Sobering new data on drinking and driving: 15 percent of US alcohol - related motor vehicle fatalities involve alcohol under the legal limit

Accidents involving drivers testing below legal blood alcohol concentration limits are more likely to cause harm to others than drivers with levels at or above the limit, according to a new study in the American Journal of Preventive Medicine, however, stronger alcohol control policies were protective against alcohol involvement in motor vehicle crashes, even at low levels


Ann Arbor, March 16, 2020

A new study in the American Journal of Preventive Medicine, published by Elsevier, found that motor vehicle crashes involving drivers with blood alcohol concentrations (BACs) below the legal limit of 0.08 percent accounted for 15 percent of alcohol-involved crash deaths in the United States. Of these deaths, 55 percent of fatalities were individuals other than the drinking driver, and these crashes were more likely to result in youth fatalities compared with crashes above the legal BAC limit.

Alcohol-involved motor vehicle accidents remain a leading cause of injury-related death in the US. Most research on crashes and alcohol focuses on alcohol above the legal limit of 0.08 percent, but cognitive impairment can begin at BACs as low as 0.03 percent. The National Transportation Safety Board and the National Academies of Sciences, Engineering, and Medicine have recommended reducing the legal blood alcohol concentration limit from 0.08 percent to 0.05 percent. In 2018, Utah became the first state to do so. Other countries have adopted this limit already and have seen decreases in motor vehicle crashes.

“Our study challenges the popular misconception that alcohol-involved crashes primarily affect drinking drivers, or that BACs below the legal limit don’t matter,” explained lead investigator Timothy S. Naimi, MD, MPH, Section of General Internal Medicine, Boston Medical Center, and Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA.

The study analyzed sixteen years of US motor vehicle crash data from the Fatality Analysis Reporting System with the Alcohol Policy Scale, a measure of state alcohol policies. From 2000 to 2015, 37 percent of more than 600,00 motor vehicle deaths occurred in crashes involving at least one driver with a positive BAC. Of these, 15 percent were from crashes involving drivers testing below the legal alcohol limit.

The results of this study also showed that more restrictive alcohol policies were associated with a 9 percent decrease in the odds that a crash involved alcohol at levels below the legal limit. This relationship was consistent for multiple subgroups (e.g., men only, women only) and at a blood alcohol cutoff of 0.05 percent.

“Lower alcohol crashes have been underestimated as a public health problem. Our research suggests that stringent alcohol policies reduce the likelihood of fatal accidents involving drivers with all levels of alcohol blood concentration,” noted Dr. Naimi. The study identified a number of policy approaches that could lead to a decrease in crash deaths involving alcohol at all levels, including increased alcohol taxes, required keg registration, and limited alcohol availability in grocery stores.

The number of lower blood alcohol concentration fatalities is substantial. States with more restrictive alcohol policies have reduced odds of lower blood alcohol concentration motor vehicle crashes than states with weaker policies. Credit: Lira MC, et al. American Journal of Preventive Medicine, 2020.

“Policies restricting impaired driving increase freedom from worry of injury or death for the majority of people on public roadways who are not drinking,” observed lead author Marlene Lira, Section of General Internal Medicine, Boston Medical Center, Boston, MA, USA.

---

Notes for editors
The article is“Alcohol Policies and Motor Vehicle Crash Deaths Involving Blood Alcohol Concentrations Below 0.08%,” by Marlene C. Lira, BA, Vishnudas Sarda, MBBS, MPH, Timothy C. Heeren, PhD, Matthew Miller, MD, MPH, ScD, and Timothy S. Naimi, MD, MPH (https://doi.org/10.1016/j.amepre.2019.12.015). It will appear in the American Journal of Preventive Medicine, volume 58, issue 5 (May 2020) published by Elsevier.

The study was supported by a grant from the Peter F. McManus Charitable Trust and awards R01AA026268, R01AA023376, and R01AA018377 from the National Institute on Alcohol Abuse and Alcoholism.

Full text of this article is available to credentialed journalists upon request; contact Jillian B. Morgan at +1 734 936 1590 or ajpmmedia@elsevier.com. It will also be openly available for 60 days following publication. Journalists wishing to interview the authors should contact Jenny Eriksen Leary, Associate Communications Director, Media Relations, Boston Medical Center, at +1 617 638 6841 or jenny.eriksen@bmc.org.

About the American Journal of Preventive Medicine
The American Journal of Preventive Medicine is the official journal of the American College of Preventive Medicine and the Association for Prevention Teaching and Research. It publishes articles in the areas of prevention research, teaching, practice and policy. Original research is published on interventions aimed at the prevention of chronic and acute disease and the promotion of individual and community health. The journal features papers that address the primary and secondary prevention of important clinical, behavioral and public health issues such as injury and violence, infectious disease, women's health, smoking, sedentary behaviors and physical activity, nutrition, diabetes, obesity, and alcohol and drug abuse. Papers also address educational initiatives aimed at improving the ability of health professionals to provide effective clinical prevention and public health services. The journal also publishes official policy statements from the two co-sponsoring organizations, health services research pertinent to prevention and public health, review articles, media reviews, and editorials. www.ajpmonline.org

About Elsevier
Elsevier is a global information analytics business that helps scientists and clinicians to find new answers, reshape human knowledge, and tackle the most urgent human crises. For 140 years, we have partnered with the research world to curate and verify scientific knowledge. Today, we’re committed to bringing that rigor to a new generation of platforms. Elsevier provides digital solutions and tools in the areas of strategic research management, R&D performance, clinical decision support, and professional education; including ScienceDirect, Scopus, SciVal, ClinicalKey and Sherpath. Elsevier publishes over 2,500 digitized journals, including The Lancet and Cell, 39,000 e-book titles and many iconic reference works, including Gray's Anatomy. Elsevier is part of RELX, a global provider of information-based analytics and decision tools for professional and business customers. www.elsevier.com

Media contact
Jillian B. Morgan, MPH, Managing Editor
AJPM
+1 734 936 1590
ajpmmedia@elsevier.com