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Current Trends Update: Alcohol-Related Traffic Fatalities -- United States, 1982-1993

Motor-vehicle crashes are the leading cause of death in the United States for persons in all age groups from 1 through 34 years (1). During 1993, 40,115 traffic fatalities occurred; of these, 17,461 were alcohol-related (2). During 1990, the economic impact of alcohol-related crashes was $46.1 billion, including $5.1 billion in medical expenses (3). In 1992, approximately 1% of licensed drivers were arrested for driving while impaired (4). This report uses data from the Fatal Accident Reporting System of the National Highway Traffic Safety Administration (NHTSA) to describe state-level changes in the number and percentage of alcohol-related traffic fatalities (ARTFs) and drivers with a blood alcohol concentration (BAC) greater than or equal to 0.01 g/dL who were involved in fatal crashes during 1982-1993.

NHTSA defines ARTFs as deaths in which either a driver, pedestrian, or bicyclist had a BAC greater than or equal to 0.01 g/dL. Each year, approximately 80% of ARTFs involve at least one driver or pedestrian with a BAC greater than or equal to 0.10 g/dL, at or above the legal level of intoxication for drivers. Where BAC test results are not available, NHTSA uses statistical models to estimate BACs for drivers and pedestrians (5). In 1993, BAC test results were available for 44.6% of all drivers, pedestrians, and bicyclists involved in fatal crashes.

From 1982 to 1993, the number of ARTFs in the United States decreased 31%, from 25,165 to 17,461; ARTFs as the percentage of all traffic fatalities decreased from 57.3% to 43.5%. In 1993, the estimated proportion of ARTFs ranged from 28.2% (Maryland) to 58.9% (Texas) Table_1. Compared with 1982, the proportion of ARTFs in 1993 decreased in 47 states and the District of Columbia; in eight states the proportion decreased by 20 percentage points or more.

From 1982 to 1993, the number of alcohol-involved drivers in fatal crashes decreased 33%, from 21,780 to 14,589, while the percentage of alcohol-involved drivers in fatal crashes decreased from 38.9% to 27.3% Table_2. In 1993, the percentage of drivers involved in fatal crashes with a BAC greater than or equal to 0.01 g/dL ranged from 14.7% (Maryland) to 43.3% (Montana). From 1982 to 1993, the percentage of alcohol-involved drivers decreased in 49 states and the District of Columbia. Reported by: JC Fell, TM Klein, National Highway Traffic Safety Administration. Div of Unintentional Injury Prevention, National Center for Injury Prevention and Control, CDC.

Editorial Note

Editorial Note: Alcohol involvement in traffic fatalities is associated with several factors external to a state's traffic safety program. These factors include population demographics (e.g., alcohol involvement generally is higher among young males), urbanization (e.g., alcohol involvement is greater in rural areas), and vehicle mix (e.g., alcohol involvement is highest for motorcycle drivers and lowest for heavy-truck drivers). In addition, the accuracy of estimates for each state is a function of the proportion of drivers, pedestrians, and bicyclists in fatal crashes for whom a BAC test result is known: during 1993, test results were known for 45% of these active participants in fatal crashes nationwide, but ranged from 12% to 83% for the 50 states and the District of Columbia. Consequently, these factors and variations constrain the reliability of direct state-to-state comparisons (6).

Although lower BACs (0.01-0.09 g/dL) can cause driving impairment associated with an increased risk for fatal crash involvement, the risk is substantially greater for high levels of alcohol (BACs greater than or equal to 0.10 g/dL) (7,8). From 1982 to 1993, the percentage of ARTFs and drivers involved in fatal crashes with a BAC greater than or equal to 0.01 g/dL decreased. Reasons contributing to this decrease in alcohol involvement in fatal crashes may include 1) a greater public awareness of the problem and the increasing social unacceptability of drinking and driving; 2) more effective legislation (e.g., prompt license suspension for persons who drive while intoxicated and lower illegal BAC per se limits * for adults {0.10 g/dL and 0.08 g/dL} and for youth {0.02 g/dL for persons aged less than 21 years}); 3) increased enforcement through sobriety checkpoints and saturation patrols, in which police are present at times and places where drinking and driving is known to occur; 4) enactment of laws that have raised the minimum drinking age to 21 years in all states; and 5) decreases in the per capita alcohol consumption in the United States (9).

The public health impact and social burden of alcohol-impaired driving underscores the need for additional and intensified efforts by traffic safety, public health, law enforcement, judicial, and citizen activist organizations. NHTSA's "Safe & Sober" Campaign has set goals to reduce alcohol-related traffic fatalities to 43% of total fatalities and increase safety-belt use to 75% by 1996. If these goals are met, an estimated additional 2900 lives and $5.8 billion annually, including $1 billion in health-care costs, may be saved (10).

To sustain the decline in ARTFs and driving while impaired, states and communities must continue to adopt legislative and enforcement measures and implement new strategies including stronger sanctions for repeat drinking and driving offenders (e.g., license plate tagging, vehicle impoundment or confiscation, and alcohol ignition interlock devices), graduated licensing systems for beginning drivers (e.g., learner's permit, provisional license with restrictions, and full license), improved enforcement procedures for detecting drinking drivers (e.g., use of passive alcohol sensors at sobriety checkpoints), and better enforcement of safety-belt-use laws because drinking drivers are less likely than others to use safety belts.

References

  1. NCHS. Health, United States, 1993. Hyattsville, Maryland: US Department of Health and Human Services, Public Health Service, CDC, 1994; DHHS publication no. (PHS)94-1232.

  2. National Highway Traffic Safety Administration. Traffic safety facts 1993: alcohol. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration, National Center for Statistics and Analysis, 1994.

  3. CDC. Economic impact of motor-vehicle crashes -- United States, 1990. MMWR 1993;43:443-8.

  4. CDC. Drivers with repeat convictions or arrests for driving while impaired -- United States. MMWR 1994;43:759-61.

  5. 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; publication no. DOT-HS-807-094.

  6. National Highway Traffic Safety Administration. Traffic safety facts 1993: state alcohol estimates. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration, National Center for Statistics and Analysis, 1994.

  7. Moskowitz H, Robinson DC. Effects of low doses of alcohol on driving-related skills: a review of the evidence. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration, 1988; publication no. DOT-HS-807-280.

  8. Zador P. Alcohol-related risk of fatal driver injuries in relation to driver age and sex. J Stud Alcohol 1991;52:302-10.

  9. CDC. Reduction in alcohol-related traffic fatalities -- United States, 1990-1992. MMWR 1993;42:905-9.

  10. National Highway Traffic Safety Administration. Saving lives and dollars. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration, 1993.

* Driving at or above the illegal BAC limit constitutes a violation of the law, regardless of whether the person exhibits signs of intoxication.



Table_1
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TABLE 1. Motor-vehicle crash fatalities * , by state and by the highest blood alcohol
concentration (BAC) + , 1993, and the percentage point difference in the proportion of alcohol-involved
fatalities, 1982 to 1993 -- United States
=================================================================================================================
                                                 1993
                      -----------------------------------------------------------------------------
                      BAC=0.00 g/dL      BAC=0.01-0.09 g/dL      BAC>=0.10 g/dL
                      ---------------    -------------------     --------------                       Change from
State                   No.      (%)        No.         (%)        No.     (%)     Total Fatalities  1982 to 1993
-----------------------------------------------------------------------------------------------------------------
Alabama                 595   (57.1)        71       ( 6.9)        376  (36.1)          1,042           -12.8
Alaska                   68   (57.6)         3       ( 2.2)         47  (40.2)            118           -12.4
Arizona                 401   (50.1)        68       ( 8.5)        332  (41.4)            801           - 6.4
Arkansas                317   (54.4)        57       ( 9.8)        209  (35.8)            583           -15.4
California            2,403   (57.7)       406       ( 9.8)      1,354  (32.5)          4,163           -16.7
Colorado                329   (58.8)        31       ( 5.5)        200  (35.7)            559           -21.1
Connecticut             192   (56.2)        23       ( 6.8)        126  (37.0)            342           -24.5
Delaware                 57   (51.7)         9       ( 7.9)         45  (40.4)            111           -17.6
District of Columbia     32   (56.8)         7       (12.3)         18  (30.9)             57           -16.5
Florida               1,468   (55.7)       203       ( 7.7)        964  (36.6)          2,635           - 2.3
Georgia                 839   (60.2)       129       ( 9.2)        426  (30.6)          1,394           -18.8
Hawaii                   59   (44.3)        19       (14.2)         56  (41.6)            134           - 5.6
Idaho                   114   (50.3)        21       ( 9.4)         91  (40.3)            227             5.7
Illinois                763   (54.8)       118       ( 8.5)        511  (36.7)          1,392           -13.4
Indiana                 556   (62.5)        75       ( 8.4)        258  (29.1)            889           -11.0
Iowa                    255   (55.6)        50       (10.8)        154  (33.6)            459           - 2.6
Kansas                  280   (65.4)        31       ( 7.2)        117  (27.4)            428           -10.5
Kentucky                550   (63.2)        67       ( 7.7)        254  (29.2)            871           -17.0
Louisiana               396   (45.1)       113       (12.8)        370  (42.1)            879             0.4
Maine                   110   (59.5)        16       ( 8.7)         59  (31.8)            185           - 9.1
Maryland                477   (71.8)        48       ( 7.2)        140  (21.0)            665           -26.2
Massachusetts           258   (54.4)        52       (10.9)        165  (34.7)            475           -13.9
Michigan                792   (56.3)       122       ( 8.7)        493  (35.0)          1,408           -15.9
Minnesota               326   (60.5)        42       ( 7.7)        171  (31.7)            538           -15.1
Mississippi             427   (52.5)        82       (10.0)        304  (37.4)            813           - 8.9
Missouri                454   (47.9)       101       (10.7)        392  (41.4)            947             2.0
Montana                  81   (41.5)        18       ( 9.3)         96  (49.2)            195           - 7.3
Nebraska                147   (57.9)        36       (14.3)         71  (27.9)            254           - 5.8
Nevada                  135   (51.3)        31       (11.9)         97  (36.9)            263           -18.0
New Hampshire            74   (60.9)         9       ( 7.6)         38  (31.5)            121           -19.3
New Jersey              501   (63.6)        76       ( 9.6)        211  (26.7)            788           -19.7
New Mexico              179   (41.6)        44       (10.3)        207  (48.1)            431           - 5.2
New York              1,186   (66.6)       146       ( 8.2)        449  (25.2)          1,781           -13.7
North Carolina          875   (63.0)        97       ( 7.0)        417  (30.0)          1,389           -23.1
North Dakota             44   (48.9)         5       ( 5.6)         40  (45.5)             89           -13.0
Ohio                    959   (64.7)       107       ( 7.2)        416  (28.1)          1,482           -21.2
Oklahoma                402   (59.8)        57       ( 8.5)        213  (31.7)            671           -15.9
Oregon                  307   (58.6)        54       (10.2)        164  (31.2)            524           -21.4
Pennsylvania            842   (55.1)       110       ( 7.2)        577  (37.8)          1,529           -13.4
Rhode Island             35   (46.9)         8       (11.0)         31  (42.1)             74           -13.1
South Carolina          610   (72.1)        37       ( 4.4)        199  (23.5)            846           -31.0
South Dakota             81   (57.6)         7       ( 5.1)         52  (37.3)            140           -17.8
Tennessee               649   (55.4)       101       ( 8.6)        422  (36.0)          1,171           -17.8
Texas                 1,248   (41.1)       325       (10.7)      1,464  (48.2)          3,037           - 9.6
Utah                    206   (67.9)        21       ( 7.0)         76  (25.1)            303           - 6.1
Vermont                  61   (55.8)         9       ( 8.4)         39  (35.8)            110           -20.1
Virginia                481   (54.8)        87       ( 9.9)        310  (35.3)            878           - 7.6
Washington              327   (49.5)        47       ( 7.1)        287  (43.4)            661           -12.9
West Virginia           245   (57.0)        23       ( 5.3)        161  (37.6)            429           - 7.9
Wisconsin               392   (54.9)        54       ( 7.6)        268  (37.5)            714           -16.5
Wyoming                  69   (57.5)         6       ( 4.6)         45  (37.9)            120           -12.9

Total                22,654   (56.5)     3,479       ( 8.7)     13,982  (34.9)         40,115           -13.8
-----------------------------------------------------------------------------------------------------------------
* Fatalities include all occupants and nonoccupants who died within 30 days of a motor-vehicle crash on a public
  roadway.
+ BAC distributions are estimates for drivers and nonoccupants involved in fatal crashes.  Numbers of fatalities
  involved are rounded to the nearest whole number.

Source: Fatal Accident Reporting System, National Highway Traffic Safety Administration.
=================================================================================================================

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Table_2
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TABLE 2. Drivers involved in fatal motor-vehicle crashes, by state and by blood alcohol concentration (BAC) of
driver * , 1993, and the percentage point difference in the proportion of alcohol-involved drivers, 1982 to 1993
-- United States
===================================================================================================================
                                                1993
                      ---------------------------------------------------------------------------------------------
                      BAC=0.00 g/dL      BAC=0.01-0.09 g/dL       BAC>=0.10 g/dL
                      --------------     ------------------       ---------------                      Change from
State                   No.      (%)       No.         (%)        No.        (%)    Total fatalities   1982 to 1993
-------------------------------------------------------------------------------------------------------------------
Alabama                 971   (71.6)        63       ( 4.6)       322      (23.7)       1,356            - 9.8
Alaska                   89   (73.1)         4       ( 3.7)        28      (23.2)         122            -14.8
Arizona                 707   (69.2)        70       ( 6.8)       245      (24.0)       1,021            - 4.0
Arkansas                550   (70.6)        56       ( 7.1)       174      (22.3)         780            -15.4
California            4,026   (74.5)       363       ( 6.7)     1,017      (18.8)       5,406            -13.8
Colorado                531   (72.3)        34       ( 4.7)       169      (23.0)         735            -17.2
Connecticut             319   (68.9)        26       ( 5.7)       118      (25.4)         463            -18.3
Delaware                125   (72.8)         6       ( 3.3)        41      (23.9)         172            -18.6
District of Columbia     62   (76.0)         8       ( 9.8)        12      (14.3)          81            -13.2
Florida               2,799   (75.0)       198       ( 5.3)       736      (19.7)       3,734            - 4.6
Georgia               1,450   (76.6)       117       ( 6.2)       326      (17.2)       1,896            -15.6
Hawaii                  110   (60.9)        21       (11.9)        49      (27.2)         180            - 3.5
Idaho                   180   (66.5)        20       ( 7.2)        71      (26.3)         271            - 0.9
Illinois              1,375   (72.5)       114       ( 6.0)       408      (21.5)       1,897            -10.0
Indiana                 977   (77.7)        65       ( 5.2)       215      (17.1)       1,257            -10.7
Iowa                    464   (72.7)        46       ( 7.2)       128      (20.1)         638            - 4.0
Kansas                  452   (78.1)        29       ( 5.0)        98      (17.0)         579            - 7.3
Kentucky                906   (77.2)        54       ( 4.6)       214      (18.2)       1,174            -12.0
Louisiana               702   (64.6)       106       ( 9.8)       278      (25.6)       1,086            - 1.3
Maine                   160   (71.0)        17       ( 7.6)        48      (21.4)         225            - 4.1
Maryland                729   (85.3)        37       ( 4.4)        88      (10.3)         855            -20.5
Massachusetts           431   (67.6)        56       ( 8.8)       151      (23.7)         638            - 9.5
Michigan              1,426   (72.9)       130       ( 6.6)       400      (20.5)       1,956            -13.2
Minnesota               554   (73.7)        42       ( 5.6)       156      (20.8)         752            - 9.6
Mississippi             682   (66.8)        86       ( 8.4)       252      (24.7)       1,020            - 5.8
Missouri                821   (65.1)       107       ( 8.5)       333      (26.4)       1,261              2.0
Montana                 122   (56.6)        17       ( 8.1)        76      (35.2)         215            - 5.9
Nebraska                246   (72.8)        36       (10.7)        56      (16.6)         338            - 4.7
Nevada                  248   (71.6)        29       ( 8.2)        70      (20.2)         347            -16.0
New Hampshire           109   (72.9)         9       ( 6.3)        31      (20.8)         149            -13.0
New Jersey              812   (78.1)        69       ( 6.6)       159      (15.3)       1,040            -14.1
New Mexico              316   (61.9)        41       ( 8.1)       153      (30.0)         511            - 5.7
New York              1,895   (80.7)       117       ( 5.0)       337      (14.3)       2,349            -10.0
North Carolina        1,463   (78.7)        81       ( 4.4)       314      (16.9)       1,858            -17.2
North Dakota             79   (63.7)         7       ( 5.4)        38      (31.0)         124            -11.3
Ohio                  1,554   (77.6)        95       ( 4.7)       354      (17.7)       2,003            -17.1
Oklahoma                663   (74.0)        54       ( 6.0)       178      (19.9)         895            - 9.8
Oregon                  512   (75.0)        43       ( 6.3)       128      (18.8)         683            -19.8
Pennsylvania          1,558   (71.9)       116       ( 5.3)       492      (22.7)       2,166            -12.0
Rhode Island             57   (61.2)         9       ( 9.6)        27      (29.2)          93            - 9.1
South Carolina          898   (82.6)        30       ( 2.8)       159      (14.6)       1,087            -20.0
South Dakota            122   (73.4)         9       ( 5.4)        35      (21.2)         166            -18.0
Tennessee             1,137   (71.6)        94       ( 5.9)       357      (22.5)       1,587            -16.7
Texas                 2,443   (60.7)       383       ( 9.5)     1,198      (29.8)       4,024            -11.5
Utah                    305   (80.4)        19       ( 5.1)        55      (14.5)         379            - 7.3
Vermont                  99   (69.9)         9       ( 6.4)        34      (23.7)         142            -14.6
Virginia                828   (71.2)        84       ( 7.3)       250      (21.5)       1,162            - 6.3
Washington              546   (65.5)        46       ( 5.5)       241      (29.0)         833            -11.0
West Virginia         3,384   (71.4)        24       ( 4.5)       129      (24.0)         537            - 6.6
Wisconsin               664   (68.9)        60       ( 6.2)       239      (24.9)         963            -13.5
Wyoming                  98   (70.3)         5       ( 3.6)        36      (26.0)         140            - 8.7

Total                38,754   (72.7)     3,362       ( 6.3)    11,227      (21.0)      53,343            -11.6
-------------------------------------------------------------------------------------------------------------------
+ BAC distributions are estimates for drivers involved in fatal crashes. Numbers of drivers involved are rounded
  to the nearest whole number. Driver(s) may or may not have been killed.

Source: Fatal Accident Reporting System, National Highway Traffic Safety Administration.
===================================================================================================================

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