Methamphetamine and alcohol detection in vehicle-driver fatalities in South Australia: A 10-year survey (2008–2018)

Motor vehicle driver fatalities (≥18 years) from the files at Forensic Science South Australia were reviewed from January 2008 to December 2018 for cases in which either positive blood sample for methamphetamine (MA) or an illegal blood alcohol concentration (BAC) >0.05g/100 ml were found. Three hundred driver deaths were found with MA detected in 28 cases (age range 21–62 years; ave. 37.8 years; M:F 23:5). Hundred and fifteen cases with a BAC > 0.05 g/100 ml were identified (age range 18–67 years; ave 35.7 years; M:F 95:20). No change was found in numbers of MA cases, although alcohol cases showed a significant decline (p < 0.001). Drunk driving-related fatal crashes tended to occur in the evening (5 p.m. to 11 p.m.), while MA-related fatal crashes had a longer peak extending from late evening until late morning (11 p.m. to 8 a.m.). This study has demonstrated that while roadside breath testing, legislative changes, and increased monitoring have resulted in reduced levels of drunk driving, similar safety countermeasures have had negligible effects on MA use in drivers. Continued monitoring of MA use by drivers will, therefore, be necessary to assess the possible effects, or not, of new countermeasures.     

Fatal positional asphyxia associated with rollover crashes

Motor vehicle rollover crashes result in complex occupant kinematics with the potential for severe injury. Five cases of fatal asphyxia in occupants suspended from their safety belt upside down after a rollover crash are presented. These fatalities accounted for 13.5% of all motor vehicle related asphyxia deaths in San Diego County over a 10-year period. This study supports previous research noting that incapacitation due to other injuries, alcohol, or obesity may be associated with fatal positional asphyxia due to inversion during rollovers. Safety belts are proven to prevent serious injury in motor vehicle crashes and should always be worn. However, redesign of the buckle could be considered to permit easier release by an occupant. We also suggest that pre-existing heart disease may contribute to the possibility of a fatal asphyxia outcome. Although this is a rare cause of motor vehicle related death, our results suggest that these are potentially preventable deaths.     

The Effect of Lowering the Legal Drink‐Drive Limit on the Toxicological Findings in Driver Fatalities: A Comparison of Two Jurisdictions,

In December 2014, the legal blood alcohol limit for drivers in both Scotland and New Zealand was reduced from 80 to 50 mg/100 mL. This paper reports a retrospective study comparing changes in the toxicological findings in deceased drivers and motorcyclists before and after the limit change in both jurisdictions. A year of fatal motor vehicle crashes prior to and following the limit change is examined for both countries. In Scotland, there was an increase in drug prevalence among fatally injured drivers and motorcyclists, with the use of all drug groups increasing after the limit change, with the exception of cannabinoids. In New Zealand, there was a reduction in cases involving drugs only, but increases in the numbers of deceased drivers and motorcyclists positive for alcohol only and co‐using alcohol and drugs.     

Driver and front seat passenger fatalities associated with air bag deployment. Part 1: A Canadian study

Real world motor vehicle collision research of injuries due to deployment of "first-generation" air bags has been conducted by Transport Canada since 1993. Fifty-three fatal crashes (36 frontal impacts; 17 side collisions) involving 48 drivers and 10 right front passengers were reviewed. In the Canadian data, air bag deployment in five of nine low severity frontal crashes (delta-V (deltaV) < 25 km/h or 15 mph) was linked to five deaths, four of whom were autopsied (four adults with craniocervical (basal skull and C2 fracture with brainstem avulsion; "closed head injury"--no autopsy) or chest trauma (aortic or pulmonary artery tears); one child with atlanto-occipital dislocation). An occupant who is close ("out-of-position") to the air bag at the time of deployment is at risk for injury. In 27 high severity frontal impacts, unusual (e.g., pulmonary "blast" hemorrhage in one autopsied case) or isolated potentially survivable injuries (e.g., clinically documented ruptured right atrium; probable flail chest observed during the autopsy on a decomposed body) localized to the head, neck or chest in three possibly out-of-position drivers pointed to the deployed air bag as a source of injury. In one of 17 side collisions an out-of-position driver sustained a radiographically confirmed C1-C2 dislocation in a minimally intruded vehicle.     

Prevalence of blood alcohol in fatal traffic crashes in Shanghai

The objective of this project was to investigate the incidence of alcohol consumption in fatal traffic deaths in Shanghai, one of the largest cities in China. A study was conducted on 803 individuals killed in road accidents during the period 2009–2011, in terms of alcohol-positive rate, mean blood alcohol content (BAC), gender, age, vehicle type, pedestrian alcohol problem, single-vehicle vs multiple-vehicle crashes, and time of day. It was found that 28.9% of the drivers involved had a BAC ≥ 0.20 mg/mL (limit of civil offense) and 21.8% had a BAC ≥ 0.80 mg/mL (limit of criminal offense). The mean BAC of alcohol-positive drivers (with a BAC ≥ 0.20 mg/mL) was 1.51 mg/mL. The vast majority of the drivers involved were males. With regards to age, the largest group was of drivers aged between 40 and 49 years group in both alcohol-negative cases (26.8%) and alcohol-positive cases (26.2%). Motorcycles were most likely to be involved, representing 34.4% of alcohol-negative crashes and 51.6% of alcohol-positive crashes. Very high BACs were common among alcohol-positive pedestrians, yet all female pedestrians were alcohol-negative. Single-vehicle crashes were over-represented in alcohol-positive cases. Alcohol-negative crashes and alcohol-positive crashes most often happened during the time period of 17:00–18:59 and 19:00–20:59, respectively.     

Toxicological Findings in Fatal Motor Vehicle Collisions in Ontario,Canada: A One‐Year Study

Drug‐impaired driving is a complex area of forensic toxicology due in part to limited data concerning the type of drugs involved and the concentrations detected. This study analyzed toxicological findings in drivers from fatal motor vehicle collisions (FMVCs) in Ontario, Canada, over a one‐year period using a standardized protocol. Of the 229 cases included in the study, 56% were positive for alcohol and/or drugs. After alcohol, cannabis was the most frequently encountered substance (27%), followed by benzodiazepines (17%) and antidepressants (17%). There were differences in drugs detected by age but no marked difference in drugs detected between single and multiple FMVC's. Not all drugs detected were considered impairing either due to drug type, concentration or case history. The findings indicate the importance of comprehensive drug testing in FMVCs and highlight the need to consider a variety of factors, in addition to drug type and concentration, when assessing the role of drugs in driving impairment.     

Injury Patterns Sustained in Fatal Motor Vehicle Collisions with Driver's Third‐Generation Airbag Deployment

The Office of the Chief Coroner for Ontario database for 2011–2012 was used to compare fatal injury patterns in drivers whose third‐generation airbags deployed compared to first‐ and second‐generation airbag deployments and airbag nondeployments with and without seatbelt use. There were 110 frontal and offset frontal crashes analyzed. The small sample size meant that the odds of craniocerebral, cervical spinal, thoracic, and abdominal injuries were not statistically different for airbag generation, deployment status, and seatbelt use; however, the risk of fatal thoracic injuries in third‐ and second‐generation cases was increased. Seatbelt usage in third‐ and second‐generation deployment cases reduced the risk of all injuries except abdominal trauma. High severity impacts and occupant compartment intrusion were frequently observed. The analyses in this retrospective study were challenged by data that were not collated in a standardized way and were limited in details about scene, vehicle, and driver variables.     

Tractor driving and alcohol—A highly hazardous combination

Introduction

Approximately half of all injury-related fatalities in the agricultural industry are associated with farm tractors. Skill-based psychomotor tasks, such as driving and operating such machines, are easily impaired as a consequence of the use of alcohol. We have analyzed characteristics of fatal traffic accidents involving tractors in Zagreb County, with special accent to prevalence of alcohol use among drivers.

Subjects and methods

The material comprised all fatal accidents involving tractor drivers in Zagreb County between the years 2001 and 2005 where a medicolegal autopsy had been performed and samples taken for subsequent forensic toxicological analysis. The total of 47 cases were included. Data were collected on characteristics of the fatally injured as well as on circumstances and dynamics of the accident itself. The results are presented with absolute and relative frequencies.

Results

Ninety-one percent (43 out of 47 cases) of fatally injured were males. No person was under the age of 18, 70% were between 18 and 65 years of age and 30% were above 65 years of age. Blood alcohol reading was negative in only 13 out of 47 analyzed cases (28%). Six cases (13%) had blood alcohol concentration (BAC) below 0.50 mg/mL, further 6 between 0.50 and 1.49 mg/mL, 16 (34%) between 1.50 and 2.49 mg/mL and the remaining six had BAC between 2.50 and 3.49 mg/mL. Median BAC among 34 fatalities with positive blood alcohol level was 1.80 mg/mL, while the highest concentration observed was 3.49 mg/mL. Multiple injuries were the most common cause of death (43%) followed by crush asphyxia (26%). Most of the victims (81%) died at the scene of the accident and all of them died within the first 24 h. In the majority of accidents (79%), the tractor operator was a victim of the vehicle rollover.

Conclusion

High percentage of farm tractor users driving under influence and high median BAC indicates that legislation alone is not sufficient in preventing accidents. Further effort should be directed toward education aimed to increase awareness of the obvious risk that alcohol use represents to driving and workplace safety. Taking into account that the overwhelming majority of fatalities occurred from rollovers, strong encouragement should be given to implementation of rollover protecting structure (ROPS) devices in order to prevent such type of fatalities.     

An epidemiological study on alcohol/drugs related fatal traffic crash cases of deceased drivers in Hong Kong between 1996 and 2000

This study is designed to evaluate the correlation between fatal vehicle crashes (FVC) and consumption of alcohol and/or drugs among drivers. Between 1996 and 2000 in Hong Kong, a total of 197 FVC cases of deceased drivers were investigated. The blood and/or urine samples of the victims were examined for the presence of alcohol and drugs. The 197 cases were then classified into two groups: single-vehicle crashes (SVC) and multiple-vehicle crashes (MVC). Out of the 106 cases for the latter group, alcohol and/or drugs were detected in 22 cases (21%) while the remaining 84 cases (79%) were regarded as no significant finding. As for the 91 cases in SVC group, 51 cases (56%) were positive for alcohol and/or drugs. The findings indicate that a driver consuming alcohol and/or drugs has a higher risk of being involved in a FVC. The most frequently detected drugs for SVC group (11 cases) were: 46% central nervous system (CNS) stimulants (including designer drugs like MDMA); 36% cannabis; 18% benzodiazepines and 9% ketamine. The detected drug for the only case in the MVC group was a CNS stimulant. The number of cases with ketamine, methamphetamine and MDMA detected has increased in recent years as these party drugs have gained popularity in Hong Kong.     

Occupational workplace and traffic fatalities in Alsace, France (2000–2005): Results of toxicological investigations

France ranks as leader country in Europe for the consumption of cannabis as well as of psychoactive medications. Whereas the relationship between psychotropics and road accidents is now well-established, few data are still available on the influence of drugs on occupational accidents. The purpose of the present study was to measure the prevalence of psychoactive drug intake (alcohol excepted) among victims of occupational fatalities (including workplace accidents + traffic accidents, i.e. on the way to and from work) occurred in the region Alsace over the period 2000–2005. Data were collected by compiling files on occupational accidents from two different public agencies (CRAM, Regional Sickness Fund Alsace-Moselle; DRTEFP, Regional Department of Work, Employment and Professional Training) together with those from the Medico-Legal Institute of Strasbourg over the period tested. Data analysis showed that 3% of the victims of workplace fatalities were under the influence of drugs (alcohol excluded) at the time of accident, as well as 5% of the victims of occupational traffic accidents. Our results also highlight a low rate of toxicological analyses, since these investigations were requested by the authorities in 41% of traffic victims and only 15% of workplace victims. In France, the relevance of psychoactive drug intake in occupational deaths is much better targeted in the case of traffic fatalities (due to the existence of specific regulations, e.g. compulsory urinalysis for drugs of abuse in drivers involved in a road accident) than in those occurred at workplace (no specific regulations).     

An Unusual Case of Multiple‐Gunshot Suicide of an Alcohol‐Intoxicated Cancer Sufferer with Prolonged Physical Activity

Multishot firearm suicides are relatively rare and suggest the possibility of homicide. Physical activity following gunshots to the head, the neck, and the thorax does occur, and immediate incapacitation does not occur in every fatal gunshot wound that penetrates the head or perforates the heart. Cancer patients appear to be at increased suicide risk, but alcohol intoxication is less common in such cases. We present—to the best of our knowledge for the first time—a case of a 54‐year old, male, liver cancer sufferer, who under the influence of alcohol, discharged his revolver three times, suffered, among other wounds, a heart‐perforating wound, and died after c. 1.5 h, being able to talk until just before he died. Our case underlines the importance of keeping an open critical mind when dealing with multiple‐gunshot fatalities, especially when posttraumatic physical activity might be crucial in differentiating homicide from suicide.     

RESPONSES OF THE CRIMINAL JUSTICE SYSTEM TO LEGISLATION PROVIDING MORE SEVERE THREATENED SANCTIONS

In 1971, the Tennessee legislature enacted legislation providing for mandatory jail sentences and driver's license revocations for anyone convicted of driving while intoxicated. This new law had no demonstrable impact on the highway traffic fatalities rate-the intended objective. This paper explores the reasons for this apparent lack of impact. Data suggest that, while there was some increase in the severity of sanctions imposed on drunken drivers, there was still a consistent tendency to suspend the jail sentences and grant drivers restricted driving privileges. Nor is there any reason to believe that the police intensified their efforts to apprehend larger numbers of drunken drivers. Thus, the more severe sanctions threatened in the new law were generally mitigated in practice. Some possible interpretations for this are offered.     

Fatal Injuries of Law Enforcement/Correctional Officers Attacked with Sharp‐Edged Weapons,

According to the National Law Enforcement Memorial Fund, there were 117 law enforcement fatalities in the United States in 2015. Assaults with sharp‐edged weapons have resulted in a total of over 400 fatalities in the United States. The goal of the current research was to examine sharp‐edged weapon assaults against law enforcement and correctional agents that resulted in a fatal outcome. A total of twelve autopsy reports were reviewed from across the United States. Four cases involved law enforcement officers, seven involved correctional officers, and one was an off‐duty border officer. The male‐to‐female ratio was 11:1. A total of 70.2% of the wounds analyzed were stab wounds (n = 85), and 29.8% of the wounds were slash wounds (n = 36). Based on this review, the neck, shoulder, and chest regions were the most vulnerable to single fatal stab/slash wounds. Multiple stab/slash wounds often resulted in exsanguination. The use of body armor was only noted in one case.     

Atlanto-occipital disarticulation. Accident characteristics

A retrospective study of cases of atlanto-occipital disarticulation was conducted to describe incident characteristics: 24 cases were identified, including nine motor vehicle drivers, two passengers, seven pedestrians, and five motorcyclists; one other person had fallen four stories. The highest rates were found among motorcyclists and pedestrians. Atlanto-occipital disarticulations occur in high-energy impacts and collisions and are associated with aortic laceration in 25% and basilar skull fracture in 21% of such cases. Current restraint systems and motorcycle helmets do not appear to prevent this generally rapidly fatal injury.     

Targeting Underage Drinking and Driving in Juvenile and Domestic Relations Courts: The Reinforcing Alcohol Prevention (RAP) Program

Alcohol use is a concern among our nation's least experienced drivers, and underage drinking contributes to the overall burden of traffic injury and mortality. The goal of the Reinforcing Alcohol Prevention (RAP) Program was to develop a court‐based program targeting underage drinking and driving among teens. An advisory board created the program which included changes to the drivers' licensing ceremonies and traffic dockets conducted in Juvenile and Domestic Relations Courts. Additions included 5‐minute videos of individuals in alcohol‐related crashes and a crash‐photo display. Exit evaluations garnering impressions/opinions of the program indicated 84% of teenagers felt every teen should view the presentation and 96% would be less likely to drive after drinking. The RAP Program has been well‐received by judges and participants and could be easily implemented by other jurisdictions.     

“How Do I Bring Diversity?” Race and Class in the College Admissions Essay

In the first systematic study of what college applicants invoke when required to submit a diversity essay, we revisit many settled assumptions on both the left and the right about how such an essay would operate after Grutter and Gratz as well as after the passage of anti–affirmative action ballot initiatives. Our data are a sample of 176 diversity essays submitted to the University of Michigan in the immediate aftermath of the University's Supreme Court win, analyzed both qualitatively and quantitatively with special attention to the differences that the essay writer's race and class position make. We find that in many respects the essays are similar when written by applicants from similar backgrounds but different races, and that conservative critics were wrong to assume the essay would function simply as a way of announcing oneself as an under‐the‐table affirmative action candidate. Rather than suggesting a straightforward lineup of advantage and disadvantage, we suggest rather that the essay is a vehicle for the youngest generation of citizens to both receive and send back a new conception of difference that has some essentializing elements but overall is turning in a postracial, cosmopolitan direction.     

Familial Vehicular Murder‐Suicide

A certain number of single‐vehicle crashes into stationary roadside objects such as trees are thought to be occult suicides. However, is it possible that some cases of multiple deaths within a family in similar crashes are due to unrecognized familial murder‐suicides? A 39‐year‐old woman and her 11‐year‐old daughter are reported who died of injuries following a vehicle impact with a tree. Unusual behavior of the mother leading up to the crash, and assessment at the scene, raised the possibility of this being a nonaccidental event. However, difficulties in retrospectively determining the intent of a driver in a vehicle crash, and the nonrecording of, or lack of separate coding for murder‐suicides on registers, make determination of the incidence of these types of events extremely difficult. It may be that this is a subcategory of murder‐suicide that is underdiagnosed and so is not being registered on central motor vehicle crash databases.     

Medical driver selection and alcohol

Due to the rapid development of motorisation in the past few decades, the epidemic of traffic injuries has become a serious problem. Numerous studies indicate that the human factor, often in connection with alcohol consumption, plays a major role in traffic accidents. Studies also show that people addicted to alcohol often drive under the influence and are not deterred by the possibility of punishment, e.g. a revocation of their driving licence.Our study examined people who caused traffic accidents under the influence of alcohol in Slovenia, the consequences of their actions, police and judicial measures and medical selection.In the last decade, the share of people causing traffic accidents under the influence of alcohol in Slovenia has been on the rise. Higher blood alcohol levels are found in people causing fatal traffic accidents, most of them are cyclists, pedestrians and tractor drivers, aged between 25 and 34; the accidents are most common on village roads, on weekends. The discrepancy between numbers of intoxicated drivers with suspended driving licences (approximately 8500/year) and between numbers of successfully terminated judicial procedures is particularly worrisome. When these drivers get their licences back, the medical selection process is inadequate.Our results emphasise the problem of medical selection for reinstatement of penalized drivers. The inadequate approach currently in force allows too many dangerous drivers, most still addicted to alcohol, to return to traffic without medical selection. The only solution to this problem is an immediate change in legislation that would require rigorous medical selection for all reinstatements of drivers who drove under the influence of alcohol. This would decrease the numbers of intoxicated drivers in traffic and at least partly decrease the numbers of alcohol addicts in society.     

Childhood Fatalities in New Mexico: Medical Examiner‐Investigated Cases, 2000–2010

To better understand risk factors and populations at risk of childhood fatalities, a review of all records of childhood deaths (≤19 years) between 2000 and 2010 from New Mexico's statewide medical examiner was conducted. Annually, 313–383 childhood deaths were investigated (3820 total). Males and American Indians were overrepresented (62% and 20.4% of deaths, respectively). The most common manner of death was natural (44.8%), followed by accidental (31.4%), homicide (8.8%), suicide (8.8%), and undetermined (4.1%). Infants under 1 year of age accounted for 41.4% of deaths. Motor vehicle crashes were responsible for the majority of accidental deaths (69%), followed by unintentional overdoses (6.9%), and drowning (5.3%). Gunshot wounds, either intentional or unintentional, caused 10.7% of childhood deaths. Complete medico‐legal investigation of childhood fatalities is needed to provide public health agencies with adequate data to evaluate and prevent childhood deaths.