugs, adopt more appropriate roadside testing, and enact stronger DUID laws to protect the public.     

Evaluation of a responsible beverage service and enforcement program: Effects on bar patron intoxication and potential impaired driving by young adults

Objective: Studies of alcohol-related harm (violence, injury, illness) suggest that the most significant risk factors are the amount of alcohol consumed and whether obviously intoxicated patrons continue to be served. This study's objective was to investigate the effects of a responsible beverage service (RBS)/enhanced alcohol enforcement intervention on bars, bar patrons, and impaired driving.

Method: Two communities—Monroe County, New York, and Cleveland, Ohio—participated in a demonstration program and evaluation. The intervention applied RBS training, targeted enforcement, and corrective actions by law enforcement to a random sample of 10 identified problem bars in each community compared to 10 matched nonintervention problem bars. Data were collected over 3 waves on bar serving practices, bar patron intoxication, drinking and driving, and other alcohol-related harm from intervention and control bars and treatment and comparison communities.

Results: In Monroe County, New York, of the 14 outcome measures analyzed, 7 measures showed statistically significant differences from pre- to postintervention. Six of those measures indicated changes in the desired or positive direction and 2 measures were in the undesired or negative direction. Of note in the positive direction, the percentage of intervention bar patrons who were intoxicated decreased from 44 to 27% and the average blood alcohol concentration of patrons decreased from 0.097 to 0.059 g/dL pre- to postintervention. In Cleveland, Ohio, 6 of the 14 measures showed statistically significant changes pre- to postintervention with 6 in the positive direction and 4 in the negative direction. Of note, the percentage of pseudo-intoxicated patrons denied service in intervention bars increased from 6 to 29%.

Conclusions: Of the 14 outcome measures that were analyzed in each community, most indicated positive changes associated with the intervention, but others showed negative associations. About half of the measures showed no significance, the sample sizes were too small, or the data were unavailable. Therefore, at best, the results of these demonstration programs were mixed. There were, however, some positive indications from the intervention. It appears that when bar managers and owners are aware of the program and its enforcement and when servers are properly trained in RBS, fewer patrons may become intoxicated and greater efforts may be made to deny service to obviously intoxicated patrons. Given that about half of arrested impaired drivers had their last drink at a licensed establishment, widespread implementation of this strategy has the potential to help reduce impaired driving.     

Policing the drunk driver: measuring law enforcement involvement in reducing alcohol-impaired driving

INTRODUCTION: With many thousands of deaths still annually attributable to driving under the influence (DUI), it remains imperative that we continually address the problem of producing and sustaining effective countermeasures, and that we subject these efforts to empirical scrutiny. This article presents relevant findings from state-wide datasets. RESULTS: A formula generating a potentially useful metric for assessing aspects of the DUI prosecutorial chain is presented, focusing on the rate of proactive DUI arrests. While in need of cautious interpretation due to issues of inherent inaccuracies in large databases, small numbers of crashes and/or arrests in multiple jurisdictions, and the lack of replication in other states, the analyses show no relationship between the level of DUI arrest activity and DUI-related crashes. This finding brings into question the efficacy of the many millions of dollars devoted each year to targeted DUI enforcement, as it is currently being implemented. CONCLUSIONS: Results are discussed in terms of developing adequate disincentives to DUI so as to raise general deterrence via dramatic increases in proactive DUI enforcement and then engaging in pervasive and persistent social marketing of such efforts to maximize the perception that arrest and punishment for DUI is always imminent, that penalties will be swift, certain, and severe. It is echoed that accurate data need to be collected at all levels of the DUI arrest and prosecution process in every jurisdiction within a state, so as to facilitate the empirical assessment of countermeasure efficacy in reducing alcohol-related crashes. IMPACT ON INDUSTRY: Given that this work needs to be replicated, the impact on the traffic safety industry is potentially huge. The present data indicate that law enforcement efforts to further abate DUI-related crashes are apparently ineffective, though likely necessary to maintain reductions achieved in the 80s and early 90s. Thus, to attain additional systematic reductions, a dramatic increase in enforcement will be necessary as will a diversification of abatement efforts, including an increase in aggressive social marketing tactics to positively impact our traffic safety culture by making DUI universally unacceptable (for a discussion of this latter issue and on the use of positive reinforcement to change driver behavior, see Dula & Geller, 2007).     

Medical review process and license disposition of drivers referred by law enforcement in Virginia

IntroductionMedically at-risk drivers come to the attention of licensing authorities through referrals from a variety of sources, including: physicians, family members, court systems, and law enforcement. A recently sponsored project by the National Highway Traffic Safety Administration examined a training intervention for law enforcement to increase their awareness of medical conditions and medications that impair driving and the procedures for reporting these drivers in Virginia.MethodA component of this project included an evaluation of the medical review process and licensing outcomes for 100 drivers randomly selected from a pool of over 1,000 drivers referred from law enforcement officers to the Virginia Department of Motor Vehicles over a 6-month period in 2007 and 2008 prior to any training program intervention.ResultsKey findings from the evaluation of 100 drivers referred for medical review by law enforcement were as follows. Over two-thirds of the drivers came to the attention of the referring officer because they were involved in a crash. The most prevalent indications of a medical condition or functional impairment provided by law enforcement for these referrals were: loss of consciousness, blackout, or seizures (28%); disorientation, confusion, and mental disability (16%); and physical impairments (8%). Eighty-eight percent of the drivers received some type of licensing action (e.g., restriction, suspension, or periodic review). Only 12% of the referred drivers did not require any licensing action.ConclusionsLaw enforcement provides a vital role in the identification and referral of medically impaired drivers to licensing authorities for reexamination. Training programs can inform law enforcement officers of the signs of medical impairment (both on-road behavior, and physical and psychological clues once a driver has been pulled over), and procedures for reporting their observations and concern for safety to licensing authorities.Impact on IndustryReexamination of drivers with functional and medical impairments and any consequent restrictions and/or periodic reporting requirements can improve the safety and mobility of these drivers, and the motoring public as well.     

Potentially preventable prehospital deaths from motor vehicle collisions

Background: In 2011, about 30,000 people died in motor vehicle collisions (MVCs) in the United States. We sought to evaluate the causes of prehospital deaths related to MVCs and to assess whether these deaths were potentially preventable.

Methods: Miami–Dade Medical Examiner records for 2011 were reviewed for all prehospital deaths of occupants of 4-wheeled motor vehicle collisions. Injuries were categorized by affected organ and anatomic location of the body. Cases were reviewed by a panel of 2 trauma surgeons to determine cause of death and whether the death was potentially preventable. Time to death and hospital arrival times were determined using the Fatality Analysis Reporting System (FARS) data from 2002 to 2012, which allowed comparison of our local data to national prevalence estimates.

Results: Local data revealed that 39% of the 98 deaths reviewed were potentially preventable (PPD). Significantly more patients with PPD had neurotrauma as a cause of death compared to those with a nonpreventable death (NPD) (44.7% vs. 25.0%, P =.049). NPDs were significantly more likely to have combined neurotrauma and hemorrhage as cause of death compared to PPDs (45.0% vs. 10.5%, P <.001). NPDs were significantly more likely to have injuries to the chest, pelvis, or spine. NPDs also had significantly more injuries to the following organ systems: lung, cardiac, and vascular chest (all P <.05). In the nationally representative FARS data from 2002 to 2012, 30% of deaths occurred on scene and another 32% occurred within 1 h of injury. When comparing the 2011 FARS data for Miami–Dade to the remainder of the United States in that year, percentage of deaths when reported on scene (25 vs. 23%, respectively) and within 1 h of injury (35 vs. 32%, respectively) were similar.

Conclusions: Nationally, FARS data demonstrated that two thirds of all MVC deaths occurred within 1 h of injury. Over a third of prehospital MVC deaths were potentially preventable in our local sample. By examining injury patterns in PPDs, targeted intervention may be initiated.