Lowered legal blood alcohol limits for young drivers: effects on drinking, driving, and driving-after-drinking behaviors in 30 states.
(25/957)
OBJECTIVES: This study evaluated the effects on drinking and driving of lowered allowable blood alcohol concentration (BAC) limits for drivers younger than 21 years in 30 US states between 1984 and 1998. METHODS: Outcome measures were based on self-reports from a cross-sectional sample of more than 5000 high school seniors in 30 states surveyed before and after BAC limits were implemented in their states. RESULTS: Frequency of driving after any drinking and driving after 5 or more drinks declined 19% and 23%, respectively. Lower BAC limits did not affect overall amount of drinking or total number of miles driven. CONCLUSIONS: Significant beneficial effects of lowered youth BAC limits have appeared despite limited publicity and enforcement of the new laws. (+info)
Saliva alcohol concentrations in accident and emergency attendances.
(26/957)
OBJECTIVES: Although alcohol is known to play a key part in accidents, no UK study has assessed alcohol concentrations in a comprehensive sample of accident and emergency (A&E) attenders. This study set out to do this, and examine the relation between alcohol concentrations and the severity, type and circumstances of presentation, and the sociodemographic characteristics of patients. METHODS: A survey was conducted of all new A&E attenders (aged 10 years or over). Two 24 hour periods for each day of the week were covered in 6, 7 or 11 hour sessions over a two month period. Alcohol concentrations were assessed from saliva samples using a disposable device. Data were collected from 638 attenders, of whom 544 provided saliva samples; the remainder refused or were unable to participate. RESULTS: Positive saliva alcohol readings were obtained in 22% of attenders (95%CI 19% to 26%); this increased to 25% if others were included (for example, those who refused to participate but were judged to be intoxicated). Alcohol was associated with 94% of incidents of self harm, 54% of non-specific/multiple complaints, 47% of collapses, 50% of assaults, and 50% of patients admitted to hospital. Higher concentrations of alcohol were found from Friday to Sunday, between midnight and 0900, and in patients aged 41 to 60. Among people with positive alcohol results, those attending with a companion had higher concentrations than those attending alone. There were no significant differences between men and women in alcohol concentrations. DISCUSSION: These findings show that alcohol use is an important factor in A&E attendance, but it should not be assumed that there is a causal relation between alcohol use and injury. Several accident related and sociodemographic variables were predictive of alcohol use before attending. The overall level of prediction was too weak to permit accurate identification of drinkers for screening purposes, but routine alcohol concentration assessments may be justified in the high risk groups identified in this study. A&E departments may be convenient and fruitful settings for brief interventions with early problem drinkers. (+info)
Comparison of the effects of sleep deprivation, alcohol and obstructive sleep apnoea (OSA) on simulated steering performance.
(27/957)
Patients with obstructive sleep apnoea (OSA) are reported to have an increased risk of road traffic accidents. This study examines the nature of the impairment during simulated steering in patients with OSA, compared to normal subjects following either sleep deprivation or alcohol ingestion. Twenty-six patients with OSA and 12 normal subjects, either deprived of one night's sleep or following alcohol ingestion [mean (SD) alcohol blood level 71.6 mg dl(-1) (19.6)], performed a simulated steering task for a total of 90 min. Performance was measured using the tendency to wander (SD), deterioration across the task, number of 'off-road' events and the reaction time to peripheral events. Control data for OSA, sleep deprivation and alcohol were obtained following treatment with nasal continuous positive airway pressure (nCPAP), after a normal night of sleep, and following no alcohol, respectively. Patients with untreated OSA, and sleep-deprived or alcohol-intoxicated normal subjects performed significantly less well, compared to their respective controls (P<0.01 for all tests), with untreated OSA lying between that of alcohol intoxication and sleep deprivation. Alcohol impaired steering error equally throughout the whole drive, whilst sleep deprivation caused progressive deterioration through the drive, but not initially. Untreated OSA was more like sleep deprivation than alcohol, although there was a wide spread of data. This suggests that the driving impairment in patients with OSA is more compatible with sleep deprivation or fragmentation as the cause, rather than abnormal cognitive or motor skills. (+info)
An analysis of consultations with the crowd doctors at Glasgow Celtic football club, season 1999-2000.
(28/957)
OBJECTIVE: To analyse all clinical presentations to the crowd doctors at Scotland's largest football stadium over the course of one complete season. METHODS: A standard clinical record form was used to document all consultations with the crowd doctors including treatment and subsequent referrals. The relevance of alcohol consumption was assessed. RESULTS: A total of 127 casualties were seen at 26 matches, a mean of 4.88 per match. Twenty casualties were transferred to hospital, including one successfully defibrillated after a cardiac arrest. Alcohol excess was a major contributing factor in 26 cases. CONCLUSIONS: The workload of the crowd doctors was very variable and diverse. The social problem of excessive alcohol consumption contributed considerably to the workload. The provision of medical facilities at football grounds means that attendance there is now one of the least adverse circumstances in which to have a cardiac arrest. The study confirmed previous impressions that more casualties are seen at high profile matches. (+info)
Court procedures for handling intoxicated drivers.
(29/957)
The courts have implemented numerous approaches to reduce the probability of recidivism among people apprehended for or convicted of driving while intoxicated. Although traditional punitive sanctions, such as fines and incarceration, are commonly used, they have not eliminated drinking and driving in the United States. Consequently, the court system has developed additional sanctioning procedures that show promise. For example, rehabilitative programs (e.g., alcohol education and alcoholism treatment) can reduce recidivism, at least marginally. These programs appear to be more effective when combined with license suspension. In addition to license suspension, several alternative methods for limiting driving opportunities of offenders have proven effective, including impounding offenders' vehicles or license plates, installing ignition interlocks, and requiring electronic home monitoring or house arrest. Effective court monitoring is a critical component in supporting recovery and compelling offenders to participate in rehabilitation programs. This role of the courts in monitoring offenders will likely increase as the use of intrusive, alternative sanctions grows. (+info)
The gin epidemic: much ado about what?
(30/957)
While there is no doubt that the era of the 'gin epidemic' was associated with poverty and social unrest, the surge in gin drinking was localized to London and was a concomitant, not the cause, of these problems. The two main underlying social problems were widespread overcrowding and poverty. The former was related to an unprecedented migration of people from the country to London. The latter stemmed from an economic ideology called 'poverty theory', whose basic premise was that, by keeping the 'inferior order' in poverty, English goods would be competitive and would remain that way since workers would be completely dependent on their employers. Widespread overcrowding and poverty led to societal unrest which manifested itself in increased drunkenness when cheap gin became available after Parliament did away with former distilling monopolies that had kept prices high. Reformers ignored the social causes of this unrest and, instead, focused on gin drinking by the poor which they feared was endangering England's wealth and security by enfeebling its labour force, and reducing its manpower by decreasing its population. Part of this hostility was also related to gin itself. While drunkenness was often spoken of affectionately when it was induced by beer, England's national drink, gin was considered a foreign drink, and therefore less acceptable. These concerns were voiced less often after the passage of the Tippling Act of 1751, which resulted in an increase in gin prices and decreased consumption. However, the second half of the century was also a period in which England's military victory over the French gave it new wealth and power, which dispelled upper-class fears about an enfeebled and dissolute working class. It was also an era when new public health measures, such as mass inoculation against smallpox, and a decrease in the marrying age, led to a population increase that dispelled reformist fears about manpower shortages. The conclusion is that, while the lower cost of gin sparked the 'gin epidemic', the social unrest associated with this unprecedented surge in gin consumption was exacerbated, rather than caused, by the increase in drinking. (+info)
Characteristics of traffic crashes in Maryland (1996-98): differences among the youngest drivers.
(31/957)
Motor vehicle crashes (MVCs) are the leading cause of death among teenagers in the US. The present study examines how crash rates and crash characteristics differed among drivers aged 16, 17, 18, 19, 20, and 21 in the state of Maryland from 1996 through 1998. The results show that, based on police reports, the youngest drivers have the highest rate of MVC per licensed driver and per annual miles driven. Furthermore, crash characteristics suggest that inexperience rather than risky driving may account for the differing rates. Younger drivers had their crashes during the day in clear weather while drinking less. (+info)
Participant-predicted, observed, and calculated peak blood alcohol levels: a gender-specific analysis.
(32/957)
In recent years there has been a push by federal and state governments to lower the maximum blood alcohol level at which drivers are considered intoxicated. Many states have lowered the maximum blood alcohol level to .08%. This paper offers insight into drinkers' ability to predict their level of impairment prior to consuming a given amount of alcohol. It addresses the problem of drinkers not knowing how many drinks they can consume before becoming legally impaired. Results indicate males and females differ in their ability to predict impairment levels. (+info)