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Current Trends Alcohol-Related Traffic Fatalities Among Youth and Young Adults -- United States, 1982-1989
Unintentional injuries account for approximately half of all deaths among young persons aged 15-24 years in the United States; of these deaths, approximately 75% involve motor vehicles (1). Although alcohol use increases the risk for a motor vehicle crash for all drivers, for young drivers the risk begins to increase at very low blood alcohol concentrations (BACs) (2-4). Moreover, in young persons who drive after drinking, the relative risk for crash involvement is greater at all BAC levels than it is for older drinking drivers (5). This report summarizes data from the National Highway Traffic Safety Administration's (NHTSA) Fatal Accident Reporting System on trends in alcohol-related traffic fatalities (ARTFs) in the United States from 1982 through 1989; trends are presented for three groups of young persons (15- to 17-, 18- to 20-, and 21- to 24-year-olds) and are compared with those for adults aged greater than or equal to 25 years.
NHTSA considers a fatal traffic crash to be alcohol-related if either a driver or nonoccupant (e.g., pedestrian) had a BAC greater than or equal to 0.01 g divided by L in a police-reported traffic crash. NHTSA defines a BAC greater than or equal to 0.01 g divided by L but less than 0.10 g divided by L as a low level of alcohol and a BAC greater than or equal to 0.10 g divided by L (the legal level of intoxication in most states) as indicating intoxication. Because BAC levels 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 (6). In this report, "alcohol-impaired" refers to drivers with a BAC greater than or equal to 0.01 g divided by L. Statistics on drivers refer only to drivers involved in fatal crashes.
From 1982 through 1989, the estimated percentage of ARTFs decreased for all four age groups (Table 1). The reductions in the proportion of ARTFs were greater for persons aged 15-17 years (31%) and 18-20 years (22%) than for those 21-24 years (7%) and greater than or equal to 25 years (11%). However, among adults aged greater than or equal to 25 years, the estimated number of fatalities increased, while for the three younger age groups, the number decreased (Table 1).
During 1982-1989, the estimated percentage of alcohol-impaired drivers involved in fatal crashes also decreased in all four age groups (Table 2). Decreases in both the total and average annual proportion of ARTFs were greater for 15- to 17-year-olds (40% and 7%, respectively) and 18- to 20-year-olds (28% and 5%, respectively) than for 21- to 24-year-olds (13% and 2%, respectively) and greater than or equal to 25-year-olds (14% and 2%, respectively).
Driver involvement rates in fatal crashes per 100,000 licensed drivers were lowest for all BACs for adults greater than or equal to 25 years (Table 3). Rates were high for young drivers aged 15-17 years, even in crashes where no alcohol was present. Drivers aged less than 25 years were more likely than those greater than or equal to 25 years to be intoxicated in a fatal crash. In 1989, the prevalence of intoxication in drivers involved in fatal crashes increased with age: of the 15- to 17-year-old alcohol-impaired drivers involved in fatal crashes, 54% were intoxicated, compared with 68% of 18- to 20-year-olds, 77% of 21- to 24-year-olds, and 79% of greater than or equal to 25-year-olds (Figure 1). 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. Unintentional Injury Section, Epidemiology Br, Div of Injury Control, Center for Environmental Health and Injury Control, CDC.
Editorial Note: Although the percentage of ARTFs has declined among young persons since 1982, alcohol-impaired driving remains a major public health problem; in 1989, approximately 7000 persons aged 15-24 years died in alcohol-related crashes (Table 1). The percentage of alcohol-impaired drivers involved in fatal crashes underscores the need for additional effective intervention efforts.
Factors that may have contributed to the reduction in both ARTFs and impaired driving among young persons include 1) increases in the minimum drinking age in 37 states from 1982 to 1988--in all 50 states and the District of Columbia, the minimum drinking age is now 21 years; 2) educational efforts and programs, such as Project Graduation, aimed at reducing drinking and driving among young persons (7); 3) formation of student groups such as Students Against Driving Drunk; and 4) changes in state laws penalizing drivers less than 21 years of age for driving with low BACs (generally, from 0.01 g divided by L to 0.05 g divided by L). Increases in the minimum drinking age have resulted in reductions in alcohol-related motor vehicle crashes, injuries, and fatalities in age groups affected by the laws (8-10). However, the consistently high proportion of alcohol-impaired driving among 18- to 20-year-olds, as well as 21- to 24-year-olds (who are legally permitted to consume alcohol), indicates a need for programmatic activities targeted specifically to drivers in these age groups.
Current NHTSA efforts to reduce alcohol-impaired driving among youth and young adults include support for student safety activities (including leadership training), provisional driver licensing guidelines, workshops for juvenile court judges, identification of effective techniques for enforcing drinking and driving laws for youth, and policy and program development workshops for college personnel and administrators. On March 15, NHTSA initiated a new public service campaign consolidating previous efforts by NHTSA, the National Basketball Association, the National Association of Broadcasters, and Mothers Against Drunk Driving. This campaign, "Celebrate with Style. Leave Alcohol Out," is directed at high school students at prom and graduation time and is designed to bring greater exposure and impact to the concept of promoting alcohol-free activities. Information on the campaign is available from Roger Kurrus, Office of Alcohol and State Programs (NTS-22), NHTSA, 400 7th Street, SW, Washington, DC 20590; telephone (202) 366-2750.
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2. Borkenstein R, Crowther R, Shumate R, Ziel W, Zylman R. The role of the drinking driver in traffic accidents. Bloomington, Indiana: Indiana University, 1964.
3. Perrine M, Waller J, Harris L. Alcohol and highway safety: behavioral and medical aspects. Burlington, Vermont: University of Vermont, 1971.
4. Farris R, Malone T, Lilliefors H. A comparison of alcohol-involvement in exposed and injured drivers: phases I and II. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration, 1976; report no. DOT-HS-801-826.
5. Mayhew DR, Donelson AC, Beirness DJ, Simpson HM. Youth, alcohol and relative risk of crash involvement. Accid Anal Prev 1986;18:273-87.
6. Klein TM. A method for estimating posterior BAC distributions for persons involved in fatal traffic accidents: final report. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration, 1986; report no. DOT-HS-807-094.
7. CDC. Project Graduation--Maine. MMWR 1985;34:233-5. 8. Moskowitz JM. The primary prevention of alcohol problems: a critical review of the research literature. J Stud Alcohol 1989;50:54-88.
9. Womble KB. The impact of minimum drinking age laws on fatal crash involvements: an update of the NHTSA analysis. Research Notes. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration, 1989. 10. General Accounting Office. Drinking-age laws: an evaluation synthesis of their impact on highway safety. Washington, DC: US General Accounting Office, 1987; report no. GAO/PEMD-87-10.
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