Effects of Dram Shop,Responsible Beverage Service Training,and State Alcohol Control Laws on Underage Drinking Driver Fatal Crash Ratios

Objectives: In this study, we aimed to determine whether three minimum legal drinking age 21 (MLDA-21) laws—dram shop liability, responsible beverage service (RBS) training, and state control of alcohol sales—have had an impact on underage drinking and driving fatal crashes using annual state-level data, and compared states with strong laws to those with weak laws to examine their effect on beer consumption and fatal crash ratios.

Methods: Using the Fatality Analysis Reporting System, we calculated the ratio of drinking to nondrinking drivers under age 21 involved in fatal crashes as our key outcome measure. We used structural equation modeling to evaluate the three MLDA-21 laws. We controlled for covariates known to impact fatal crashes including: 17 additional MLDA-21 laws; administrative license revocation; blood alcohol concentration limits of.08 and.10 for driving; seat belt laws; sobriety checkpoint frequency; unemployment rates; and vehicle miles traveled. Outcome variables, in addition to the fatal crash ratios of drinking to nondrinking drivers under age 21 included state per capita beer consumption.

Results: Dram shop liability laws were associated with a 2.4% total effect decrease (direct effects: β =.019, p =.018). Similarly, RBS training laws were associated with a 3.6% total effect decrease (direct effect: β =.048, p =.001) in the ratio of drinking to nondrinking drivers under age 21 involved in fatal crashes. There was a significant relationship between dram shop liability law strength and per capita beer consumption, F (4, 1528) = 24.32, p <.001, partial η² =.016, showing states with strong dram shop liability laws (Mean (M) = 1.276) averaging significantly lower per capita beer consumption than states with weak laws (M = 1.340).

Conclusions: Dram shop liability laws and RBS laws were both associated with significantly reduced per capita beer consumption and fatal crash ratios. In practical terms, this means that dram shop liability laws are currently associated with saving an estimated 64 lives in the 45 jurisdictions that currently have the law. If the remaining 6 states adopted the dram shop law, an additional 9 lives could potentially be saved annually. Similarly, RBS training laws are associated with saving an estimated 83 lives in the 37 jurisdictions that currently have the laws. If the remaining 14 states adopted these RBS training laws, we estimate that an additional 28 lives could potentially be saved.     

Preventing highway crashes by raising the legal minimum age for drinking: An empirical confirmation

In recent years there has been increased interest in reducing the massive social costs due to alcohol-related motor vehicle crashes. Raising the legal minimum age for purchase and consumption of alcohol beverages has been proposed as one way to reduce alcohol-related crashes among young drivers. Currently, many states are raising the legal age, in contrast to the trend towards lower legal drinking ages in the early 1970s. Recent studies of the effects of raising the drinking age are reviewed, and results from a controlled multiple time-series evaluation of the experience in Michigan are presented. Significant 11 to 28% reductions in alcohol-related crash involvements are shown to be attributable to the raised drinking age in Michigan. Suggestions for further research and discussion of policy implications are included.     

Understanding the context of alcohol impaired driving for fatal crash–involved drivers: A descriptive case analysis

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.     

Underage drinking: frequency, consequences, and interventions

OBJECTIVES: To examine the frequency of underage drinking, driving after drinking and alcohol-related crashes, trends in these behaviors, and promising interventions. METHODS: We examined drinking and drinking- and-driving behaviors reported in the United States in the 2001 U.S. National Household Survey of Drug Abuse, the Centers for Disease Control and Prevention 2001 Youth Risk Behavior Survey, the 1992 National Longitudinal Alcohol Epidemiologic Study, and the 1999 National Survey of Drinking and Driving conducted for the National Highway Traffic Administration. We also examined the 1999 European School Survey Project on Alcohol and Other Drugs. Alcohol-related fatal crashes were examined from the U.S. Fatality Analysis Reporting System. Evaluation of interventions to reduce teenage drinking and driving after drinking were reviewed. RESULTS: In the United States, 19% of youth ages 12-20 consumed five or more drinks on an occasion in the past 30 days. Although European nations have lower legal drinking ages (16-18) than in the United States (21), similar proportions engage in underage drinking. In two-thirds of European countries, a greater percentage of 15-16 year-olds drank five or more drinks on an occasion in the past month than in the United States. In both the United States and Europe, the earlier people begin to drink, the greater the likelihood of developing alcohol dependence and other alcohol-related problems, including alcohol-related crash involvement, during adolescence and adult years. During the past 20 years alcohol-related traffic deaths among people younger than 21 have been cut in half in the United States, but progress has halted since 1995 and the problem is still large. Interventions shown by research to reduce alcohol-related crashes among youth include raising the legal drinking age to 21, zero tolerance laws, and some interventions that are family, school, or community based. CONCLUSIONS: Despite research showing that a variety of interventions can reduce underage drinking and alcohol-related crash fatalities, the frequency of these behaviors remains high and the average age of drinking initiation is declining in the United States. Efforts are needed to enhance publicized enforcement of underage drinking laws. Comprehensive community interventions that include enforcement of these laws also are needed.     

Temporal factors in motor-vehicle crash deaths: Ten years later

ObjectiveTo assess trends in traffic fatalities on several temporal scales: year to year, by month, by day of week, and by time of day, to determine why some times correspond with higher rates of crash deaths, and to assess how these trends relate to age, the role of the deceased, and alcohol consumption.MethodTraffic fatalities were identified using the Fatality Analysis Reporting System (FARS) for 1998 through 2014 and assessed for their time of occurrence. Three days that, on average, contained particularly high numbers of crash deaths were then assessed in greater detail, considering the age of the deceased, role of the deceased (vehicle occupant, bicyclist, motorcyclist, or pedestrian), and the blood alcohol content of either the driver (for passenger vehicle occupants) or the deceased.ResultsAnnual crash fatality totals were much lower in 2014 than in 1998, but the decrease was not steady; a marked drop in crash deaths occurred after 2007 and continued until 2014. On average the most fatalities per day occurred in July and August (116 per day), followed closely by June, September, and October. During the week, the greatest number of fatalities on average occur on weekend days, and during the day the most fatalities tend to occur between the hours of 3 p.m. and 7 p.m. Holidays like Independence Day and New Year's Day show elevated crash fatalities, and a greater percentage of these crashes involved alcohol, when compared with adjacent days.ConclusionCertain days and times of year stand out as posing an elevated crash risk, and even with the decrease in average daily fatalities over the past decade, these days and times of year have remained consistent.Practical applicationThese results indicate focused areas for continued efforts to reduce fatal crashes.     

A classification tree based modeling approach for segment related crashes on multilane highways

Introduction

This study presents a classification tree based alternative to crash frequency analysis for analyzing crashes on mid-block segments of multilane arterials.

Method

The traditional approach of modeling counts of crashes that occur over a period of time works well for intersection crashes where each intersection itself provides a well-defined unit over which to aggregate the crash data. However, in the case of mid-block segments the crash frequency based approach requires segmentation of the arterial corridor into segments of arbitrary lengths. In this study we have used random samples of time, day of week, and location (i.e., milepost) combinations and compared them with the sample of crashes from the same arterial corridor. For crash and non-crash cases, geometric design/roadside and traffic characteristics were derived based on their milepost locations. The variables used in the analysis are non-event specific and therefore more relevant for roadway safety feature improvement programs. First classification tree model is a model comparing all crashes with the non-crash data and then four groups of crashes (rear-end, lane-change related, pedestrian, and single-vehicle/off-road crashes) are separately compared to the non-crash cases. The classification tree models provide a list of significant variables as well as a measure to classify crash from non-crash cases. ADT along with time of day/day of week are significantly related to all crash types with different groups of crashes being more likely to occur at different times.

Conclusions

From the classification performance of different models it was apparent that using non-event specific information may not be suitable for single vehicle/off-road crashes.

Impact on Industry

The study provides the safety analysis community an additional tool to assess safety without having to aggregate the corridor crash data over arbitrary segment lengths.     

The effect of a campus-community environmental alcohol prevention initiative on student drinking and driving: results from the "a matter of degree" program evaluation

OBJECTIVE: Motor vehicle crashes involving alcohol are a major contributor to morbidity and mortality among college students in the United States. This study evaluates the effect on drinking and driving outcomes of the "A Matter of Degree" program, a campus-community coalition initiative to reduce college binge drinking. METHODS: We used a quasi-experimental longitudinal study design that compared student responses at 10 colleges participating in the program and students attending 32 similar colleges that did not participate in the program. We also divided the program sites into two groups of five according to their level of program implementation and compared each with the non-program colleges. We examined driving after any alcohol consumption and driving after five or more drinks among drinkers who drove one or more times a week per month and riding with a high or drunk driver among all students at these colleges beginning in 1997 through 2001. Outcomes were based on data collected from repeated cross-sectional surveys using the Harvard School of Public Health College Alcohol Study. Analyses were conducted using MLwiN multilevel statistical software. RESULTS: We found significant reductions in driving after drinking, driving after five or more drinks and riding with a high or drunk driver at the program colleges relative to the comparison colleges. Further analyses indicated that these reductions among the AMOD program colleges occurred at the sites with high program implementation relative to comparison sites, while no statistically significant change was noted at the program sites with low implementation. The program effect on the two drinking and driving outcomes appeared to be mediated by frequent binge drinking, while significant decline in the riding with an intoxicated driver outcome was not mediated by the individual's drinking. CONCLUSIONS: Campus-community based environmental alcohol prevention is a promising approach for reducing alcohol-impaired motor vehicle crashes among this population.     

Spatial relationships between alcohol outlet densities and drunk driving crashes: An empirical study of Tianjin in China

Introduction: Numerous studies have demonstrated the close relationship between alcohol availability and alcohol-related crashes. However, there is still a lack of spatial empirical analysis regarding this relationship, particularly in large cities of developing countries. Differences in alcohol outlets and drinking patterns in these cities may lead to quite different patterns of crash outcomes. Method: 3356 alcohol-related crashes were collected from the blood-alcohol test report of a forensic institution in Tianjin, China. Density of alcohol outlets such as retail locations, entertainment venues, restaurants, hotels, and companies were extracted based on 2114 Traffic Analysis Zones (TAZ) together with the residential and demographic characteristics. After applying the exploratory spatial data analysis, this research developed and compared the traditional Ordinary Least Square model (OLS), Spatial Lag Model (SLM), Spatial Error Model (SEM) and Spatial Durbin Model (SDM) to explore spatial effects of all the variables. Results: The results of incremental spatial autocorrelation show that the most significant distance threshold of alcohol-related roadway traffic crashes is 3 km. The SDM is found to be the optimal spatial model to characterize the relationship between alcohol outlets and crashes. The number of alcohol-involved traffic crashes is positively related to population density and retail density, but negatively related to the company density, hotel density, and residential density within the same TAZ. Meanwhile, dense population and hotels have reverse spillover effects in adjacent zones. Conclusions: The significant spatial direct effect and spillover effect of alcohol outlet densities on drunk driving crashes should not be neglected. These findings could help improve transportation planning, traffic law enforcement and traffic management for large cities in developing countries.     

Administrative license suspension: Does length of suspension matter?

Objective: Administrative license revocation (ALR) laws, which provide that the license of a driver with a blood alcohol concentration at or over the illegal limit is subject to an immediate suspension by the state department of motor vehicles, are an example of a traffic law in which the sanction rapidly follows the offense. The power of ALR laws has been attributed to how swiftly the sanction is applied, but does the length of suspension matter? Our objectives were to (a) determine the relationship of the ALR suspension length to the prevalence of drinking drivers relative to sober drivers in fatal crashes and (b) estimate the extent to which the relationship is associated to the general deterrent effect compared to the specific deterrent effect of the law.

Methods: Data comparing the impact of ALR law implementation and ALR law suspension periods were analyzed using structural equation modeling techniques on the ratio of drinking drivers to nondrinking drivers in fatal crashes from the Fatality Analysis Reporting System (FARS).

Results: States with an ALR law with a short suspension period (1–30 days) had a significantly lower drinking driver ratio than states with no ALR law. States with a suspension period of 91–180 days had significantly lower ratios than states with shorter suspension periods, while the three states with suspension lengths of 181 days or longer had significantly lower ratios than states with shorter suspension periods.

Discussion: The implementation of any ALR law was associated with a 13.1% decrease in the drinking/nondrinking driver fatal crash ratio but only a 1.8% decrease in the intoxicated/nonintoxicated fatal crash ratio. The ALR laws and suspension lengths had a significant general deterrent effect, but no specific deterrent effect.

Practical Implications: States might want to keep (or adopt) ALR laws for their general deterrent effects and pursue alternatives for specific deterrent effects. States with short ALR suspension periods should consider lengthening them to 91 days or longer.     

Issues with using police citations to assign responsibility in quasi-induced exposure

Crash fault determination is one of the most critical issues in applications of quasi-induced exposure. Traditionally, the driver citation issued by the investigating police officer is the primary source to assign responsibility for motor vehicle crashes. Such citations are based on the “evidence” or observation of a moving violation (such as engaged hazardous actions) in combination with non-moving violations (such as suspended driver license) prior to the crash. The objective here is to identify the contributing factors that may lead to driver citations in two-vehicle crashes in addition to the hazardous action. Multivariate binary logistic regression modeling is employed to explore the behavior of the investigating police officer in terms of issuing citation at the crash scene. A series of explanatory parameters including roadway characteristics, environmental factors, and driver and vehicle attributes is assessed. The results show that whether the crash type was a hit-and-run, alcohol and illegal drug use, driver gender, driver age, and injury severity all appear to have significant impacts on the investigating officer’s decision-making. Specific examples are given to demonstrate how two factors hit-and-run and drinking status can skew the exposure estimates in the context of quasi-induced exposure. The findings will help to serve as a basis to select appropriate parameters in assigning crash responsibility in quasi-induced exposure applications; and we make recommendations to modify existing crash database for better safety research in the future.     

Prevalence of alcohol impairment and odds of a driver injury or fatality in on-road farm equipment crashes

Objective: The objective of this article was to estimate the prevalence of alcohol impairment in crashes involving farm equipment on public roadways and the effect of alcohol impairment on the odds of crash injury or fatality.

Methods: On-road farm equipment crashes were collected from 4 Great Plains state departments of transportation during 2005–2010. Alcohol impairment was defined as an involved driver having blood alcohol content of ≥0.08 g/100 ml or a finding of alcohol impairment as a driver contributing circumstance recorded on the police crash report. Injury or fatality was categorized as (a) no injury (no and possible injury combined), (b) injury (nonincapacitating or incapacitating injury), and (c) fatality. Hierarchical multivariable logistic regression modeling, clustered on crash, was used to estimate the odds of an injury/fatality in crashes involving an alcohol-impaired driver.

Results: During the 5 years under study, 3.1% (61 of 1971) of on-road farm equipment crashes involved an alcohol-impaired driver. One in 20 (5.6%) injury crashes and 1 in 6 (17.8%) fatality crashes involved an alcohol-impaired driver. The non-farm equipment driver was significantly more likely to be alcohol impaired than the farm equipment driver (2.4% versus 1.1% respectively, P = .0012). After controlling for covariates, crashes involving an alcohol-impaired driver had 4.10 (95% confidence interval [CI], 2.30–7.28) times the odds of an injury or fatality. In addition, the non-farm vehicle driver was at 2.28 (95% CI, 1.92–2.71) times higher odds of an injury or fatality than the farm vehicle driver. No differences in rurality of the crash site were found in the multivariable model.

Conclusion: On-road farm equipment crashes involving alcohol result in greater odds of an injury or fatality. The risk of injury or fatality is higher among the non-farm equipment vehicle drivers who are also more likely to be alcohol impaired. Further studies are needed to measure the impact of alcohol impairment in on-road farm equipment crashes.     

The effects of minimum legal drinking age 21 laws on alcohol-related driving in the United States

Objective

To examine trends in alcohol consumption and alcohol-related crashes among people younger than 21 in the United States and to review evidence on the effects of minimum legal drinking age (MLDA) laws.

Methods

Trends in alcohol-related crashes and alcohol consumption among young people were examined, and studies on the effects of lowering and raising the drinking age were reviewed.

Results

MLDA laws underwent many changes during the 20th century in the United States. Since July 1988, the MLDA has been 21 in all 50 states and the District of Columbia. Surveys tracking alcohol consumption among high school students and young adults found that drinking declined since the late 1970 s, and most of the decline occurred by the early 1990 s. These were the years when states were establishing, or reinstating, a MLDA-21. Among fatally injured drivers ages 16-20, the percentage with positive BACs declined from 61% in 1982 to 31% in 1995, a bigger decline than for older age groups; declines occurred among the ages directly affected by raising MLDAs (ages 18-20) and among young teenagers not directly affected (ages 16-17). Almost all studies designed specifically to gauge the effects of drinking age changes show MLDAs of 21 reduce drinking, problematic drinking, drinking and driving, and alcohol-related crashes among young people. Yet many underage people still drink, many drink and drive, and alcohol remains an important risk factor in serious crashes of young drivers, especially as they progress through the teenage years. Stepped-up enforcement of MLDA and drinking and driving laws can reduce underage drinking. Recent efforts to lower MLDAs to 18 and issue licenses to drink upon completion of alcohol education have gained local and national media attention. There is no evidence that alcohol education can even partially replace the effect of MLDA-21.

Conclusions

The cause and effect relationship between MLDAs of 21 and reductions in highway crashes is clear. Initiatives to lower the drinking age to 18 ignore the demonstrated public health benefits of MLDAs of 21.

Impact on Industry

Lowering the drinking age to 18 will increase highway crash deaths among young people.     

Pedestrians under influence (PUI) crashes: Patterns from correspondence regression analysis

Introduction: Alcohol-related impairment is a key contributing factor in traffic crashes. However, only a few studies have focused on pedestrian impairment as a crash characteristic. In Louisiana, pedestrian fatalities have been increasing. From 2010 to 2016, the number of pedestrian fatalities increased by 62%. A total of 128 pedestrians were killed in traffic crashes in 2016, and 34.4% of those fatalities involved pedestrians under the influence (PUI) of drugs or alcohol. Furthermore, alcohol-PUI fatalities have increased by 120% from 2010 to 2016. There is a vital need to examine the key contributing attributes that are associated with a high number of PUI crashes. Method: In this study, the research team analyzed Louisiana’s traffic crash data from 2010 to 2016 by applying correspondence regression analysis to identify the key contributing attributes and association patterns based on PUI involved injury levels. Results: The findings identified five risk clusters: intersection crashes at business/industrial locations, mid-block crashes on undivided roadways at residential and business/residential locations, segment related crashes associated with a pedestrian standing in the road, open country crashes with no lighting at night, and pedestrian violation related crashes on divided roadways. The association maps identified several critical attributes that are more associated with fatal and severe PUI crashes. These attributes are dark to no lighting, open country roadways, and non-intersection locations. Practical Applications: The findings of this study may be used to help design effective mitigation strategies to reduce PUI crashes.     

Crash data analysis: collective vs. individual crash level approach

INTRODUCTION: Traffic safety literature has traditionally focused on identification of location profiles where "more crashes are likely to occur" over a period of time. The analysis involves estimation of crash frequency and/or rate (i.e., frequency normalized based on some measure of exposure) with geometric design features (e.g., number of lanes) and traffic characteristics (e.g., Average Annual Daily Traffic [AADT]) of the roadway location. In the recent past, a new category of traffic safety studies has emerged, which attempts to identify locations where a "crash is more likely to occur." The distinction between the two groups of studies is that the latter group of locations would change based on the varying traffic patterns over the course of the day or even within the hour. METHOD: Hence, instead of estimation of crash frequency over a period of time, the objective becomes real-time estimation of crash likelihood. The estimation of real-time crash likelihood has a traffic management component as well. It is a proactive extension to the traditional approach of incident detection, which involves analysis of traffic data recorded immediately after the incident. The units of analysis used in these studies are individual crashes rather than counts of crashes. RESULTS: In this paper, crash data analysis based on the two approaches, collective and at individual crash level, is discussed along with the advantages and shortcomings of the two approaches.     

Temporal patterns of crashes of 16-to 17-year-old drivers in Fairfax County, Virginia

OBJECTIVE: To develop a better understanding of the frequency and characteristics of teenage driver crashes occurring during school commute times. METHOD: Data were obtained from police reports of crashes involving drivers ages 16-17 that occurred between September 2001 and August 2004 in Fairfax County, Virginia. Temporal patterns and other characteristics of crash involvement during the school year were examined, and crashes during school commute times were compared with those at other times. RESULTS: Teenage driver crash involvement spiked during weekday school commute times. Compared with other times, crashes during school commute times were significantly more likely to involve multiple vehicles but less likely to result in injuries or involve drivers who were male, made driving errors, or had been drinking alcohol. Crashes during school commute times were more likely to involve more than one teenage driver and occur close to schools. CONCLUSIONS: Crashes involving teenage drivers are prevalent during school commute times. Many of these crashes involve multiple teenage drivers and occur near schools. Schools and communities should consider programs and policies that reduce teenage driving to school and enhance the safety of teenagers that do drive.     

The legal minimum drinking age in texas: Effects of an increase from 18 to 19

Effects on motor vehicle crash involvement of raising the legal drinking age in Texas from 18 to 19 were examined, using an interrupted time-series design. Rates of single-vehicle-nighttime (SVN) and non-SVN crashes per 100,000 licensed drivers from 1978 through 1984 were examined for three levels of crash severity (serious injury, minor injury, property damage only) and four age groups (16–17, 18, 19–20, 21 and over). Results revealed significant reductions in SVN crashes for the 18-year-old target population across all levels of crash severity: serious injury, down 10.8% ; minor injury, down 14.3% ; and property damage only, down 12.8%. In comparison, no significant changes in SVN crashes among drivers age 21 and over were found. When the effects of macroeconomic conditions on crash rates were controlled statistically, no change in the estimated effect of the legal age law was seen. It is clear that the 1-year increase in legal age in Texas had a significant effect on youth crash involvement.     

Fatal motorcycle crashes in wide urban area of Zagreb,Croatia—A 10-year review

Objective: The objective of our study was to determine the prevalence of alcohol and drug intoxication among fatally injured motorcyclists in a wide urban area of Zagreb, Croatia.

Methods: We conducted a single-center observational retrospective study over a 10-year period (2007–2016) in 3 counties covering an area including 1.2 million residents. We reviewed the records on fatally injured motorcyclists, collecting information relating to sex, age, cause of death, time of death in relation to the time of the crash, and the circumstances of the crash (time of day, day of the week, season). Blood alcohol concentration (BAC) and toxicology analysis results were collected and analyzed.

Results: We identified 163 deaths (95.7% males, 4.3% females). Overall, 64.2% of the victims were 20 to 39 years old. The majority (50.9%) of those fatally injured were responsible for causing the traffic crash; the rest were determined not to be responsible or the responsibility could not be determined. The most frequent causes of death were multiple injuries (55.8%) and isolated head trauma (23.3%). The rider’s BAC was above the legal limit for driving (>0.50?g/kg) in 53.8% of cases, with a mean BAC of 1.91?g/kg. There was no difference in riding a motorcycle with a BAC above the legal limit between groups defined as younger (≤39 years of age) and older (≥40 years of age). The number of people with an illegal BAC was significantly higher during weekends than during the work week. The BAC of riders who were responsible for the crash was significantly higher than that of those who were not responsible or whose responsibility could not be determined. Use of illegal drugs or nontherapeutic use of legal drugs was not common and was detected in 10.4% of fatally injured riders.

Conclusions: Alcohol intoxication has a major role in motorcycle crash–related mortality. A significant difference in BAC between fatally injured riders responsible for the accident and those who were not responsible implies that measures directed toward prevention of drinking and driving behavior could lower the number of fatal motorcycle crashes. Weekend measures, especially during spring and summer, could have particularly significant effects.     

An Analysis of Young Driver Crash Types and the Associated Lifetime Care Cost in Victoria,Australia

Objective: The elevated crash involvement rate of young drivers is well documented. Given the higher crash risk of young drivers and the need for innovative policy and programs, it remains important to fully understand the type of crashes young drivers are involved in, and knowledge of the lifetime care cost of crashes can support effective policy development. The aim of this article is to document the number and type of young driver crashes, as well as the associated lifetime care cost over a 9-year period (2005–2013) in Victoria, Australia.

Methods: In Victoria, Australia, the Transport Accident Commission (TAC) has legislated responsibility for road safety and the care of persons injured in road crashes, irrespective of fault. TAC claims data for the period 2005–2013 were used to document the number and type of young driver crashes. Lifetime care costs (past and future payment liabilities) were calculated by Taylor Fry actuarial consultancy. License and population data were used to define the crash involvement rate of young drivers.

Results: Over the 9-year period, 16,817 claims were lodged to the TAC by drivers 18–25 years of age following a crash. There were 646 fewer drivers aged 18–25 killed and injured in 2013, compared to 2005, representing an unadjusted change of ?28.7% (?29.8% males; ?28.4% females). The total lifetime care cost of young drivers killed and injured in Victoria for the period 2005–2013 was estimated to be AU$634 million (US$493 million). Differences between males and females, single- and multivehicle crashes, and fatalities and injuries were found to be statistically significant. Run-off-road crashes and crashes from opposing direction were overrepresented in the lifetime care costs for young driver claimants. Twenty-eight injured drivers were classified as high-severity claims. These 28 claimants require additional long-term care, which was estimated to be AU$219 million; of these 28, 24 were male (85.7%). The long-term care costs for these 28 drivers (0.16%) accounts for 34.5% of the total lifetime care cost of all 18- to 25-year-old injured drivers.

Conclusions: By using no-fault lifetime care costs that account for medical and like expenses, rehabilitation, and social reintegration costs, a more accurate understanding of the cost of young driver crashes can be determined. Application of these costs to specific crash types highlights new priorities and opportunities for developing programs to reduce young driver crashes.     

The Illinois .08 law. An evaluation

Lowering state blood alcohol concentration (BAC) limits to 0.08, though controversial, has been supported by most evaluation studies to date. The Illinois .08 BAC law implemented in 1997 provided a unique opportunity to evaluate the effect of the law without the simultaneous passage of an administrative license revocation (ALR) law, which has clouded some previous evaluations of the .08 laws. The proportion of all drinking drivers in fatal crashes was compared before versus after implementing the .08 law using time-series analysis to evaluate 12 years of fatal crash data for Illinois and five bordering states. The results showed that the proportion of drinking drivers in fatal crashes decreased by 14% in Illinois and increased by 3% in bordering states. The proportion of drinking drivers in fatal crashes in Illinois, though increasing since 1995, was sharply reduced after passage of the .08 law in 1997, saving more than 100 lives in 1998 and 1999 than it would have without the .08 law.     

Motorists' knowledge,attitudes and practices toward alcohol-impaired driving/riding in Ghana

Objectives: The main objective of this study was to establish the knowledge, attitudes, and practices toward drink driving/riding as a risk factor for road traffic crashes in 3 regional capitals in Ghana.

Methods: The study used a face-to-face approach to randomly sample motorists who were accessing various services at fuel/gas stations, garages, and lorry terminals in 3 cities in Ghana.

Results: Over the previous 12 months, 24% of all motorists and 55% of motorists who were current alcohol users reported driving or riding a vehicle within an hour of alcohol intake. On average, motorists/riders who were current alcohol users consumed 4 standard drinks per drinking occasion. Generally, 83% of motorists who currently use alcohol walked, rode, or drove home after consuming alcohol away from their homes. Motorists/riders who reported drink driving were 4 times more likely to have had previous traffic violation arrests compared to those who reported no drink driving/riding (P =.001). Respondents were of the opinion that speeding was the major cause of traffic crashes, followed by driver carelessness, poor road conditions, inexperienced driving, and drink driving, in that order. Thirty-six percent of motorists who use alcohol had the perception that consuming between 6 and 15 standard drinks was the volume of alcohol that will take them to the legal blood alcohol concentration (BAC) limit of 0.08%. Compared to females, male motorists/riders were more likely to report drink driving (adjusted odds ratio [AOR] = 5.15; 95% confidence interval [CI], 2.31 to 11.47). Private motorists also reported a higher likelihood of drink driving compared to commercial drivers (AOR = 3.36; 95% CI, 1.88 to 6.02). Only 4% of motorists knew the legal BAC limit of Ghana and only 2% had ever been tested for drink driving/riding.

Conclusion: The volumes of alcohol that motorists typically consume per drinking occasion were very high and their estimates of the number of drinks required to reach the legal BAC limit was also very high. Provision of authoritative information advising motorists about safe, responsible, or low-risk levels of alcohol consumption is imperative. Many traffic violations including drink driving were reported, thus suggesting a need for enhanced policing and enforcement. However, given the low level of knowledge of the legal BAC limit, educating motorists about how many drinks will approximate the legal BAC should be intensified prior to an increase in enforcement; otherwise, the desired outcome of enforcement may not be achieved.