The effectiveness of reducing illegal blood alcohol concentration (BAC) limits for driving: evidence for lowering the limit to .05 BAC

PURPOSE: This scientific review provides a summary of the evidence regarding the benefits of reducing the illegal blood alcohol concentration (BAC) limit for driving and providing a case for enacting a .05 BAC limit. RESULTS: Fourteen independent studies in the United States indicate that lowering the illegal BAC limit from .10 to .08 has resulted in 5-16% reductions in alcohol-related crashes, fatalities, or injuries. However, the illegal limit is .05 BAC in numerous countries around the world. Several studies indicate that lowering the illegal per se limit from .08 to .05 BAC also reduces alcohol-related fatalities. Laboratory studies indicate that impairment in critical driving functions begins at low BACs and that most subjects are significantly impaired at .05 BAC. The relative risk of being involved in a fatal crash as a driver is 4 to 10 times greater for drivers with BACs between .05 and .07 compared to drivers with .00 BACs. SUMMARY: There is strong evidence in the literature that lowering the BAC limit from .10 to .08 is effective, that lowering the BAC limit from .08 to .05 is effective, and that lowering the BAC limit for youth to .02 or lower is effective. These law changes serve as a general deterrent to drinking and driving and ultimately save lives. IMPACT ON INDUSTRY: This critical review supports the adoption of lower illegal BAC limits for driving.     

Can progress in reducing alcohol-impaired driving fatalities be resumed? Results of a workshop sponsored by the Transportation Research Board,Alcohol, Other Drugs,and Transportation Committee (ANB50)

Objective: Despite successes in the 1980s and early 1990s, progress in reducing impaired driving fatalities in the United States has stagnated in recent years. Since 1997, the percentage of drivers involved in fatal crashes with illegal blood alcohol concentration (BAC) levels has remained at approximately 20 to 22%. Many experts believe that public complacency, competing social and public health issues, and the lack of political fortitude have all contributed to this stagnation. The number of alcohol-related crashes, injuries, and fatalities is still unacceptable, and most are preventable. The public needs to be aware that the problem presented by drinking drivers has not been solved. Political leaders need guidance on which measures will affect the problem, and stakeholders need to be motivated once again to implement effective strategies.

Methods: The National Academy of Sciences (NAS) Transportation Research Board (TRB), Alcohol, Other Drugs, and Transportation Committee (ANB50) sponsored a workshop held at the NAS facility in Woods Hole, Massachusetts, on August 24–25, 2015, to discuss the lack of progress in reducing impaired driving and to make recommendations for future progress. A total of 26 experts in research and policy related to alcohol-impaired driving participated in the workshop. The workshop began by examining the static situation in the rate of alcohol-impaired driving fatal crashes to determine what factors may be inhibiting further progress. The workshop then discussed 8 effective strategies that have not been fully implemented in the United States. Workshop participants (16 of the 26) rated their top 3 strategies.

Results: 3 strategies received the most support: 1. Impose administrative sanctions for drivers with BACs = 0.05 to 0.08 g/dL.

2. Require alcohol ignition interlocks for all alcohol-impaired driving offenders.

3. Increase the frequency of sobriety checkpoints, including enacting legislation to allow them in the 11 states that currently prohibit them.

5 other important strategies included the following: (1) increase alcohol taxes to raise the price and reduce alcohol consumption; (2) reengage the public and raise the priority of impaired driving; (3) lower the illegal per se BAC limit to 0.05 for a criminal offense; (4) develop and implement in-vehicle alcohol detection systems; and (5) expand the use of screening and brief interventions in medical facilities.

Conclusions: Each of these strategies is proven to be effective, yet all are substantially underutilized. Each is used in some jurisdictions in the United States or Canada, but none is used extensively. Any one of the 3 strategies implemented on a widespread basis would decrease impaired driving crashes, injuries, and fatalities. Based on the research, all 3 together would have a substantial impact on the problem.     

Rat urinary metabolites from O,O‐diethyl‐O‐(3, 5, 6‐trichloro‐2‐pyridyl) phosphorothioate

Abstract

Rats metabolized single oral doses of O,O‐diethy1–0‐(3,5,6‐trichloro‐2‐pyridyl‐2,6‐¹⁴C) phosphorothioate to at least six radiolabeled urinary metabolites. The urine contained about 90 percent of the dose. Three of these metabolites were identified as the glucuronide of 3,5,6‐trichloro‐2‐pyridinol (80% the urinary ^l4C), a glycoside of 3,5,6‐trichloro‐2‐pyridinol (4%), and 3,5,6‐trichloro‐2‐pyridinol (12%).     

Changes in blood lead and water lead in Edinburgh. An eight year follow-up to the Edinburgh lead study

This study aimed to measure changes in household water lead and blood lead in young people living in Edinburgh over a period of 8 years. Two hundred and twenty-three families were eligible and 207 (93%) agreed to participate. A half-hour stagnation sample of kitchen cold water was taken from each household, and 171 young people (aged 14–17 years) provided a blood sample for lead analysis. Information on plumbing changes, exposure to other sources of lead and factors which might influence blood lead was collected by questionnaire. Edinburgh is supplied with water treated in one of two treatment plants. There was a different programme of water treatment in each plant. In one (A) lime and orthophosphate was introduced in the interval between the original and follow-up studies. In the other (F) lime treatment began before the original study and orthophosphate was introduced subsequently. In water from treatment plant A, mean water lead levels fell from 34 to 4.3 gL-1 (87%). In water supplied from treatment plant F the corresponding values were 9.3 to 3.6 gL-1 (61%). These reductions were due to both water treatment and removal of lead plumbing. Houses with no lead plumbing have water lead levels 89% lower than houses with lead tanks, and 47% lower than houses with lead pipes. About one-third of households with lead tanks are predicted to have water lead levels above the current EC limit of 50 gL- 1, though only 3% or less of the remaining households would exceed this limit. If the proposed 10 gL-1 limit were introduced, 34% of households supplied from plant A and 25% from plant F would breach the limit. Blood lead levels fell from an average of 11.0 gdL-1 to 4.0 gdL-1. Males had higher values than females and the main factors influencing levels were water lead and age of house. Our results show substantial reductions in household water lead and blood lead in our sample over a period of 8 years and represent an important achievement in public health. However, more progress will be required if the proposed new limit of 10 gL-1 for water lead is to be met. There is a need for the continuing surveillance of household water lead and blood lead levels in representative samples of the population.     

Impact of primary safety belt laws on alcohol-related front-seat occupant fatalities: five case studies

OBJECTIVE: Impaired drivers and other high-risk road users are less likely to use their safety belts, thus increasing the risk of fatal injury in the event of a crash. Although safety belt laws have been shown to increase wearing rates for daytime non-crash-involved drivers and their front-seat passengers, little evidence is available on the effect these laws have on belt usage by crash-involved drinking drivers and their passengers. METHODS: This study evaluated the influence of primary safety belt law upgrades from secondary laws on front-seat occupants of passenger cars driven by drinking drivers in fatal crashes in five states: California, Illinois, Maryland, Michigan, and Washington. The outcome measures used to evaluate these law upgrades were (1) the change in safety belt usage rates of front-seat occupants in passenger cars driven by drinking drivers in fatal crashes and (2) the change in alcohol-related front-seat occupant fatalities in passenger cars driven by drinking drivers. RESULTS: Four of the five states demonstrated increases in safety belt use by front-seat occupants of passenger cars of drinking drivers in fatal crashes following the upgrade to primary safety belt laws. Three states (California, Michigan, and Washington) experienced significant reductions in the number of front-seat occupant fatalities in vehicles driven by drinking drivers. CONCLUSIONS: The adoption of primary law upgrades was associated with significant increases in safety belt use (four of five states) and significant reductions in fatalities among high-risk occupants (i.e., front-seat occupants involved in fatal crashes in vehicles driven by drinking drivers) in three of the five states studied.     

The variability of lead in dusts within the homes of young children

The variability of household dust lead concentration and loadings over the period of about a year has been examined in 10 homes. The overall uncertainty on a single sample is ± 65% for lead concentration and ± 81% for lead loading. Redecoration involving electric sanding and/or blow lamp preparation of painted surfaces is the major cause of variation in lead levels. The effect is short lived, levels returning to normal within 2 months of redecoration ending. There is evidence of a seasonal trend for dust loading and lead loading but not for lead concentration. The implications of these findings for blood lead — dust lead exposure studies are considered.This paper is also being published in the proceedings of the conference on Lead in the Home Environment and is one of several selected from the SEGH sponsored conferences for republication in this journal.     

Cadmium concentrations in human kidney in the UK: 1978-1993

Almost 2700 samples of human renal cortex have been collected from throughout the UK over a 16 year period from 1978 to 1993. The mean Cd concentration was 19 micrograms g-1 and the median 16 micrograms g-1. Smokers were, on average, about 5 micrograms g-1 higher than non-smokers. Cd increased from low concentration in the young to a maximum of 23 micrograms g-1 in middle age followed by a decrease in old age. Subjects who had died of renal disease had lower Cd concentrations. Geographical variations in the UK are small and the concentrations appear to be static over the 16 year period. Some 3.9% of the population had Cd concentrations > 50 micrograms g-1, the critical level at which beta 2-microglobulin appears in urine.     

Age dependence of potentially toxic elements (Sb,Cd, Pb,Ag) in human liver tissue from paediatric subjects

Toxic elements are present at low concentrations in the environment. This work was undertaken to investigate the age dependence of the liver content of selected elements in paediatric populations, as an index of internal exposure. Liver samples were collected at autopsy from 157 subjects, aged < 1 day to 6 years, as part of investigations on a possible role of Sb compounds in sudden infant death syndrome (SIDS). In addition to Sb, the concentrations of Ag, Cd and Pb were also determined by inductively coupled plasma mass spectrometry on the remaining digest. Comparison of 95% confidence intervals of the median concentrations of the four elements suggested that there were no differences between the two categories of cause of death, SIDS or those who had died of an identified disease. Cadmium, lead and antimony median concentrations were lower than corresponding values observed in adult populations. Silver concentrations were significantly higher at birth and decreased with age. Cadmium levels were almost negligible in neonates and infants, but increased in older children. The finding of non-negligible concentrations of both Ag and Pb in neonatal liver provides further direct evidence that these elements cross the human placental barrier. The reported data, by far the largest collection observed in subjects less than 1 year old, are the result of exposure, during pregnancy and in early childhood, to present levels of these elements in the environment. They can serve as a reference to compare post-mortem values from individuals or groups of subjects in this age range when an exposure risk is suspected and to highlight trends in human exposure.     

Macroinvertebrate and fish populations in a restored impounded salt marsh 21 years after the reestablishment of tidal flooding

During the last two decades, the State of Connecticut has restored tidal flow to many impounded salt marshes. One of the first of these and the one most extensively studied is Impoundment One in the Barn Island Wildlife Management Area in Stonington, Connecticut. In 1990, twelve years after the re-establishment of tidal flooding, the density of the marsh snail Melampus bidentatus, the numerically dominant macroinvertebrate of the high marsh, in Impoundment One was about half that in reference marshes below the breached impoundment dike. By 1999 the densities of Melampus above and below the dike were not significantly different, but the shell-free biomass was greater above the dike as a result of the somewhat larger number and size of the snails there. Twenty-one years after the renewal of tidal flooding, three marsh macroinvertebrates (the amphipods Orchestia grillus and Uhlorchestia spartinophila and the mussel Geukensia demissa) were significantly less abundant in the previously impounded marsh than in the reference marshes, whereas another amphipod (Gammarus palustris) was more abundant above the breached dike where conditions appeared to be somewhat wetter. In 1991 the fish assemblage in a mosquito-control ditch in Impoundment One was similar to that in a ditch below the breached dike; however, the common mummichog Fundulus heteroclitus appeared to be less abundant in the restoring marsh. By 1999 the number of mummichogs caught in ditches was significantly greater in Impoundment One than in the reference marsh, but the numbers of mummichogs trapped along the tidal creek were comparable above and below the dike. The results obtained in this study and those of other restoring marshes at Barn Island indicate the full recovery of certain animal populations following the reintroduction of tidal flow to impounded marshes may require up to two or more decades. Furthermore, not only do different species recover at different rates on a single marsh, but the time required for the recovery of a particular species may vary widely from marsh to marsh, often independently of other species.