Factors Potentially Associated with Reductions in Alcohol-Related Traffic Fatalities -- United States, 1990 and 1991

Traffic crashes are the single greatest cause of death among persons aged 5-32 years in the United States (1); almost half of all traffic fatalities are alcohol-related (1,2). An estimated 40% of persons in the United States may be involved in an alcohol-related traffic crash sometime during their lives (1). In 1991, the number of alcohol-related traffic fatalities (ARTFs) declined almost 10% when compared with 1990 (3), and the total number of deaths during 1991 (19,900) is the lowest since more complete alcohol-related fatal crash data became available in 1982. This report summarizes data from the National Highway Traffic Safety Administration's (NHTSA) Fatal Accident Reporting System on trends in ARTFs in the United States from 1982 through 1991 and presents information regarding several factors potentially related to the decline in fatalities during 1991.

A fatal traffic crash is considered alcohol-related by NHTSA if either a driver or nonoccupant (e.g., a pedestrian) had a blood alcohol concentration (BAC) greater than or equal to 0.01 g/dL in a police-reported traffic crash. NHTSA defines a BAC greater than or equal to 0.01 g/dL but less than 0.10 g/dL as indicating a low level of alcohol and a BAC greater than or equal to 0.10 g/dL (the legal level of intoxication in most states) as indicating intoxication. Because BACs are not available for all persons involved in fatal crashes, NHTSA estimates the number of ARTFs based on a discriminant analysis of information from all cases for which driver or nonoccupant BAC data are available (4). In this report, "alcohol-involved" refers to drivers or nonoccupants with a BAC greater than or equal to 0.01 g/dL. Data on alcohol-involved drivers refer only to drivers involved in fatal crashes.

From 1990 through 1991, the number of ARTFs decreased 9.9% and nonalcohol-related fatalities decreased 4.2% (Table 1). From 1982 through 1991, the proportion of ARTFs has decreased steadily from 57.3% to 48.0%.

To better understand the decrease in the number of ARTFs from 1990 through 1991, driver age, time of day, and crash location were investigated. Alcohol- and nonalcohol-related fatalities declined among all age groups; however, the decline in alcohol- and nonalcohol-related fatalities was greatest in the 15-20-year age group (12.7% and 6.0%, respectively) (Table 2). From 1990 through 1991, declines in ARTFs were greater during daylight hours (i.e., 6:00 a.m.-7:59 p.m.) than at night (11.7% and 9.1%, respectively) and were greater on urban roads * than on rural roads (12.9% and 7.8%, respectively).

From 1990 through 1991, the estimated number of alcohol-involved drivers in fatal crashes decreased 10.7%, and the estimated number of nonalcohol- involved drivers in fatal crashes decreased 6.4% (Table 1). From 1982 through 1991, the proportion of alcohol-involved drivers in fatal crashes declined from 38.9% to 31.1% (Table 1).

From 1990 through 1991, decreases in the numbers of alcohol-involved drivers compared with nonalcohol-involved drivers were greatest for persons aged 15-20 years (14.6% and 6.9%, respectively); among drivers involved in fatal crashes during the daytime (12.7% and 5.8%, respectively); and among drivers involved in fatal crashes on urban roads (14.1% and 7.4%, respectively) (Table 3).

To further characterize the decline in alcohol-involved fatal crashes during the daytime, data were analyzed by low (i.e., 0.01 g/dL less than or equal to BAC and BAC less than or equal to 0.09 g/dL) and high (i.e., BAC greater than or equal to 0.10 g/dL) BACs. From 1990 through 1991, the decrease in ARTFs and alcohol- involved drivers in fatal crashes during the daytime was substantial among drivers with low BACs. The number of fatalities among drivers with low BACs decreased 16.7% during daytime hours compared with 6.4% at night. Similarly, the number of alcohol-involved drivers with low BACs declined 15.3% during daytime hours compared with 7.6% at night. The number of all drivers with high BACs decreased 10.7% from 1990 through 1991.

Reported by: ME Vegega, PhD, Office of Alcohol and State Programs, Traffic Safety Programs; TM Klein, National Center for Statistics and Analysis, Research and Development, National Highway Traffic Safety Administration. National Center for Injury Prevention and Control, CDC.

Editorial Note

Editorial Note: From 1990 through 1991, the decreases in the numbers of ARTFs and alcohol-involved drivers in fatal crashes were the largest annual decreases since 1982. Despite these changes, during 1991, nearly 20,000 ARTFs occurred in the United States, and an estimated 17,000 drivers had detectable BACs at the time of the fatal crash.

Efforts by federal, state, and local government agencies and by private groups are helping to reduce the public health impact of alcohol-impaired driving. Factors that may have contributed to the recent reduction in the numbers of ARTFs and alcohol-involved drivers among persons aged 15-20 years include the enactment of minimum drinking age laws (to age 21 years) and increased enforcement of these laws; increased emphasis on zero tolerance (i.e., laws prohibiting underaged persons from driving with any detectable BAC) and use-lose (i.e., loss of driver's license for use of alcohol by underaged persons) laws for youth; and the implementation of education and prevention activities to prevent underage drinking.

The numbers of ARTFs and alcohol-involved drivers during the daytime declined more rapidly among drivers with low-level BACs than for drivers with high BACs. One potential explanation is that persons with low BACs may be social drinkers who may be more likely to be influenced by general deterrence efforts (e.g., legislation and increased enforcement of existing laws) and publicity about the dangers of drinking and driving.

One national health objective for the year 2000 is to reduce deaths associated with alcohol-related traffic crashes to less than 8.5 per 100,000 persons (objective 4.1) (5). The findings in this report, combined with preliminary census data, indicate that the rate of ARTFs has declined from the 1987 baseline of 9.8 per 100,000 persons (6) to 7.9 per 100,000 persons in 1991-- rates surpassing the year 2000 goal.

NHTSA and CDC are collaborating to continue reducing alcohol-related crashes and alcohol-involved driving. Specific efforts include 1) supporting activities to promote prompt license suspension for persons who drive while intoxicated;2) supporting expanded use of sobriety checkpoints; 3) developing enforcement policies specific to reducing alcohol-impaired driving among youth; and 4) continuing to educate the public about alcohol-impaired driving (7). In addition, NHTSA encourages states to meet the criteria for impaired driving prevention grants designated under the Intermodal Surface Transportation Efficiency Act of 1991. ** Grant criteria include administratively revoking licenses of persons who drive impaired, lowering the BAC per se limit to 0.08 g/dL, using sobriety checkpoints, implementing programs to prevent drinking among persons under age 21 years, mandatory sentencing of repeat driving-under-the-influence offenders, lowering the BAC limit to 0.02 g/dL for persons under age 21 years, and passing open container laws (i.e., laws prohibiting opened alcohol containers in a motor vehicle).

References

1. National Highway Traffic Safety Administration. Drunk driving facts. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration, 1991.

2. National Highway Traffic Safety Administration. Fatal Accident Reporting System, 1990: a review of information on fatal traffic crashes in the United States. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration, 1991; publication no. DOT-HS-807-794.

3. National Highway Traffic Safety Administration. Fatal Accident Reporting System, 1991: a review of information on fatal traffic crashes in the United States. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration (in press).

4. Klein TM. A method for estimating posterior BAC distributions for persons involved in fatal traffic accidents. Washington, DC: US Dept of Transportation, National Highway Traffic Safety Administration, 1986 (report no. DOT-HS-807- 094).

5. Public Health Service. Healthy people 2000: national health promotion and disease prevention objectives -- full report, with commentary. Washington, DC: US Department of Health and Human Services, Public Health Service, 1991; DHHS publication no. (PHS)91-50212.

6. Office of the Surgeon General. Surgeon General's Workshop on Drunk Driving: proceedings. Washington, DC: US Department of Health and Human Services, Public Health Service, 1989.

7. National Highway Traffic Safety Administration. Highway safety priority plan: moving America into the 21st century. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration, 1991.

• Based on information from the Federal Highway Administration. Urban versus rural roadway classes are based on boundaries used for federal aid highway programs. A roadway is considered urban if it is in a boundary area of 5000 persons or more. ** Public Law no. 102-388 (23 U.S.C. section 410).

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