Alcohol involvement in fatal traffic crashes in the United States: 1979-90.

Trends in alcohol-related traffic crash fatalities for the United States were examined with data from the Fatal Accident Reporting System for the years 1979-90. Alcohol-related traffic crash fatalities have decreased 10% over the 12 years studied, from 20,245 in 1979 to 18,279 in 1990. Fatality rates per 100 million vehicles miles traveled, and per 100,000 population, registered vehicles and licensed drivers have decreased even more sharply. Rates of blood alcohol testing of fatally injured drivers rose substantially among the States, with the nationwide rate increasing from 44% in 1979 to 75% in 1990. Factors that may be affecting these trends are discussed.

Trends in alcohol-related morbidity and mortality.

Two major trends regarding alcohol use and consequences of alcohol abuse in the United States are showing significant improvement. Continued declines are evident in age-adjusted rates of liver cirrhosis mortality, and per capita alcohol consumption is at its lowest level in 15 years. Two other trends, however, are less clear. After declining in 1982 and continuing through 1984, alcohol-related morbidity--as measured by principal diagnoses listed on short-stay, community hospital discharges--showed a slight increase in 1985. Similarly, after declining every year but one since 1981, alcohol-related motor vehicle fatalities showed a significant increase in 1986. The downward trends suggest that progress is being made in efforts to reduce alcohol-related deaths and morbidity, but there are no easy explanations for any of the trends. Reductions in liver cirrhosis death rates may reflect coding changes in liver disease categories, less chronic heavy drinking, or better medical care. Lower per capita alcohol consumption may indicate the public's increased awareness of drinking risks or the aging of the U.S. population. Ironically, the recent increase in alcohol-related motor vehicle fatalities may reflect stronger enforcement of drunk driving laws and increased BAC (blood alcohol content) testing.

Methods used in studies of drink-drive control efforts: a meta-analysis of the literature from 1960 to 1991.

We searched the drink-drive control literature over the past three decades, finding over six thousand documents. After detailed review of the abstracts and papers, 125 studies contained separate empirical evaluations of the effects of 12 DWI control policies and enforcement efforts (administrative license suspension, illegal per se, implied consent, preliminary breath test, mandatory jail sentence, mandatory community service, mandatory license suspension, limits on plea bargaining, mandatory fines, selective enforcement patrols, regular police patrols, and sobriety checkpoints). The 125 studies contained 664 distinct analyses that formed the basis for meta-analysis. All of the DWI control efforts were associated with reductions in drink-driving and traffic crashes. The DWI control literature is limited by the preponderance of weak study designs and reports that often fail to include basic data required for meta-analysis. Because of the poor quality of much extant research, we were limited to simple gain scores or percent change estimates in the current study. Further research that does not include appropriate research designs and analytic methods will be of limited utility. We recommend that all future reports include effect estimates and standard error estimates, minimum data required for effective meta-analysis.