Spatial-temporal analysis of drink-driving patterns in Hong Kong

Choosing to drive from alcohol serving establishments (ASEs)

OBJECTIVE

The prevalence of Driving Under the Influence (DUI) of alcohol or drugs has become a prominent factor in the occurrence of severe road crashes worldwide. Driving often occurs after visiting, and presumably drinking, at Alcohol-Serving Establishments (ASEs), and is thus of interest as a possible source of DUI events.

METHODS

We apply statistical and machine learning models to the Victorian Integrated Survey of Travel and Activity (VISTA) to identify factors that contribute to driving in trips from ASEs in Australia's state of Victoria.

RESULTS

Our results highlight that approximately 10% of individuals who traveled to ASEs as car passengers switched to driving after leaving there. It was also observed that travel distance shorter than 1 km and activity duration between 3 and 4 h positively impacts the mode switching from car driver to other modes in ASEs trips. Further findings illustrate a decline in driving after midnight, with an increase in the use of public transport and taxis. Individuals prefer driving for long-distance ASEs trips and walking for short distances. Going home also increased the likelihood of driving, whereas engaging in other social activities did not. Longer stays at ASEs and leaving vehicles overnight reduce the propensity to drive, likely due to increased alcohol consumption during these times.

CONCLUSIONS

These findings suggest behavioral adjustments that can mitigate driving under the influence. Specifically, people may walk for short-distance trips and use public transport or taxis for longer ASEs trips.

Impact of alcohol taxes on violence in Hong Kong: a population-based interrupted time series analysis

BACKGROUND

Interpersonal violence is a major public health concern with alcohol use a known risk factor. Despite alcohol taxation being an effective policy to reduce consumption; Hong Kong, contrary to most developed economies, embarked on an alcohol tax reduction and elimination policy.

METHODS

To assess the impact of the alcohol tax reductions, we analysed population-based hospitalisation data for assault from the Hong Kong Hospital Authority, and violent and sexual crimes recorded by the Hong Kong Police Force (2004-2018). We conducted an interrupted time series using seasonal autoregressive integrated moving average models on monthly rates. Breakpoints in March 2007 and March 2008 were applied separately.

RESULTS

The 2007 tax cut was associated with sustained increases in violence-related hospitalisation rates for 35-49 age group (female: 0.19%, p=0.007; male: 0.22%, p<0.001; overall: 0.16%, p=0.007); and an immediate increase of 51.3% (p=0.005) in the rate of sexual crimes reported. Results for the 35-49 age group after the 2008 tax cut were similar with sustained increases in hospitalisation rates (female: 0.21%, p=0.010; male: 0.23%, p<0.001; overall: 0.17%, p<0.001). The 2008 tax cut was also associated with immediate increases in hospitalisation rates in children (female: 33.1%, p=0.011; male: 49.2%, p<0.001, overall: 31.5%, p=0.007). For both tax cuts, results were insignificant in males and females for other age groups (15-34 and 50+ years).

CONCLUSIONS

Both alcohol tax reductions in 2007 and 2008 were in some age groups associated with increases in violence-related hospitalisations and reports of sexual assault even in an environment of low crime.

The impact of road safety policies in a deregulated alcohol tax environment in Hong Kong: a 15-year time series analysis

BACKGROUND AND AIMS

Hong Kong reduced beer and wine tax in 2007, eliminated taxes on beer and wine and strengthened drink-driving legislation in 2008, and increased police traffic enforcement after the 2014 social unrest. This study aimed to measure the effects of implementing road safety policies on road traffic harm in the context of deregulated alcohol control policy in Hong Kong.

DESIGN

Population-based interrupted time series analysis using seasonal autoregressive integrated moving average (sARIMA) models. Multiple sensitivity analyses were conducted.

SETTING

Hong Kong, China and Singapore from January 2004 to December 2019.

CASES

A total of 313 728 road traffic injuries in Hong Kong and 163 773 road traffic injuries in Singapore as controls.

MEASUREMENTS

Monthly rates of road traffic injuries, non-fatal injuries and serious/fatal injuries from Hong Kong and Singapore Police Force.

FINDINGS

The elimination of alcohol taxes and the enactment of road safety legislation in 2008 were associated with immediate reductions in total road traffic injuries of 6.71% (95% CI, 1.99%-11.20%), serious/fatal injuries of 13.80% (95% CI, 1.85%-24.30%) and sustained declines in drink-driving and collisions involving drink-driving. The effects of the 2007 tax reduction were inconclusive. Progressively increasing traffic enforcement was associated with continuous reductions in road traffic injuries by 0.21% per month (95% CI, 0.13%-0.30%), and serious/fatal injuries by 1.10% per month (95% CI, 0.85%-1.35%). Effects at the corresponding timepoints in Singapore did not reach statistical significance; the results were inconclusive regarding confounding effects on both regions.

CONCLUSIONS

Despite weakened alcohol control and increased alcohol sales over the same period, road safety policies in Hong Kong are associated with net reductions in road traffic injuries, particularly serious/fatal injuries.

Analysis of drink-driving behavior: Considering the subjective and objective factors of drivers

OBJECTIVE

Drink-driving is one of the key behavioral risk factors in road traffic safety. The main purposes of this study are the identification of the influence of drivers' subjective and objective factors on drink-driving behavior and the correlation between subjective and objective factors to design targeted measures for the prevention and control of drink-driving behavior.

METHODS

To analysis the influence of the subjective and objective factors on the behavior of alcohol value simultaneously. A Bayesian structural equation model is conducted with the data collected via questionnaire issued on the Internet in China.

RESULTS

The results using the Bayesian structural equation model reveals that the subjective factors (e.g., drivers' behavior intention and perceived behavioral control) and objective factors (e.g., age, gender, and driving years of drivers) significantly affect drink-driving behaviors. Drivers' behavior intention is the strongest predictor, and perceived behavioral control also has a significant influence on drink-driving. Drivers who are male, older, lower driving years, driving a motorcycle or car and noncommercial vehicle have a higher probability in drink-driving. The results also suggest that there is a certain correlation between the driver's subjective and objective factors. For instance, male drivers have a more positive attitude toward drink-driving behaviors, drivers over thirty years old more cling to the region's alcohol culture and feel less guilty about drink-driving than youngsters, and truck or bus drivers perceived more disapproval of drink-driving behavior from their significant others.

CONCLUSIONS

A more nuanced understanding of the influence of drivers to drink-driving behavior can be found in these results. These results about the influence mechanism of subjective and objective factors on drink-driving behavior of this study have implications for governments and other interested bodies for better targeting and delivery of public education campaigns and interventions.

Enhancement of unsafe behaviors in simulated moped-riding performance under the influence of low dose of alcohol

The effects of low levels of blood alcohol concentration (BAC) on motorcyclist performance are still not fully comprehended. The great majority of the studies are, in fact, focused on car driving. So far, it is known that even BAC levels below the legal limit negatively affect riding motor skills correlated with crash rate. In the present study, we used a moped riding simulator to investigate the effects of low alcohol dosages (under the limits established in Italy, and in most European countries) on the defensive riding ability of light drinkers, particularly focusing on the degree of danger characterizing their riding performance. We recruited 24 participants through a double-blind, random distribution, balanced, cross-over design. We administered moderate amounts of alcohol to participants during two sessions of moped riding simulation. The results showed that even though BAC levels were always below (mean value: 0.03 g/dL) the limit allowed by Italian traffic law (0.05 g/dL), alcohol induced a reduction in safe riding behaviors, as indicated by the greater amount of hazardous scenes faced with dangerous riding behaviors when participants were under the influence of alcohol than when they were sober. Moreover, low BAC levels had a greater detrimental influence when a certain amount of learning had already been achieved by the participants (i.e., in the last experimental session). The results suggest that the effect of a low dose of alcohol interacts with participants' self-confidence.

Experimental study of the temporal profile of breath alcohol concentration in a Chinese population after a light meal

In forensic science, the Widmark equation is widely used to deduce the blood alcohol concentration (BAC) at different time points. But the linear model specified by Widmark might be deficient in predicting the breath alcohol concentration (BrAC) at different time points, and extrapolating the peak and the corresponding time. In order to establish the temporal profile of alcohol concentration which captures the effects of non-linear nature of alcohol absorption, elimination, and peak, in particular of Chinese population after a light meal, a drinking experiment was conducted in this study. To achieve this, a double-blind drinking experiment was conducted to measure the BrAC of 52 Chinese participants after a light meal in this study. Prior to the experiment, all participants were required to abstain from food for 4 hours, more importantly, from alcohol and sedatives for 24 hours. A standard light meal was provided about 30 minutes prior to the alcohol intake in the experiment. The BrAC was measured at a 10-minute interval during the absorption phase and 30-minute interval during the elimination phase respectively. The measurements were stopped when the BrAC fell to 0.010 mg/100 ml or below, or more than 8 hours after the alcohol intake. Then, the temporal profiles of BrAC, assuming linear and non-linear relationships, were established using Full Bayesian approach. The linear component indicated the alcohol impairment in normal social function, with which a light meal is usually accompanied with drinking. On the other hand, the non-linear (gamma distribution) part replicated the absorption phase, elimination phase, and the peak of alcohol concentration. The proposed model well performed than the conventional regression model. Additionally, the confounding factors including gender, body weight, and dosage were controlled for. Results should be useful for the development of cost-effective enforcement measures that could deter against drink driving.

Using latent class analysis and mixed logit model to explore risk factors on driver injury severity in single-vehicle crashes

The single-vehicle crash has been recognized as a critical crash type due to its high fatality rate. In this study, a two-year crash dataset including all single-vehicle crashes in New Mexico is adopted to analyze the impact of contributing factors on driver injury severity. In order to capture the across-class heterogeneous effects, a latent class approach is designed to classify the whole dataset by maximizing the homogeneous effects within each cluster. The mixed logit model is subsequently developed on each cluster to account for the within-class unobserved heterogeneity and to further analyze the dataset. According to the estimation results, several variables including overturn, fixed object, and snowing, are found to be normally distributed in the observations in the overall sample, indicating there exist some heterogeneous effects in the dataset. Some fixed parameters, including rural, wet, overtaking, seatbelt used, 65 years old or older, etc., are also found to significantly influence driver injury severity. This study provides an insightful understanding of the impacts of these variables on driver injury severity in single-vehicle crashes, and a beneficial reference for developing effective countermeasures and strategies for mitigating driver injury severity.

The effect of lowering the legal blood alcohol concentration limit on driving under the influence (DUI) in southern Taiwan: a cross-sectional retrospective analysis

OBJECTIVES

We aimed to profile the epidemiological changes of driving under the influence (DUI) in southern Taiwan after the legal blood alcohol concentration (BAC) limit was lowered from 50 to 30 mg/dL in 2013.

SETTING

Level 1 trauma medical centre in southern Taiwan.

PARTICIPANTS

Data from 7447 patients (4375 males and 3072 females) were retrieved from the trauma registry system of a single trauma centre to examine patient characteristics (gender, age and BAC), clinical outcome variables (Abbreviated Injury Score, Injury Severity Score and mortality) and vehicular crash-related factors (vehicle type, airbag use in car crashes, helmet use in motorcycle crashes and time of crash) before and after the BAC limit change.

RESULTS

Our results indicated that the percentage of DUI patients significantly declined from 10.99% (n=373) to 6.64% (n=269) after the BAC limit was lowered. Airbag use in car crashes (OR: 0.30, 95% CI 0.10 to 0.88, p=0.007) and helmet use in motorcycle crashes (OR: 0.20, 95% CI 0.15 to 0.26, p<0.001) was lower in DUI patients compared with non-DUI patients after the BAC limit change, with significant negative correlation. DUI behaviour increased crash mortality risk before the BAC limit change (OR: 4.33, 95% CI 2.20 to 8.54), and even more so after (OR: 5.60, 95% CI 3.16 to 9.93). The difference in ORs for mortality before and after the change in the BAC legal limit was not significant (p=0.568).

CONCLUSION

This study revealed that lowering the BAC limit to 30 mg/dL significantly reduced the number of DUI events, but failed to result in a significant reduction in mortality in these trauma patients.

Analysis of risk factors affecting driver injury and crash injury with drivers under the influence of alcohol (DUI) and non-DUI

OBJECTIVE

The objective of this research was to study risk factors that significantly influence the severity of crashes for drivers both under and not under the influence of alcohol.

METHODS

Ordinal logistic regression was applied to analyze a crash data set involving drivers under and not under the influence of alcohol in China from January 2011 to December 2014.

RESULTS

Four risk factors were found to be significantly associated with the severity of driver injury, including crash partner and intersection type. Age group was found to be significantly associated with the severity of crashes involving drivers under the influence of alcohol. Crash partner, intersection type, lighting conditions, gender, and time of day were found to be significantly associated with severe driver injuries, the last of which was also significantly associated with severe crashes involving drivers not under the influence of alcohol.

CONCLUSIONS

This study found that pedestrian involvement decreases the odds of severe driver injury when a driver is under the influence of alcohol, with a relative risk of 0.05 compared to the vehicle-to-vehicle group. The odds of severe driver injury at T-intersections were higher than those for traveling along straight roads. Age was shown to be an important factor, with drivers 50-60 years of age having higher odds of being involved in severe crashes compared to 20- to 30-year-olds when the driver was under the influence of alcohol. When the driver was not under the influence of alcohol, drivers suffered more severe injuries between midnight and early morning compared to early nighttime. The vehicle-to-motorcycle and vehicle-to-pedestrian groups experienced less severe driver injuries, and vehicle collisions with fixed objects exhibited higher odds of severe driver injury than did vehicle-to-vehicle impacts. The odds of severe driver injury at cross intersections were 0.29 compared to travel along straight roads. The odds of severe driver injury when street lighting was not available at night were 3.20 compared to daylight. The study indicated that female drivers are more likely to experience severe injury than male drivers when not under the influence of alcohol. Crashes between midnight and early morning exhibited higher odds of severe injury compared to those occurring at other times of day. The identification of risk factors and a discussion on the odds ratio between levels of the impact of the driver injury and crash severity may benefit road safety stakeholders when developing initiatives to reduce the severity of crashes.

A simulation study of the effects of alcohol on driving performance in a Chinese population

Driving under the influence of alcohol (DUIA) is a significant factor contributing to road traffic crashes, injuries, and fatalities. Although the effects of alcohol on driving performance are widely acknowledged, studies of the effects of alcohol impairment on driving performance and particularly on the control system of Chinese adults are rare. This study attempts to evaluate the effects of alcohol on the driving performance of Chinese adults using a driving simulator.

METHOD

A double-blind experimental study was conducted to evaluate the effects of alcohol impairment on the driving performance of 52 Chinese participants using a driving simulator. A series of simulated driving tests covering two driving modules, including emergency braking (EB) and following braking (FB), at 50km/h and 80km/h were performed. Linear mixed models were established to evaluate driving performance in terms of braking reaction time (BRT), the standard deviation of lateral position (SD-LANE), and the standard deviation of speed (SD-SPEED).

RESULTS

Driving performance in terms of BRT and SD-LANE was highly correlated with the level of alcohol consumption, with a one-unit increase in breath alcohol concentration (BrAC) degrading BRT and SD-LANE by 0.3% and 0.2%, respectively. Frequent drinkers generally reacted faster in their BRT than less-frequent drinkers and non-drinkers by 10.2% and 30.6%, respectively. Moreover, alcohol impairment had varying effects on certain aspects of the human control system, and automatic action was less likely to be affected than voluntary action from a psychological viewpoint.

CONCLUSION

The findings should be useful for planning and developing effective measures to combat drink driving in Chinese communities.

Driving under the influence of alcohol in the Netherlands by time of day and day of the week

The purpose of this study is to provide an overview of the variation in the prevalence of alcohol in everyday traffic in the Netherlands during all days of the week and all times of day. Breath tests were taken from randomly selected car drivers and drivers of small vans in six police regions in the Netherlands between January 2007 and August 2009. A total of 28,057 drivers were included in the study. The prevalence of driving under the influence of alcohol was highest during night-time hours of weekend days. Large proportions of sampled drivers under the influence of alcohol were also found during day-time hours on weekend days, especially early in the morning and early in the evening. Furthermore, a small proportion of sampled drivers under the influence of alcohol was found during morning traffic on Monday and Friday mornings. The results of this study indicate that drink driving is not only limited to night-time hours and that prevalence of drink driving is also high during evening hours from Wednesday to Sunday. In addition to these time periods, breath testing activities may also be effective from a police enforcement perspective on Monday, Friday, and Saturday mornings between 06.00h and 08.00h and on Sunday mornings until 10.00h.