Getting to Zero Alcohol-Impaired Driving Fatalities A Comprehensive Approach to a Persistent Problem (2018) / Chapter Skim
Currently Skimming:
4 Alcohol-Impaired Driving Interventions
4 Alcohol-Impaired Driving Interventions
Pages 173-250
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 173... ...
Along the continuum between initial alcohol consumption and the occurrence of a fatal or serious motor vehicle crash, there are numerous opportunities for interventions that could reduce or eliminate alcohol-impaired driving incidents. This chapter examines several intervention opportunities for reducing alcohol-impaired driving, including changes in policies, laws, and enforcement; technological advances and vehicle features that could offer protections to drivers, occupants, and others; and programs or policies that could affect the sociocultural environment.
|
From page 174... ...
Blood Alcohol Concentration (BAC) Laws Overview Laws limiting permissible BAC among operators of motor vehicles are important interventions for reducing alcohol-impaired driving and related injuries and fatalities.
|
From page 175... ...
. These deficits become more evident as the amount of alcohol ingested increases and, as a result, an individual's ability to operate a motor vehicle safely can be negatively affected (see Chapter 1 for more details on alcohol impairment)
|
From page 176... ...
impaired • Impaired perception 0.10% Clear deterioration of • Reduced ability to maintain • reaction time and control lane position and brake Slurred speech, poor • appropriately coordination, and slowed thinking 0.15% • Far less muscle control Substantial impairment in • than normal vehicle control, attention • Vomiting may occur (unless to driving task, and in this level is reached slowly necessary visual and auditory or a person has developed information processing a tolerance for alcohol) • Major loss of balance SOURCE: Adapted from NHTSA, n.d.-a.
|
From page 177... ...
. Because of the relationship between BAC and impairment, law enforcement officials have used BAC measurements to estimate whether a driver's alcohol consumption has impaired his or her capacity to drive.
|
From page 178... ...
178 GETTING TO ZERO ALCOHOL-IMPAIRED DRIVING FATALITIES FIGURE 4-1 Average relationship between alcohol consumption (based on number of standard drinks and body weight)
|
From page 179... ...
. In the United States, the vast majority of BAC laws fall under the jurisdiction of state courts, although an existing federal BAC per se law prohibits driving at a BAC of ≥0.08% on federal land -- including, for example, military bases, national parks or forests, and court houses -- and some localities have enacted local traffic codes that regulate BAC limits.
|
From page 180... ...
. In the 1970s, the National Highway Traffic Safety Administration (NHTSA)
|
From page 181... ...
. In 2000 the Community Preventive Services Task Force recommended lowering the BAC limit set by state law to 0.08%, making it clear that it was an effective public health countermeasure (Community Preventive Services Task Force, 2000)
|
From page 182... ...
. Overall the committee found consistent evidence for impairment at BAC levels of 0.05% on the basis of experimental motor vehicle driving simulator studies.
|
From page 183... ...
In 2015 there were 10,265 alcohol-impaired driving fatalities (BAC ≥0.08) in the United States and 1,808 fatalities involved a driver with a BAC between 0.01% and 0.07% (NHTSA, 2015)
|
From page 184... ...
Researchers conducted four interviews with non-crash drivers at 2,000 former crash sites between July 1962 and 1963. They found that drivers with BAC levels in excess of 0.04% had an increased rate of crashes while drivers with BAC levels over 0.08% were significantly more likely to have single-vehicle crashes and crashes that were more severe and costly than those involving sober drivers.
|
From page 185... ...
(2000) updated the 1991 study using FARS data from 1996 and exposure data from the 1996 National Roadside Survey of Drivers to evaluate BAC levels in drivers of single-vehicle and two-vehicle fatal crashes.
|
From page 186... ...
, and BAC -- were used to compare changes in RR between 1996 and 2007. The percentage of alcohol-impaired drivers involved in fatal crashes remained largely unchanged between 1996 and 2007 (~22 percent)
|
From page 187... ...
(2004) in Auckland, New Zealand, evaluated the effect of alcohol consumption on vehicle crashes in which at least one occupant was seriously injured or killed.
|
From page 188... ...
Therefore, the committee also evaluated international studies that assessed whether or the degree to which reducing the BAC limit to 0.05% is effective in decreasing alcohol-related crashes. Overall, the majority of international evidence suggests that lowering the BAC limit to 0.05% reduces alcohol-related crashes and driving fatalities, and those effects are greatest among those groups at highest risk.
|
From page 189... ...
and conducted highly visible sobriety checkpoints, thereby increasing the perceived risk of being caught. Some of the reviewed studies found that the beneficial effects of the new law declined over time, which the authors posited may have been attributable to the public's belief that, over time, the actual risk of apprehension was not as high as the perceived risk when the BAC limit was first lowered.
|
From page 190... ...
, both of which were effective in reducing alcoholrelated driving fatalities. The evidence also finds that lowering the BAC limit from 0.10% to 0.08% for drivers in the United States was an effective policy for reducing alcohol-impaired traffic fatalities -- particularly among young drivers, the age group at the highest risk for alcohol-related driving fatalities (Dee, 2001; Wagenaar et al., 2007)
|
From page 191... ...
This is indicative of the general deterrent effect of lowering allowable BAC to drive, or of increased awareness of impaired driving across consumption levels. The impact of lower BAC laws is observable whether enforced through administrative or criminal sanctions, and seems enhanced when introduced alongside high-visibility enforcement, sobriety checkpoints, and publicity activities (Mann et al., 2001)
|
From page 192... ...
The enactment of 0.05% per se laws should be accompa nied by media campaigns and robust and visible enforcement efforts. The effectiveness of lowering the per se laws from 0.08% to 0.05% will be supported by legislation that currently applies to 0.08% per se laws, including, but not limited to, use of sobriety checkpoints, administrative license revocation, and penalties for refusing preliminary breath tests or blood tests that are equal to or greater than penalties for alcohol-impaired driving offenses.
|
From page 193... ...
. Although lowering the BAC limit may result in fewer alcohol-impaired drivers on the roads, law enforcement officials would still require special training and equipment to allow them to detect impaired drivers, as is currently the case for 0.08% laws.
|
From page 194... ...
As with any successful campaign, it is important for advocacy and research groups to work in concert to present a unified message and clearly counter any misleading or inaccurate information. Research into the best practices for launching, focusing, and running a successful campaign to increase support of new laws lowering BAC limits would advance the likelihood of passing new legislation and decreasing the number of alcohol-related crashes, injuries, and fatalities.
|
From page 195... ...
The evidence reviewed by the committee suggests that lowering BAC per se laws is an effective policy in reducing alcohol-impaired driving fatalities, nonfatal injuries, and crashes. By studying the process of lowerng the BAC limit from 0.10% to 0.08% in the United States, i there are insights to be learned regarding what it might take to lower it further to 0.05%.
|
From page 196... ...
. States with GDL systems rated as "good" -- based on unsupervised driving restrictions, minimum age requirements for obtaining learners permits, and driving restrictions after licensing for a period of time or until a certain age -- were associated with a 30 percent reduction in fatal crashes involving 15- to 17-year-old drivers (McCartt et al., 2010)
|
From page 197... ...
. The largest reductions in fatal crashes among teen drivers were seen in states with stricter nighttime driving restrictions and states that restricted new drivers to zero or one passenger for a designated period of time after receiving their driver's license (McCartt et al., 2010)
|
From page 198... ...
Despite existing DWI child endangerment laws, children continue to be killed in crashes involving alcohol-impaired drivers. Of the 1,132 children ages 14 and younger who were killed in motor vehicle traffic crashes in 2015, 16 percent, or 181 children, were killed in alcohol-impaired driving crashes.
|
From page 199... ...
Sobriety Checkpoints Background Sobriety checkpoints are a high-visibility prevention and enforcement strategy that aims to prevent alcohol-impaired driving. Law enforcement officers can conduct breath testing at sobriety checkpoints selectively or randomly.
|
From page 200... ...
Some state and local jurisdictions employ saturation patrols either in conjunction with sobriety checkpoints or on their own. When conducting saturation patrols, law enforcement officials carry out alcohol-impaired driving enforcement efforts within specific geographic areas rather than at one specific location.
|
From page 201... ...
. In some states law enforcement agencies also face legal obstacles that prevent sobriety checkpoints and breath testing (Voas and Fell, 2013)
|
From page 202... ...
The first "No Refusal" effort to be implemented was the "No Refusal Weekends" initiative that has existed in certain jurisdictions in Texas since 2005. In one county the program led to a decrease in breath test refusal rates at sobriety checkpoints from 50 percent in 2005 to 10 percent in 2010; in addition, DWI conviction rates have significantly increased and case dismissal rates have decreased (NHTSA, n.d.-b)
|
From page 203... ...
In 2009 sobriety checkpoints in the California cities of Oakland, San Jose, San Rafael, Hayward, and Redwood City generated about $40 million from towing and law enforcement fines; the majority of impounded motor vehicles were taken from persons of racial or ethnic minority, many of whom were undocumented immigrants (Gabrielson, 2010)
|
From page 204... ...
In order to be confident of the cost-effectiveness of sobriety checkpoints, new and more rigorous studies are needed. International Perspective There is strong evidence for the effectiveness of publicized sobriety checkpoint programs in other countries, including Australia, Canada, New Zealand, Spain, Taiwan, and Thailand (Alcañiz et al., 2014; Chang and Shih, 2012; Chuliá et al., 2016; Ditsuwan et al., 2015; Erke et al., 2009; Miller et al., 2004; Solomon et al., 2011)
|
From page 205... ...
. Box 4-1 describes a successful motor vehicle injury prevention program implemented in a tribal community in Arizona that combined sobriety checkpoints with culturally appropriate social marketing methods, emphasizing the importance of publicity and high visibility for sobriety checkpoints to be effective.
|
From page 206... ...
The police department increased patrols at high-risk times in high-risk areas. The tribe passed laws that lowered the blood alcohol concentration limit from 0.10% to 0.08% and made seat belt violations a stoppable offense.
|
From page 207... ...
. Conclusion Evidence indicates that publicized sobriety checkpoints are effective at decreasing alcohol-impaired driving and resulting crashes and fatalities.
|
From page 208... ...
Updated studies with more rigorous methods are needed to more accurately and confidently assess the cost-effectiveness of sobriety checkpoints. Based on its review of a strong body of evidence supporting the effectiveness of sobriety checkpoints at decreasing alcohol-impaired driving in a variety of geographical environments and for a range of specific populations, the committee recommends: Recommendation 4-2: States and localities should conduct fre quent sobriety checkpoints in conjunction with widespread publicity to promote awareness of these enforcement initiatives.
|
From page 209... ...
Smartphone technologies are discussed in the Alternative Transportation section located at the end of this chapter. Passenger Restraints Primary Seat Belt Laws Seat belt use and infant and child restraints provide a means for drivers and passengers in cars or trucks to reduce their risk of injury or death during a crash.
|
From page 210... ...
. Further ore, only 26 percent of alcohol-impaired drivers -- versus 52 per m cent of nighttime drivers in the zero BAC group -- were wearing seat belts at the time of their fatal crash.
|
From page 211... ...
Seat belt use has been shown to be an effective intervention for saving lives and protecting individuals from harm and although the equitable implementation of seat belt laws has been a concern, the committee does not believe the controversy negates the need for, or enforcement of, these laws. Based on the evidence described in this section, the committee concludes: Conclusion 4-1: Seat belts are highly effective in reducing serious inju ries and fatalities caused by motor vehicle crashes.
|
From page 212... ...
accessed data from NHTSA's 2005–2007 National Motor Vehicle Crash Causation Survey to analyze 631 lane-drift crashes that occurred between 6 a.m. and midnight to determine the proportion of drivers who might have been able to regain control of their vehicle if a lane departure warning system had been used at the time of the crash.
|
From page 213... ...
. Once the driver's finger is in contact with the device's optical touch pad, near-infrared light propagates into the skin tissue and the touch pad collects a sample of the light reflected back to the tissue surface, from which the unique chemical and tissue structure 6 Personal communication with Robert Strassburger, Automotive Coalition for Traffic Safety.
|
From page 214... ...
. Blood and breath alcohol concentrations are closely correlated, but breath from around the driver's face or within the vehicle cabin is diluted with cabin air; the degree of dilution can be calculated from measuring carbon dioxide and alcohol at the same point (the concentration of carbon dioxide in ambient air and the concentration of carbon FIGURE 4-3 Evolution of breath-based DADSS device.
|
From page 215... ...
. 14 Personal communication with Robert Strassburger, Automotive Coalition for Traffic Safety.
|
From page 216... ...
. The accuracy and speed requirements adopted by the DADSS program are far more rigorous than current alcohol measurement devices are capable of achieving.
|
From page 217... ...
and to ensure that the driver's age is not under 21 years. Furthermore, the devices are being tested assuming a BAC limit of 0.08% (ACTS, 2013)
|
From page 218... ...
. Given strong public support and endorsement from various sectors as well as a significant potential reduction of alcohol-impaired driving fatalities, the committee concludes: Conclusion 4-2: If its use becomes widespread, Driver Alcohol Detection System for Safety (DADSS)
|
From page 219... ...
New Technologies on the Horizon In-vehicle technologies that aim to improve traffic safety are rapidly being developed and tested. While evidence supporting the effectiveness of these technological interventions will remain limited until they are more widely implemented and adopted, many have the potential to decrease fatalities from alcohol-impaired driving (e.g., smartphone technologies discussed later in this chapter or autonomous vehicles)
|
From page 220... ...
. 19 V2V and V2I technologies are intelligent transportation systems that communicate data (such as infrastructure advisories and other environmental factors that may affect traffic safety)
|
From page 221... ...
It is important that efforts continue to be made to reduce alcohol-impaired driving and related injuries and fatalities using technological resources. There may come a day when vehicle occupants no longer have to be mindful of their alcohol consumption as it relates to driving and their BAC, but that day is a long time from now and may, in fact, not ever be a reality.
|
From page 222... ...
222 GETTING TO ZERO ALCOHOL-IMPAIRED DRIVING FATALITIES TABLE 4-3 Autonomous Vehicle Planning Impacts by Time Period Functional Impact Requirements Planning Impacts Time Period Become legal Demonstrated Define performance, 2015−2025 functionality and testing, and data safety collection requirements for automated driving on public roads Increase traffic Road lanes Evaluate impacts; define 2020−2040 density by vehicle dedicated to requirements; identify coordination vehicles with lanes to be dedicated coordinated to vehicles capable of platooning coordinated operation capability Independent Fully autonomous Allows affluent 2020−2030s mobility for vehicles available nondrivers to enjoy nondrivers for sale independent mobility Automated car Moderate price May provide demand 2030s−2040s sharing/taxis premium; and response services in successful affluent areas; supports business model car sharing Independent Affordable Reduced need for 2040−2050s mobility for autonomous conventional public lower-income vehicles for sale transit services in some driver areas Reduced parking Major share Reduced parking 2040−2050s demand of vehicles are requirements autonomous Reduced traffic Major share Reduced road supply 2050−2060s congestion of urban peak vehicle travel is autonomous Increased safety Major share of Reduced traffic risk; 2040−2060s vehicle travel is possibly increased autonomous walking and cycling activity Energy Major share of Supports energy 2040−2060s conservation vehicle travel conservation and emission and emission is autonomous; reduction efforts reductions walking and cycling become safer
|
From page 223... ...
. This section discusses several interventions -- designated drivers, smartphone-enabled transportation network ridesharing, and alternative transportation such as safe ride programs and public transportation.
|
From page 224... ...
. The two most common approaches to promoting designated driver use are population-based campaigns and programs that incentivize patrons at drinking establishments to act as designated drivers.
|
From page 225... ...
(2005) found inconsistent and insufficient evidence to determine whether designated driver programs are an effective intervention for reducing alcohol-impaired driving or reducing alcohol-impaired driving fatalities.
|
From page 226... ...
. In its originally intended and safest version of implementation, a designated driver should be chosen prior to alcohol consumption and remain abstinent; only 39.3 percent of respondents fulfilled both of these criteria (Lange et al., 1998)
|
From page 227... ...
. The authors note that use of male designated drivers may be ineffective at preventing alcohol-impaired driving.
|
From page 228... ...
Empirical evidence is beginning to emerge regarding the association between the uptake of network ridesharing and alcohol-impaired driving crashes, alcohol-related driving fatalities, and potential unintended consequences. The current literature is limited to evaluating data available after the publicly reported start date of Uber's launch in a given local market, given that Uber has had the largest market share to date.
|
From page 229... ...
on motor vehicle crashes. The evidence is limited to three peer-reviewed papers and three working papers.
|
From page 230... ...
Those safe ride programs that have been studied lack robust outcomes, making it difficult to make conclusions regarding the effectiveness of alternative transportation options on reducing alcohol-related driving fatalities (Decina et al., 2009; Huseth, 2012)
|
From page 231... ...
. Although safe ride programs can be modified to specific community needs and can play a role in a community's broader strategy to reduce alcohol-impaired driving (Decina et al., 2009; Goodwin et al., 2015)
|
From page 232... ...
DWIs declined 7 percent per hour of additional service, and alcohol-related arrests increased 8 percent in areas close to a metro station. However, while alcohol-related fatal crashes decreased in areas of DC serviced by metro (including a small 21 The American Public Transportation Association reports an annual savings of $9,797 if a commuter switches from a car to public transportation (http://www.apta.com/ mediacenter/pressreleases/2017/Pages/June-Transit-Savings.aspx)
|
From page 233... ...
As technology gains in popularity and becomes accessible and available to more individuals and communities, there is an opportunity to use the alternative transportation options previously discussed -- smartphoneenabled network ridesharing, safe ride programs, and public transportation (mass transit, taxis, subways, buses, metro) -- more broadly to provide options for drivers who have been drinking.
|
From page 234... ...
Enforcement and arrest: • Research examining the effectiveness and impact of child endan germent laws to improve their effectiveness and how to increase public awareness of these laws to reduce child fatalities. • Research to identify ideal frequency of sobriety checkpoints.
|
From page 235... ...
Physical environment and transportation: • Research into the effectiveness of designated driver programs and how they could be utilized to reduce the number of alcohol impaired drivers. • Further research into the effectiveness and usefulness of alterna tive rideshare options, including smartphone-enabled network ridesharing, safe ride programs, and public transportation.
|
From page 236... ...
2014. Automatic sobriety checkpoints aim to bar drunk drivers.
|
From page 237... ...
2012. Using a multidimensional Rasch model approach to mea sure the police's perceived ability to detect, detain and intercept DWI vehicles when conducting sobriety checkpoints.
|
From page 238... ...
2000. Motor vehicle injury -- Alcohol-impaired driving: 0.08% blood alcohol concentration (BAC)
|
From page 239... ...
2015. Sobriety checkpoints in Thailand: A review of effectiveness and developments over time.
|
From page 240... ...
2003. Why are sobriety checkpoints not widely adopted as an enforcement strategy in the United States?
|
From page 241... ...
1996. Lowering state legal blood alcohol limits to 0.08%: The effect on fatal motor vehicle crashes.
|
From page 242... ...
2005. Sobriety checkpoints deter impaired drivers.
|
From page 243... ...
: Results of a California survey on definitions and use of designated drivers. Journal of Traffic Medicine 26(3–4)
|
From page 244... ...
2010. Effects of different blood alcohol concentrations and post alcohol impairment on driving behavior and task performance.
|
From page 245... ...
2006. Low manpower sobriety checkpoints in rural and small communities.
|
From page 246... ...
2015. Traffic safety facts 2015: A compilation of motor vehicle crash data from the Fatality Analysis Reporting System and the General Estimates System.
|
From page 247... ...
1995. The general deterrent impact of California's 0.08% blood alcohol concentration limit and administrative per se license suspension laws volume 1 of: An evaluation of the ef fectiveness of California's 0.08% blood alcohol concentration limit and administrative per se license suspension laws.
|
From page 248... ...
Final report. Washington, DC: National Highway Traffic Safety Administration.
|
From page 249... ...
2007. Effects of legal BAC limits on fatal crash involvement: Analyses of 28 states from 1976 through 2002.
|
From page 250... ...
2014. Legal BAC limits data by country.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.