THE ROLE OF ALCOHOI, IN ROAD ACCIDENTS IN HUNGARY i s t van bal i n t M.D. Hospital Janos, BUDAPEST Psychiatrist Consultant Alcohol consumption of drivers significantly influence the number of Hungarian road accidents. To be able to analyse the role as a factor of alcohol, adequately first we have to give an outline of the Hungarian alcohol situation. Similarly to most countries of the world, there is a growing tendency in alcohol consummation in Hungary, consequently a great number of problems can be observed relating to social and sanitary consequences of alcoholism. To make the background clear, we have to examine some symptoms, which influence the number of road accidents caused under the influence of alcoholic drink. Hungary has about I0.7 million inhabitants of which, more than two million people live in the capital, Budapest. Compared to Budapest the other towns are smaller, with less than 2oo thousand inhabitants. Hungary occupies the place in alcohol consumption statistics of the world. She gained this 7 place by the per capita consumption of 11.5 litres of spirits converted into absolute alcohol. If we examine which kind of alcoholic drinks constituted this quantity of 11.5 litres, we can see the following: In 1978 the per capita wine consumption was 3^- litres, where the lowest rate of increase is to 251
be observed compared to the basic year i9 6 0. Taken this as loo per cent then the value of 1978 amounts only to 117 per cent, similarly to the tendency occuring in a number of other countries, where there is also a decrease or moderate increase recorded in wine consumption. Contrary to this increase of consumption of distilled spirits is significant. From i960 till 1978 the consumption of distilled spirits increased more than threefold and in consequence of it Hungary occupied the third place after Poland and Luxemburg according to the statistics relating to the consumption of distilled spirits. Beer consumption increased also more than twofold between i960 and 1978. For this reason the per capita consumption of alcohol increased and within the growth the increase in consumption of distilled spirits was the highest. As a consequence of these changes in the structure of consumption phenomena frequently occuring among consumers of alcoholic drinks can be observed which fall into the sphere of deviating behavior and which appear in a form of antisocial conduct and antisocial driving. The directions in force in Hungary unambigously prohibit consumption of alcoholic drinks for car drivers, but as will be seen later this prohibition is often transgressed by car drivers. Alcoholism and deviating behavior under the influence of alcohol have consequences not only in connection with road accidents, but in commission of crimes too. The number of offenders showed decreasing tendency between 1965 and 1975» there were 87 thousand crimes registered in 1965 and. this number decreased tc 72 thousand by 15 thousand less, in 1975* Whilst examining the ratio of offenders committing crimes under the influence of alcohol, a reverse tendency is to be observed, 18 per cent in 1965 increased to 27 per cent in 1975, at the same time the per capita consumption of distilled spirits converted into absolute alcohol in- 252
creased from one and half litres to three and half litres. The changes in drinking habits, the great increase in consumption of distilled spirits produce the change and degradation of the personality and loosening of morals. Drinking habits have been modified that the consumption of distilled spirits in the morning before going to work, respectively before getting into the car, have spread to a great extent. It is evident, that quick absorbtion of distilled spirits damages the functioning of the nervous system to a high degree, it influences attention as well as perception, reaction time as well as thinking. Consciousness of the driver narrows down, the level of judgement decreases and these phenomena explain for instance the increasing number of crimes failing to stop after having caused a road accident. The scope of deviating phenomena includes also the increasing number of divorces and suicides, in which the role of alcoholic effect is unambi- gously shown by the statistics. There is also an increasing number of patients suffering with alcoholism and need to be treated. The outpatient network where alcoholics get treatment register 47 thousand patients, of which about 42 thousand are males and about 5 thousand females. This number covers only a part of all exisiting patients, according to the Jellinek formula, the number of alcohol patients in need of treatment amounts to about 15o thousand in Hungary. In the psychiatric and alcohol wards of hospitals round 1.3 thousand patients were treated in 1978» according to the cross - section examination carried out on 1. December, 1978, one thousand patients were treated in hospitals due to some forms of alcoholism, similarly to that a year ago, on It December, 1977* this number constituted 8 per cent of all psychiatric patients. As we can see there is a growing tendency in the consumption of alcoholic drinks in Hungary, the structure of consumption is developing in an un 253
favourable way, the consumption of distilled spirits came to the foreground, while wine consumption remained in the background, the deviating behavior of the alcohol consuming part of the population presents itself more and more markedly, the proportion of alcoholic drink consumers increased also among those committing crimes. \le have to mention, that the proportion of female alcoholics is also increasing as well as that of juveniles. After these we want to examine the role of alcohol in the trend of road accidents, we have to study the data of the last three years. The number of road accidents amounted to about 2o thousand in all the three years, it was the highest in 1979» when 2o.4-65 road accidents were registered, in 32oo to 33oo cases, that is in 16 to 17 per cent out of the about 2o thousand accidents, when influence of alcohol could be proved, the proportion increased by 6 per cent in 1979* In 1979 among the accidents caused under the influence of alcohol the drivers were drunken in 287o cases and pedestrians in 6 0 0 cases. In course of the analysis of the 2o.465 road accidents we got the result, that 78*8 per cent of road accidents were caused by the faults of drivers, major reasons being speeding and transgressing speed regulations, denied priority, irregular overtaking that is facts that arose due to loss of necessary self control and discontinuation conscious behavior during driving due to distraction of attention. Technical reasons caused accidents only in 3*2 per cent of all road accidents, so there is a significant difference between personal factors, errors in action and objective factors. There are other factors belonging to personal factors, this is for instance, neglect of using compulsory safety - belts. The statistical analysis stated, that passengers sitting in the front seats and 13 per cent of children sitting in the back seats were not fastened by belts in the moment of the accident. The 254
The proportion of fatal accidents in cases when the safety - belt was not used was twice as much as for those who used it. We have to mention here, that more than 2o per cent of the injured by road accidents were children under the age of 14, to whom the drivers should pay increased attention. The increase of alcohol consumption and succeeding phenomena - among them drivers and pedestrians under alcoholic influence - create increased hazards of accidents. There are several methods adopted in Hungary to solve this significant problem. The state and social organizations try to do their best to cut down the consumption of alcohol. One of these methods is the alcohol-test in factories and public roads. In 1979* 4oo thousand alcohol tests were performed of which the influence of alcohol could be proved in 5o thousand cases. In 13-5oo cases the police withdrew the driving licence and the court imposed imprisonment as penalty and as supplementary penalty, the driver was for ever forbidden to drive in case of causing fatal accident by running over of pedestrian or in other cases the driving was forbidden for a considerably long time. Obtaining a driving licence sets strict requirements to candidates. The examination is preceeded by several tests, that are not only of a medical character, but include several kinds of psychological examinations having a socialpsychological aspect as well these examinations of the personality aim at screening out agressive persons. This activity is completed by a wide - spread social activity that tries by methods of health education to influence drivers and the whole poxrulation in the direction of temperance and sobriety. This wide - spread activity is all the more justified fact, that the number of passenger cars approaches one million, which means that every fourth family have a car. Young people living in their families begin to drive cars very early. Unfortunately 255
it often happens, that young people begin drinking at the same tine as driving and this co - incidence significantly increases the number of road accidents. 256