Worldwide Trends in Impaired Driving

Transcription

1 Worldwide Trends in Impaired Driving BM Sweedler Safety and Policy Analysis International, L.L.C., 3798 Mosswood Drive, Lafayette, California 94549, USA Background This paper summarizes the latest trends in a number of countries around the world and discuss the reasons for the changes that occurred, and reviews current programs designed to produce further reductions in impaired driving. The information and data in this paper comes from papers prepared by researchers from various countries for presentation at T2004, the 17 th International Conference on Alcohol, Drugs and Traffic Safety in Glasgow, United Kingdom, in August 2004 and from a paper prepared for a special edition of Traffic Injury Prevention. For additional detail about each country, you are encouraged to review each of the referenced papers. This is the sixth occasion where experts from around the world met to continue discussions began in The reasons for the changes that occurred were discussed and published in a special report. 1 The results of the continued discussions in 1995, 1997, 2000 and 2002 were also published. 2, 3, 4, 5 Discussion In the decade of the 1980s, there were impressive declines in drinking and driving in much of the industrialized world. The declines included about 50% in the Great Britain, 28 % in Canada and The Netherlands, 32% in Australia, 37% in Germany and 26% in the U.S. These declines did not continue in the early part of the 1990s. In some countries, there were actually increases. Toward the middle and latter part of the decade the increases stabilized and we again began to see some decreases. However, these decreases have been at a slower rate than the dramatic decreases in the 1980s. Approaching the end of the 1990s and early in the new century, the record has been mixed. Some countries (France and Germany (until 2002)) continued to reduce drinking and driving while in other countries (Canada, the Netherlands, Great Britain and the United States), there was stagnation and in some cases small increases or even large increase as was the case in Sweden. While it is not possible to compare the record of one country against another, it is useful to examine the trends in each country. Canada - Previous research has shown that during the 1980s in Canada there was a reasonably consistent and rather dramatic decline in the percent of fatally injured drivers who were positive for alcohol (Mayhew et. al. 2002). 6 The downward trend was clearly interrupted in 1991 when the percentage of fatally injured drinking drivers positive for alcohol increased to 48%. But this increase occurred because the number of fatally injured non-drinking drivers declined but the number of fatally injured drinking drivers remained relatively stable. The percentage of fatally injured drinking drivers remained at 48% in This reflects a decrease in both the numbers of non-drinking and drinking fatally injured drivers. From 1992 to 1999, there has been an annual decline in the percentage of fatally injured drivers who tested positive for alcohol i.e., a decrease from 48% in 1992 to 33% in The level achieved in 1999 was the lowest point reached in the past three decades and this downward trend strongly suggests a resurgence of the declines in the magnitude of the alcohol-fatal crash problem characteristic of the 1980s. In fact, both the decades of the 1980s and 1990s witnessed an initial increase in the magnitude of the problem followed by a consistent and comparable drop reductions of

2 about 30% in both of these decades. It is, however, important to note that the decline in the percent of fatally injured drinking drivers that began in 1993 was again a function of two things a decline in the actual number of drinking-driver fatalities, combined with an increase in the number of non-drinking driver fatalities. This divergence was particularly marked after 1996 and had a salutary effect on the percentage. Nonetheless, from 1992 to 1999, the absolute number of drinking drivers did decrease by 38%, an amount slightly higher than the decrease in the percentage of fatally injured drivers who tested positive for alcohol i.e., a 31% reduction. Since 1999, the percentage of fatally injured drivers with positive BACs has increased to 38% in Again this increase reflects divergent trends in the numbers of drinking and non-drinking driver fatalities. Over this recent period, the number of non-drinking driver fatalities dropped but the number of drinking-driver fatalities increased slightly. The recent upward trend in the alcohol-fatal crash problem suggests that progress witnessed in much of the 1990s has halted. Whether this constitutes a new trend will not be known until additional data become available over the next few years. 7 France - From 1983 to 2002 the number of alcohol-related injury accidents has been reduced by more than half and from 1990 by almost one third (216,139 in 1983,162,573 in 1990 and 105,470 in 2002). The number of fatally injured victims in alcohol-related crashes has also been reduced (from 11,946 in 1983, to 10,289 in 1990, and 7,242 in 2002). There has also been a reduction in seriously injured victims (from 79,447 in 1983, to 52,578 in 1990 and 24,091 in 2002). The lowering of the BAC legal limit to 0.5 % from 1996 logically ought to have increased the proportion of drivers over the legal limit, but this does not appear to be the case. The data show that the prevalence of illegal alcohol levels as well as the proportion of alcohol-related accidents did not increase and even tended to diminish since the end of the 90s, especially for fatal accidents. This progress is attributable to the massive alcohol screening enforcement. Over the three last years all the figures remained stable. From 5 % to 6 % of drivers involved in injury accidents are over the legal limit (with a mean level of.0173%); this proportion rises for fatal accidents from 16 % to 17 % (with a mean level of.082%). Approximately 10 % of injury accidents involve a driver over the legal limit; the proportion is 30 % for fatal accidents. Considering all the victims, not only drivers but also passengers and pedestrians, 30% of fatally injured, 16% of seriously injured and 9% of slightly injured have been victims of alcohol-related accidents. 8 Over the last twenty years, the number of random breath tests has risen steadily to reach a plateau in (9.7 million) before a slight decrease in The percentage of positive tests was around 2% at the end of 1990s and rose to around 3% in The increase is attributed to better targeted and more productive testing rather than to an actual increase in impaired driving. The future focus will continue to be on young drivers as the relevant target because of their well identified excess risk. Nevertheless, the older drivers with a lesser risk, in absolute numbers, represent a major problem. 9 Germany - In the years after unification till 1993 in Germany (East) the road accident development in general and especially concerning alcohol related accidents worsened. But the figures from 1994 to 2002 show in general a stabilisation and improvement of the road accident development in Germany, especially with respect to related injuries and fatalities. But in 2002 the decrease of alcohol related accidents and casualties was lower than expected after the lowering of the BAC-limit to 0.5%. Whereas the decline of alcohol related accidents and casualties continued on a very low level, the number of alcohol related fatalities in road traffic even rose by 2.5%. While in the years

3 before the decrease of alcohol related accidents was higher than of accidents in general, in 2002 the development turned. So in 2002 the share of alcohol related accidents as well as of injuries and fatalities increased slightly. At the current point of time one cannot assess if the figures in 2002 indicates a turn of the tide, or if the recent development is only a short term deviation from a positive trend in the long term like 1999, one year after the first introduction of the 0.05%. But the frequency distribution of the BAC level of involved car drivers influenced by alcohol indicates that the problem is not to be solved only by lowering the legal BAC-limit. From this point of view, it is not only the problem of low-level-driver, but also of driving alcoholics, especially within the age-group of 25 years and older. The establishment of breath tests gives the possibility of a less costly and more efficiently policing of drink driving. In further years it has to be examined in which way a more efficient policing together with a more severe sanctioning of drink driving (fine and suspension of licence for at least one month upwards 0.05 % BAC) could contribute to reduce alcohol related accidents and so to improve traffic safety. 10 The Netherlands - In the period from , the proportion of motorists with a BAC above 0.05% has decreased 70 percent from 15% to 4.5%, which at first glance seems to be a very good result of Dutch drink-driving policy. The proportion of alcoholrelated serious road injuries and fatalities, however, has decreased to a much lesser degree. A recent case-control study indicated that the proportion of alcohol-related serious road injuries in 2000 was still at least 30% of all serious road injuries and that of alcohol-related road fatalities at least 35%, down from approximately 50% in the early 1970s. Key factor in the favourable development of drink-driving in the Netherlands were the increased enforcement levels and associated publicity, following the introduction of the statutory BAC limit, of random breath testing, and of evidential breath testing. Drinkdriving increased in the following years, which coincided with a reduced level of RBT due to a nationwide police reorganisation. The main reasons for the somewhat disappointing trend in the alcohol-related road toll are: 1) high BAC-levels have decreased less than average, 2) the combined use of alcohol and illegal drugs has increased, 3) in recent years, drink-driving by young males aged has increased. Future drink-driving policy in the Netherlands should specially target high BAC levels, combined alcohol and drug use, and drink-driving by young males. An important countermeasure might be a relatively small increase of police capacity, totally aimed at the apprehension of high-bac drivers, without decreasing the level of random breath testing. Selective enforcement activities should focus on high-risk hours and places, e.g. near pubs, bars and discos, around their closing hours. Another effective countermeasure is the introduction of a lowered legal limit for novice drivers, and the plan to introduce alcohol interlock programs. 11 Sweden - For a number of years, Sweden enjoyed a position as an example of successful work against drunk driving and its consequences. In the years around 1990 the proportion of alcohol related fatalities declined sharply coming down from 31% in 1989 to 18% in This decline has a number of plausible causes the lowering of the legal limit from 0.05% to 0.02% in 1990; the massive increase of police enforcement going from approximately random breath tests per year to 1.8 million in 1994; augmented resources for attitudinal campaigns; and tougher penalties for DUI.

4 Sweden joined the European Union in This meant, among other things, that it had to accept a gradual loss of its restrictive alcohol policies. The alcohol monopoly was partly broken; the ban on alcohol advertising now only applies to hard liquor; the import restrictions have been reduced. In conjunction with recent reduction of alcohol taxes in Germany and Denmark the pressure is now tremendously high on the Swedish Government to lower alcohol taxation. These and other changes have led to an increase in total consumption from 8 liters of pure alcohol/capita in 1996 to 10 liters in 2002, plus of course, many more conflicts between transportation needs and consumption of alcohol. In parallel with this development, Sweden has seen a 30% reduction of police enforcement of the 0.02% limit; in 1998, 68% of drivers charged with gross DUI were sentenced to imprisonment in 2002, the proportion was down to 42%; in the same period, the resources for attitudinal don t-drink-and-drive campaigns were more than halved. Unfortunately, the records also demonstrate that these factors have contributed to a corresponding increase in the involvement of alcohol among fatally injured drivers. The percentage of fatally injured drivers who had been drinking had risen from 18% in 1997 to 28% by the end of The gravity of this development is slowly being realized by the authorities but many of the traditional tools to combat the problem are no longer available. Most badly needed is a tangible increase in numbers of random breath tests. 12 Great Britain - The level of drink driving has been continually and consistently monitored in Great Britain since the late 1960s. A clear relationship is evident between the percentage of drivers killed in accidents who were over the UK limit (0.08%) and the level of roadside breath tests conducted. Not until the introduction of evidential breath testing in police stations in 1983 did the situation radically change. This allowed a substantial increase in the number of roadside tests that could be carried out with the same traffic police resources. These increased from 200,000 per year in 1982 to 800,000 in 1998, with a consequent reduction in the level of drink driving. The percentage of driver fatalities over the drink drive limit dropped from around 30% to 20 % over the same period. Although not independent of other activities such as Department for Transport anti drink drive campaigns this shows clearly the value of increased police roadside enforcement in reducing drink driving. Indeed, in the late 1990s and onwards despite sustained high levels of anti drink drive campaigning there is evidence that reductions in the levels of roadside breath testing are again leading to increased levels of drink driving. A number of measures are being considered to combat this rise, including an extension of drink drive rehabilitation courses, evaluation of the value of breath alcohol interlocks and the practicality of evidential roadside breath testing. Although the number of pedestrians killed with a BAC exceeding the drink-drive limit has fallen by about 50%; from nearly 600 to around 300, the proportion with a BAC exceeding the drink-drive limit has risen from 33% to 39%. 13 This is certainly an issue that warrants further research. Another issue of importance is drugs and driving. Recent evidence has suggested that illicit drug taking in Great Britain has increased considerably since the mid 1980s. Results from a 2000 study showed that at least one medicinal or illicit drug was detected in 24.1% of the 1184 casualties. 14 Since the previous survey in the late 1980's the incidence of illicit drugs has increased from 3% to around 18% whereas the incidence of medicinal drugs remained at around 6%. Attention needs to be given to finding ways to raise awareness of the dangers of driving whilst under the influence of illicit drugs and medicines. The passage of the Railways and Transport Safety Act 2003 will give police officers mandatory powers to undertake roadside Drug Recognition and Field Impairment Tests as well as to test drivers for the presence of appropriate drugs in a sample of saliva or sweat. Developments are currently underway within the UK, both politically and scientifically, to introduce such tests as soon as practically possible.

5 United States - After years of decline, alcohol-related crash rates have stalled and actually increased. From 1982 to 1999, rates of alcohol-related (BAC >.00) crashes declined, as did the total number of alcohol-related crashes in the United States. In 1982, there were 26,173 alcohol-related fatalities in the United States, 60 percent of the total number of people killed on U.S. roadways. By 1999, that percentage had fallen to 40 percent and alcohol-related fatalities fell to 16,572; decreases of 33.3% and 36.7% respectively. The most dramatic declines occurred from 1982 to In addition, the prevalence of drinking drivers on the roadways (BAC.05%) on Friday and Saturday nights did not change much in the U.S. between 1986 (8.4%) and 1996 (7.7%) after falling sharply from 1973 (13.7%) to Also, the proportion of drivers involved in fatal crashes estimated to have been legally intoxicated (BAC.08%) has been fairly constant, varying between 20-22% since 1995 after falling steadily from 1982 to It is likely that the factors contributing to the change are complex and interconnected and the proportion of change attributable to each cannot be determined. Three factors that appear to have contributed to the decline include: 1) deterrence, including enforcement practices, administrative license revocation, and lower BAC limits; 2) raising of the drinking age to 21; and 3) increased public awareness and activism. 17 The largest drop in crash fatalities occurred in the teen age group, mainly due to federally mandated zero tolerance and age 21 drinking laws. In the group with the highest rate of alcohol-related fatalities (per year of age), ages 21 and 24, fatalities dropped by almost 50 percent between 1982 and Since 1999, however, the number of alcohol-related fatalities has begun to slowly increase, reaching 17,419 by For 2000, 2001 and 2002, 40 percent of all fatalities involved alcohol. Highly publicized and frequent enforcement has great potential for reducing impaired driving crashes in the U.S. Two key areas for enforcement are sobriety checkpoints, and enforcement of minimum drinking age and zero tolerance laws. Changes in alcohol policy, such as higher taxes and laws that decrease the availability and accessibility of alcohol can also have an impact. Public information and awareness campaigns, especially when tied to enforcement efforts, can play a role. 18 Conclusions As is apparent from the discussions above, the worldwide trends in impaired driving have some common threads and many variations. Most countries experienced declines in crashes and fatalities throughout the early 1980s and 1990s. The progress in many countries has stalled or even reversed, while in some countries it has continued, albeit at a slower rate. Stronger laws, vigorous enforcement, and changes in social norms have all contributed to the progress that has been made. A number of countries found a strong link between levels of enforcement (especially random and roadside breath tests) and the alcohol-related fatalities. When the number of breath tests increased, the alcohol-related fatalities dropped. When the number of tests dropped, alcohol-related fatalities increased. Complacency and a deflection of attention to other issues in recent years have been difficult to overcome in some countries. Harmonization of traffic safety laws in the European Union has strengthened laws in some countries but threatens existing strong policies in others. It may be that the major gains have already been made and that additional progress will require a much greater level of scientific knowledge, use of new technologies and political and social commitment to implement proven countermeasures.

6 References 1. U.S. Transportation Research Board (1994) The Nature of and the Reasons for the Worldwide Decline in Drinking and Driving, Sweedler B (ed), Circular No. 422, Wash, DC 2. Sweedler, BM (1995) The Worldwide Decline in Drinking and Driving, Proc. 13th Int. Conf. Alcohol, Drugs and Traffic Safety. Pp Sweedler, BM (1997) The Worldwide Decline in Drinking and Driving-Where are we Now, Proc. 14th Int. Conf. Alcohol, Drugs and Traffic Safety. Pp Sweedler, BM (2000) The Worldwide Decline in Drinking and Driving: Has it Continued, Proc. 15th Int. Conf. Alcohol, Drugs and Traffic Safety. 5. Sweedler, BM (2002) Worldwide Trends in Drinking and Driving Has the Progress Continued, Proc. 16th Int. Conf. Alcohol, Drugs and Traffic Safety. 6. Mayhew DR, Simpson, HM, and Beirness DJ (2002) Are the Declines in Drinking Driving Fatalities Being Overestimated? In: The Proceedings of the 16 th International Conference on Alcohol, Drugs and Traffic Safety, Montreal, Canada, August 4-9, Summarized from Mayhew DR, Beirness DJ, and Simpson HM, Trends in Drinking- Driving Fatalities in Canada Progress Stalls, In: The Proceedings of the 17 th International Conference on Alcohol, Drugs and Traffic Safety, Glasgow, UK, ONISR (2002) (Observatoire National Interministériel de Sécurité Routière). La sécurité routière en France. Bilan de l année 2001, Ed la Documentation Française, Paris 2002 (et Bilan de l année 2002) 9. Summarized from Biecheler-Fretel MB, Peytavin JF, To what extent the 10% decline of crashes and fatalities from 2002 in France can be attributed to the alcohol factor?, In: The Proceedings of the 17 th International Conference on Alcohol, Drugs and Traffic Safety, Glasgow, UK, Summarized from Kroj G, Lerner M, Alcohol Related Road Accidents in the Federal Republic of Germany Status till 2002?, In: The Proceedings of the 17 th International Conference on Alcohol, Drugs and Traffic Safety, Glasgow, UK, Summarized from Mathijssen, MPM, Three Decades of Drink-Driving Policy in The Netherlands; An Evaluation, In: The Proceedings of the 17 th International Conference on Alcohol, Drugs and Traffic Safety, Glasgow, UK, Sweedler BM, Biecheler, MB, Laurell H, Kroj G, Lerner M, Mathijssen MPM, Mayhew D and Tunbridge RJ, Worldwide Trends in Impaired Driving, In: Traffic Injury Prevention, Vol. 5, Issue 2 (in press) 13. Keigan M and Tunbridge R (2003) The Incidence of Alcohol in Fatally Injured Adult Pedestrians. TRL Report 579, Crowthorne, UK. 14. Tunbridge, RJ, Keigan, M and James, F (2001). The Incidence of drugs and alcohol in road accident fatalities. TRL Report 495. Crowthorne, UK. 15. Voas, R, Wells, J, Lestina, D, Williams, A, and Greene, M (1998) Drinking and driving in the U.S.: the 1996 National Roadside Survey. J Accid Anal and Prev; 30:2, Fell J, Setting a National Goal in the U.S. for Reducing Alcohol-Related Traffic Fatalities, Presentation at the Transportation Research Board 83rd Annual Meeting, Washington, DC, January, Stewart, K, Voas, R and Fell, J (1995) The Nature of and Reasons for the Decline in Drinking and Driving in the United States: An Update, Proc. 13th Int. Conf. Alcohol, Drugs and Traffic Safety. 18. Summarized from Stewart K, Fell, J and Sweedler, B, Trends in Impaired Driving in the United States, In: The Proceedings of the 17 th International Conference on Alcohol, Drugs and Traffic Safety, Glasgow, UK, 2004.