Conference Proceedings and Papers
Proceedings of all the major conference have been published amounting to thousands of pages of materials which provide a history of the development of research and policy over the past five decades in alcohol, drugs and traffic safety. After many years of work and effort by both current and previous ICADTS Executive Board members, the Council is delighted to make available all available conference papers in electronic form.
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Search results for: 15th_T2000_Stockholm
Alcohol and Illicit Drugs among Spanish Drivers
Alcohol; Driver; Illicit drugs; Medicinal drugs; Road traffic accidents;
The aim of this article was to assess the presence of alcohol and illicit drugs among Spanish drivers involved in fatal road accidents between 1991 and 1998. In addition, in this study the results from alcohol breath tests carried out on Spanish motor vehicle operators between 1989-1998 are also analysed. The data show that in 53.6% of those killed in traffic accidents, some type of psychoactive substance was detected: 47.3% alcohol, 8.9% illicit drugs, 4.8% medicinal drugs. In a little over one out of every three cases (35.1%), a blood alcohol level over the legal limit allowed in Spain during the period studied (0.8 gr/l) was detected. The results show that the presence of psychoactive substances in motor vehicle operators is frequent; a clear trend could not be established for the period analysed, although a trend is observed towards a decrease in the frequency with which some type of psychoactive substance was detected (58.7% in 1991, 50.8% in 1998), with the same for alcohol (51.3% in 1991, 43.2% in 1998). As far as alcohol breath tests given to motor vehicle operators are concerned, these have been positive in 3.5% of cases in 1998. The percentage of positive tests has been increasing as years go by, especially in those tests given to drivers involved in accidents and in traffic offences (1989-1997).
Alcohol and Traffic Delinquency: Psychological and criminological aspects of prevention and rehabilitation in Western Pomerania
Alcohol-drinking-prevention-and-control, driving, longitudinal-studies, self-control, Pomerania
The "Study of Health in Pomerania" (SHIP) was initiated in 1997 in order to assess the general health status of 7000 inhabitants of the region of Pomerania. Associated with this epidemiological project, an interdisciplinary group of researchers in the fields of medicine, psychology, sociology, and criminology, started to investigate the patterns of alcohol consumption and the related problem of drunk driving. In a longitudinal design, our preliminary results are based on the statistical evaluation of the first wave of 353 out of 760 cases. Results confirm assumptions of prior investigations, showing that two factors are of high relevance in the prediction of drunk driving: Drinking habits and behavior control. Further we found out that most of the drunken drivers show a lot of supplementary health problems. Concerning intervention, the present sentencing practice often misses opportunities to use temporarily given readiness of offenders to participate in rehabilitative treatment, as the penal sanctions are not matched with the problem structure of offenders.
Alcohol and Vehicle Crashes in Spain: Trends and Prospects for Prevention
Alcohol and Vehicle Crashes, DWI (driving while intoxicated), prevention policies blood alcohol levels
(Poster) We are conducting a study in a trauma hospital of Barcelona, where screening is mainly performed at the emergency room and brief intervention is left to a post-acute phase (trauma ward or outpatient setting). Its pilot trial is under way. After assessing the feasibility of the intervention, a controlled blind study is going to be performed comparing the outcome of both samples (intervention and control group) concerning reported drinking patterns and eventual new traumatic events.
Alcohol ignition interlock: One-year's experience in Quebec
Alcohol, ignition interlock, conviction, recidivism, crashes
Since December 1997, an alcohol ignition interlock program has been in place in Quebec. Working on a voluntary basis, the program operates on a user-pay rental scheme with an installation fee of C$150 plus C$87.50 per month. The incentive to participate in the program is a 9-month reduction of the license suspension for a first DWI offence (3-month suspension plus 9 months on interlock instead of 1-year suspension) and, until July 1999, an 18-month reduction for a second DWI offence (6-month suspension plus 18 months on interlock instead of 2-year suspension). During the first year of implementation, 4 160 drivers had obtained a restricted license (must drive with an interlock). On average, these 4 160 drivers stayed 223.4 days on the program between December 1, 1997 and May 31, 1999 (772 restricted licenses obtained before December 1998 were still active on May 31, 1999). A simple before-during-after comparison of traffic convictions, DWI convictions, casualty crashes and property damage only (PDO) crashes per 10 000 days of exposure was performed. Preliminary results indicate a very low DWI re-conviction rate and a large decrease in crashes for both during and after periods. Despite more formal evaluation needed, preliminary results clearly suggest that it is worth continuing the program.
Alcohol in motorcycle crashes
Motorcycles; alcohol; accident, traffic; wounds and injuries
A case-control study of motorcycle crashes was undertaken in which injured riders and pillion passengers from 222 crashes in Melbourne, Australia were compared with 1200 motorcyclists riding through the crash sites at the same time of day and week. Having a BAC greater than zero was associated with a five-fold increase in the odds of crashing compared to having a BAC of zero. The increase in risk associated with a BAC of greater than 0.05% was about forty-fold. Night-time crashes were more likely to involve alcohol and had fewer controls than daytime crashes. Alcohol may play a smaller role in motorcycle crashes than in car crashes because of the largely daytime pattern of motorcycle riding. Having a positive BAC was associated with greater riding experience, unlicensed riding, riding a
borrowed motorcycle, carrying a pillion passenger, illicit drug use, excessive speed and single-vehicle crashes. The odds ratios related to BAC level were possibly reduced by matching cases and controls on time of day and day of week and by the greater range of BAC values for cases than controls.
Alcohol Involvement in Recreational Vehicle Fatalities in Canada
Alcohol Involvement, Recreational Vehicle fatalities, snowmobiles, bicycles and all terrain vehicles (ATVs), Canada
This paper examines alcohol use among fatally injured operators of three types of recreational vehicles - snowmobiles, bicycles and all terrain vehicles (ATVs) -- in Canada between 1987 and 1997. It uses data from the TIRF Fatality Database to compare alcohol involvement in fatally injured operators of these vehicles to that among fatally injured drivers of automobiles. The implications of the findings for programs and policies are discussed.
Alcohol-related road accidents in the Federal Republic of Germany - Status till 1998
alcohol- related accidents, alcohol consumption, soft drinks, Germany
In the period from 1975 to 1990 there can be seen a favourable and continuous drop of alcohol related road accidents in Germany. This relatively favourable development among alcohol- related accidents is accompanied by a slight drop in alcohol consumption: 11,8 l pure alcohol per capita was consumed in 1990-compared to 1980, a decrease of 10 %. In addition, a steady increase in soft drinks was found: from 405,2 l in 1980 to 513,0 l in 1990, i. e. an increase by 26,6 % [Kretschmer-Baumel, 1993].
Alcohol-related Problems and Fitness to Drive among Spanish Drivers
Alcohol; Alcoholism; Alcohol related problems; Driver; Fitness to drive; Spain
This article analyses the patterns of alcohol consumption, the presence of alcohol-related problems, and the fitness to drive of 8043 Spanish drivers who reported to 25 Medical- Psychological Centres for the assessment of their fitness to drive. 60.3% drink alcohol, and 1.93% were diagnosed with an alcohol-related problem, although only 12.2% of these patients were considered unfit to drive and given a negative medical-psychological report.
An Empirical Typology of Persistent Drinking Drivers
Alcohol, DWI, drinking drivers, typology, cluster analysis
Information on the characteristics of persistent drinking drivers is essential to facilitate efforts to reduce alcohol-related crashes. This study utilized cluster analysis of the Alcohol Use Inventory (AUI) to identify subgroups of persistent drinking drivers (n=363). Persistent drinking drivers were defined as individuals with at least two drinking and driving convictions. Clusters were identified by a non-hierarchical technique using the second-level factors of the AUI. Indices suggested the presence of typologies consisting of two and three clusters. For the two cluster solution, the first cluster had scores below the mean and the second cluster scores above the mean on the derivation variables. The three cluster model had a low scoring cluster and high scoring cluster that
were more extreme than their counterparts in the two cluster model, with an additional intermediate cluster that had mildly positive scores on all of the derivation variables, except a slightly negative score on obsessed drinking. Differences between the empirical groups were also reflected in statistical differences on relevant measures external to the cluster derivation. These results indicate that persistent drinking drivers are not a homogeneous group, and may be characterized by levels of problem severity.
An Evaluation of the Swedish Drunken Driving Legislation Implemented on February 1, 1994
Driving under the influence, Evaluation, Legislation, Traffic accidents, Time
Today there are two levels of drunken driving in Sweden (drunken driving and aggravated drunken driving). In the year 1990 the lower BAC limit was reduced from 0.05 to 0.02 percent. Some years later, in 1994, the upper BAC limit was also reduced from 0.15 to 0.10 percent. In addition, the maximum penalty for aggravated drunken driving was increased and the police got more far-reaching possibilities of control. This study examines the effects of the most recent drunken driving legislation on fatal road-traffic accidents and road-traffic accidents with severe personal injury. The assessment of the effect is carried out by ARIMA analysis on monthly data for 1986 to 1997. The models include alcohol sales (measure of alcohol consumption) and delivery of petrol to retailers (measure of traffic density) as well as the two legislative reforms implemented in 1990 and 1994. The analysis showed a significant reduction of fatal road-traffic accidents depending on the 1990 and 1994 legislation. The results concerning road-traffic accidents with severe personal injury are more unstable, but the results points in the same direction.
AN EXAMINATION OF THE EFFICIENCY OF SOBRIETY TESTING IN DETECTING LEVELS OF THC: A Research Protocol
cannabis intoxication, impaired drving, accidents and road deaths, sobriety test, Australia
(Poster) As the number of individuals using cannabis in Australia increases, so does the number of accidents and road deaths caused by the drug. Previous research has shown that cannabis can impair driving performance, although compared to alcohol the level of impairment is smaller. The combination of the two on the other hand can be very dangerous even when blood alcohol levels are below .05%. For this reason, Governments have found it necessary to target the detection of impaired driving ability caused by drugs other than alcohol. Since a simplistic device such as a breath analysis instrument for the detection of alcohol, does not exist for the detection of cannabis, one possible tool for testing for impaired driving ability due to drugs, is the sobriety test. The sobriety test has been used for many years in the United States of America by the Los Angeles Police Department and has proven to be a successful tool in detecting drivers impaired by alcohol and drugs. This study aims to scientifically examine the efficiency of the sobriety test in detecting levels of cannabis intoxication and to examine whether any decrements in performance on the sobriety test is related to impaired driving ability.
An information campaign for health professionals and patients about the influence of medicines on driving: a Belgian experience
Information campaign, driving performance, categorisation, medicines and driving, prevention
We describe the organisation of an information and prevention campaign that was launched in Belgium in 1999 to inform health professionals and the general public about the possible influence of medicines on driving abilities. A brochure was distributed to the public in pharmacies and doctor's offices; all physicians and pharmacists received a compact professional brochure. A scientific report containing literature data of 179 medicines, with categorisation in 7 classes according to the impairing effect, was available for a small fee. The campaign was introduced by a press conference. Both brochures proved to be a success with much interest from public and (non)-professionals.
An lntersubstance Approach to Drug-Concentration-Drug Effect Correlation via Metaanalytic Data of Experimental Studies
drug effects, human performance, pharmacokinetic, stochastic correlation
Based on a metaanalytical analysis of experimental studies combined with pharmacokinetic data we tried to correlate the time of worst human performance and the time of highest se- rum-concentration after oral application of several drugs. Critically discussed we can postu- late - as a first result - that the dosage does not influence the time of highest concentration but the time of worst performance, and that for substances with short resorption times the maximum of performance decrements is situated after the maximum of concentration and vice versa.
Analyzing the decision making process
of drunk drivers before driving
Alcohol-drinking-prevention-; attitude; automobil-Driving, decision-making, Motivation
The aim of the present study was to further our understanding of the cognitions and motives underlying decision making in drunk driving (MacDonald, Zanna & Fong, 1995). Oriented to the theory of planned behavior (Ajzen 1985) and the model of alcohol-myopia (Steele & Josephs, 1990), aspects of the decision making process were investigated. 185 drivers who have been officially registered by the police for drunk driving were compared to a group of 145 drivers who have never been detected for drunk driving. Each subject was asked to imagine a standard scenario with low (BAC < 0.5 o/oo) and one with high alcohol consump- tion (BAC > 1.1 o/oo). Descriptive analysis shows that a decision process takes place, that the number of both, inhibiting and impelling beliefs is reduced under the condition of high alco- hol consumption, and that there is a lack of inhibiting beliefs in the group of detected drivers. These drivers show a strong and significant tendency to neglect social norms and to lower the perceived risks of detection and accident.
Application of a Computerized Battery of Mental Tests for Driving and Workplace Safety
Mental Tests, Driving and Workplace Safety,
Graded dosages of alcohol (.01-.12 BAC) were regressed against a ten test computerized battery administered to 40 subjects in order to examine sensitivity and specificity. Multiple regression analyses comparing performance decrements to alcohol dosage were statistically predictive (R's > 0.60; p's < .001). Multiple cut-off analyses, using proportion of tests passed and size of the cut-off (in percent), permitted specificity (percentage correctly identified as being fit out of the total that are fit) above 97%; sensitivity (percentage identified as being unfit, out of the total who are unfit) was >80% for high dosages of alcohol; 60+% for low. We believe that these data support the feasibility of a performance-based test battery that is a simple and economic measure of alcohol impairment.
Application of Alcohol Markers in Traffic Medicine
Alcohol; traffic; drunk driving; diagnosis; biochemical markers
Measuring alcohol in breath or body fluids is the principal means by which drunk-driving statutes are enforced and scores of reliable methods are available for forensic alcohol analysis. However, finding a punishable blood alcohol concentration (e.g. >1.0 giL) is not a reliable indication of the person s drinking habits and whether there might be underlying alcohol problems. Indeed, treatment for dependence on alcohol instead of punishment for drunk driving might be a good strategy. Moreover, monitoring alcohol consumption of convicted drunk drivers during rehabilitation has proven effective to reduce recidivism rates after relicensing. For this purpose, sensitive and specific biochemical markers are needed to assess whether a person has recently consumed alcohol and to provide a rough estimate of the amounts consumed and the duration of ingestion. Markers based on abnormal blood and urinary chemistry or altered haematology have become available and new ones are being developed. Elevated concentrations of urinary methanol (>2 mgiL) and a raised ratio of serotonin metabolites, 5HTOLi5HIAA (>1.5%), give a strong indication of recent drinking even if the associated urinary ethanol concentration is zero. Carbohydrate-deficient transferrin (CDT) and 0-glutamyltransferase (GGT) are examples of clinical tests used as indicators of prolonged overconsumption of alcohol (>60 g per day) and damage to organs and tissue, respectively. This paper gives a survey of biochemical markers of alcohol use and abuse and highlights some applications in traffic medicine.
APPLICATIONS OF DRUGWIPE IN ALTERNATIVE SPECIMENS
Drugwipe, drugs of abuse, toxicology, driving, saliva, sweat
Although alcohol consumption remains the main cause of fatal road accidents in most countries, it is now well established that the use of drugs of abuse (such as cannabis, opiates, amphetamines or cocaine) can impair a person's ability to drive safely. This is the reason why a growing interest has been expressed by law enforcement agencies for carrying out roadside tests with immediate results. Recently, the Drugwipe, a non-instrumental immunodiagnostic assay for the detection of drugs on surfaces was introduced by Securetec (Ottobrunn, Germany). During the last years, several studies were performed in order to evaluate the scientific applications of this tool when applied to easily accessible biological fluids, such as saliva and sweat. Different sampling procedures were performed for both saliva (wiping the tongue, plunging the Drugwipe into saliva, ...) and sweat (wiping forehead, hands, ...). Despite these differences, a survey of the results indicates that the conclusions of these different studies are quite similar. Drugwipe appears to be sufficiently sensitive for the detection of a recent use of cocaine and amphetamine in these fluids. On the opposite, a lack of sensitivity was sometimes observed in documenting heroin exposure. Concerning cannabinoids, all the authors observed insuffisant results with an important number of false negative and even false positive results. Therefore, until new antibodies (higher sensitivity for THC or opiates) will be developed, Drugwipe should not be considered as a good tool for on-site
detection of drugs of abuse in saliva and sweat.
Assessment and Screening of Impaired Driving Offenders: An Analysis of Underlying Hypotheses as a Guide for Development of Validation Strategies
intervention, screening, rehabilitation, DUI, assessment
Diverse screening and assessment techniques are used to make decisions about the interventions and sanctions that a detected impaired driver will receive. It is possible to discern several distinct underlying hypotheses that are the basis for most screening/assessment procedures, and these hypotheses have distinctly different implications for choice of validation strategies. Two primary hypotheses are Arisk assessment@ and Atreatment matching@. Risk assessment hypotheses are shown to posit differences in base rates of risk, whereas Atreatment matching hypotheses@ are shown to posit specific interactions that must be tested to establish the validity of the screening/assessment procedure. Most underlying screening rationales can be shown to be versions of one of these hypotheses. Failure to identify the underlying rationale and hypotheses for use of screening/assessment can lead to inappropriate choice of validation procedures. Each hypothesis is defined, and the necessary conditions for establishing validity under each hypothesis and common combinations of these hypotheses are developed.
Assessment of Recidivism Risk of DUI Offenders
Assessment, DUI-offenders, personality, performance, traffic psychology, test for alcohol
prone drivers, ART 2020 units for traffic-psychology testing of drivers
In Austria traffic-psychology assessment is obligatory for drivers with a BAC of 0,16 % or more as well as for those who refuse the breathalyser test and who have 3 or more alcohol offences in traffic during the last 5 years. According to Austrian law, traffic-psychology assessment has to be based on the following three sources: performance testing, personality testing, and a personal interview (Driving Licence Health Act, FSG-GV, 1998). The goal of traffic-psychology assessment of DUI offenders is to assess the individual recidivism risk, i.e. to make a prognosis of the probability of future driving under the influence of alcohol .
Athenolol and Ramipril in Arterially Hypertensioned Motor Vehicle Drivers: Efficacy and Safety
driver; athenolol; ramipril; safety; efficacy
Arterial hypertension (AH) is one of the most spread diseases in our country. Its rates in Russia are very high indeed, and the mean percentage in males reaches 18.6%, in females 19.3%. Meanwhile, the population is rather poorly informed about AH: more than half of the subjects are unaware of their disease, in those aware, only 17% are embraced with treatment being effective just in 8% of the total. AH, along with coronary heart disease, is considered to cause morbidity and mortality in adult population which consequently endangers good health. Therefore, a timely AH diagnostics, treatment and prevention measures become a topical problem [2,3]. There is an extremely significant aspect  to this - AH in motor vehicle drivers (VD). The AH spread index in VD is now having an increasing trend, and for the recent 14 years has had a 2.9% rise. There is a number of working factors involved in driving performance: chronical nerve-emotional strain, hypodynamics, hypokenesis in combination with noise, vibration, infrasounds, toxic substances that may be the reasons for the disfunctions of the cardio-vascular system, and AH, as well. The VD, state of health and psychophysiological profile, according to some authors [1,4,7,10,11] play a significant role causing car accidents (CA). Specially targeted studies brought about a decreasing trend in professional fitness indices of VD suffering from AH . Heavy and malignant forms of AH are a contraindication to drive. A hypotensive therapy in VD with AH has its own peculiarities. Of a vast group of hypotensives, only those should be advised that do not deteriorate professionally relevant functions (PRF) and qualities. The studies aiming at the investigation of safe drugs are rather few. To solve a problem like this, S. Ferrara (1994), B. Friedel (1994), H. Laaksonen (1994) suggest specially deviced studies in terms of updated methods.