Prevalence and concentrations of drugs in older suspected drugged drivers

Objective: Older drivers are somewhat more likely to be involved in car crashes than middle-aged drivers but less likely to be involved than younger drivers. This study aimed to assess the extent of drug use in older suspected drunk and drugged drivers, with respect to which drugs were detected and at which concentrations.

Methods: Blood samples from older suspected drunk and drugged drivers taken between February 1, 2012, and May 22, 2013, were identified from the database at the Norwegian Institute of Public Health and were retrospectively analyzed for a broad repertoire of drugs relevant for impairment. The prevalence of different drugs among the suspected drunk and drugged drivers was studied. Regarding drug concentrations, the findings in older drivers (>65 years) were compared to a reference group of apprehended drivers aged 20–40 years.

Results: Four hundred and ten older suspected drunk and drugged drivers were included. Any drug (including ethanol) was detected in 92% of blood samples, and ethanol was detected in 81%. Benzodiazepines were found in 15% of the older drivers and z-hypnotics (zopiclone or zolpidem) were detected in 13%. The most frequent single legal drugs found in blood samples taken from older impaired drivers were zopiclone (9.8%) and diazepam (9.3%). Regarding drug combinations, older drivers used a mean number of 1.4 drugs, and 20% of ethanol-positive cases showed at least one other drug. High drug concentrations of clonazepam and diazepam were more frequently seen in the younger group.

Conclusions: This study showed that drugs were detected in the vast majority of older drivers suspected for drunk or drugged driving. Ethanol was the most frequent drug detected, followed by zopiclone and diazepam. Older drivers combine drugs to a lesser degree than younger drivers, but their combination of ethanol and other drugs represents a considerable traffic risk. Lower concentrations of benzodiazepines are seen in older compared to younger drivers.     

Impairment due to alcohol,tetrahydrocannabinol, and benzodiazepines in impaired drivers compared to experimental studies

Objective: In some countries, per se laws for other drugs than alcohol are used to judge drunk and drugged drivers. These blood concentration limits are often derived from experimental studies on traffic relevant behavior of healthy volunteers. Knowledge about how results from experimental studies could be transferred to a real-life setting is missing. The aim of this study was to compare impairment seen in experimental studies to the impairment seen at equivalent concentrations in apprehended drunk and drugged drivers.

Methods: Results from previously performed meta-analyses of experimental studies regarding impairment from alcohol, tetrahydrocannabinol (THC), and benzodiazepines were compared to impairment in apprehended drunk and drugged drivers as judged by a clinical test of impairment. Both experimental studies and real-life cases were divided into 4 groups according to increasing blood drug concentration intervals. The percentage of impaired test results in experimental studies was compared to the percentage of impaired subjects among drivers within the same blood drug concentration window.

Results: For ethanol, the percentage of impaired drivers (n = 1,223) increased from 59% in the lowest drug concentration group to 95% in the highest drug concentration group, compared to 7 and 72% in the respective groups in experimental studies. For THC, the percentage of impaired drivers (n = 950) increased from 42 to 58%, the corresponding numbers being 11 and 42% for experimental studies. For benzodiazepines, the percentage of impaired drivers (n = 245) increased from 46 to 76%, the corresponding numbers being 16 and 60% for experimental studies. The increased odds ratio for impairment between 2 concentration groups was comparable for experimental studies and impaired drivers.

Conclusions: Fewer test results indicated impairment in experimental studies compared to impaired drivers in real life when influenced by similar blood concentrations of either ethanol, THC, or benzodiazepines. In addition, a comparable relationship between drug concentration and impairment was seen for both experimental studies and real-life cases.

We believe that the present study strengthens the background for using experimental studies to establish fixed concentration limits for drunk and drugged drivers, but experimental studies in an impaired driver population could further expand our knowledge.     

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.     

Predicting categories of drugs used by suspected drug-impaired drivers using the Drug Evaluation and Classification Program tests

Objective: The purpose of this study was to statistically determine which combination(s) of drug-related signs and symptoms from the Drug Evaluation and Classification (DEC) protocol best predict the drug category used by the suspected drug-impaired driver.

Methods: Data from 1,512 completed DEC evaluations of suspected impaired drivers subsequently found to have ingested central nervous system (CNS) depressants, CNS stimulants, narcotic analgesics, and cannabis were analyzed using a multinomial logistic regression procedure. A set of evaluations completed on drug-free subjects was also included. The relative importance of clinical, behavioral, and observational measures in predicting drug categories responsible for impairment was also examined.

Results: Thirteen drug-related indicators were found to significantly contribute to the prediction of drug category, including being under the care of a doctor or dentist, condition of the eyes, condition of the eyelids, mean pulse rate, assessment of horizontal gaze nystagmus (HGN), convergence, performance on the One Leg Stand (OLS) Test, eyelid tremors, pupil size in darkness, reaction to light, presence of visible injection sites, systolic blood pressure, and muscle tone. Indicators related to the appearance and physiological response of the eye contributed the most to the prediction of drug category, followed closely by clinical indicators and performance on the psychophysical tests.

Conclusions: The findings from this study suggest that drug recognition experts (DREs) should be careful to review a set of key signs and symptoms when determining the category of drug used by suspected drug-impaired drivers. Drug use indicators related to the appearance and physiological response of the eye were found to contribute the most to the prediction of the drug category responsible for the impairment. These results could help form the basis of a core set of indicators that DREs could initially consult to form their opinion of drug influence. This in turn may enhance the validity, effectiveness, and efficiency of drug detection and identification by DREs and lead to a more effective and efficient DEC program, improved enforcement of drug-impaired driving, and greater acceptance of the DEC program by the courts.     

Methiopropamine in blood samples from drivers suspected of being under the influence of drugs

Objectives: Methiopropamine (MPA; 1-(thiophen-2-yl)-2-methylaminopropane) belongs to the new psychoactive substances (NPS) that have emerged on the drug market in recent years. MPA appeared in 2011 and is an analogue of methamphetamine, sold as, for example, "Slush Eric"and "Blow." It is reported to have effects similar to those of methamphetamine, but the toxicity in humans is not known. Three fatal cases involving MPA have been reported. One analytical confirmed intoxication case has been published, and this supports the symptoms described by the users. The prevalence of recreational use of MPA is unknown, and no studies have reported the prevalence in driving under the influence of drug (DUID) cases.

Methods: We investigated the frequency of MPA in DUID cases received at our institute during a 12-week period and report the analytical method using an ultraperformance liquid chromatography.tandem mass spectrometry for quantification of MPA in whole blood. The analytical findings were compared to the results from a clinical test of impairment performed by a physician shortly after the driving episode. The samples were analyzed for 42 different psychoactive substances.

Results: MPA was detected in 10 DUID cases (0.8% of the cases), only from male drivers. Other drugs were detected concomitantly in all the cases. Two of the cases were traffic accidents.

Conclusions: Our study shows that MPA is found in DUID cases and reveals that NPS are used among drivers and also proven in blood from drivers involved in traffic accidents. More studies are requested regarding the pharmacological and toxicological effects of MPA and other NPS. This is the first article that describes a method for analyzing and quantifying MPA in whole blood samples.     

Driving while impaired (DWI) by alcohol convictions among alcohol, cocaine, and cannabis clients in treatment

OBJECTIVE: Although studies have demonstrated that clients in treatment for alcohol abuse are more at risk of driving while impaired (DWI) by alcohol than normal licensed drivers from the general population, no research was found on DWI convictions among those in treatment for abusing cannabis or cocaine. The purpose of this article is to compare DWI convictions among clients in treatment for alcohol, cannabis, cocaine, or various combinations of these substances, compared to a matched population control group. METHOD: A stratified random sample of driver records was drawn from seven client groups who sought treatment in 1994 for alcohol, cannabis, cocaine, or any combination of these substances (n = 445). A random sample of drivers, frequency matched by age and sex (n = 566), served as control subjects. RESULTS: Logistic regression analysis, controlling for sex and age, was conducted to assess whether DWI convictions were elevated for each of the client groups, compared to controls. Two sets of analyses were conducted, before treatment (from 1985 to 1993) and after treatment (from 1995 to 2000). In the time period before treatment, every drug group except the "cannabis only" group had significantly more DWI convictions than controls (p < .05). In the period after treatment, the "alcohol only," "cocaine only," "alcohol and cocaine," and the "cocaine and cannabis" groups still had significantly more DWI convictions than controls (p < .05). CONCLUSION: The results show that DWI convictions are elevated among those who abused cocaine but not among those who abused cannabis. The results suggest that cross-addiction of alcohol and cocaine is common, and problematic drinking among cocaine clients can go undetected when clients are being diagnosed for treatment.     

The Victorian legislative framework for testing drivers for impairment caused by drugs other than alcohol: an evaluation of the characteristics of drivers detected from 2000 to 2005

On December 1, 2000, new legislation came into force in Victoria, Australia, that involved a framework for the procedure to be followed by the police for the detection of drivers impaired by drugs other than alcohol. An integral part of the procedure is the use of performance tests known as the standardized field sobriety tests (SFSTs) and the analysis of blood samples for the presence of drugs other than alcohol. This paper outlines the new legislative framework and the drug impairment detection procedures currently in place in Victoria. This paper also evaluates the data collected using the framework for the first five years since implementation in Victoria.     

Driving while impaired by alcohol: An analysis of drink-drivers involved in UK collisions

Objective: Drink-driving represents a critical issue on international organizations’ agendas as one of the key behavioral risk factors in road traffic safety, alongside speed and nonuse of motorcycle helmets, seat belts, and child restraints. Changing road user behaviors regarding these 5 factors is a critical component in reducing road traffic injuries and casualties. The objective of this study is the identification of drivers who are more likely to contribute to crashes in the UK while impaired by alcohol to design targeted drink drive compliance campaigns.

Method: To profile drivers with the factor “impaired by alcohol” assigned in collisions, an extensive data set is used, including all reported injury collisions between 2011 and 2015 in the UK (police records), merged with the Experian Mosaic Database. A multilevel mixed-effects logistic regression is conducted, utilizing the hierarchical nature of the data (drivers within Mosaic types).

Results: Using multilevel mixed-effects logistic regression analysis, the finding is that some driver profiles are more likely to contribute to crashes and are assigned the contributory factor “impaired by alcohol.” Drink-related crashes are more common in some circumstances or for some crash-involved driver groups than others. For instance, alcohol-related crashes are more likely to occur on single carriageways and among males and 25- to 35-year-olds. Drink-drive-related crashes are found to be strongly associated with dark lighting conditions and, more specifically, with late night hours (the interval between 3:00 a.m. and 4:00 a.m. accounts for a third of the drink-drive-related collisions). Using the Experian Mosaic Database which divides the UK population into 66 types based on demographic, lifestyle, and behavior characteristics, the finding is that, among crash-involved drivers, some Mosaic types are significantly more likely (e.g., pocket pensions, dependent greys, streetwise singles) and others are significantly less likely (e.g., crowded kaleidoscope, cultural comfort, penthouse chic) to contribute to a drink-related crash.

Conclusions: The outcome is a more nuanced understanding of drivers contributing to drink-related crashes in the UK. The study concludes by discussing the implications for governments and other interested bodies for better targeting and delivery of public education campaigns and interventions.     

Blood alcohol concentration in fatally injured drivers and the efficacy of alcohol policies of the new law on road traffic safety: A retrospective 10-year study in autonomous province of Vojvodina,Republic of Serbia

Objective: The aim of this study was primarily to evaluate inebriated fatally injured drivers (FIDs) according to blood alcohol concentration (BAC) in a 10-year period (2004–2013) in Autonomous Province (AP) of Vojvodina, Republic of Serbia, to analyze the efficacy of alcohol polices in the new law on road traffic safety through changes in the number of inebriated FIDs before and after implementation of the law, as well as to identify factors that influence the occurrence of FIDs with BACs above the legal limit.

Methods: All data for this retrospective study were obtained from the Centre of Forensic Medicine, Toxicology and Molecular Genetics of Clinical Centre of Vojvodina, Novi Sad. Autopsy records for each case included age, gender, BAC, type of vehicle, and date of accident (year, month, and recalculated day of the week). BAC was determined by gas chromatography with flame ionization detection. Statistical analysis was carried out by chi-square tests and Student's t test, with P < .05 as a statistical significance, and multiple binary logistic regression.

Results: Of the 354 inebriated FIDs (60% of all FIDs), the majority had BACs between of 0.031 and 0.3 mg/ml (28%), followed by those with BAC > 2.01 mg/ml (23%). The average BAC of those driving under the influence of alcohol (DUIA) for the whole period was 1.235 ± 1.00 mg/ml and the average number of DUIA/year was 35. Among the total number of FIDs there were significantly more males (93.7%; P < .001) than females (6.3%), though the distribution of intoxicated men and women was not different (P > .05). There was a statistically significant difference in the distribution of sober and inebriated FIDs according to age (P < .001) with the predominance of inebriated FIDs between 21 and 30 years. Although gender and age were found to be significant predictors of BAC above legal limit in FIDs, the area under the receiver operating characteristics (ROC) curve showed that the model had poor discrimination (ROC = 0.673). Of all observed FIDs, 65 cases per year were attributed to the first 5-year period (2004–2009) and 49 to the second 5-year (2010–2013) period, which indicates that there was no statistically significant decrease in the number of FIDs after implementation of the new law.

Conclusion: The highest number of intoxicated FIDs during the period in AP Vojvodina were mildly and completely inebriated. In the 4-year post-policy period (2010–2013), the number of FIDs and average BAC levels of inebriated FIDs did not significantly change. The abolition of a permissible BAC should be considered.     

Improved recovery of repeat intoxicated drivers using fingernails and blood spots to monitor alcohol and other substance abuse

Objectives: This study reports the results of a pilot program in Kenosha County that used a combination of direct biomarkers extracted from blood spots and nails to monitor repeat intoxicated drivers for their use of alcohol and drugs with a detection window spanning from 3 weeks to several months. The objectives were to test whether the direct biomarkers phosphatidylethanol (PEth), ethylglucuronide (EtG), and 5 drug metabolites would (1) help assessors obtain a more objective evaluation of repeat offenders during the assessment interview, (2) allow for timely identification of relapses and improve classification of drivers into risk categories, and (3) predict recidivism by identifying offenders most likely to obtain a subsequent operating while intoxicated (OWI) offense within 4 years of enrollment in the program.

Methods: All (N = 261) repeat offenders were tested using PEth obtained from blood spots and EtG obtained from fingernails; 159 participants were also tested for a 5 drugs of abuse nail panel. Drivers were tested immediately after the assessment interview (baseline) and at 3, 6, 9, and 12 months after baseline. Based on biomarker results and self-reports of abstinence, offenders were classified into different risk categories and required to follow specific testing timelines based on the program's decision tree.

Results: The baseline analysis shows that 60% of drivers tested positive for alcohol biomarkers (EtG, PEth, or both) at the assessment interview, with lower detection rates (0–11%) for the 5 drug metabolites. The comparison of biomarkers results to self-reports of abstinence identified 28% of all offenders as high risk and assigned them to more frequent testing and more intense monitoring. The longitudinal analysis shows that 56% (completers) of participants completed the program successfully and the remaining 44% (noncompliant) terminated prematurely. Two thirds (68%) of the completers were able to reduce or control their drinking and one third relapsed at least one time during their mandated monitoring periods. After a brief intervention by the assessors, 79% of relapsers tested negative for biomarkers in their repeat tests. The rearrest analysis showed that offenders classified in the noncompliant and relapsers groups were 7 times more likely to receive a new OWI 4 years after enrollment compared to drivers classified as abstainers or controllers. Refractory drivers were monitored the longest and reported no subsequent rearrests.

Conclusion: These findings demonstrate the benefits of more individualized interventions with repeat OWI offenders and calls for further development of multimodal approaches in traffic medicine including those that use direct alcohol biomarkers as evidence-based practices to reduce recidivism.     

Roadside survey on alcohol and drug use among drivers in the Arctic county of Finnmark (Norway)

Objective: The objective of this study was to determine the prevalence of alcohol and potentially impairing drugs among the general driving population in Finnmark and to compare the prevalence among Norwegian, Russian, and other foreign drivers by analyzing samples of oral fluid.

Methods: In collaboration with local police, drivers were selected for a voluntary and anonymous study using a multistage cluster sampling procedure (selection of roads, time intervals, and drivers within each interval) from September 2014 to October 2015. Age, gender, citizenship, time, and geographical site were recorded. Samples of oral fluid were collected using the Quantisal device. The samples were analyzed for alcohol with an enzymatic method and for 12 illicit drugs and 16 medicinal drugs and some metabolites using ultra-high-performance liquid chromatography with tandem mass spectrometry detection.

Results: A total of 3,228 drivers were asked to participate in the study. The refusal rate was 6.2%. Of the 3,027 participants in the study, 111 (3.7%) were Russian and 204 (6.7%) had citizenship other than Norwegian or Russian. The total prevalence of psychoactive substances was 4.3%. Alcohol was detected in 0.3%, psychoactive medicinal drugs in 2.5%, and illicit drugs in 1.6% of the samples. The most commonly found substances were the sleeping agent zopiclone (1.1%), tetrahydrocannabinol (THC; 1.1%), and the analgesic agent codeine (0.6%). Illicit drugs were detected significantly more often in samples from drivers of citizenship other than Norwegian or Russian. The prevalence of alcohol was somewhat higher among Russian drivers but not statistically significant. There were large differences between age groups and genders concerning illicit drugs and psychoactive medicinal drugs; illicit drugs were more frequently in samples from young male drivers, whereas psychoactive medicinal drugs were more frequently in samples from elderly female drivers.

Conclusion: The total prevalence of alcohol and drugs among the general driving population in Finnmark was low and similar to previous Norwegian roadside surveys. Illicit drugs were detected significantly more often in samples from drivers with citizenship other than Russian and Norwegian and among young male drivers.     

Fatally injured pedestrians and bicyclists in the United States with high blood alcohol concentrations

IntroductionLittle research has focused on the problem of alcohol impairment among pedestrians and bicyclists in the United States. The aim of the current study was to investigate the prevalence, trends, and characteristics of alcohol-impaired fatally injured pedestrians and bicyclists.MethodData from the Fatality Analysis Reporting System (FARS) were analyzed for fatally injured passenger vehicle drivers, pedestrians, and bicyclists 16 and older during 1982–2014. Logistic regression models examined whether personal, roadway, and crash characteristics were associated with high blood alcohol concentrations (BACs) among fatally injured pedestrians and bicyclists.ResultsFrom 1982 to 2014, the percentage of fatally injured pedestrians with high BACs (≥ 0.08 g/dL) declined from 45% to 35%, and the percentage of fatally injured bicyclists with high BACs declined from 28% to 21%. By comparison, the percentage of fatally injured passenger vehicle drivers with high BACs declined from 51% in 1982 to 32% in 2014. The largest reductions in alcohol impairment among fatally injured pedestrians and bicyclists were found among ages 16–20. During 2010–2014, fatally injured pedestrians and bicyclists ages 40–49 had the highest odds of having a high BAC, compared with other age groups.ConclusionsA substantial proportion of fatally injured pedestrians and bicyclists have high BACs, and this proportion has declined less dramatically than for fatally injured passenger vehicle drivers during the past three decades. Most countermeasures used to address alcohol-impaired driving may have only limited effectiveness in reducing fatalities among alcohol-impaired pedestrians and bicyclists.Practical applicationsEfforts should increase public awareness of the risk of walking or bicycling when impaired. Results suggest the primary target audience for educational campaigns directed at pedestrians and bicyclists is middle-age males. Further research should evaluate the effectiveness of potential countermeasures, such as lowering speeds or improving lighting in urban areas.     

The influence of the age and sex distributions of drivers on the reduction of impaired crashes: Ontario, 1974-1999

Legislative changes and public media campaigns to prevent impaired driving are often cited as explanations for the reduction in the rate of impaired crashes over the past 25 years in most of the industrialized world. Other factors may have contributed to these reductions, such as changes in the age and sex distribution of the driver population. The primary purpose of this article is to assess the extent to which the reduction in impaired crashes in Ontario, Canada, may be attributable to the changing age and sex distribution of drivers. In Ontario, the rate of impaired crashes declined by 78.1% from 1974 to 1999. During this time period, the average age of drivers increased from 39.4 years in 1974 to 43.2 in 1999. Similarly, from 1974 to 1999 the percentage of all drivers that were women increased from 39.6% to 46.8%. Since statistics show the likelihood of impaired crashes is lower for both older drivers and women, the reduction of impaired crashes is partially due to these demographic changes. Using indirect standardization, the aging population accounted for an 8.6% decline in the rate of impaired crashes. The changing sex distribution of drivers accounted for a 9.4% decline in impaired crashes. Other global factors may also help to explain the reduction of impaired crashes, such as general road safety improvements and reductions in per adult consumption of alcohol.     

Analysis of risk factors affecting driver injury and crash injury with drivers under the influence of alcohol (DUI) and non-DUI

Objective: The objective of this research was to study risk factors that significantly influence the severity of crashes for drivers both under and not under the influence of alcohol.

Methods: Ordinal logistic regression was applied to analyze a crash data set involving drivers under and not under the influence of alcohol in China from January 2011 to December 2014.

Results: Four risk factors were found to be significantly associated with the severity of driver injury, including crash partner and intersection type. Age group was found to be significantly associated with the severity of crashes involving drivers under the influence of alcohol. Crash partner, intersection type, lighting conditions, gender, and time of day were found to be significantly associated with severe driver injuries, the last of which was also significantly associated with severe crashes involving drivers not under the influence of alcohol.

Conclusions: This study found that pedestrian involvement decreases the odds of severe driver injury when a driver is under the influence of alcohol, with a relative risk of 0.05 compared to the vehicle-to-vehicle group. The odds of severe driver injury at T-intersections were higher than those for traveling along straight roads. Age was shown to be an important factor, with drivers 50–60 years of age having higher odds of being involved in severe crashes compared to 20- to 30-year-olds when the driver was under the influence of alcohol.

When the driver was not under the influence of alcohol, drivers suffered more severe injuries between midnight and early morning compared to early nighttime. The vehicle-to-motorcycle and vehicle-to-pedestrian groups experienced less severe driver injuries, and vehicle collisions with fixed objects exhibited higher odds of severe driver injury than did vehicle-to-vehicle impacts. The odds of severe driver injury at cross intersections were 0.29 compared to travel along straight roads. The odds of severe driver injury when street lighting was not available at night were 3.20 compared to daylight. The study indicated that female drivers are more likely to experience severe injury than male drivers when not under the influence of alcohol. Crashes between midnight and early morning exhibited higher odds of severe injury compared to those occurring at other times of day.

The identification of risk factors and a discussion on the odds ratio between levels of the impact of the driver injury and crash severity may benefit road safety stakeholders when developing initiatives to reduce the severity of crashes.     

Motivational factors underlying the intention to drink and drive in young male drivers

Problem: Anyone drinking and driving has a high risk of being involved in an accident. Young male drivers, however, run the highest risk at the same levels of blood alcohol as other candidates, as they have more accidents than any other group. A better understanding of their motivations toward drinking and driving is needed to help create effective prevention. Method: In the present study, 115 male drivers aged 18–24 completed a questionnaire—based on Ajzen's theory of planned behavior—designed to study the motivational factors leading to drinking and driving. Results: Young males' intention to drink and drive is predicted by their attitudes, their perceived behavioral control (PBC), and, to a lesser degree, subjective norms. Impact on Industry: The results showing slightly positive PBC over driving after drinking suggest that work aimed at reducing this perception to a more realistic level is a potential prevention avenue.     

Investigating the self-reported behavior of drivers and their attitudes to traffic violations

IntroductionDriving behavior theoretical models consider attitudes as an important determinant of driver behavior. Moreover, the association between the self-reported tendency to commit violations and accident involvement is widely recognized. This research investigates drivers’ self-reported behavior and attitudes to risky behaviors related to the traffic violations of speeding, drink-driving, and cell phone use using cluster analysis.MethodA sample of 601 Greek drivers participating at the SARTRE 4 pan-European survey is utilized. The analysis identified three clusters of drivers. Drivers in Cluster 1 commit traffic violations more often; drivers in Cluster 2 favor traffic violation countermeasures while having moderate views toward compliance with traffic rules; and drivers in Cluster 3 strongly support traffic violation countermeasures and also have strong views toward compliance with traffic rules. Risky behaviors and related attitudes that differentiate the three distinct groups of drivers (clusters) were determined.ResultsThe findings indicate that differences in attitudes and behaviors may be attributed to factors such as age, gender, and area of residence. The research findings also provided some insight about the current level of drivers’ attitudes to traffic violations, especially those that negatively affect traffic safety. The pattern of their views on violations may form the basis of risk behavior-related interventions tailored to the identified groups, aiming at informing, educating, and raising the awareness of the public.Impact on IndustryAgencies focused on safety interventions could exploit this information in designing and implementing education campaigns, enforcement programs and in defining relevant priorities.     

Prevalence of alcohol and illicit drugs in blood specimens from drivers involved in traffic law offenses. Systematic review of cross-sectional studies

OBJECTIVE: To determine which is the reported prevalence of alcohol and illicit drugs in blood specimens from drivers involved in traffic law offenses worldwide. METHODS: The search was performed by using several international biomedical databases. In order to reduce publication bias, additional publications were identified using further sources of information. The present review includes cross-sectional studies published between 1990 and 2005 in English, Spanish, German, Portuguese, and Italian. Only studies based on the analysis of blood specimens and chromatographic quantification of drugs were included. RESULTS: Forty-nine studies fulfilled the inclusion criteria. Eighteen were excluded considering practical reasons regarding limitations for a reliable interpretation of their results. Alcohol appears to be still the predominant substance, with the consideration that among drivers primarily suspected of DUID, cannabinoids are more prevalent. Among the illicit drugs, cannabinoids are the most commonly found substance. Certain trends could be identified, e.g., very low prevalence of cocaine in reports from Nordic countries, a high prevalence of amphetamines between Norwegian and Swedish studies, and low rates of THC among Australian studies. CONCLUSION: The results of this study should be regarded as an attempt to obtain more reliable data concerning the prevalence of alcohol and illicit drugs among drivers. To obtain a better assessment of the real current role of alcohol and drugs (illicit and medications), it seems strongly necessary to update the case-control study conducted by Borkenstein et al. in 1964, including now blood analyses of the whole spectrum of substances that can impair drivers.