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Occurrence
and Consequences
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Alcohol-related
motor vehicle crashes kill someone every 30
minutes and non-fatally injure someone every
two minutes (NHTSA 2003a).
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During
2002, 17,419 people in the U.S. died in
alcohol-related motor vehicle crashes,
representing 41% of all traffic-related
deaths (NHTSA 2003a).
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In
2001, more than 1.4 million drivers were
arrested for driving under the influence of
alcohol or narcotics (FBI 2001). That’s
slightly more than 1 percent of the 120
million self-reported episodes of
alcohol–impaired driving among U.S. adults
each year (Dellinger 1999).
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Drugs
other than alcohol (e.g., marijuana and
cocaine) have been identified as factors in
18% of motor vehicle driver deaths. Other
drugs are generally used in combination with
alcohol (NHTSA 1993).
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Nearly
two-thirds of children under 15 who died in
alcohol-related crashes between 1985 and
1996 were riding with the drinking driver.
More than two-thirds of the drinking drivers
were old enough to be the parent of the
child who was killed, and fewer than 20% of
the children killed were properly restrained
at the time of the crash (Quinlan 2000).
Cost
In
its publication The Economic Impact of
Motor Vehicle Crashes, the National
Highway Traffic Safety Administration reported
that alcohol-related crashes in 2000 were
associated with more than $51 billion in total
costs (Blincoe 2002).
Groups
at Risk
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Male
drivers involved in fatal motor vehicle
crashes are almost twice as likely as
female drivers to be intoxicated with a
blood alcohol concentration (BAC) of 0.10%
or greater (NHTSA 2003a).
A BAC of 0.08% is equal to or
greater than the legal limit in most
states.
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At
all levels of blood alcohol concentration,
the risk of being involved in a crash is
greater for young people than it is for
older people (Mayhew 1986). In
2002, 24% of
drivers ages 15 to 20 who died in motor
vehicle crashes had been drinking alcohol
(NHTSA 2003b).
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Young
men ages 18 to 20 (too young to buy
alcohol legally) report driving while
impaired almost as frequently as men ages
21 to 34 (Liu 1997).
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In
2002, 22% of the 2,197 traffic fatalities
among children ages 0 to 14 years involved
alcohol (NHTSA 2003c).
Risk
Factors
CDC
Activities
Actions
to decrease alcohol-related fatal crashes
involving young drivers have been
effective
Over the past 20 years, alcohol-related
fatal crash rates have decreased by 60
percent for drivers ages 16 to 17 years
and 55 percent for drivers ages 18 to 20
years. However, this progress has stalled
in the past few years. To further decrease
alcohol-related fatal crashes among young
drivers, communities need to implement and
enforce strategies that are known to be
effective, such as minimum legal drinking
age laws and "zero tolerance"
laws for drivers under 21 years of age.
Elder RW, Shults RA. Trends in alcohol
involvement in fatal motor vehicle crashes
among young drivers – 1982-2001. MMWR
2002;51:1089–91.
Sobriety checkpoints reduce
alcohol-related crashes
Fewer alcohol-related crashes occur when
sobriety checkpoints are implemented,
according to a CDC report published in the
December 2002 issue of Traffic Injury
Prevention. Sobriety checkpoints are
traffic stops where law enforcement
officers systematically select drivers to
assess their level of alcohol impairment.
The goal of these interventions is to
deter alcohol-impaired driving by
increasing drivers’ perceived risk of
arrest. The conclusion that they are
effective in reducing alcohol-related
crashes is based on a systematic review of
research about sobriety checkpoints. The
review was conducted by a team of experts
led by CDC scientists, under the oversight
of the Task Force on Community Preventive
Services—a 15-member, non-federal group
of leaders in various health-related
fields. (Visit www.thecommunityguide.org
for more information.) The review combined
the results of 23 scientifically-sound
studies from around the world. Results
indicated that sobriety checkpoints
consistently reduced alcohol-related
crashes, typically by about 20 percent.
The results were similar regardless of how
the checkpoints were conducted, for
short-term “blitzes,” or when
checkpoints were used continuously for
several years. This suggests that the
effectiveness of checkpoints does not
diminish over time.
Elder RW, Shults RA, Sleet DA, Nichols JL,
Zaza S, Thompson RS. Effectiveness of
sobriety checkpoints for reducing
alcohol-involved crashes. Traffic Inj Prev
2002;3:266-74.
Stronger state DUI prevention
activities may reduce alcohol-impaired
driving
Strong state activities designed to
prevent driving under the influence (DUI),
including legislation, enforcement, and
education, may reduce the incidence of
drinking and driving, according to a study
from the Centers for Disease Control and
Prevention (CDC). For the study, which was
published in the June 2002 issue of Injury
Prevention, CDC analyzed data from the
1997 Behavioral Risk Factor Surveillance
System (BRFSS) national telephone survey,
and the Mothers Against Drunk Driving
(MADD) Rating the States 2000 survey, that
graded states on their DUI countermeasures
from 1996-1999. Results showed that
residents of states with a MADD grade of
"D" were 60 percent more likely
to report alcohol-impaired driving than
were residents from states with a MADD
grade of "A." MADD based the
grades on 11 categories of prevention
measures, including DUI legislation;
political leadership; statistics and
records availability; resources devoted to
enforcing DUI laws; administrative
penalties and criminal sanctions;
regulatory control and alcohol
availability; youth DUI legislation;
prevention and education; and victim
compensation and support.
The study also found that 4 percent of the
residents who consume alcohol reported
they had driven after having too much to
drink at least once during the previous
month. Men were nearly three times as
likely as women to report alcohol-impaired
driving, and single people were about 50
percent more likely to report
alcohol-impaired driving than married
people or those living with a partner.
Shults RA, Sleet DA, Elder RW, Ryan GW,
Sehgal M. Association between state-level
drinking and driving countermeasures and
self-reported alcohol-impaired driving.
Inj Prev 2002;8:106–10.
Research leads to bills that protect
children from drinking drivers
CDC’s findings about the number of
children killed in cars driven by drinking
drivers has led legislators in several
states to introduce bills to help protect
them from drinking drivers. Such
legislation creates special penalties
under state child abuse laws for persons
who transport children while driving
drunk. Results from the study showed that
nearly two-thirds of children killed in
drinking driver-related crashes were
riding with the impaired driver. Fewer
than 20 percent of the children killed
were properly restrained at the time of
the crash, and restraint use decreased as
the driver’s blood alcohol concentration
increased.
Quinlan KP, Brewer RD, Sleet DA, Dellinger
AM. Child passenger deaths and injuries
involving drinking drivers. JAMA
2000:283(17):2249–52.
Research identifies effective
interventions against alcohol-impaired
driving
CDC and the Task Force on Community
Preventive Services—an independent,
nonfederal panel of community health
experts—published systematic reviews of
the literature for five community-based
interventions to reduce alcohol-impaired
driving. The reviews revealed strong
evidence of effectiveness for 0.08% blood
alcohol concentration (BAC) laws, minimum
legal drinking age laws, and sobriety
checkpoints. They also found sufficient
evidence of effectiveness for lower BAC
laws specific to young or inexperienced
drivers (zero tolerance laws) and
intervention training programs for alcohol
servers. A detailed description of the
sobriety checkpoints systematic review was
published in the December 2002 issue of
Traffic Injury Prevention. The systematic
review of the effectiveness of 0.08% BAC
laws for drivers was helpful in
establishing a 0.08% standard nationwide.
The review revealed that state laws that
lowered the illegal BAC for drivers from
0.10% to 0.08% reduced alcohol-related
fatalities by a median of 7 percent,
translating to 500 lives saved annually.
With this evidence, the Task Force on
Community Preventive Services strongly
recommended that all states pass 0.08% BAC
laws. In October 2000, the President
signed the Fiscal Year 2001 transportation
appropriations bill, requiring states to
pass the 0.08% BAC law by October 2003 or
risk losing federal highway construction
funds. As of October 1, 2003, 45 states
and the District of Columbia had enacted
0.08% BAC legislation.
In June 2001, Tommy G. Thompson, Secretary
of the Department of Health and Human
Services, awarded the Secretary’s Award
for Distinguished Service to the
systematic review team for their
contribution to the field. The team is
currently conducting systematic reviews of
mass media campaigns, school-based
education programs, and designated driver
programs, which are scheduled for
publication in 2004.
The Guide to Community Preventive Services
Shults RA, Elder RW, Sleet DA, Nichols JL,
Alao MA, Carande-Kulis VG, et al. Reviews
of evidence regarding interventions to
reduce alcohol-impaired driving [published
erratum appears in American Journal of
Preventive Medicine 2002;23:72]. American
Journal of Preventive Medicine
2001;21(4S):66–88.
Prevention Strategies
Effective
measures to prevent injuries and deaths
from impaired driving include:
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Promptly
suspending the driver's licenses of
people who drive while intoxicated (DeJong
1998).
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Lowering
the permissible levels of blood
alcohol concentration (BAC) for adults
to 0.08% in all states (Shults 2001).
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Zero
tolerance laws for drivers younger
than 21 years old in all states (Shults
2001).
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Sobriety
checkpoints (Shults 2001).
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Multi-faceted
community-based approaches to alcohol
control and DUI prevention (Holder
2000, DeJong 1998).
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Mandatory
substance abuse assessment and
treatment for
driving-under-the-influence offenders
(Wells-Parker, 1995).
Other
suggested measures include:
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Reducing
the legal limit for blood alcohol
concentration (BAC) to 0.05% (Howat
1991; National Committee on Injury
Prevention and Control 1989).
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Raising
state and federal alcohol excise taxes
(National Committee on Injury
Prevention and Control 1989).
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Implementing
compulsory blood alcohol testing when
traffic crashes result in injury
(National Committee on Injury
Prevention and Control 1989).



References
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L, Seay A, Zaloshnja E, Miller T, Romano
E, Luchter S, Spicer R. The
Economic Impact of Motor Vehicle Crashes,
2000. Washington (DC): National
Highway Traffic Safety Administration,
U.S. Department of Transportation; 2002.
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Brewer
RD, Morris PD, Cole TB, Watkins S, Patetta
MJ, Popkin C. The risk of dying in
alcohol-related automobile crashes among
habitual drunk drivers. New
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DeJong
W. Hingson R. Strategies to reduce driving
under the influence of alcohol. Annual
Review of Public Health
1998;19:359–78.
Dellinger
AM, Bolen J, Sacks JJ. A comparison of
driver– and passenger–based estimates
of alcohol–impaired driving. American
Journal of Preventive Medicine
1999;16(4):283–8.
Federal Bureau of Investigation. Crime in
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Reports. Washington (DC): FBI; 2002.
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Holder
HD, Gruenewald PJ, Ponicki WR, Treno AJ,
Grube JW, Saltz RF, et al. Effect of
community-based interventions on high-risk
drinking and alcohol-related injuries.
JAMA 2000;284:2341-7.
Howat
P, Sleet D, Smith I. Alcohol and driving:
is the .05% blood alcohol concentration
limit justified? Drug and Alcohol
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Liu
S, Siegel PZ, Brewer RD, Mokdad AH, Sleet
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DR, Donelson AC, Beirness DJ, Simpson HM.
Youth, alcohol and relative risk of crash
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Miller
BA, Whitney R, Washousky R. Alcoholism
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Committee for Injury Prevention and
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challenge. American Journal of
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National
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RA, Elder RW, Sleet DA, Nichols JL, Alao
MO, Carande-Kulis VG, Zaza S, Sosin DM,
Thompson RS, Task Force on Community
Preventive Services. Reviews of evidence
regarding interventions to reduce
alcohol-impaired driving. American
Journal of Preventive Medicine
2001;2(4 Suppl):66–88.
Quinlan
KP, Brewer RD, Sleet DA, Dellinger AM.
Characteristics of child passenger deaths
and injuries involving drinking drivers. JAMA
2000;283(17):2249–52.
Wells-Parker
E, Bangert-Drowns R, McMillen R, Williams
M. Final results from a meta-analysis of
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