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Goel R, Tiwari G, Varghese M, Bhalla K, Agrawal G, Saini G, Jha A, John D, Saran A, White H, Mohan D. Effectiveness of road safety interventions: An evidence and gap map. CAMPBELL SYSTEMATIC REVIEWS 2024; 20:e1367. [PMID: 38188231 PMCID: PMC10765170 DOI: 10.1002/cl2.1367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
Background Road Traffic injuries (RTI) are among the top ten leading causes of death in the world resulting in 1.35 million deaths every year, about 93% of which occur in low- and middle-income countries (LMICs). Despite several global resolutions to reduce traffic injuries, they have continued to grow in many countries. Many high-income countries have successfully reduced RTI by using a public health approach and implementing evidence-based interventions. As many LMICs develop their highway infrastructure, adopting a similar scientific approach towards road safety is crucial. The evidence also needs to be evaluated to assess external validity because measures that have worked in high-income countries may not translate equally well to other contexts. An evidence gap map for RTI is the first step towards understanding what evidence is available, from where, and the key gaps in knowledge. Objectives The objective of this evidence gap map (EGM) is to identify existing evidence from all effectiveness studies and systematic reviews related to road safety interventions. In addition, the EGM identifies gaps in evidence where new primary studies and systematic reviews could add value. This will help direct future research and discussions based on systematic evidence towards the approaches and interventions which are most effective in the road safety sector. This could enable the generation of evidence for informing policy at global, regional or national levels. Search Methods The EGM includes systematic reviews and impact evaluations assessing the effect of interventions for RTI reported in academic databases, organization websites, and grey literature sources. The studies were searched up to December 2019. Selection Criteria The interventions were divided into five broad categories: (a) human factors (e.g., enforcement or road user education), (b) road design, infrastructure and traffic control, (c) legal and institutional framework, (d) post-crash pre-hospital care, and (e) vehicle factors (except car design for occupant protection) and protective devices. Included studies reported two primary outcomes: fatal crashes and non-fatal injury crashes; and four intermediate outcomes: change in use of seat belts, change in use of helmets, change in speed, and change in alcohol/drug use. Studies were excluded if they did not report injury or fatality as one of the outcomes. Data Collection and Analysis The EGM is presented in the form of a matrix with two primary dimensions: interventions (rows) and outcomes (columns). Additional dimensions are country income groups, region, quality level for systematic reviews, type of study design used (e.g., case-control), type of road user studied (e.g., pedestrian, cyclists), age groups, and road type. The EGM is available online where the matrix of interventions and outcomes can be filtered by one or more dimensions. The webpage includes a bibliography of the selected studies and titles and abstracts available for preview. Quality appraisal for systematic reviews was conducted using a critical appraisal tool for systematic reviews, AMSTAR 2. Main Results The EGM identified 1859 studies of which 322 were systematic reviews, 7 were protocol studies and 1530 were impact evaluations. Some studies included more than one intervention, outcome, study method, or study region. The studies were distributed among intervention categories as: human factors (n = 771), road design, infrastructure and traffic control (n = 661), legal and institutional framework (n = 424), post-crash pre-hospital care (n = 118) and vehicle factors and protective devices (n = 111). Fatal crashes as outcomes were reported in 1414 records and non-fatal injury crashes in 1252 records. Among the four intermediate outcomes, speed was most commonly reported (n = 298) followed by alcohol (n = 206), use of seatbelts (n = 167), and use of helmets (n = 66). Ninety-six percent of the studies were reported from high-income countries (HIC), 4.5% from upper-middle-income countries, and only 1.4% from lower-middle and low-income countries. There were 25 systematic reviews of high quality, 4 of moderate quality, and 293 of low quality. Authors' Conclusions The EGM shows that the distribution of available road safety evidence is skewed across the world. A vast majority of the literature is from HICs. In contrast, only a small fraction of the literature reports on the many LMICs that are fast expanding their road infrastructure, experiencing rapid changes in traffic patterns, and witnessing growth in road injuries. This bias in literature explains why many interventions that are of high importance in the context of LMICs remain poorly studied. Besides, many interventions that have been tested only in HICs may not work equally effectively in LMICs. Another important finding was that a large majority of systematic reviews are of low quality. The scarcity of evidence on many important interventions and lack of good quality evidence-synthesis have significant implications for future road safety research and practice in LMICs. The EGM presented here will help identify priority areas for researchers, while directing practitioners and policy makers towards proven interventions.
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Affiliation(s)
- Rahul Goel
- Transportation Research and Injury Prevention CentreIndian Institute of Technology DelhiNew DelhiIndia
| | - Geetam Tiwari
- Transportation Research and Injury Prevention CentreIndian Institute of Technology DelhiNew DelhiIndia
| | | | - Kavi Bhalla
- Department of Public Health SciencesUniversity of ChicagoChicagoIllinoisUSA
| | - Girish Agrawal
- Transportation Research and Injury Prevention CentreIndian Institute of Technology DelhiNew DelhiIndia
| | | | - Abhaya Jha
- Transportation Research and Injury Prevention CentreIndian Institute of Technology DelhiNew DelhiIndia
| | - Denny John
- Faculty of Life and Allied Health SciencesM S Ramaiah University of Applied Sciences, BangaloreKarnatakaIndia
| | | | | | - Dinesh Mohan
- Transportation Research and Injury Prevention CentreIndian Institute of Technology DelhiNew DelhiIndia
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Lie A, Tingvall C, Michael JP, Fell JC, Bella Dinh-Zarr T. Vision Zero and Impaired Driving: Near and Longer-Term Opportunities for Preventing Death and Injuries. ACCIDENT; ANALYSIS AND PREVENTION 2024; 194:107344. [PMID: 37924565 DOI: 10.1016/j.aap.2023.107344] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 10/01/2023] [Accepted: 10/15/2023] [Indexed: 11/06/2023]
Abstract
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.
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Affiliation(s)
- Anders Lie
- AFRY (ÅF Pöyry AB), Chalmers University of Technology, Gothenburg, Sweden
| | - Claes Tingvall
- AFRY (ÅF Pöyry AB), Chalmers University of Technology, Gothenburg, Sweden. Monash University Accident Research Centre, Clayton, VIC, Australia
| | - Jeffrey P Michael
- Center for Injury Research and Policy, Johns Hopkins University, Baltimore, MD, USA.
| | - James C Fell
- Economics Justice and Society, NORC at the University of Chicago, Bethesda, MD, USA
| | - Tho Bella Dinh-Zarr
- FIA Foundation and Traffic Injury Research Foundation, Ottawa, Ontario, Canada
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Morrison CN, Gobaud AN, Mehranbod CA, Bushover BR, Branas CC, Wiebe DJ, Peek-Asa C, Chen Q, Ferris J. Optimizing sobriety checkpoints to maximize public health benefits and minimize operational costs. Inj Epidemiol 2023; 10:17. [PMID: 36915163 PMCID: PMC10010209 DOI: 10.1186/s40621-023-00427-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 03/03/2023] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND Sobriety checkpoints are a highly effective strategy to reduce alcohol-impaired driving, but they are used infrequently in the USA. Recent evidence from observational studies suggests that using optimized sobriety checkpoints-operating for shorter duration with fewer officers-can minimize operational costs without reducing public health benefits. The aim of this research was to conduct a pilot study to test whether police can feasibly implement optimized sobriety checkpoints and whether researchers can examine optimized sobriety checkpoints compared to usual practice within a non-randomized controlled trial study design. METHODS The study site was the Town of Apex, NC. We worked with Apex Police Department to develop a schedule of sobriety checkpoints during calendar year 2021 that comprised 2 control checkpoints (conducted according to routine practice) and 4 optimized checkpoints staffed by fewer officers. Our primary operations aim was to test whether police can feasibly implement optimized sobriety checkpoints. Our primary research aim was to identify barriers and facilitators for conducting an intervention study of optimized sobriety checkpoints compared to usual practice. A secondary aim was to assess motorist support for sobriety checkpoints and momentary stress while passing through checkpoints. RESULTS Apex PD conducted 5 of the 6 checkpoints and reported similar operational capabilities and results during the optimized checkpoints compared to control checkpoints. For example, a mean of 4 drivers were investigated for possibly driving while impaired at the optimized checkpoints, compared to 2 drivers at control checkpoints. The field team conducted intercept surveys among 112 motorists at 4 of the 6 checkpoints in the trial schedule. The survey response rate was 11% from among 1,045 motorists who passed through these checkpoints. Over 90% of respondents supported sobriety checkpoints, and momentary stress during checkpoints was greater for motorists who reported consuming any alcohol in the last 90 days compared to nondrinkers (OR = 6.7, 95%CI: 1.6, 27.1). CONCLUSIONS Results of this study indicate the sobriety checkpoints can feasibly be optimized by municipal police departments, but it will be very difficult to assess the impacts of optimized checkpoints compared to usual practice using an experimental study design.
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Affiliation(s)
- Christopher N Morrison
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th St, R505, New York, NY, 10032, USA. .,Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
| | - Ariana N Gobaud
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th St, R505, New York, NY, 10032, USA
| | - Christina A Mehranbod
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th St, R505, New York, NY, 10032, USA
| | - Brady R Bushover
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th St, R505, New York, NY, 10032, USA
| | - Charles C Branas
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th St, R505, New York, NY, 10032, USA
| | - Douglas J Wiebe
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Corinne Peek-Asa
- Office of Research Affairs, University of California San Diego, San Diego, CA, USA
| | - Qixuan Chen
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Jason Ferris
- Centre for Health Services Research, The University of Queensland, Woolloongabba, Queensland, Australia
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O’Hara SE, Paschall MJ, Herd D. Determining a dosage threshold of drink-driving enforcement operations: A systematic review. Drug Alcohol Rev 2022; 41:1610-1620. [PMID: 35894270 PMCID: PMC9633361 DOI: 10.1111/dar.13519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 06/17/2022] [Accepted: 07/01/2022] [Indexed: 11/29/2022]
Abstract
ISSUES Policy enforcement is crucial to achieve impacts on alcohol-related harm. It is not clear what level of enforcement intensity or 'dosage' is necessary for addressing drink driving and related harms. Given competing enforcement demands and agencies' resource constraints, understanding how much enforcement is sufficient to deter drink driving is critical. APPROACH This systematic literature review followed Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA) guidelines to examine research about dosage effects of enforcement and related visibility on drink-driving outcomes, including motor vehicle crashes and fatalities. Risk of bias was assessed using the Cochrane Collaboration Effective Practice and Organization of Care tool and the JBI checklist. KEY FINDINGS The 21 studies that met the inclusion criteria for this review differed in measures of enforcement dosage and outcomes, making it difficult to synthesise results across studies and draw conclusions about a threshold or optimal level of enforcement. Although most included studies found that sustained enforcement was associated with reductions in drink driving or related harms, only two studies tested an optimal dosage. Due to study design limitations, a substantial percentage of these studies must be considered with caution. IMPLICATIONS Additional research with rigorous study designs with appropriate controls is needed to determine an optimal high visibility enforcement dosage level to help law enforcement agencies make realistic decisions about allocating enforcement resources to address drink driving. CONCLUSION Consistent evidence about a drink-driving enforcement dosage threshold is lacking, partly due to an insufficient number of well-designed studies. Addressing challenges of conducting rigorous studies in community settings is crucial.
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Affiliation(s)
- Sharon E. O’Hara
- School of Public Health University of California, Berkeley, Berkeley, CA
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck Avenue, Suite 601, Berkeley, CA 94704
| | - Mallie J. Paschall
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck Avenue, Suite 601, Berkeley, CA 94704
| | - Denise Herd
- School of Public Health University of California, Berkeley, Berkeley, CA
- Othering and Belonging, Institute University of California, Berkeley, Berkeley, CA
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Morrison CN, Kwizera M, Chen Q, Puljevic C, Branas CC, Wiebe DJ, Peek-Asa C, McGavin KM, Franssen SJ, Le VK, Keating M, Williams FM, Ferris J. Alcohol-involved motor vehicle crashes and the size and duration of random breath testing checkpoints. Alcohol Clin Exp Res 2021; 45:784-792. [PMID: 33616237 DOI: 10.1111/acer.14583] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 02/15/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Sobriety checkpoints have strong empirical and theoretical support as an intervention to reduce alcohol-involved motor vehicle crashes. The purpose of this study was to examine whether checkpoint size (the number of police officers) and checkpoint duration (the amount of time in operation) affect associations between individual checkpoints and subsequent alcohol-related crash incidence. METHOD Queensland Police Service provided latitude-longitude coordinates and date and time data for all breath tests that occurred in Brisbane, Australia, from January 2012 to June 2018. We applied hierarchical cluster analysis to the latitude-longitude coordinates for breath tests, identifying checkpoints as clusters of ≥25 breath tests conducted by ≥3 breath testing devices over a duration of 3 to 8 hours. Generalized linear autoregressive moving average (GLARMA) models related counts of alcohol-involved motor vehicle crashes to the number of checkpoints conducted per week, as well as 1 week prior and 2 weeks prior. RESULTS A total of 3420 alcohol-related crashes occurred and 2069 checkpoints were conducted in Brisbane over the 6.5-year (339-week) study period. On average, checkpoints included a mean of 266.0 breath tests (SD = 216.3), 16.4 devices (SD = 13.7), and were 286.3 minutes in duration (SD = 104.2). Each 10 additional checkpoints were associated with a 12% decrease in crash incidence at a lag of 1 week (IRR = 0.88; 95%CI: 0.80, 0.97). We detected no differential associations according to checkpoint size or duration. CONCLUSIONS Sobriety checkpoints are associated with fewer alcohol-related motor vehicle crashes for around 1 week. Checkpoint size and duration do not appear to affect this relationship.
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Affiliation(s)
- Christopher N Morrison
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Vic., USA
| | - Muhire Kwizera
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Qixuan Chen
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Cheneal Puljevic
- Centre for Health Services Research, The University of Queensland, Woolloongabba, Qld, USA
| | - Charles C Branas
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Douglas J Wiebe
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, USA
| | - Corinne Peek-Asa
- Injury Prevention Research Center, University of Iowa College of Public Health, Iowa City, IA, USA
| | - Kirsten M McGavin
- Research and Policy Development, Road Policing Command, Queensland Police Service, Brisbane, Qld, USA
| | - Shellee J Franssen
- Research and Policy Development, Road Policing Command, Queensland Police Service, Brisbane, Qld, USA
| | - Vy K Le
- Research and Policy Development, Road Policing Command, Queensland Police Service, Brisbane, Qld, USA
| | - Michael Keating
- Research and Policy Development, Road Policing Command, Queensland Police Service, Brisbane, Qld, USA
| | - Frances M Williams
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Jason Ferris
- Centre for Health Services Research, The University of Queensland, Woolloongabba, Qld, USA
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Pressley JC, Hines LM, Bauer MJ, Oh SA, Kuhl JR, Liu C, Cheng B, Garnett MF. Using Rural⁻Urban Continuum Codes (RUCCS) to Examine Alcohol-Related Motor Vehicle Crash Injury and Enforcement in New York State. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16081346. [PMID: 30991657 PMCID: PMC6518428 DOI: 10.3390/ijerph16081346] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 04/08/2019] [Accepted: 04/10/2019] [Indexed: 11/16/2022]
Abstract
Rural areas of New York State (NYS) have higher rates of alcohol-related motor vehicle (MV) crash injury than metropolitan areas. While alcohol-related injury has declined across the three geographic regions of NYS, disparities persist with rural areas having smaller declines. Our study aim was to examine factors associated with alcohol-related MV crashes in Upstate and Long Island using multi-sourced county-level data that included the Crash Outcome Data Evaluation System (CODES) with emergency department visits and hospitalizations, traffic citations, demographic, economic, transportation, alcohol outlets, and Rural–Urban Continuum Codes (RUCCS). A cross-sectional study design employed zero-truncated negative binominal regression models to assess relative risks (RR) with 95% confidence interval (CI). Counties (n = 57, 56,000 alcohol-related crashes over the 3 year study timeframe) were categorized by mean annual alcohol-related MV injuries per 100,000 population: low (24.7 ± 3.9), medium (33.9 ± 1.7) and high (46.1 ± 8.0) (p < 0.0001). In multivariable analyses, alcohol-related MV injury was elevated for non-adjacent, non-metropolitan counties (RR 2.5, 95% CI: 1.6–3.9) with higher citations for impaired driving showing a small, but significant protective effect. Less metropolitan areas had higher alcohol-related MV injury with inconsistent alcohol-related enforcement measures. In summary, higher alcohol-related MV injury rates in non-metropolitan counties demonstrated a dose–response relationship with proximity to a metropolitan area. These findings suggest areas where intervention efforts might be targeted to lower alcohol-related MV injury.
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Affiliation(s)
- Joyce C Pressley
- Departments of Epidemiology and Health Policy and Management and Center for Injury Epidemiology and Prevention at Columbia, Columbia University, New York, NY 10032, USA.
| | - Leah M Hines
- Bureau of Occupational Health and Injury Prevention, New York State Department of Health, Albany, NY 12237, USA.
| | - Michael J Bauer
- Bureau of Occupational Health and Injury Prevention, New York State Department of Health, Albany, NY 12237, USA.
| | - Shin Ah Oh
- Department of Epidemiology, Columbia University, New York, NY 10032, USA.
| | - Joshua R Kuhl
- Department of Epidemiology, Columbia University, New York, NY 10032, USA.
| | - Chang Liu
- Department of Epidemiology, Columbia University, New York, NY 10032, USA.
| | - Bin Cheng
- Department of Biostatistics, Columbia University, New York, NY 10032, USA.
| | - Matthew F Garnett
- Bureau of Occupational Health and Injury Prevention, New York State Department of Health, Albany, NY 12237, USA.
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Eby DW, Molnar LJ, Kostyniuk LP, St Louis RM, Zanier N, Lepkowski JM, Bergen G. Perceptions of alcohol-impaired driving and the blood alcohol concentration standard in the United States. JOURNAL OF SAFETY RESEARCH 2017; 63:73-81. [PMID: 29203026 PMCID: PMC6862781 DOI: 10.1016/j.jsr.2017.08.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 07/13/2017] [Accepted: 08/17/2017] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Although the number of alcohol-impaired driving (AID) fatalities has declined over the past several years, AID continues to be a serious public health problem. The purpose of this effort was to gain a better understanding of the U.S. driving population's perceptions and thoughts about the impacts of lowering the blood alcohol concentration (BAC) driving standard below.08% on AID, health, and other outcomes. METHODS A questionnaire was administered to a nationally representative sample of licensed drivers in the U.S. (n=1011) who were of age 21 or older on driving habits, alcohol consumption habits, drinking and driving habits, attitudes about drinking and driving, experiences with and opinions of drinking and driving laws, opinions about strategies to reduce drinking and driving, general concerns about traffic safety issues, and demographics. RESULTS One-third of participants supported lowering the legal BAC standard, and participants rated a BAC standard of .05% to be moderately acceptable on average. 63.9% indicated that lowering 30 the BAC to .05% would have no effect on their decisions to drink and drive. Nearly 60% of respondents lacked accurate knowledge of their state's BAC standard. CONCLUSIONS Public support for lowering the BAC standard was moderate and was partially tied to beliefs about the impacts of a change in the BAC standard. The results suggest that an opportunity for better educating the driving population about existing AID policy and the implications for lowering the BAC level on traffic injury prevention. PRACTICAL APPLICATIONS The study results are useful for state traffic safety professionals and policy makers to have a better understanding of the public's perceptions of and thoughts about BAC standards. There is a clear need for more research into the effects of lowering the BAC standard on crashes, arrests, AID behavior, and alcohol-related behaviors.
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Affiliation(s)
- David W Eby
- University of Michigan Transportation Research Institute, United States.
| | - Lisa J Molnar
- University of Michigan Transportation Research Institute, United States
| | - Lidia P Kostyniuk
- University of Michigan Transportation Research Institute, United States
| | - Renée M St Louis
- University of Michigan Transportation Research Institute, United States
| | - Nicole Zanier
- University of Michigan Transportation Research Institute, United States
| | - James M Lepkowski
- University of Michigan, Institute for Social Research, United States
| | - Gwen Bergen
- Division of Unintentional Injury Prevention, Centers for Disease Control and Prevention, United States
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Fell JC, Beirness DJ, Voas RB, Smith GS, Jonah B, Maxwell JC, Price J, Hedlund J. Can progress in reducing alcohol-impaired driving fatalities be resumed? Results of a workshop sponsored by the Transportation Research Board, Alcohol, Other Drugs, and Transportation Committee (ANB50). TRAFFIC INJURY PREVENTION 2016; 17:771-81. [PMID: 26980557 PMCID: PMC5025339 DOI: 10.1080/15389588.2016.1157592] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 02/19/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Despite successes in the 1980s and early 1990s, progress in reducing impaired driving fatalities in the United States has stagnated in recent years. Since 1997, the percentage of drivers involved in fatal crashes with illegal blood alcohol concentration (BAC) levels has remained at approximately 20 to 22%. Many experts believe that public complacency, competing social and public health issues, and the lack of political fortitude have all contributed to this stagnation. The number of alcohol-related crashes, injuries, and fatalities is still unacceptable, and most are preventable. The public needs to be aware that the problem presented by drinking drivers has not been solved. Political leaders need guidance on which measures will affect the problem, and stakeholders need to be motivated once again to implement effective strategies. METHODS The National Academy of Sciences (NAS) Transportation Research Board (TRB), Alcohol, Other Drugs, and Transportation Committee (ANB50) sponsored a workshop held at the NAS facility in Woods Hole, Massachusetts, on August 24-25, 2015, to discuss the lack of progress in reducing impaired driving and to make recommendations for future progress. A total of 26 experts in research and policy related to alcohol-impaired driving participated in the workshop. The workshop began by examining the static situation in the rate of alcohol-impaired driving fatal crashes to determine what factors may be inhibiting further progress. The workshop then discussed 8 effective strategies that have not been fully implemented in the United States. Workshop participants (16 of the 26) rated their top 3 strategies. RESULTS 3 strategies received the most support: 1. Impose administrative sanctions for drivers with BACs = 0.05 to 0.08 g/dL. 2. Require alcohol ignition interlocks for all alcohol-impaired driving offenders. 3. Increase the frequency of sobriety checkpoints, including enacting legislation to allow them in the 11 states that currently prohibit them. 5 other important strategies included the following: (1) increase alcohol taxes to raise the price and reduce alcohol consumption; (2) reengage the public and raise the priority of impaired driving; (3) lower the illegal per se BAC limit to 0.05 for a criminal offense; (4) develop and implement in-vehicle alcohol detection systems; and (5) expand the use of screening and brief interventions in medical facilities. CONCLUSIONS Each of these strategies is proven to be effective, yet all are substantially underutilized. Each is used in some jurisdictions in the United States or Canada, but none is used extensively. Any one of the 3 strategies implemented on a widespread basis would decrease impaired driving crashes, injuries, and fatalities. Based on the research, all 3 together would have a substantial impact on the problem.
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Affiliation(s)
- James C. Fell
- NORC at the University of Chicago, 4350 East-West Highway, 8th Floor, Bethesda MD 20814
| | - Douglas J. Beirness
- Canadian Centre on Substance Abuse, 75 Albert Street, Suite 500, Ottawa, Ontario, K1P 5E7, Canada
| | - Robert B. Voas
- Pacific Institute for Research and Evaluation, 11720 Beltsville Drive, Suite 900, Calverton, MD 20705
| | - Gordon S Smith
- University of Maryland School of Medicine, 655 West Baltimore Street, Baltimore, MD 21201-1559
| | - Brian Jonah
- Canadian Association of Road Safety Professionals, 17 Meadowbrook Crescent, St. Catharines, Ontario, L2M 7G8, Canada
| | - Jane Carlisle Maxwell
- University of Texas at Austin, School of Social Work, 1 University Station D3500, Austin, TX 78712
| | - Jana Price
- National Transportation Safety Board, 490 L'Enfant Plaza, SW, Washington, DC 20594
| | - James Hedlund
- Highway Safety North, 110 Homestead Road, Ithaca, NY 14850-6216
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Eichelberger AH, McCartt AT. Impaired driving enforcement practices among state and local law enforcement agencies in the United States. JOURNAL OF SAFETY RESEARCH 2016; 58:41-47. [PMID: 27620933 DOI: 10.1016/j.jsr.2016.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 05/18/2016] [Accepted: 06/16/2016] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Alcohol-impaired driving (DUI) persists as a substantial problem, yet detailed data on DUI enforcement practices are rarely collected. The present study surveyed state and local law enforcement agencies about their DUI enforcement activities. METHOD Telephone interviews were conducted with law enforcement liaisons in state highway safety offices. Officers from a nationally representative sample of municipal, county, and state law enforcement agencies were also interviewed about their agency's DUI enforcement activities, including the types of enforcement, frequency of use, and whether activities were publicized. Response rates were 100% among law enforcement liaisons, 86% among county agencies, 93% among municipal agencies, and 98% among state agencies. RESULTS Based on the highway safety office survey, 38 states conducted sobriety checkpoints in 2011. Nationally, 58% of law enforcement agencies reported that they conducted or helped conduct sobriety checkpoints during 2011-12, with 14% of all agencies conducting them monthly or more frequently. The vast majority (87%) of agencies reported conducting dedicated DUI patrols. However, dedicated DUI patrols were less likely to be publicized than checkpoints. Less than a quarter of agencies reported using passive alcohol sensors to improve detection of alcohol-impaired drivers. CONCLUSIONS Results show that 38 states conducted sobriety checkpoints in 2011, little changed from a previous survey in 2000. Despite evidence of effectiveness, many agencies do not conduct frequent, publicized DUI enforcement or use passive alcohol sensors. PRACTICAL APPLICATIONS The survey suggests that there are several areas in which impaired driving enforcement could be improved: increasing the frequency of special enforcement, such as sobriety checkpoints and/or dedicated patrols; publicizing these efforts to maximize deterrent effects; and using passive alcohol sensors to improve detection of alcohol-impaired drivers.
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Affiliation(s)
- Angela H Eichelberger
- Insurance Institute for Highway Safety, 988 Dairy Road, Ruckersville, VA 22968, United States.
| | - Anne T McCartt
- Insurance Institute for Highway Safety, 1005 North Glebe Road, Arlington, VA 22201, United States.
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Fell JC, Waehrer G, Voas RB, Auld-Owens A, Carr K, Pell K. Relationship of impaired-driving enforcement intensity to drinking and driving on the roads. Alcohol Clin Exp Res 2014; 39:84-92. [PMID: 25515820 DOI: 10.1111/acer.12598] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Accepted: 10/08/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND It is principally the area of enforcement that offers the greatest opportunity for reducing alcohol-impaired driving in the near future. How much of a reduction in drinking and driving would be achieved by how much improvement in enforcement intensity? METHODS We developed logistic regression models to explore how enforcement intensity (6 different measures) related to the prevalence of weekend nighttime drivers in the 2007 National Roadside Survey who had been drinking (blood alcohol concentration [BAC] ≥ 0.00 g/dl), who had BACs ≥ 0.05 g/dl, and who were driving with an illegal BAC ≥ 0.08 g/dl. RESULTS Drivers on the roads in our sample of 30 communities who were exposed to fewer than 228 traffic stops per 10,000 population aged 18 and older had 2.4 times the odds of being BAC positive, 3.6 times the odds of driving with a BAC ≥ 0.05, and 3.8 times the odds of driving with a BAC ≥ 0.08 compared to those drivers on the roads in communities with more than 1,275 traffic stops per 10,000 population. Drivers on the roads in communities with fewer than 3.7 driving under the influence (DUI) arrests per 10,000 population had 2.7 times the odds of BAC-positive drivers on the roads compared to communities with the highest intensity of DUI arrest activity (>38 DUI arrests per 10,000 population). CONCLUSIONS The number of traffic stops and DUI arrests per capita were significantly associated with the odds of drinking and driving on the roads in these communities. This might reflect traffic enforcement visibility. The findings in this study may help law enforcement agencies around the country adjust their traffic enforcement intensity to reduce impaired driving in their community.
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Affiliation(s)
- James C Fell
- Pacific Institute for Research & Evaluation, Calverton, Maryland
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Fell JC, Waehrer G, Voas RB, Auld-Owens A, Carr K, Pell K. Effects of enforcement intensity on alcohol impaired driving crashes. ACCIDENT; ANALYSIS AND PREVENTION 2014; 73:181-186. [PMID: 25240134 PMCID: PMC4254192 DOI: 10.1016/j.aap.2014.09.002] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Revised: 06/23/2014] [Accepted: 09/05/2014] [Indexed: 05/30/2023]
Abstract
BACKGROUND Research measuring levels of enforcement has investigated whether increases in police activities (e.g., checkpoints, driving-while-intoxicated [DWI] special patrols) above some baseline level are associated with reduced crashes and fatalities. Little research, however, has attempted to quantitatively measure enforcement efforts and relate different enforcement levels to specific levels of the prevalence of alcohol-impaired driving. OBJECTIVE The objective of this study was to investigate the effects of law-enforcement intensity in a sample of communities on the rate of crashes involving a drinking driver. We analyzed the influence of different enforcement strategies and measures: (1) specific deterrence - annual number of driving-under-the-influence (DUI) arrests per capita; (2) general deterrence - frequency of sobriety checkpoint operations; (3) highly visible traffic enforcement - annual number of traffic stops per capita; (4) enforcement presence - number of sworn officers per capita; and (5) overall traffic enforcement - the number of other traffic enforcement citations per capita (i.e., seat belt citations, speeding tickets, and other moving violations and warnings) in each community. METHODS We took advantage of nationwide data on the local prevalence of impaired driving from the 2007 National Roadside Survey (NRS), measures of DUI enforcement activity provided by the police departments that participated in the 2007 NRS, and crashes from the General Estimates System (GES) in the same locations as the 2007 NRS. We analyzed the relationship between the intensity of enforcement and the prevalence of impaired driving crashes in 22-26 communities with complete data. Log-linear regressions were used throughout the study. RESULTS A higher number of DUI arrests per 10,000 driving-aged population was associated with a lower ratio of drinking-driver crashes to non-drinking-driver crashes (p=0.035) when controlling for the percentage of legally intoxicated drivers on the roads surveyed in the community from the 2007 NRS. Results indicate that a 10% increase in the DUI arrest rate is associated with a 1% reduction in the drinking driver crash rate. Similar results were obtained for an increase in the number of sworn officers per 10,000 driving-age population. DISCUSSION While a higher DUI arrest rate was associated with a lower drinking-driver crash rate, sobriety checkpoints did not have a significant relationship to drinking-driver crashes. This appeared to be due to the fact that only 3% of the on-the-road drivers were exposed to frequent sobriety checkpoints (only 1 of 36 police agencies where we received enforcement data conducted checkpoints weekly). This low-use strategy is symptomatic of the general decline in checkpoint use in the U.S. since the 1980s and 1990s when the greatest declines in alcohol-impaired-driving fatal crashes occurred. The overall findings in this study may help law enforcement agencies around the country adjust their traffic enforcement intensity in order to reduce impaired driving in their community.
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Affiliation(s)
- James C Fell
- Pacific Institute for Research and Evaluation (PIRE), 11720 Beltsville Drive, Suite 900, Calverton, MD 20705-3111, USA.
| | - Geetha Waehrer
- Pacific Institute for Research and Evaluation (PIRE), 11720 Beltsville Drive, Suite 900, Calverton, MD 20705-3111, USA
| | - Robert B Voas
- Pacific Institute for Research and Evaluation (PIRE), 11720 Beltsville Drive, Suite 900, Calverton, MD 20705-3111, USA
| | - Amy Auld-Owens
- Pacific Institute for Research and Evaluation (PIRE), 11720 Beltsville Drive, Suite 900, Calverton, MD 20705-3111, USA
| | - Katie Carr
- Pacific Institute for Research and Evaluation (PIRE), 11720 Beltsville Drive, Suite 900, Calverton, MD 20705-3111, USA
| | - Karen Pell
- Pacific Institute for Research and Evaluation (PIRE), 11720 Beltsville Drive, Suite 900, Calverton, MD 20705-3111, USA
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Bergen G, Pitan A, Qu S, Shults RA, Chattopadhyay SK, Elder RW, Sleet DA, Coleman HL, Compton RP, Nichols JL, Clymer JM, Calvert WB. Publicized sobriety checkpoint programs: a community guide systematic review. Am J Prev Med 2014; 46:529-39. [PMID: 24745644 DOI: 10.1016/j.amepre.2014.01.018] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 01/21/2014] [Accepted: 01/28/2014] [Indexed: 11/28/2022]
Abstract
CONTEXT Publicized sobriety checkpoint programs deter alcohol-impaired driving by stopping drivers systematically to assess their alcohol impairment. Sobriety checkpoints were recommended in 2001 by the Community Preventive Services Task Force for reducing alcohol-impaired driving, based on strong evidence of effectiveness. Since the 2001 review, attention to alcohol-impaired driving as a U.S. public health problem has decreased. This systematic review was conducted to determine if available evidence supports the effectiveness of publicized sobriety checkpoint programs in reducing alcohol-impaired driving, given the current context. The economic costs and benefits of the intervention were also assessed. EVIDENCE ACQUISITION This review focused on studies that evaluated the effects of publicized sobriety checkpoint programs on alcohol-involved crash fatalities. Using Community Guide methods, a systematic search was conducted for studies published between July 2000 and March 2012 that assessed the effectiveness of publicized sobriety checkpoint programs. EVIDENCE SYNTHESIS Fourteen evaluations of selective breath testing and one of random breath testing checkpoints met the inclusion criteria for the systematic review, conducted in 2012. Ten evaluations assessed the effects of publicized sobriety checkpoint programs on alcohol-involved crash fatalities, finding a median reduction of 8.9% in this crash type (interquartile interval=-16.5%, -3.5%). Five economic evaluations showed benefit-cost ratios ranging from 2:1 to 57:1. CONCLUSIONS The number of studies, magnitude of effect, and consistency of findings indicate strong evidence of the effectiveness of publicized sobriety checkpoint programs in reducing alcohol-involved crash fatalities. Economic evidence shows that these programs also have the potential for substantial cost savings.
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Affiliation(s)
- Gwen Bergen
- Home, Recreation, and Transportation Branch, Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, CDC, Atlanta, Georgia.
| | - Adesola Pitan
- Community Guide Branch, Epidemiology and Analysis Program Office, Office of Surveillance, Epidemiology, and Laboratory Services, CDC, Atlanta, Georgia
| | - Shuli Qu
- Community Guide Branch, Epidemiology and Analysis Program Office, Office of Surveillance, Epidemiology, and Laboratory Services, CDC, Atlanta, Georgia
| | - Ruth A Shults
- Home, Recreation, and Transportation Branch, Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, CDC, Atlanta, Georgia
| | - Sajal K Chattopadhyay
- Community Guide Branch, Epidemiology and Analysis Program Office, Office of Surveillance, Epidemiology, and Laboratory Services, CDC, Atlanta, Georgia
| | - Randy W Elder
- Community Guide Branch, Epidemiology and Analysis Program Office, Office of Surveillance, Epidemiology, and Laboratory Services, CDC, Atlanta, Georgia
| | - David A Sleet
- Home, Recreation, and Transportation Branch, Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, CDC, Atlanta, Georgia
| | - Heidi L Coleman
- National Highway Traffic Safety Administration, Washington, District of Columbia
| | - Richard P Compton
- National Highway Traffic Safety Administration, Washington, District of Columbia
| | - James L Nichols
- National Highway Traffic Safety Administration, Washington, District of Columbia
| | - John M Clymer
- National Forum for Heart Disease & Stroke Prevention, Washington, District of Columbia
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Voas RB, Fell JC. Strengthening impaired-driving enforcement in the United States. TRAFFIC INJURY PREVENTION 2013; 14:661-670. [PMID: 23944649 PMCID: PMC3840953 DOI: 10.1080/15389588.2012.754095] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVE Progress in reducing alcohol-impaired driving crash fatalities in the United States has stagnated over the last 15 years. This article reviews 2 current U.S. driving-while-intoxicated (DWI) laws and their enforcement with an aim toward generating opportunities to improve their enforcement approaches. METHODS Impaired-driving enforcement methods in Europe and Australia are compared with those in the United States, and the legal basis for current DWI criminal procedures is examined. RESULTS An examination of relevant U.S. Supreme Court decisions and current legal practices indicates that the requirements for use of breath test technology to determine blood alcohol concentrations of drivers on public roads are not entirely clear. Several potential methods for using field breath test technology to improve the detection of impaired drivers are suggested. These include (a) breath testing all drivers stopped for certain violations that have a high probability of involving an impaired driver, (b) breath testing all drivers at sobriety checkpoints, and (c) breath testing all drivers involved in fatal and serious injury crashes. CONCLUSIONS Breath test technology has enabled other countries around the world to adopt and implement enforcement strategies that serve as both general and specific deterrents to alcohol-impaired driving. Many of these enforcement strategies have been shown to be effective. If any one of these strategies can be adopted in the United States, further progress in reducing impaired driving is probable. It may be necessary to provide the U.S. Supreme Court with a test case of breath testing all drivers at a sobriety checkpoint, depending upon whether or not a police agency is willing to use that strategy.
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Affiliation(s)
- Robert B Voas
- Impaired Driving Center, Pacific Institute for Research and Evaluation, Calverton, Maryland 20705-3111, USA.
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Ditsuwan V, Lennert Veerman J, Bertram M, Vos T. Cost-effectiveness of interventions for reducing road traffic injuries related to driving under the influence of alcohol. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2013; 16:23-30. [PMID: 23337212 DOI: 10.1016/j.jval.2012.08.2209] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2010] [Revised: 08/17/2012] [Accepted: 08/23/2012] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To determine the cost-effectiveness of interventions to reduce road traffic injuries caused by driving under the influence of alcohol in Thailand. METHODS We used generalized cost-effectiveness analysis and included costs from a health sector perspective. The model considered road traffic crash victims who were injured, disabled, or died. We obtained proportions of alcohol-related crashes from the Thai Injury Surveillance system. Intervention effectiveness was derived from published reviews and a study in one province of Thailand. Random breath testing, selective breath testing, and mass media campaigns, both current and intervention scenarios, were compared with a "do-nothing" scenario. We calculated intervention costs and cost offsets of prevented treatment costs in 2004 Thai baht (US $1 = 41 baht) and measured benefits in terms of disability-adjusted life-years averted. Interventions with incremental cost-effectiveness ratios below 110,000 Thai baht (1×gross domestic product per capita) per disability-adjusted life-year (US $2,680) were considered very cost-effective. RESULTS Compared with doing nothing, mass media campaigns, random breath testing, and selective breath testing are all cost saving. When averted treatment costs are ignored and only intervention costs are included, all three interventions are very cost-effective, with incremental cost-effectiveness ratios of 10,300, 14,300 and 13,000 baht/disability-adjusted life-year, respectively. The current mix of mass media campaigns and sobriety checkpoints is therefore also cost-effective, but underinvestment in checkpoints limits its overall effect. CONCLUSIONS A greater intensity of conducting sobriety checkpoints in Thailand is recommended to complement the investment in mass media campaigns. Together these interventions have the potential to reduce the burden of alcohol-related road traffic injuries by 24%.
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Affiliation(s)
- Vallop Ditsuwan
- Faculty of Health and Sports Science, Thaksin University, Phatthalung Province, Thailand.
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Ferguson SA. Alcohol-impaired driving in the United States: contributors to the problem and effective countermeasures. TRAFFIC INJURY PREVENTION 2012; 13:427-441. [PMID: 22931172 DOI: 10.1080/15389588.2012.656858] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To review the effectiveness of current countermeasures in alcohol-impaired driving. METHOD This article provides an overview of the contributors to the alcohol-impaired driving problem in the United States and reviews the effectiveness of alcohol-impaired driving countermeasures. RESULTS Many effective countermeasures have been used during the past few decades both to deter drivers from driving when they are over the legal limit for alcohol and to discourage driving while intoxicated (DWI) offenders from reoffending once they have been caught and convicted. In recent years, greater attention has been given to the problem of "hardcore" drinking drivers, a term coined to refer to those who repeatedly drive with high blood alcohol concentrations and are resistant to changing their behavior. Although such individuals are a legitimate target for attention, focusing predominantly on this group will result in missed opportunities to address a large portion of alcohol-impaired driving crashes. This article provides a review of the primary countermeasures that have been used to reduce alcohol-impaired driving and summarizes evidence for their effectiveness. It asks the question of where, in an environment of limited resources, attention should be focused. CONCLUSIONS General deterrent approaches, such as frequent and highly publicized sobriety checkpoints, have the greatest potential to save lives and should be the mainstay of state and local efforts. Specific deterrent approaches, aimed at deterring DWI offenders from reoffending, such as alcohol ignition interlocks, should be applied to all apprehended drivers, whatever their drinking history. Evidence suggests that they could benefit from them. In the future, advanced in-vehicle technologies that would prevent vehicles from being driven when their drivers are over the legal limit may hold the key to drastically reducing the alcohol-impaired driving problem.
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Abstract
While individual studies from several South American countries have shown driving while intoxicated to be a problem, there are no objective systematically collected alcohol-associated driving data obtained in most South American countries. This limits their ability to implement and enforce targeted prevention strategies, evaluate whether proven prevention efforts from North America (particularly the United States and Canada) can be transferred to the South, and to sustain momentum for the improvement of road safety by demonstrating that previously implemented legal and policy changes are effective. The aim of this paper is to discuss the abysmal differences that exist between northern and southern American countries regarding the current status of driving while intoxicated prevention strategies-their implementation, impacts and effects-using Brazil as a case example. We propose a three-pronged approach to close this northern-southern American gap in driving while intoxicated prevention and intervention: (a) systematic collection on road traffic crash/injury/death as well as risk factor data, (b) passage of laws without loopholes requiring compliance with blood alcohol concentration testing and (c) provision of appropriate training and equipment to the police in concomitance with vigilant enforcement. Resources and energies must be put towards data collection, implementation of prevention strategies and enforcement in order to decrease the unacceptably high rates of these preventable driving while intoxicated deaths.
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Affiliation(s)
- Flavio Pechansky
- Department of Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
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Caudill BD, Rogers JW, Howard J, Frissell KC, Harding WM. Avoiding DWI Among Bar-room Drinkers: Strategies and Predictors. SUBSTANCE ABUSE-RESEARCH AND TREATMENT 2010; 4:35-51. [PMID: 22879742 PMCID: PMC3411537 DOI: 10.4137/sart.s5414] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
We examined the prevalence and predictors of 11strategies to avoid driving when feeling intoxicated among 561 bar-room patrons in two medium-sized Maryland communities. Logistic regression analyses identified demographic, behavioral, and attitudinal predictors of avoidance strategies and interactions among predictors. Overall, 89% reported one or more DWI avoidance actions in the past year, and 38% reported driving intoxicated during that time. Average frequencies of avoidance behavior and intoxicated driving increased significantly as drinking level increased. However, the higher the drinking level, the smaller the ratio of avoidance actions to DWI experiences, highlighting the vulnerability of heavy drinkers who had driven intoxicated. Using a sober driver or one who allegedly drank less than the respondent were the most popular and frequent strategies, but paying for a cab, walking, and using a bus or free cab were relatively unpopular. Higher drinking levels predicted significantly higher odds of using avoidance approaches, as did intoxicated driving. Confidence in driving safely when intoxicated was positively related to drinking level and intoxicated driving, but it tended to predict lower odds of avoidance actions. Similarly, marital status, age, gender, and location influenced the odds of avoidance behaviors. Interventions should be strategically tailored to exploit or counter drinker predilections among avoidance options.
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McCartt AT, Hellinga LA, Wells JK. Effects of a college community campaign on drinking and driving with a strong enforcement component. TRAFFIC INJURY PREVENTION 2009; 10:141-147. [PMID: 19333826 DOI: 10.1080/15389580802701284] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVES A program of publicized intensive enforcement of minimum drinking age law and drinking and driving laws was implemented in a college community. The effects on driving at various blood alcohol concentrations (BACs) were evaluated, particularly for drivers ages 16-24 targeted by the program. METHODS Objective measures of driver BACs were collected through nighttime roadside surveys before and during the program in the experimental college community and a comparison college community. Logistic regression models estimated the program's effects on the likelihood of driving at various BAC thresholds in the program community, after accounting for BAC patterns in the comparison community. RESULTS Relative to the comparison community, consistent reductions in driving at various BAC levels (positive BAC and BAC at least 0.02, 0.05, or 0.08%) were achieved in the experimental community. Reductions were greatest for 16- to 20-year-olds (from 66% for positive BAC to 94% for BAC > or = 0.05%), followed by 21- to 24-year-olds (from 32% for positive BAC to 71% for BAC > or = 0.08%) and drivers 25 and older (from 23% for positive BAC to 53% for BAC > or = 0.08%). All reductions for 16- to 20-year-olds were significant (p < 0.05), and all except the reduction for BAC > or = 0.08 percent were significantly greater than the corresponding reductions for drivers 25 and older. Reductions for 21- to 24-year-olds were significant for BACs at least 0.02, 0.05, and 0.08 percent, but they were not significantly greater than the corresponding reductions for drivers 25 and older. Although large, reductions for drivers 25 and older were not significant, based on 95 percent confidence intervals. CONCLUSIONS A college community program with a strong enforcement component produced substantial reductions in drinking and driving among teenagers and young adults and smaller reductions among older adults. It is hoped that this will encourage colleges and communities to incorporate enforcement into interventions directed at alcohol use among young people.
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Affiliation(s)
- Anne T McCartt
- Insurance Institute for Highway Safety, 1005 North Glebe Road, Arlington, VA 22201, USA.
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Voas RB. A new look at NHTSA's evaluation of the 1984 Charlottesville Sobriety Checkpoint Program: implications for current checkpoint issues. TRAFFIC INJURY PREVENTION 2008; 9:22-30. [PMID: 18338291 DOI: 10.1080/15389580701682114] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE Currently, the implementation of sobriety checkpoint programs, which have been demonstrated to be effective in reducing alcohol-related crashes, is limited by the belief that they require large consignments of police officers and result in few arrests. However, one of the earliest evaluations of a checkpoint program in Charlottesville, Virginia, demonstrated that effective checkpoints could be mounted in which police officers made as many arrests as officers on regular patrols. That study was printed by the NHTSA but was not published in a peer-reviewed journal. Because of its significance to current issues in the staffing of and procedures for checkpoint operations, this article reanalyzes the results of that study and describes the procedures implemented in checkpoints. METHODS A before-and-after control design was used to measure the change in nighttime crashes from three baseline years to the program year. Two analyses were conducted: the first on the percentage of all crashes occurring at night in the test city--Charlottesville--and the second on the percentage of all nighttime crashes in the state of Virginia that occurred in the test city. In addition, three waves of random-digit-dialing telephone surveys were conducted: one before and two during the checkpoint program in the test city, and the comparison city, Blacksburg. Finally, the number of impaired-driving arrests per officer hour at the checkpoints was compared with the number of arrests per hour by officers on regular patrol and the effect on arrests of the use of passive sensors was determined. RESULTS The monthly percentage of nighttime crashes in Charlottesville was reduced by 17% (p = 000) in relation to the baseline level. The percentage of nighttime crashes in the state of Virginia that occurred in Charlottesville was reduced by 11% (p = .013) from baseline levels. Drivers arrested at checkpoints had lower BACs than those arrested by the regular patrols; however, the conviction rates were the same. The arrest per officer hour did not differ significantly between the two types of enforcement operations. Awareness of the checkpoint activity was high (72%) among nighttime at-risk drivers in the test city. Half reported seeing a checkpoint operation, and a quarter reported being interviewed. Use of a passive alcohol sensor by officers at the checkpoint increased arrests by almost a factor of three. CONCLUSIONS The results of the evaluation suggest that small-scale sobriety checkpoints can be implemented as part of the regular enforcement program in moderate-sized jurisdictions and that they can be as efficient in producing arrests as standard enforcement patrols, particularly if passive alcohol sensors are used.
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Affiliation(s)
- Robert B Voas
- Pacific Institute for Research and Evaluation, Calverton, Maryland, USA.
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