Approaches for reducing alcohol-impaired driving: Evidence-based legislation, law enforcement strategies, sanctions, and alcohol-control policies.

Reducing impaired driving requires a systematic, consistent, and multifaceted approach. There is strong evidence on the effectiveness of both direct and indirect measures. The strategy that has the most immediate and largest impact has been highly publicized, visible, and frequent impaired-driving enforcement, especially deploying sobriety checkpoints or random breath testing. Lowering legal blood alcohol concentration (BAC) limits for driving to 0.05 g/dL or lower has also had a world-wide impact. Raising the legal drinking age has been successful in the US and other countries in reducing young impaired-driver fatal crashes. Graduated drivers' licensing for youth has also been effective by restricting conditions under which youth can drive. Sanctions that reduce impaired-driving recidivism include special driving-under-the-influence (DUI)/driving-while-intoxicated (DWI) courts, mandatory alcohol ignition interlocks, and consistent alcohol-monitoring programs. Opportunities for further progress include better enforcement of the drinking age and refusing to serve obviously intoxicated patrons. Technology for detecting alcohol impairment and autonomous vehicles will also play an important role in future efforts to eliminate impaired driving.

Evaluation of the use and benefit of passive alcohol sensors during routine traffic stops.

Past studies have demonstrated that police officers fail to detect a substantial proportion of alcohol-impaired drivers during traffic enforcement and that the use of passive alcohol sensors (PAS) could increase the driving-under-the-influence (DUI) arrest rate. Does the use of a PAS in routine traffic enforcement by officers without specialized DUI training increase the detection and arrest rate of alcohol-impaired drivers? In Anne Arundel County, Maryland, the Police Department provided the PAS devices to 24 randomly selected officers, divided equally between two squads of 12 officers each (one squad with the PAS and one squad without). After both squads made approximately 500 traffic stops each, the squads switched roles with regard to using the PAS, and the pattern was repeated. Overall, there were no significant differences in the DUI arrest rate between the officers with the PAS and the officers without the PAS, although there was evidence that the PAS helped some officers increase their DUI arrests. In summary, the PAS is probably best used at sobriety checkpoints rather than during routine stops.

The relationship of 16 underage drinking laws to reductions in underage drinking drivers in fatal crashes in the United States.

The minimum legal drinking age 21 (MLDA 21) legislation in the United States (U.S.) has been documented as one of the most effective public health measures adopted in recent times. This study reports on an effort to evaluate and interrelate a basic set of 16 laws directed at younger than age 21 youth that are designed to (a) control the sales of alcohol to youth, (b) prevent possession and consumption of alcohol by youth, and (c) prevent alcohol impaired driving by those younger than age 21. The first objective of this study was to determine whether there was any relationship between the existence and strength of the various underage drinking laws in a State and the percentage of younger than age 21 drivers involved in fatal crashes who were drinking. After controlling for various factors, the only significant finding that emerged was for the existence and strength of the law making it illegal for an underage person to use fake identification ( p <0.016). The second objective was to determine if the enactment of two of the sixteen provisions (possession and purchase laws) was associated with a reduction in the rate of underage drinking driver involvements in fatal crashes. Analysis of variance (ANOVA) showed that there was a national 11.2% reduction ( p <0.05) in the ratio of underage drinking drivers to underage non-drinking drivers in fatal crashes after the possession and purchase laws were adopted in 36 States and the District of Columbia (DC). This suggests that the two mandatory elements of the Federal MLDA 21 law are having the desired effect of reducing underage alcohol-related highway deaths.

Older drivers: their night fatal crash involvement and risk.

The 1983 Fatal Accident Reporting System (FARS) data and the Nationwide Personal Transportation Study (NPTS) exposure data were used to describe the major problems in night driving that involved older drivers, aged 65 or more, in fatal crashes and to assess their risk. One of the major findings was that the rate of involvement in fatal crashes in darkness of older drivers was much less than for drivers under the age of 25, but greater overall than for drivers aged 25-64. The rate for older females was much less than for older males. Although the overall fatal crash involvement of older drivers is not a serious cause for alarm at this time, the performance of older males does indicate a substantial increase in risk of fatal crash involvement in darkness. These trends can be expected to become more noticeable over the years as a greater proportion of the population in the United States exceeds the age of 65. The older driver crash involvement at night seems to be particularly troublesome for males in multivehicle crashes where they are struck in the side or rear by another vehicle, and single-vehicle crashes where they run off the road on a straight section. Some suggested improvements of the overall night driving environment are discussed.

The nature of the alcohol problem in U.S. fatal crashes.

Alcohol is involved in more than half of all U.S. traffic fatalities. In 1987, an estimated 23,630 people were killed in alcohol-related crashes. Alcohol-related traffic fatalities continue to be the leading cause of death for young people. Alcohol is involved in almost 80% of the fatal crashes that occur between 8 p.m. and 4 a.m. on any night of the week. During the 1980s, alcohol involvement in fatal crashes declined. The proportion of drivers involved in fatal crashes who were intoxicated at the time of the crash decreased 17% from 1982 to 1987. The reduction was especially significant for teenaged drivers, females, surviving drivers, teenaged pedestrians, older drivers, and drivers in daytime crashes. On the other hand, there was little or no change for drivers aged 25-34, motorcycle drivers, pedestrians aged 20 to 64, and drivers in late-night crashes. Reasons for the reduction in alcohol appear to be: (1) increased public awareness of the problem during that time period; (2) tougher laws and better enforcement of existing laws by state and local governments; (3) the raising of the drinking age to 21 in most states; (4) other public and private programs to reduce drinking and driving, and (5) socioeconomic and demographic factors.