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Traffic Injury Research Foundation of Canada, 171 Nepean Street, Suite 200, Ottawa, Ontario, Canada K2P 0B4
This presentation will describe the results of a special study undertaken in the province of Ontario, Canada to determine the number of persons killed in motor vehicle crashes that could be linked to the use of alcohol. A motor vehicle fatality was considered to have involved alcohol if: (1) at least one of the drivers involved tested positive for alcohol; (2) at least one of the drivers involved was judged by the investigating police officer to have consumed alcohol; or (3) in the case of a pedestrian fatality, if either the pedestrian or the driver of the vehicle that struck them had been drinking.
In 1992, 1,291 persons died in 1,1,41 motor vehicle crashes in Ontario. In 81% of cases it was possible to make a judgment about alcohol involvement. Of these cases, it was determined that alcohol was involved in 44% of motor vehicle fatalities. Vehicle operators accounted for 65% of alcohol involved fatalities, while passengers and pedestrians accounted for 22% and 13%, respectively.
The findings will be discussed in terms of the overall magnitude of the alcohol crash problem and areas for future countermeasure initiatives.
The extent of alcohol use among fatally injured drivers of highway vehicles has traditionally been considered one of the most valid and reliable indicators of the alcohol-crash problem. This focus on fatally injured drivers, however, reveals only part of the picture. As a means to provide a better indication of the magnitude and scope of motor vehicle fatalities involving alcohol, this paper presents the results of special studies undertaken to examine the extent to which alcohol was involved in all motor vehicle fatalities in Ontario during 1992 and 1993. These studies were part of comprehensive statistical reports on drinking and driving in Ontario (Beirness et al., 1994; 1995).
The primary data were obtained from the Fatality Database of the Traffic Injury Research Foundation and the Ontario Ministry of Transportation Master Accident Data File. For this study, a fatality was defined as any person who died within one year as the result of injuries sustained in a crash involving any type of motor vehicle, regardless of whether the crash occurred on a public roadway or on private property. Including fatalities that involve any type of motor vehicle as well as those that do not occur on a public roadway provide a more comprehensive estimate of the number of persons who died in motor vehicle crashes that involved alcohol.
To obtain an estimate of the extent of alcohol involvement in motor vehicle fatalities, coroner's reports were searched for evidence of alcohol use by the person killed and/or any the drivers involved in the crash. The Ministry of Transportation's Master Accident Data File was used to determine if the investigating police officer indicated whether or not any of the drivers involved in the crash had consumed alcohol. A motor vehicle fatality was considered to have involved alcohol (1) if at least one of the drivers involved tested positive for alcohol; or (2) if at least one of the drivers involved was judged by the investigating police officer to have been drinking or to have been impaired by alcohol; or (3) in the case of pedestrian fatalities, if either the pedestrian or the driver of the vehicle that struck them had been drinking. No attempt was made to determine responsibility for the crash or the causal role of alcohol. The analysis was restricted to an examination of the extent to which alcohol was present in fatal crashes.
In 18% of cases there was insufficient information available on which to make a judgment about the involvement of alcohol. Although the rate of testing for alcohol among fatally injured drivers in Ontario is relatively high (i.e., 87%), there remain a number of victims who are not tested. In addition, information about alcohol use by drivers who survive fatal crashes is often missing. For example, if surviving drivers are severely injured in the crash, they may be taken to hospital for treatment before the investigating police officer has been able to determine if they had been drinking. And, unless there is some evidence to indicate that the driver may have been drinking, the officer has no basis for demanding that a blood sample be taken. For these reasons, in a relatively small number of cases there is no information on which to determine whether or not alcohol was involved in the crash.
In total, 2,606 persons died in 2,283 motor vehicle crashes in Ontario in the two-year period 1992-1993. Vehicle drivers/operators accounted for 60% (1,566) of the fatalities, while passengers represented 26% (670) and pedestrians 14% (370).
Of the 2,606 persons killed in motor vehicle crashes, it was possible to make a judgment about alcohol involvement in 82% of cases. This is comparable to the rate of testing for alcohol among fatally injured drivers (87%) and provides a sufficient basis for determining the true extent of alcohol-involved fatalities in Ontario.
Using the criteria noted above for judging alcohol involvement, it was determined that alcohol was involved in 43.3% of motor vehicle fatalities. Assuming the distribution of alcohol involvement is similar across the 18% of cases in which there was no information available, it is estimated that over the two-year period examined 1,128 persons died in alcohol-involved motor vehicle crashes. In 73% of cases, the victim was found to have been drinking.
In the past, examinations of alcohol involvement in fatal crashes have been largely restricted to a consideration of fatally injured drivers of highway vehicles. The present analysis was not limited to drivers of highway vehicles but included operators of other types of vehicles, passengers and pedestrians.
Figure 1 shows the number of fatalities among victim types (shown on the left side of the Figure) and types of vehicles (other than automobiles) driven by fatally injured drivers (shown on the right side of the Figure) as well as the percent of each category that were determined to have involved alcohol.
Number of Motor Vehicle Fatalities and Percent Alcohol Involved by Type of Victim
Overall, motor vehicle operators accounted for 60% of all fatalities. In all but 17% of these cases it was possible to make a judgment about alcohol involvement. Among the 83% of driver/operator fatalities where there was sufficient information to determine whether or not alcohol was involved, there was evidence of alcohol use in 47% of cases. In 91% of alcohol-involved driver deaths, it was the fatally injured driver who had been drinking.
Drivers of automobiles comprised the largest group of fatalities; 45% of these fatalities involved alcohol. Operators of other types of vehicles accounted for 22% of fatalities. Overall, alcohol was involved in 51% of these fatalities. The bar on the right side of Figure 1 shows the distribution of other vehicle types driven by persons who died in crashes. As indicated in the figure, alcohol involvement rates varied considerably among drivers of different types of vehicles.
Passengers accounted for 26% of all motor vehicle deaths. Among passenger fatalities, the involvement of alcohol could be determined in 81% of cases. In 36% of these fatalities, at least one of the drivers involved had been drinking.
The use of alcohol by passengers is rarely implicated as a factor in fatal crashes. Consequently, fatally injured passengers are much less likely to be tested for alcohol than fatally injured drivers. In fact, less than 20% of fatally injured passengers age 16 and over were tested for alcohol. Nevertheless, among the relatively small number of cases that were tested, there is a strong relationship between alcohol use among passengers and drivers in the same vehicle. Among fatally injured passengers who tested positive for alcohol, 86% were riding in a vehicle operated by a driver who had also been drinking. On the other hand, all fatally injured passengers who tested negative for alcohol were riding with a nondrinking driver.
As indicated previously, pedestrian fatalities were determined to have involved alcohol if either the pedestrian or the driver of the vehicle that struck the pedestrian had been drinking. Sufficient information was available to determine the involvement of alcohol in 75% of these cases. Thirty-nine percent of pedestrian fatalities involved alcohol. Of those cases determined to have involved alcohol, 88% involved alcohol use by the pedestrian and 12% involved a drinking driver.
Figure 2 shows the percent of alcohol-related fatalities in various age groups. It is apparent in the figure that about six out of every ten persons aged 25 to 34 killed in motor vehicle crashes involved alcohol. Over half of fatalities age 19 to 24 and 35 to 44 involved alcohol. Only 7% of the fatalities over 74 years of age died in crashes involving alcohol. Alcohol was involved in 21% of the crashes in which a child (i.e., under age 16) died.
Percent of Motor Vehicle Fatalities in Each Age Group that Involved Alcohol
Men outnumber women as fatally injured victims of motor vehicle crashes by a margin of 2.2 to 1. In crashes involving alcohol, men outnumber women by more than 4 to 1. Men account for 69% of all persons killed in motor vehicle crashes and 80% of all alcohol-related fatalities. About half of all male motor vehicle fatalities involved alcohol compared to only 27% of female fatalities.
In the past, the best estimate of alcohol-related fatalities was derived from the percent of fatally injured drivers who had been drinking. The present analysis confirms the validity of this estimate. In the period examined, 45% of fatally injured drivers were positive for alcohol. This is comparable to the 43% of all motor vehicle fatalities that were determined to have involved alcohol in the present analysis.
The analysis also revealed that 73% of persons killed in crashes involving alcohol were themselves positive for alcohol. This finding is of interest for two reasons. First, there is a widespread belief among the general public that the impaired driver often walks away from a fatal crash unscathed. The present analysis, however, indicates that while such cases occur far too often, they account for, at most, 27% of the alcohol-related fatalities. Second, the persons most often killed in alcohol-related crashes are drinking drivers, their drinking passengers, or impaired pedestrians. Alcohol consumption increases the risk of a motor vehicle fatality, particularly for drivers, but also for passengers and pedestrians. Even if a person who has been drinking is not driving, alcohol interferes with decision-making skills such that they may be more likely to ride with a drinking driver or to cross the roadway without due care and attention to traffic. To date, countermeasure programs have focussed primarily on drinking drivers. Future initiatives might well target passengers and pedestrians.
The tendency for drinkers to ride together in the same vehicle highlights the importance of designated driver programs. The effective use of designated driver programs involves having the designated member of the group refrain from consuming any alcohol to ensure that his or her drinking passengers arrive home safely. Past countermeasure initiatives have primarily been intended to prevent drinkers from operating a vehicle. The present data, however, indicate that drinking passengers don't necessarily make good decisions about choosing their driver. Future initiatives need to encourage the selection of a driver who will remain alcohol-free prior to any alcohol being consumed.
It is also evident that driving is not the only activity that becomes unsafe after consuming alcohol. Intoxicated pedestrians face increased risk of being struck and killed by a vehicle. The public may be unaware of the dangers of walking along or crossing the roadway after consuming alcohol. Public information campaigns may be of considerable value in this area.
This research was funded by the Drinking-Driving Countermeasures Office of the Ontario Ministry of the Attorney General. Fatality data were obtained with the cooperation and assistance of the Office of Chief Coroner for Ontario and Ministry of Transportation. TIRF's Fatality Database is jointly sponsored by the Canadian Council of Motor Transport Administrators and Transport Canada.
Beirness DJ, Simpson HM, Mayhew DR, Brown SW (1994). Drinking and Driving in Ontario. Statistical Yearbook 1992. Toronto: Ministry of the Attorney General.
Beirness DJ, Simpson HM, Mayhew DR, Brown SW (1995). Drinking and Driving in Ontario. Statistical Yearbook 1993. Toronto: Ministry of the Attorney General.