Blood Alcohol Concentration Limit Research Articles

Concentration units used to report blood- and breath-alcohol concentration for legal purposes are important to consider when blood-breath ratios of alcohol are calculated and compared between countries: re-evaluation of a German study with Alcotest 9510 DE evidential instrument

This article re-evaluates the results of a controlled drinking study done in Germany to determine inter-subject variation in the blood-to-breath ratio (BBR) of alcohol. Statutory blood-alcohol concentration (BAC) limits for driving in Germany are 0.50 g/kg (administrative offence) and 1.1 g/kg (criminal offence). Mass/mass concentration units (g/kg) are 6 % lower than mass/volume (g/L) units, because the density of blood is 1.06 kg/L on average. The corresponding statutory breath-alcohol concentration (BrAC) limits for driving in Germany are 0.25 mg/L and 0.55 mg/L, respectively. BAC in road traffic cases is determined indirectly by the analysis of serum and dividing by 1.236, which underestimates the true BAC. Using Alcotest 9510 DE evidential breath analyzer, the mean ± SD, median and range of BBRs of alcohol were 2047 ± 150, 2053, and 1571-2394 and 61% were less than 2100:1. After re-calculating BAC assuming a serum/blood distribution ratio of ethanol of 1.14:1 and reporting results in mass/volume units, the corresponding BBRs were 2220 ± 162, 2226, and 1703-2595 and 21% were less than 2100. Care is needed when the results of German studies of the BBR of alcohol are compared and contrasted with studies done in other countries.

Implementation of the new acts on driving under the influence of alcohol and clinical outcomes for patients severely injured in road traffic crashes

Objective Driving under the influence (DUI) of alcohol is a major risk factor for fatal road traffic injuries (RTIs) worldwide. This study aimed to investigate the relationship between the implementation of new acts on DUI of alcohol and the clinical outcomes of patients with severe RTIs in Korea. Methods This is a community-based cross-sectional study using a nationwide severe trauma registry in Korea. In 2018, 2 acts with the Yoon Chang-Ho Act (Yoon’s Act) were passed to strengthen the punishment for drunk driving fatal RTIs (first Yoon’s act) and lower the blood alcohol concentration limit to restrict driver’s licenses (second Yoon’s act). The first Yoon’s act was implemented on December 18, 2018, and the second Yoon’s act was implemented on June 25, 2019. The study periods were categorized as pre-Act-1, pre-Act-2, Act-1, and Act-2 according to the application of Yoon’s Act, and the study outcome was in-hospital mortality. Multivariable logistic regression analysis was conducted to estimate the relationship of the new acts and in-hospital mortality. Results Among a total of 20,376 patients with severe RTIs and 7,928 patients (drivers) with RTIs (hereafter drivers), the in-hospital mortality rates were 20.8% and 17.0%, and alcohol-related RTIs accounted for 9.7% and 8.1%, respectively. Severe RTIs tended to increase with each period (25.5 cases/day, 24.5 cases/day, 26.8 cases/day, and 30.4 cases/day, P for trend <.01). In-hospital mortality significantly decreased during the Act-2 period compared to the pre-Act-2 period for all patients with severe RTIs (adjusted odds ratio = 0.54, 95% confidence interval 0.43–0.67) and drivers with RTIs (adjusted odds ratio = 0.50, 95% confidence interval 0.34–0.73). Conclusions Implementation of the new acts on DUI of alcohol was associated with lower odds for in-hospital mortality for patients with severe RTIs. Further studies are needed to evaluate the long-term impact of the new acts on reducing alcohol-related RTIs.

Concentration units used to report blood- and breath-alcohol concentration for legal purposes differ between countries which is important to consider when blood/breath ratios of alcohol are compared and contrasted.

This technical note reviews the plethora of concentration units used to report blood-alcohol concentration (BAC) and breath-alcohol concentrations (BrAC) for legal purposes in different countries. The choice of units sometimes causes confusion when scientific papers originating from a certain country might be introduced into evidence via expert testimony, such as when alcohol-related crimes are prosecuted. The concentration units are also important to consider when blood/breath ratios (BBRs) of alcohol are calculated and compared between countries. Statutory BAC limits for driving in most nations are reported in mass/volume (m/v) units, such as g/100 mL (g%) in the United States, mg/100 mL (mg%) in the United Kingdom and Republic of Ireland, or g/L (mg/mL) in many EU nations. By contrast, Germany and the Nordic countries report BAC as mass/mass (m/m) units, hence g/kg or mg/g, which are ~5.5% lower than m/v units, because whole blood has an average density of 1.055 g/mL. There are historical reasons for reporting BAC in mass/mass units because the aliquots of blood analyzed were measured by weight rather than volume. The difference between m/m and m/v is also important in postmortem toxicology, such as when distribution ratios of ethanol between blood and other biological specimens, such as urine, vitreous humor, and cerebrospinal fluid, are reported.

Hit-and-run or hit-and-stay? Unintended effects of a stricter BAC limit.

Although they comprise a relatively small subset of all traffic deaths, hit-and-run (HR) fatalities are both contemptible and preventable. We analyze longitudinal data from 1982 to 2008 to examine the effects of blood alcohol concentration (BAC) laws on HR traffic fatalities. Our results suggest that lower BAC limits may have an unintended consequence of increasing HR fatalities, whereas a similar effect is absent for non-HR fatalities. Specifically, we find that the adoption of a 0.08 BAC limit is associated to an 8.3% increase in HR fatalities. This unintended effect is more pronounced in urban areas and during weekends, which are typical settings for HR incidents.

The effectiveness of regulations preventing alcohol-related road traffic crashes and fatalities in the European Union countries

Introduction: This article addresses the impact of policy measures on the number of alcohol-related crashes and fatalities in European Union countries. In particular, it assesses (1) whether mild or severe penalty measures should be used to reduce the number of crashes and fatalities caused by alcohol; and (2) whether alcoholic beverages should be treated differently or proportionally to their alcohol content. Methods: This study analyzed the number of alcohol-related crashes and fatalities in 24 European Union countries between 2002 and 2014. The methodology involved fixed-effects panel models, models with instrumental variables, the Hausman–Taylor model, and seemingly unrelated regressions (SUR). SUR improve the results of coefficient estimates when the data are not complete. Results: The results of the SUR indicated that vehicle impoundment, community service, and alcolocks correlate with lower crashes, while detention correlates with lower fatalities. Furthermore, a higher alcohol content in beverages is positively associated with fatalities and negatively associated with the number of crashes. Conclusions: Mild and harsh measures for preventing alcohol-related crashes and fatalities differ in effectiveness; therefore, they should be used simultaneously. Blood alcohol concentration limits were found to be an ineffective tool for preventing crashes and fatalities under the influence of alcohol. Practical implications: The regulatory restrictions on different types of alcohol should be stricter for hard alcohol (especially spirits) and lower for low-alcohol beverages, such as beer, if fewer fatalities are preferred to fewer crashes.

Breathalyzer Test &amp; Its Importance in Aviation Industry

The Indian aviation industry has witnessed significant growth in recent years, making safety and regulatory compliance paramount. To maintain the highest standards of safety, the Directorate General of Civil Aviation (DGCA) has implemented rigorous measures, including breathalyser testing for pilots and crew members. This abstract explores the significance of breathalyser testing in the Indian aviation sector, focusing on its role in enhancing safety and ensuring compliance with international aviation standards. Breathalyser testing has become a crucial component of the DGCA's safety protocols, aiming to prevent pilots and crew from operating aircraft under the influence of alcohol. This paper examines the key elements of the DGCA's alcohol testing regulations, including permissible blood alcohol concentration (BAC) limits, testing procedures, prohibition periods, and penalties for violations. The strict adherence to these regulations is essential to guarantee the safety of air travel and to maintain public trust in the industry. The abstract also delves into the impact of breathalyser testing on pilot behaviour and the overall safety culture within the Indian aviation sector. By acting as a strong deterrent against alcohol consumption before or during duty, these tests contribute to a safer and more responsible aviation workforce. Furthermore, this abstract discusses the role of breathalyser testing in aligning the Indian aviation industry with international standards, particularly those set by the International Civil Aviation Organization (ICAO). The adoption of stringent testing procedures demonstrates India's commitment to upholding global aviation safety norms. Finally, this paper highlights the importance of continuous monitoring and improvement of breathalyser testing programs, including pilot education and rehabilitation efforts for those facing alcohol-related issues. Such initiatives not only enhance safety but also promote a culture of responsibility and accountability within the industry. In conclusion, breathalyser testing has emerged as a pivotal tool for enhancing safety and compliance in the Indian aviation industry. It not only aligns with international standards but also plays a vital role in fostering a culture of safety and responsibility among aviation personnel. As the industry continues to expand, the strict enforcement of alcohol testing regulations remains essential to safeguarding the integrity of Indian aviation and ensuring the well-being of passengers and crew.

Vision Zero and Impaired Driving: Near and Longer-Term Opportunities for Preventing Death and Injuries

Vision Zero involves the use of a systems approach to eliminate fatal and serious injuries from motor vehicle crashes by accommodating basic human limitations that lead to crashes through fundamental behavioral expectations, together with sound vehicle and road design.Alcohol-related crashes account for a significant proportion of motor vehicle crash death and injury and can be addressed in a safe road transport system. We look at near-term policy and program interventions that are known to motivate drivers to make safe drinking and driving decisions, and possibilities for using technology over the longer term to address risks resulting from driver impairment that is either inadvertent or willful high-risk behavior.From the Vision Zero perspective,”normal driving” refers to a situation where traffic and road users are operating as desired and planned. A driver in this normal driving envelope operates at a safe speed, wears a seat belt, focuses on the driving task, and is not impaired. A safe system accommodates human errors, mistakes, and misjudgments in the normal driving envelope. However, it may not be capable of compensating for deliberate violations and rule-breaking.A critical role of behavioral programs and policies is to motivate safe decisions by drivers and other road users and keep them in the normal driving envelope where they can be protected from unintentional errors by a safe system. While much progress has been made in developing and implementing impaired driving policies and programs, much potential remains in the their ability to motivate drivers to meet the fundamental expectations required in a safe system. Examples of behavioral programs and policies that have strong evidence of effectiveness but are underutilized in the U.S. include conducting periodic sobriety checkpoints, lowering the blood alcohol concentration limit for driving, and mandating the use of ignition interlock devices. While the specific interventions may differ, it is likely that the same situation of incomplete implementation of behavioral programs and policies - and consequent unrealized value to a comprehensive safe system - applies to many other nations.To reach the goal of zero deaths, a comprehensive Vision Zero program needs to address the problem of deliberate risk-taking, which can include driver impairment from alcohol or other causes and extend to dangerous and reckless driving. Advanced safety technologies offer a range of opportunities for this purpose. Cars available today and in the future will have a plethora of sensors that monitor circumstances inside and around the car. These systems can identify whether a driver is in their safe driving envelope and respond with interventions that are appropriate for the severity and nature of the risk. Interventions could range from those that are not perceivable to the driver, such as putting driver assist systems into active mode, to stronger steps such as limiting or preventing vehicle operation.Zero fatalities or serious injuries in motor vehicle crashes is possible with a systems approach that accommodates human errors and mistakes that occur with the normal driving envelope and incorporates effective responses to deliberate risk-taking outside of this envelope.

Associations between state-level general population alcohol policies and drinking outcomes among women of reproductive age: Results from 1984 to 2020 National Alcohol Surveys.

Policies specific to alcohol use during pregnancy have not been found to reduce risks related to alcohol use during pregnancy. In contrast, general population alcohol policies are protective for the general population. Here, we assessed whether US state-level general population alcohol policies are related to drinking outcomes among women of reproductive age. We conducted secondary analyses of 1984-2020 National Alcohol Survey data (N = 13,555 women ≤44 years old). State-level policy exposures were government control of liquor retail sales, heavy beer at gas stations, heavy beer at grocery stores, liquor at grocery stores, Sunday off-premise liquor sales, and blood alcohol concentration (BAC) driving limits (no law, 0.10 limit, 0.05-0.08 limit). Outcomes were past 12-month number of drinks, ≥5 drink days, ≥8 drink days, and any DSM-IV alcohol abuse/dependence symptoms. Regressions adjusted for individual and state-level controls, clustering by state, and included fixed effects for survey month and year. Allowing Sunday off-premise liquor sales versus not was related to having 1.20 times as many drinks (95% CI: 1.01, 1.42), 1.41 times as many ≥5 drink days (95% CI: 1.08, 1.85), and 1.91 times as many ≥8 drink days (95% CI: 1.28, 2.83). BAC limits of 0.05-0.08 for driving versus no BAC limit was related to 0.51 times fewer drinks (95% CI: 0.27, 0.96), 0.28 times fewer days with ≥5 drinks (95% CI: 0.10, 0.75), and 0.20 times fewer days with ≥8 drinks (95% CI: 0.08, 0.47). US state-level policies prohibiting Sunday off-premise liquor sales and BAC limits of 0.05-0.08 for driving are related to less past 12-month overall and heavy drinking among women 18-44 years old.

Perception of Alcohol Use and Alcohol Use Disorder among Persons Involved in Road Accidents at an Emergency Department: A Cross-Sectional Study.

Alcohol plays a significant role in road traffic accidents in Ghana. However, little is known about the perspectives of victims who suffer road traffic accidents, RTAs, and the extent to which alcohol use disorder is involved. We conducted a three-month cross-sectional study in a teaching hospital involving 102 patients involved in a road accident and presented to the hospital's emergency. The Alcohol Use Disorder Identification Test, AUDIT, was used to assess for Alcohol Use Disorder, AUD, at a score of 8. In addition, we used open-ended questionnaires to assess their perception of alcohol use and road accidents. Of the 102 respondents, 75% were males, and 60% were between 15 and 35 years old. About 69% of respondents admitted to using alcohol, while 31%, including a single female, screened positive for alcohol use disorder. A significant majority of about 90% of respondents believed in some myths of alcohol use in Ghana, and a similar percentage were aware of the risks alcohol use posed to road use. Over 30% of respondents, mainly drivers or riders, had used alcohol within 12 hours of the accident. All but three respondents knew alcohol-induced aggression and poor coordination of movements. A similar number of respondents knew alcohol made people cross roads carelessly and were hyperactive or disinhibited. Alcohol use and alcohol use disorder are significantly high among persons presenting with RTA to the emergency. Knowledge of the deleterious effects of alcohol is high, yet their behavior did not reflect the knowledge. Therefore, a significant reduction in RTA can be achieved by enforcing blood alcohol concentration limits for road users and intensive education to the populace.

A new alcohol-related traffic law, a further reduction in traffic fatalities? Analyzing the case of Turkey

Background: In June 2013, an alcohol-related traffic law took effect in Turkey. The law 6487 introduced administrative fines for not respecting blood alcohol concentration limits, health warning messages on alcohol containers (bottles, cans), and prohibited the sale of alcohol beverages in retail facilities between 10 p.m. and 6 a.m.. This article examines how this law is associated with traffic fatality variation. Methods: Data from the Turkish Statistical Institute for the 2008–2019 period were analyzed. Outcomes were traffic fatality rates per 100,000 population and 10,000 motor vehicles. Exposure variable was the presence of law 6487. Alcohol, tobacco, and related beverages’ household expenditure, unemployment rate, number of health professionals, number of crashes, and lags of the outcomes represented control variables. A time-series cross-regional fixed effect model was applied. Results: Empirical estimates suggest that the law 6487 was associated with a reduction of 15% (Incidence Rate Ratio (IRR) 0.85, 95% Confidence Interval (CI): 082, 0.94) in the traffic fatality per population rate and with a reduction of 14% (IRR: 0.86 (95% CI: 0.78, 0.92) in the traffic fatality per motor-vehicle rate. After 6 years of its implementation, this intervention was associated with an absolute reduction of 1519 (95% reduction interval: 1177, 1810) traffic fatalities. Conclusions: Our research emphasizes that legislation with direct and indirect measures targeting driving under the influence of alcohol (DUIA) may be related to traffic fatalities reduction. Practical applications: This finding has important implications for policy and future research in contexts in which alcohol consumption is low such is in Turkey. Future research should seek to identify mechanisms that explain how laws are ultimately associated with DUIA variation.

Lowering the legal alcohol limit in Belgium: Potential effects on the number of traffic victims

BackgroundSince 1994, the legal limit of Blood Alcohol Concentration (BAC) is 0.5 g/L for the general drivers’ population in Belgium. Since 2015, this limit has been lowered to 0.2 g/L for professional drivers. So far, no specific limitation has been adopted for novice drivers in Belgium. Recently, two bills were submitted to the House of Representatives: the first one proposed to impose a zero-limit for every driver, the second one proposed to restrict this zero-limit only to novice drivers. ObjectiveThe present study evaluated the potential impact of the two bills that aim to reduce the legal BAC limit from 0.5 to zero, either for all drivers or for novice drivers only. We elaborated three scenarios related to the BAC categories for which lowering the legal BAC limit to zero would affect drink-driving behaviour:“Targeted BAC levels” scenario assumed that the new policy would impact only the specifically targeted BAC category, i.e., drivers in the category BAC below 0.5 g/L.“Extended impact” scenario corresponded to the “Targeted BAC levels” scenario to which we added a “halo effect” on drivers in the BAC category “0.5 g/L ≤ BAC < 0.8 g/L”.“Broad range impact” scenario corresponded to the “Extended impact” scenario to where we extended the “halo effect” to drivers in the BAC category “0.8 g/L ≤ BAC < 1.2 g/L”. MethodsThe effect estimates were based on firstly, scientific literature on risks related to drink-driving at different BAC-levels, secondly data on crashes in Belgium and thirdly data on drink-driving behaviour in Belgium and in other European countries. ResultsIn case of a zero limit for all drivers, an annual reduction can be expected of 10 to 17 fatalities (i.e., a decrease of 2.4% to 3.9%), 8 to 20 severe injuries (i.e., a decrease of 0.3% to 0.8%) and 135 to 315 slight injuries (i.e., a decrease of 0.4% to 0.8%). In case a zero limit is only applied to novice drivers, an annual decrease can be expected by 2 to 4 fatalities (i.e., a decline of 3.7% to 6.2%), 8 to 16 serious injuries and 135 to 262 slight injuries (i.e., a decline of 1.7% to 3.2% in both cases). DiscussionThere is no clear evidence on which of the three scenarios would be the most plausible. As the relative risk of a car crash increases strongly with the BAC level, the success of either measure will strongly depend on its ability to also affect drink driving at concentrations that are forbidden already. This also means that most of the casualties could be prevented if compliance with current rules increased.

A ‘Hands on’ Public Service Program to Help People Stay Sober and Safer on the Roadway

Despite the existence of many different “Don’t drink and drive” programs and campaigns over the past 30 years, alcohol intoxication has continued to account for approximately one quarter to one third of all traffic crashes and crash-related deaths in the United States. The present study describes a new ‘hands on’ evidence-based approach involving real alcohol-intoxicated subjects using a virtual reality (VR) driving ‘game’ to educate the public more effectively about the dangers of drunk driving. A single demonstration subject ‘drove’ a VR-based portable driving simulator on multiple occasions before (Pre) and at 30 min intervals for up to six hours after either vehicle (no alcohol), two, four or six ‘drinks’ (3, 6, or 9 ounces of 80 proof vodka). The defensive driving task was a choice reaction crash avoidance steering maneuver in which the driver’s task was to determine which way to turn to avoid a crash and then aggressively steer away to avoid a crash. The primary dependent variable was the latency to initiate an avoidance steering response. Blood alcohol concentration (BAC) determinations (estimations) were conducted immediately prior to driving tests using BAC Track portable breathalyzers. Control drives (Pre-Treatment and Vehicle treatment) were characterized by an approximately 300–320 ms reaction time to initiate a crash avoidance. Alcohol increased crash-avoidance reaction time. Peak BAC values were 35, 78 and 120 mg/dL for two, four and six drinks, respectively; the decline in BAC was comparable and linear for all three treatments. There was a strong correlation (r = 0.85) between pre-drive BAC level and reaction time across all of the alcohol-related drives. There was a significant increase in crash avoidance reaction time when the BAC was 50–79 mg/dL, which is below the legally defined BAC limit (80 mg/dL) currently used in most states in the US. These results demonstrate that (1) this VR-based driving simulator task could be a useful ‘hands on’ tool for providing public service demonstrations regarding the hazards of drinking and driving and (2) a BAC concentration of 50 mg/dL represents a reasonable evidence-based cut-off for alcohol-impaired driving.

Nigerian law enforcement agents’ knowledge and enforcement of drink-drive law

Objective To understand how knowledgeable and equipped the law enforcement agents in Nigeria are to enforce the drink-drive law. Method We conducted a descriptive cross-sectional study of Law Enforcement Agents in four Nigerian states selected by convenient sampling. The study utilized a pre-tested questionnaire designed to obtain subjects’ demographic data, elicit their knowledge about drink-drive law, and understand how equipped the subjects are. A team member walked respondents through the questions to ensure comprehension and accuracy with completion of the questions. Result 496 law enforcement agents were studied. They were 414(83.5%) male and 82(16.5%) females, mostly aged 21-40 years (64.3%). Close to half (48.2%) were police officers, while 35.7% were officers in the Federal Road Safety Corp (FRSC). 45% of respondents had secondary/high school education, while 39.5% had bachelor’s degree; with a significant majority in the FRSC. 269(54.2%) respondents had convicted a road user of drunk driving/riding on the basis of subjective assessment. The use of breathalyzers and awareness of permissible Blood Alcohol Concentration (BAC)/Breath Alcohol Concentration (BrAC), was reported by a few respondents (5%), mostly FRSC officers, and others with relatively higher educational attainment. The majority were ignorant of the approved BAC limit in Nigeria (0.05 g/100 dl) and objective methods of assessing breath alcohol concentrations. Conclusion In Nigeria, there is a huge knowledge gap on the drink-drive law and the acceptable penalties for offenders in Nigeria among law enforcement agents. The law enforcement agents lack equipment for objectively detecting drunk driving among road users. Our findings call for an urgent intervention in the training and practice of law enforcement agents if the prevalence of RTC arising from drunk driving will be reduced in Nigeria.

Accuracy of Consumer-marketed smartphone-paired alcohol breath testing devices: A laboratory validation study.

Although alcohol breath testing devices that pair with smartphones are promoted for the prevention of alcohol-impaired driving, their accuracy has not been established. In a within-subjects laboratory study, we administered weight-based doses of ethanol to two groups of 10 healthy, moderate drinkers aiming to achieve a target peak blood alcohol concentration (BAC) of 0.10%. We obtained a peak phlebotomy BAC and measured breath alcohol concentration (BrAC) with a police-grade device (Intoxilyzer 240) and two randomly ordered series of 3 consumer smartphone-paired devices (6 total devices) with measurements every 20min until the BrAC reached <0.02% on the police device. Ten participants tested the first 3 devices, and the other 10 participants tested the other 3 devices. We measured mean paired differences in BrAC with 95% confidence intervals between the police-grade device and consumer devices. The enrolled sample (N=20) included 11 females; 15 white, 3 Asian, and 2 Black participants; with a mean age of 27 and mean BMI of 24.6. Peak BACs ranged from 0.06-0.14%. All 7 devices underestimated BAC by >0.01%, though the BACtrack Mobile Pro and police-grade device were consistently more accurate than the Drinkmate and Evoc. Compared with the police-grade device measurements, the BACtrack Mobile Pro readings were consistently higher, the BACtrack Vio and Alcohoot measurements similar, and the Floome, Drinkmake, and Evoc consistently lower. The BACtrack Mobile Pro and Alcohoot were most sensitive in detecting BAC driving limit thresholds, while the Drinkmate and Evoc devices failed to detect BAC limit thresholds more than 50% of the time relative to the police-grade device. The accuracy of smartphone-paired devices varied widely in this laboratory study of healthy participants. Although some devices are suitable for clinical and research purposes, others underestimated BAC, creating the potential to mislead intoxicated users into thinking that they are fit to drive.

Are Countries' Drink-Driving Policies Associated With Harms Involving Another Driver's Impairment?

International drink-driving policy research generally focuses on aggregate outcomes (e.g., rates of crashes, fatalities) without emphasizing secondhand alcohol-related vehicular harms. In contrast, we investigate associations between drink-driving policies and harms involving another driver's impairment. Alcohol's harms to others (AHTO) survey data from 12 countries (analytic N=29,616) were linked to national alcohol policy data from the World Health Organization. We examined separately associations of two 12-month driving-related AHTOs (passenger with an impaired driver; vehicular crash involving someone else's drink driving) with 3 national drinking-driving policies-legal blood alcohol concentration (BAC) limits, use of random breath testing, use of sobriety checkpoints, and comprehensive penalties for drink-driving (community service, detention, fines, ignition interlocks, license suspension/revocation, mandatory alcohol treatment, vehicle impoundment, and penalty point system), plus 2 alcohol tax variables (having excise taxes and value-added tax [VAT] rate). Multilevel logistic regression addressed clustering of individuals within countries and subnational regions, while adjusting for individuals' gender, age, marital status, risky drinking, and regional drinking culture (% male risky drinkers in sub-national region). Controlling for national-, regional-, and individual-level covariates, comprehensive penalties were significantly and negatively associated with both outcomes; other vehicular policy variables were not significantly associated with either outcome. A society's VAT rate was negatively associated with riding with a drunk driver. Regional male drinking culture was positively associated with riding with an impaired driver, but was not significantly associated with being in a vehicular crash due to someone else's drinking. In both models, being male, being younger, and engaging in risky drinking oneself each were positively associated with vehicular harms due to someone else's drinking. Although results are associational and not causal, comprehensive penalties may be promising policies for mitigating driving-related harms due to another drinker. Higher VAT rate might reduce riding with a drunk driver.

Assessment of the impact of implementation of a zero blood alcohol concentration law in Uruguay on moderate/severe injury and fatal crashes: a quasi‐experimental study

Debates regarding lowering the blood alcohol concentration (BAC) limit for drivers are intensifying in the United States and other countries, and the World Health Organization recommends that the limit for adults should be 0.05%. In January 2016, Uruguay implemented a law setting a zero BAC limit for all drivers. This study aimed to assess the effect of this policy on the frequency of moderate/severe injury and fatal traffic crashes. A quasi-experimental study in which a synthetic control model was used with controls consisting of local areas in Chile as the counterfactual for outcomes in Uruguay, matched across population counts and pre-intervention period outcomes. Sensitivity analyses were also conducted. Uruguay and Chile. Panel data with crash counts by outcome per locality-month (2013-2017). A zero blood alcohol concentration law implemented on 9 January 2016 in Uruguay, alongside a continued 0.03g/dl BAC threshold in Chile. Per-capita moderate/severe injury (i.e. moderate or severe), severe injury and fatal crashes (2013-2017). Our base synthetic control model results suggested a reduction in fatal crashes at 12months [20.9%; P-value=0.018, 95% confidence interval (CI)=-0.340, -0.061]. Moderate/severe injury crashes did not decrease significantly (10.2%, P=0.312, 95% CI=-0.282, 0.075). The estimated effect at 24months was smaller and with larger confidence intervals for fatal crashes (14%; P=0.048, 95% CI=-0.246, -0.026) and largely unchanged for moderate/severe injury crashes (-9.4%, P=0.302, 95% CI=-0.248, 0.058). Difference-in-differences analyses yielded similar results. As a sensitivity test, a synthetic control model relying on an inferior treatment-control match pre-intervention (measured by mean squared error) yielded similar-sized differences that were not statistically significant. Implementation of a law setting a zero blood alcohol concentration threshold for all drivers in Uruguay appears to have resulted in a reduction in fatal crashes during the following 12and 24months.

Economic arguments for population interventions to reduce alcohol consumption in Russian population

Abstract Aim To get economic arguments for population-based interventions to reducing the consumption of alcohol in the Russian Federation. Material and Methods Studies of international practice on the implementation of population-based preventive measures to reducing alcohol consumption was carried out in order to identify interventions with proven effectiveness. We used the official statistics data collected by Ministry of health on the number of patients, health care resources utilization. Directs nonmedical costs included disability payments. Indirect costs included decreased productivity due to premature mortality and disability. Results Russian Federation has on the moment rather strong legislation in the area of alcohol regulation, but still there is a potential for further improvement. Increase in the price for alcoholic beverages by 10% in the Russian Federation can potentially prevent 7 477 potential years of life lost, the prognosed economic effect due to premature deaths reduction will be 42 002 523€ for 5 years. Increase in the minimum age for alcohol sales from 18years to 21years can save 48 920 potential years of life lost in Russian population, and the economic effect will be 279 912 075€ for 3 years. Reducing the permissible limit of blood alcohol concentration in vehicle drivers to 0.03mg/ml will allow to gain 8 834 673€ of economic effect for 3years.The deprivation of driving license for longer period after drinking and driving will give economic 916 809€ for 1 year due to prevent 217fatal accidents in alcohol intoxicated condition. And the effect of a complete ban on advertising alcoholic beverages in all media will give potential impact of 678 437 773€ for 10years Conclusions There are still potential for improvement the legislation in the area of alcohol control in Russian Federation. Described interventions demonstrate substantial potential economic effect. These data can be used as an argument for policy makers to justify the investments in these interventions Key messages The main results obtained in the simulation demonstrated the possibility of improving the prognosis of mortality and morbidity from NCDs associated with alcohol consumption. These data can be used as an argument for policy makers to justify the investments in these interventions.

Effect of Lowering the Blood Alcohol Concentration Limit to 0.03 Among Hospitalized Trauma Patients in Southern Taiwan: A Cross-Sectional Analysis.

BackgroundIn June 2013, the legal blood alcohol concentration (BAC) limit for driving was lowered from 0.05 to 0.03 mg/mL in Taiwan. Thus, this study aimed to assess the epidemiological changes in terms of drinking among drivers in southern Taiwan before and after the law was imposed.MethodsOnly patients who had undergone the BAC test at the emergency room were included in the study. The patients during the study period before (n = 2735) and after (n = 2413) the implementation of the law were selected for comparison. Drunk patients were defined as those who had a BAC ≥0.005 and were considered as driving under the influence (DUI) of alcohol. Meanwhile, driving while intoxicated (DWI) was defined as a BAC ≥0.05, which was the level adopted in the new law.ResultsSince the BAC limit lowered to 0.03, the number of DUI patients significantly decreased from 340 (12.4%) to 171 (7.1%), and that of DWI patients significantly reduced from 273 (10.0%) to 146 (6.1%) based on the alcohol test. In addition, after the implementation of the law, the number of associated injuries did not significantly decrease from that before the law was implemented in patients involved in alcohol-related crashes.ConclusionAfter lowering the legal BAC limit from 0.05 to 0.03, responsiveness to the change in law was observed among the studied population. However, such responsiveness may not be observed in some citizens who may need special interventions to help reduce their behavior of drinking and driving.

Drink, death, and driving: Do blood alcohol content limit reductions improve road safety?

This study exploits a natural experiment in Scotland where the legal blood alcohol content (BAC) limit was reduced from 0.8 to 0.5mg per 100ml of blood while staying constant in all other parts of the United Kingdom. Using a difference-in-differences design, we find that this change in the BAC level had no impact on either traffic accident or fatality rates.

Motorcycle crashes resulting in hospital admissions in South Australia: Crash characteristics and injury patterns

Motorcycle riders have a high risk of serious injury if they crash. To assist with identification of countermeasures, the present study examined records from the Royal Adelaide Hospital (RAH) in South Australia for 763 motorcyclists (including scooter riders) admitted between January 2008 and November 2010 and between April 2014 and December 2016. Records were linked with police-reported crash data and results of forensic blood tests for alcohol and drugs. When compared with 1617 car drivers admitted to the RAH over the same periods, motorcyclists were younger, were more commonly male, more likely to hold a learner permit, less likely to hold a provisional licence, less likely to be over the legal alcohol limit and less likely to be at-fault in multiple vehicle crashes. Their crashes were more likely to be single vehicle crashes (specifically roll over, left road – out of control and hit object/animal/pedestrian on road crashes) and were more common on weekends, during the afternoon, on sloping roads, on curved roads, on roads with speed limits of 50 and 80 km/h, during daylight hours, in dry weather and on dry roads. They had a higher severity of injury than car drivers, spent longer in hospital, and were more likely to sustain injuries to multiple body regions. Linear regression showed that older age, higher blood alcohol concentration and higher speed limit increased injury severity for motorcyclists. Based on present findings, motorcycling safety can be improved through countermeasures related to Graduated Licensing Systems, infrastructure, motorcycle technology and protective clothing.