Understanding the context of alcohol impaired driving for fatal crash-involved drivers: A descriptive case analysis

Disadvantaged by More Than Distance: A Systematic Literature Review of Injury in Rural Australia

Rural populations experience injury-related mortality and morbidity rates 1.5 times greater than metropolitan residents. Motivated by a call for stronger epidemiological evidence around rural injuries to inform prevention, a systematic review of peer-reviewed literature published between January 2010 and March 2021 was undertaken to explore the epidemiology of rural injury and associated risk factors in Australia. A subsequent aim was to explore definitions of rurality used in injury prevention studies. There were 151 papers included in the review, utilizing 23 unique definitions to describe rurality. People living in rural areas were more likely to be injured, for injuries to be more severe, and for injuries to have greater resulting morbidity than people in metropolitan areas. The increase in severity reflects the mechanism of rural injury, with rural injury events more likely to involve a higher energy exchange. Risk-taking behavior and alcohol consumption were significant risk factors for rural injury, along with rural cluster demographics such as age, sex, high socio-economic disadvantage, and health-related comorbidities. As injury in rural populations is multifactorial and nonhomogeneous, a wide variety of evidence-based strategies are needed. This requires funding, political leadership for policy formation and development, and implementation of evidence-based prevention interventions.

Modeling the temporal relationship between contributing factors and injury severities in rural single-vehicle alcohol-impaired driving crashes: Insights from random parameters logit models in the means and variances

OBJECTIVES

Alcohol-impaired driving (A-ID) crashes have been acknowledged as fatality-concentrated while there is a limited understanding of how contributors relating to A-ID influence crash severity and lead to more severe injuries in rural areas. The current paper utilized North Carolina crash data to investigate the unobserved heterogeneity and temporal stability of the rural single-vehicle A-ID crash injury-severity determinants over a five-year period from 2014-2018.

METHODS

Crash injury severities were estimated using a group of random parameters logit models in the means and variances with three categories of injury-severity determined as outcome variables including no injury, minor injury, and severe injury. Explanatory variables were selected across multiple factors that could be classified as roadway characteristics, environmental characteristics, crash characteristics, temporal characteristics, vehicle characteristics and driver characteristics. The temporal stability of the models was examined through a series of likelihood ratio tests. Marginal effects were also adopted to analyze the temporal stability of the explanatory variables.

RESULTS

The result uncovers an overall temporal instability. Some contributors present relatively temporal stability such as female, turning, passenger car, motorcycle, vehicle age (5-9 years old), speed limit (<45 mph), curved segment, dry road surface, animal collision and overturned collision. Curved segment and dry road surface are found to consistently increase the possibility of severe injuries in rural alcohol-involved crashes.

CONCLUSIONS

This paper can provide insights into preventing single-vehicle A-ID crashes and could potentially facilitate the development of single-vehicle A-ID crash injury mitigation policies in rural areas. More studies could be conducted adopting the advanced data-driven methods for A-ID crash prediction.

Alcohol and Alcohol Combined with Texting: Evaluation of Driving Impairment Effects in a Closed-Course Section

OBJECTIVE

Examine the driving impairment effects of alcohol alone and of alcohol combined with texting.

METHODS

Fifteen drivers (nine male, six female; mean age: 31.1 ± 6.9 years, range: 23 to 43 years) with similar drinking habit (i.e., social drinkers) completed a lap in a closed-course section in six different situations: (I) sober; (II) sober and while texting; (III) 30 minutes after ingesting a moderate dose of ethanol (0.50 g/kg); (IV) 30 minutes after drinking and while texting; (V) 60 minutes after drinking, (VI) 60 minutes after drinking and while texting. Driving performance was analyzed by means of maximum and mean speed, braking time and braking distance; and ability to control the car (i.e., evaluating if the drivers hit a traffic cone or exceeded the boundaries of the course). P values of < 0.05 were considered significant.

RESULTS

Pre and post-alcohol consumption results show a significant increase concerning the drivers' mean and maximum speed after drinking (p < 3.2x10^-8). However, neither alcohol nor texting had significant effects on braking parameters (p > 0.05). Traffic cones were knocked down only in texting experiments. In addition, when using the cell phone drivers tended to reduce the speed, and to accelerate abruptly right after they finish texting.

CONCLUSION

Our findings strengthen the hypothesis that even moderate alcohol doses may significantly impair the driving performance. Additionally, alcohol and texting have complementary effects on driving impairment, and their combination represents a significant risk factor for crashes.

Methamphetamine and alcohol detection in vehicle-driver fatalities in South Australia: A 10-year survey (2008-2018)

Motor vehicle driver fatalities (≥18 years) from the files at Forensic Science South Australia were reviewed from January 2008 to December 2018 for cases in which either positive blood sample for methamphetamine (MA) or an illegal blood alcohol concentration (BAC) >0.05g/100 ml were found. Three hundred driver deaths were found with MA detected in 28 cases (age range 21-62 years; ave. 37.8 years; M:F 23:5). Hundred and fifteen cases with a BAC > 0.05 g/100 ml were identified (age range 18-67 years; ave 35.7 years; M:F 95:20). No change was found in numbers of MA cases, although alcohol cases showed a significant decline (p < 0.001). Drunk driving-related fatal crashes tended to occur in the evening (5 p.m. to 11 p.m.), while MA-related fatal crashes had a longer peak extending from late evening until late morning (11 p.m. to 8 a.m.). This study has demonstrated that while roadside breath testing, legislative changes, and increased monitoring have resulted in reduced levels of drunk driving, similar safety countermeasures have had negligible effects on MA use in drivers. Continued monitoring of MA use by drivers will, therefore, be necessary to assess the possible effects, or not, of new countermeasures.

Interpol review of toxicology 2016-2019

This review paper covers the forensic-relevant literature in toxicology from 2016 to 2019 as a part of the 19th Interpol International Forensic Science Managers Symposium. The review papers are also available at the Interpol website at: https://www.interpol.int/content/download/14458/file/Interpol%20Review%20.Papers%202019.pdf.

Social Drinking Contexts and Their Influence on Problematic Drinking at Age 30

Aims: Understanding the social contexts in which problematic drinking occurs can inform prevention strategies. In this article, we investigate gender-specific social contexts associated with problematic drinking and depression among adults aged 30 years. Because depression has been consistently linked with harmful alcohol consumption, we will also examine its association with drinking contexts. Methods: We used data from 2490 young adults who completed the 30-year follow-up phase of the Mater-University of Queensland Study of Pregnancy and its Outcomes, a prospective study commenced in 1981. Exploratory and confirmatory factor analyses were used to identify latent constructs of drinking contexts stratified by gender, with subsequent regression analysis to assess the role of these contexts in problematic drinking (measured using the Alcohol Use Disorders Identification Test). Results: Six distinct drinking contexts were identified, which differed by gender, three for men and three for women. For both men and women, "social drinking", was associated with problematic drinking. "Home drinking" was also common to men and women but associations with problematic drinking differed, being risky only among men. "Daytime drinking" (women) was associated with risk but "work-related drinking" (men) was not. Both "home drinking" (men) and "daytime drinking" (women) were linked to depression symptoms. Conclusion: Specific contexts appeared to be associated with problematic drinking for both sexes. Among both men and women, "social drinking" was associated with problematic drinking. Both "home drinking" (men) and "daytime drinking" (women) contexts, were associated with problematic drinking and depressive symptoms. Targeted alcohol-focused interventions need to address co-occurring mental health issues.

Drivers with alcohol use disorders and their risks of crash involvement

BACKGROUND

The relationship between driver blood alcohol concentration (BAC) and crash involvement is well understood. However, the role of alcohol use disorders (AUDs) (i.e., dependence or abuse) in crash occurrence, as distinguished from non-clinical heavy alcohol consumption, has not been adequately explored.

METHODS

Data from the 2010-2011 Crash Risk Study conducted in Virginia Beach, VA, were used in this study. Drivers involved in crashes were compared with control drivers, and four drinker groups were examined: alcohol dependent, alcohol abusers, heavy drinkers, and all other current (i.e., normative) drinkers. Logistic regression analyses were conducted on two outcomes: having a moderate BAC (≥0.05 g/dl), and crash involvement.

RESULTS

Overall, 2411 crash-involved and 5514 control drivers provided useable data, 52.4% of which were men and 70.8% Whites. The prevalence of drivers with AUDs was lower for the crash-involved drivers (8.7%) than for the control drivers (12.7%). Only heavy drinkers, but not abusive or dependent drinkers, were over four times more likely to drive with moderate BACs at nighttime. More important, at nighttime, the odds of crash involvement for dependent drinkers were only one third of those for normative drinkers. Daytime crashes, however, were more likely to involve normative drinkers than any of the other three drinker types.

CONCLUSIONS

Drivers with AUDs are not more likely than normative drinkers to drive with moderate BACs at night. After accounting for the influence of BAC, dependent drinkers have a lower risk of being involved in a crash, at any time of the day.