Abstract
The primary objective of the present study was to evaluate the frequency of positive tests for alcohol and drugs during roadside testing or after road accidents among drivers in the Brittany region of France. The study’s secondary objective was to describe the blood concentrations of the substances found during these tests, in order to provide a scientific basis for the establishment or modification of legislative threshold values for road injuries prevention. We performed a cross-sectional study of a database compiled by Rennes University Hospital’s toxicology laboratory in the Brittany region of France between 2010 and 2018. Driver’s age, sex, and test status (positive or negative), and blood levels of ethanol, 9-tetrahydrocannabinol (THC), methylene dioxymethamphetamine (MDMA), amphetamine, benzoylecgonine and 6-monoacetylmorphine (6-MAM) were collected. Twelve thousand four hundred and ninety-seven drivers (males: 86.1%; median (range) age: 29 (15–94)) have provided roadside blood samples, giving a total of 25,998 test results. Among the 10,996 drivers with at least one positive test, the median blood concentrations of ethanol, THC, MDMA, amphetamine, benzoylecgonine, and 6-MAM were respectively 1.82 g/L, 2.41 ng/mL, 138.4 ng/mL, 67.7 ng/mL, 173.3 ng/mL, and 0.97 ng/mL. 1159 (10.54%) of the 10,996 drivers tested positive for two or more substances, and 151 (1.4%) tested positive for three or more substances. With the exception of heroin, the currently recommended threshold values appear to be appropriate for road injuries prevention with regard to the concentrations observed in offenders.
Highlights
According to a World Health Organization (WHO) report published in 2018, 27% of road traffic deaths worldwide are attributable to alcohol; this represented 373,000 deaths in 2016, including 187,000 people other than the driver (World Health Organization, 2018)
In France, driving under the influence of alcohol (DUIA) is the second leading cause of fatal road crashes; it accounted for 18% of the 3503 deaths in 2018 (Observatoire national Interministeriel de la securite routiere, 2018)
In line with the literature, we found that methylene dioxymetham phetamine (MDMA) use (n = 436) was more frequent than amphetamine use (n = 195)
Summary
According to a World Health Organization (WHO) report published in 2018, 27% of road traffic deaths worldwide are attributable to alcohol; this represented 373,000 deaths in 2016, including 187,000 people other than the driver (World Health Organization, 2018). In France, driving under the influence of alcohol (DUIA) is the second leading cause (after speeding) of fatal road crashes; it accounted for 18% of the 3503 deaths in 2018 (Observatoire national Interministeriel de la securite routiere, 2018). Drink-driving campaigns are frequent and prominent, the general public is less aware of the impact of driving under the influence of drugs (DUID) on fatal road crashes. The conse quences of DUID are more difficult to identify than those of DUIA because of the difficulty in (i) confirming blood screening results for the drug substance using high-performance equipment (i.e. chromatographic separation coupled to mass spectrometry) and (ii) establishing a causal relationship between a drug concentration threshold and an impairment in driving skills. Data from the USA show that in 2016; 43.6% of the drivers responsible for fatal road injuries were positive for at least one narcotic substance (Governors Highway Safety Association, 2018)
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