Ideas and Opinions
17 January 2018

Eliminating Alcohol-Impaired Driving Fatalities: What Can Be Done?

Publication: Annals of Internal Medicine
Volume 168, Number 8
Despite decades of progress, more than 10 000 alcohol-related driving fatalities occur each year, and that number is increasing. Alcohol impairment remains the leading cause of traffic deaths: Approximately 30% involve 1 or more drivers with a blood alcohol concentration (BAC) above state limits for driving, and 50% involve a BAC above 0. To identify ways of reinvigorating efforts to reduce this trend, the National Highway Traffic Safety Administration asked the National Academies of Sciences, Engineering, and Medicine to form a committee to study the problem. The committee's report (1) makes recommendations based on that rigorous study.
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References

1.
National Academies of Sciences, Engineering, and Medicine. Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem. Washington, DC: National Academies Pr; 2017.
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Rosencrantz HEdvardsson SHansson O. Vision Zero—is it irrational? Transp Res Part A Policy Pract. 2007;41:559-67.
3.
National Highway Traffic Safety Administration. U.S. DOT, National Safety Council launch ‘Road to Zero' Coalition to end roadway fatalities. 2016. Accessed at www.nhtsa.gov/press-releases/us-dot-national-safety-council-launch-road-zero-coalition-end-roadway-fatalities on 16 November 2017.
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Elder RWLawrence BFerguson ANaimi TSBrewer RDChattopadhyay SKet alTask Force on Community Preventive Services. The effectiveness of tax policy interventions for reducing excessive alcohol consumption and related harms. Am J Prev Med. 2010;38:217-29. [PMID: 20117579]  doi: 10.1016/j.amepre.2009.11.005
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Mann REMacdonald SStoduto LGBondy SJonah BShaikh A. The effects of introducing or lowering legal per se blood alcohol limits for driving: an international review. Accid Anal Prev. 2001;33:569-83. [PMID: 11491238]
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Fell JCScherer M. Estimation of the potential effectiveness of lowering the blood alcohol concentration (BAC) limit for driving from 0.08 to 0.05 grams per deciliter in the United States. Alcohol Clin Exp Res. 2017;41:2128-39. [PMID: 29064571]  doi: 10.1111/acer.13501
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Elder RWVoas RBeirness DShults RASleet DANichols JLet alTask Force on Community Preventive Services. Effectiveness of ignition interlocks for preventing alcohol-impaired driving and alcohol-related crashes: a Community Guide systematic review. Am J Prev Med. 2011;40:362-76. [PMID: 21335270]  doi: 10.1016/j.amepre.2010.11.012
8.
U.S. Preventive Services Task Force. Final recommendation statement: alcohol misuse: screening and behavioral counseling interventions in primary care. 2013. Accessed at www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/alcohol-misuse-screening-and-behavioral-counseling-interventions-in-primary-care on 27 October 2017.

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Coleen Madigan, MD 18 January 2018
Responsibility
Once again the recommendations shift the burden to the 'health community'. With dwindling reimbursement for primary doctors , now with shrunken 10 minute appointments to meet overhead, when is the impracticality of shifting additional large responsibility of testing, counseling and referral get addressed. The federal and state governments need to decide who or what should have the most influence on making the alcohol taxes so high that it thwarts access; the alcohol industry or the welfare of the community.

Information & Authors

Information

Published In

cover image Annals of Internal Medicine
Annals of Internal Medicine
Volume 168Number 817 April 2018
Pages: 587 - 589

History

Published online: 17 January 2018
Published in issue: 17 April 2018

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Authors

Affiliations

Steven M. Teutsch, MD, MPH
UCLA Fielding School of Public Health and University of Southern California, Los Angeles, California, and Public Health Institute, Oakland, California (S.M.T.)
Timothy S. Naimi, MD, MPH
Boston University Schools of Medicine and Public Health and Boston Medical Center, Boston, Massachusetts (T.S.N.)
Acknowledgment: The authors thank the National Academies Committee and National Academies staff who worked tirelessly on a very complex task under tight time constraints.
Financial Support: The authors received no funding for their participation in the National Academies of Sciences, Engineering, and Medicine report, which was funded by the Department of Transportation, or for preparing this manuscript.
Corresponding Author: Steven M. Teutsch, MD, MPH; e-mail, [email protected].
Current Author Addresses: Dr. Teutsch: [email protected].
Dr. Naimi: Section of General Internal Medicine, Boston Medical Center, 801 Massachusetts Avenue, Crosstown Center, Room 2046, Boston, MA 02118.
Author Contributions: Conception and design: S.M. Teutsch.
Drafting of the article: S.M. Teutsch.
Critical revision of the article for important intellectual content: S.M. Teutsch, T.S. Naimi.
Final approval of the article: S.M. Teutsch, T.S. Naimi.
Administrative, technical, or logistic support: S.M. Teutsch.
This article was published at Annals.org on 17 January 2018.

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Steven M. Teutsch, Timothy S. Naimi. Eliminating Alcohol-Impaired Driving Fatalities: What Can Be Done?. Ann Intern Med.2018;168:587-589. [Epub 17 January 2018]. doi:10.7326/M18-0069

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