Effectiveness of lowering the blood alcohol concentration (BAC) limit for driving from 0.10 to 0.08 grams per deciliter in the United States

Objective: The current study evaluates of the effects of lowering the blood alcohol concentration (BAC) limit from 0.10 to 0.08?g/dL across all 50 states in the United States. Our objectives were to (1) estimate the effects of the 0.08?g/dL BAC limit on drinking driver fatal crash rates; (2) compare the effects from early-adopting states to the effects of late-adopting states; (3) determine the effects on drivers with low BACs (0.01–0.07?g/dL) and high BACs (0.08+ g/dL); and (4) estimate the lives saved since 1983 due to the adoption of 0.08?g/dL BAC laws.

Methods: Our study examined annual data from the Fatality Analysis Reporting System (FARS) for each jurisdiction from 1982 through 2014. Our basic outcome measure was the ratio of drinking drivers (BAC ≥0.01?g/dL) to nondrinking drivers (BAC?=?0.00?g/dL). Covariates included 0.10 BAC laws, administrative license revocation (ALR) laws, seat belt laws, minimum legal drinking age (MLDA) laws, and unemployment rates. We utilized autoregressive integrated moving average (ARIMA) models for each state, where the implementation date of the law was modeled as a zero-order transfer function in the series, in addition to any extant trends that may have been occurring simultaneously. Before determining the specific impact of the implementation of 0.08?g/dL BAC laws, we conducted a time series analysis for each state. We tested for between-state mediating factors relating to our covariates.

Results: A total of 38 of the 51 jurisdictions showed that lowering the BAC limit was associated with reduced drinking driver fatal crash ratios, with 20 of those reductions being significant. The total effects showed a 10.4% reduction in annual drinking driver fatal crash rates, which is estimated to have saved an average of 1,736 lives each year between 1983 and 2014 and 24,868 lives in total. Implementing a BAC limit of 0.08?g/dL had significant impacts on both high- and low-BAC fatal crash ratios. Though early-adopting jurisdictions (1983–1999) demonstrated a larger decrease in fatal drinking driver crash ratios than did late-adopting jurisdictions (2000–2005), the results were not statistically significant (P?>?.05).

Conclusions: Our study of the effects of lowering the BAC from 0.10 to 0.08?g/dL in the United States from 1982 to 2014 showed an overall effect of 10.4% on annual drinking driver fatal crash rates, in line with other multistate studies. This research provides strong evidence of the relationship between lowering the BAC limit for driving and the general deterrent effect on impaired-driving fatal crash rates.     

Driving concerns among older adults: Associations with driving skill,behaviors, and experiences

Objectives: The purpose of this investigation was to determine what older adults find most concerning about driving as they age and how these concerns are related to driving skill, behaviors, and experiences.

Methods: In partnership with the Maryland Motor Vehicle Administration, a sample of 751 older adults ages 65 and older completed an online survey between October 2017 and May 2018. A content analysis was used to code open-ended responses about driver concerns, and multivariate logistic regression models were used to analyze the associations between driving concerns and driving skill, behavior, and experiences.

Results: Eighty-four percent of participants reported at least one driving concern, with 44% concerned about others’ driving, 34% concerned about their own driving, and 24% concerned about driving conditions. The most frequently mentioned driving concerns were other drivers in general, driving at night, visual ability and awareness, and other drivers being aggressive or reckless. Being concerned with their own driving was significantly associated with decreased perceived driving skill and increased odds of experiencing negative driving experiences in the past year. Being concerned about others’ driving was associated with increased odds of wearing a seat belt (adjusted odds ratio [AOR]?=?2.67; 95% confidence interval [CI], 1.02, 7.00), having high perceived driving skills in emergency situations (AOR = 1.56; 95% CI, 1.14, 2.12), and getting in a near crash or collision in the past year (AOR = 1.50; 95% CI, 1.04, 2.18).

Conclusions: Older adult drivers are frequently concerned about their own driving as well as the driving of others. Implications for future research and health practice are discussed.     

Lower back pain and its association with whole-body vibration and manual materials handling among commercial drivers in Sabah

A cross-sectional study was undertaken to determine the prevalence of lower back pain (LBP) and its association with whole-body vibration (WBV) and manual materials handling (MMH). We studied 110 commercial vehicle drivers using a self-administered questionnaire and the VI-400Pro human vibration monitor. Prevalence of LBP was 66.4%. The percentage of drivers who had frequent manual handling of heavy loads was 45.5% and those who handled heavy loads in awkward postures accounted for 86.4%. Daily vibration A(8) averaged on the z axis was 0.25 (0.06) m·s^?2 and at vector sum was 0.29 (0.07) m·s^?2. Daily vibration exposures on the z axis, frequent manual handling of heavy loads and awkward posture during MMH were significantly associated with LBP. Drivers who are exposed to WBV and frequently handle heavy loads manually and with awkward postures probably have more LBP than drivers who are exposed to only one of these risk factors.     

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.     

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.     

Motorcycle safety among motorcycle taxi drivers and nonoccupational motorcyclists in developing countries: A case study of Maoming,South China

Objective: An increasing number of motorcycle taxis have been involved in traffic crashes in many developing countries. This study examines the characteristics of both motorcycle taxi drivers and nonoccupational motorcyclists, investigates the risks they pose to road safety, and provides recommendations to minimize their risks.

Methods: Based on the data collected from a questionnaire survey of 867 motorcycle taxi drivers and 2,029 nonoccupational motorcyclists in Maoming, South China, comparisons were made to analyze differences of personal attributes, attitudes toward road safety, and self-reported behavior of the 2 groups.

Results: Results of the chi-square tests show that not only motorcycle taxi drivers but also nonoccupational motorcyclists in Maoming held poor attitudes toward road safety and both groups reported unsafe driving behavior. There is much room for improving local road safety education among all motorcyclists in Maoming. Yet, motorcycle taxi drivers were more likely to pose road safety risks than nonoccupational motorcyclists under some circumstances, such as speeding late at night or early in the morning, not requiring passengers to wear helmets, and running a red light. The results of the binary logistic regression model show that possessing a vehicle license for a motorcycle or not was the common significant predictor for unsafe driving behavior of motorcycle taxi drivers and nonoccupational motorcyclists. Therefore, enforcement against all motorcyclists not showing vehicle licenses for their motorcycles should be stepped up.

Conclusion: Motorcycle safety is largely poor in Maoming. Therefore, efforts to improve motorcycle safety should be strengthened by targeting not only motorcycle taxi drivers but also nonoccupational motorcyclists.     

Ankle fracture patterns in drivers are associated with femoral fracture,higher BMI,and advanced age

Objective: Despite advances in vehicle safety systems, motor vehicle crashes continue to cause ankle fractures. This study attempts to provide insight into the mechanisms of injury and to identify the at-risk population groups.

Methods: A study was made of ankle fractures patients treated at an urban level 1 trauma center following motor vehicle crashes, with a concurrent analysis of a nationally representative crash data set. The national data set focused on ankle fractures in drivers involved in frontal crashes. Statistical analysis was applied to the national data set to identify factors associated with fracture risk.

Results: Malleolar fractures occurred most frequently in the driver's right foot due to pedal interaction. The majority of complex/open fractures occurred in the left foot due to interaction with the vehicle floor. These fractures occurred in association with a femoral fracture, but their broad injury pattern suggests a range of fracture causation mechanisms. The statistical analysis indicated that the risk of fracture increased with increasing driver body mass index (BMI) and age.

Conclusions: Efforts to reduce the risk of driver ankle injury should focus on right foot and pedal interaction. The range of injury patterns identified here suggest that efforts to minimize driver ankle fracture risk will likely need to consider injury tolerances for flexion, pronation/supination, and axial loading in order to capture the full range of injury mechanisms. In the clinical environment, physicians examining drivers after a frontal crash should consider those who are older or obese or who have severe femoral injury without concurrent head injury as highly suspicious for an ankle injury.     

驾驶员心理特征与驾驶安全的关系研究

随着人-车-环境系统复杂性的增加和交通事故数量的上升,新型交通工具对驾驶员的要求随之提高。从人的心理与控制的关系及汽车驾驶员的心理特征出发,具体分析心理各特征因素对驾驶员的影响,在此基础上建立汽车驾驶员安全评价模型,最后提出了在考虑心理因素的前提下提高道路行车安全的具体措施。     

Rare earth elements distribution in seawater and suspended particulate of the Central Mediterranean Sea

Rare earth element (REE) content in suspended and dissolved phases from the Strait of Sicily (Central Mediterranean Sea) has been measured. Vertical profiles of several dissolved REEs along the water column reflect the 3-D oceanographic features of the studied area and identifies the different water masses present there. Shale-normalized REE distribution patterns and derived parameters calculated for the suspended particulate show different atmospheric dust-surface inputs and their interactions with seawater. Finally, combined information from [La/Yb]_N, ratios, REE/La ratios and Eu anomalies measured in the suspended particulate suggest an important contribution of volcanic materials from the Etna volcano and Saharan dust to the lithogenic fraction of the suspended particulate.