Fatigue in multiple-car fatal accidents

In a re-examination of 334 fatal multiple car accidents, without any reasonable explanation besides possible intoxication, 205 drivers were found responsible for the accident. Twenty-one of these accidents happened between midnight and 0600 h and 11 of the drivers were found to be intoxicated with a blood/alcohol content (BAC) of more than 0.080%. The remaining 184 accidents took place during the rest of the day and 55 drivers were intoxicated. By comparing this apparent over-representation of intoxicated drivers in night-time accidents with that of a control group of no less than 15,923 drivers, it was possible to convert this over-representation into an under-representation. This decline in accidents while under influence seems to indicate another human accident factor specific to night-time traffic. It is concluded that fatigue is an overlooked but most obvious cause of otherwise unexplainable accidents in the night-time traffic.     

Fatigue in single car fatal accidents

In a reexamination of 101 fatal single car accidents without any reasonable explanation besides possible intoxication, 50 drivers were found to have been intoxicated with a blood alcohol content (BAC) of more than 0.08 mg% at the time of the accident. Thirty-seven of these accidents happened between 2400 h and 0600 h in the morning and 21 of the drivers were found to be intoxicated. The remaining 64 accidents took place during the rest of the day and 21 drivers were found to be intoxicated. By comparing this apparent over-representation of intoxicated drivers in night-time accidents with that of a control group of no less than 15.923 drivers it was possible to convert this over-representation into a significant under-representation indicating another human accident factor specific to night-time traffic. It is concluded that fatigue is an often overlooked but most obvious cause to an otherwise unexplainable accident in the night-time traffic.     

论道路交通事故与驾驶员血中酒精含量关系

目的探讨道路交通事故与饮酒驾车血中酒精含量关系及其法医学意义,为预防、控制道路交通事故提供重要依据。方法对2005份道路交通事故肇事驾驶员血酒精鉴定资料进行系统分析性研究。结果饮酒驾车以男性为主,女性饮酒驾车出现醉酒驾车的比例与男性无差别。市区驾驶员醉酒驾车高于郊区。驾驶员BAC<20mg/100mL肇事导致死亡的比例高于饮酒驾车肇事组(BAC20￣79mg/100ML),而BAC≥80mg/100mL则低于饮酒驾车肇事组。结论应降低饮酒驾车和醉酒驾车BAC标准,以利于减少交通事故肇事死亡率。     

涉嫌酒后驾驶交通事故人体损伤与驾驶员血中乙醇质量浓度关系研究

目的探讨涉嫌酒后驾驶所致道路交通事故中人体损伤情况与驾驶员血中乙醇质量浓度关系,为预防、控制道路交通事故及人体损伤提供依据。方法对467例涉嫌酒后驾驶机动车的道路交通事故损伤人员相关鉴定资料与肇事驾驶员血中乙醇质量浓度进行系统分析性研究。结果涉嫌酒后驾驶发生道路交通事故的损伤人员中,以20~39岁男性居多;事故中驾驶员损伤机率最高;酒后交通事故以长头小车及摩托车最多,而驾驶员血中乙醇质量浓度（BAC）为0.1~20mg/100mL浓度的摩托车驾乘人员伤亡构成比最高;酒后驾驶机动车肇事导致的人体致命性损伤及人员死亡的饮酒组危险程度均高于未饮酒组,在驾驶员血中乙醇质量浓度（BAC）为0.1~20mg/100mL组与20.1~80mg/100mL组比较无明显差异。结论酒后驾驶肇事导致的人员伤亡比未饮酒驾车交通事故严重;未达酒后驾车组（BAC为0.1~20mg/100mL）和酒后驾车组（BAC为20.1~80mg/100mL）交通事故导致的人员伤亡无明显差异。研究结果提示,应降低饮酒后驾车血中乙醇质量浓度（BAC）法定标准阈值,进一步控制和减少道路交通事故人身伤亡率。     

人体内乙醇含量检测的影响因素分析

人体内乙醇含量检测不仅是法医鉴定工作中常规检测项目,也是交通肇事案件最终的仲裁依据,其检测结果直接影响着受检人员的责任判罚。本文根据乙醇的毒理特征及在人体内的代谢过程,就不同检材、送检时效性、尸体腐败、血液检品中不同成分和保存方式、以及检测结果的不确定度等对乙醇含量检测结果的影响进行分析,以利于对受检者是否饮酒及其程度做出科学、公正的判定。     

Motor accidents and blood samples in New South Wales

In the 12 months to June 2007, more than 26,000 people were injured in motor accidents on New South Wales roads. More than 400 people were killed. Alcohol was an important factor in a significant number of these accidents. The Road Transport (Safety and Traffic Management) Act 1999 (NSW) contains provisions for the mandatory taking of blood samples from drivers who have caused death while driving and who are suspected of having driven under the influence of drugs or alcohol. This article considers the law regarding the requirement of hospital staff to collect blood samples from drivers involved in motor vehicle accidents in New South Wales.     

Occurrence of barbiturate, benzodiazepine, meprobamate, methaqualone and phenothiazine in car occupants killed in traffic accidents in the south of Sweden

An investigation of the following psychoactive drugs: barbiturate, benzodiazepine, meprobamate, methaqualone and phenothiazine, was performed on all automobile occupants killed in accidents in southern Sweden during 1977 and 1978. Of 122 drivers and 55 passengers analysed, low concentrations of these drugs were found in nine drivers and in five passengers. Thus, 7.3% of the drivers were driving under the influence of drugs and, of these, two drivers (1.6% of all analysed drivers) were also inebriated. Twenty-three per cent of the drivers were inebriated only. According to the circumstances in the accidents and the number of drivers whose analyses proved positive, drug influence seldom seems to be the cause of fatal traffic accidents.     

Is Toxoplasma gondii a potential risk for traffic accidents in Turkey?

In Turkey, traffic accidents are the major causes of mortality and morbidity. According to the statistics made by Turkish Security Headquarters in the year 2000, 7500 people are killed in the traffic accidents every year. Drivers are mostly blamed for the traffic accidents. Tired, weary, sleepy and absentminded driving are common reasons for traffic accidents due to many reasons. Among these reasons mental and reflex conditions of drivers are significant. Toxoplasmosis is one of the most common zoonoses throughout the world. In immunocomponent adults, toxoplasmosis has no clinical signs or symptoms and infection in such people can only be detected by serological examinations. This kind of latent or dormant toxoplasmosis can be located in neural or muscular tissues and cause prolonged reaction times of the muscles. Extended reaction times also lead to deceleration of the reflexes which could be a major cause of the traffic accidents. By the light of this situation, the incidence of Toxoplasma gondii is investigated among the population who were involved in a traffic accident while driving. A total of 185 people (100 men and 85 women), aged between 21 and 40 years, living in Izmir and Manisa cities, were enrolled in the study group (SG) during a period of 6 months time. Their informed consents were taken initially and the laboratory tests of all these individuals related to blood alcohol levels after the accidents were found negative. The control group (CG) were also consisted 185 people (95 men and 90 women), residents of the same region, in same age group. The people in CG had no clinical signs or symptoms concerning toxoplasmosis. All collected sera were examined using a commercial IgG and IgM ELISA kit. According to the results of serological tests of the SG, 45 (24.32%) sera were IgG positive, six (3.24%) were IgM positive and 10 (5.40%) were both IgG and IgM positive. On the other hand in CG, 12 (6.48%) people found IgG positive, one (0.54%) found IgM positive and three (1.62%) found both IgG and IgM positive. This data was considered as statistically significant by Yates corrected chi2-test. (p < 0.05). In conclusion, there is an increased risk for traffic accidents for drivers owing to these high seroprevalence of latent toxoplasmosis. Prospective studies are still necessary on this subject but latent toxoplasmosis of drivers should be taken into account while developing strategies to prevent traffic accidents in Turkey.     

酒后驾车道路交通事故流行病学研究

目的比较酒后驾车交通事故与非酒后驾车交通事故的流行特征。方法1999～2003年成都地区酒后驾车交通事故542例组成病例组,另从同期发生的75324例交通事故数据库中随机抽取1%非酒后驾车交通事故731例组成对照组。运用统计方法进行分析。结果酒后驾车交通事故造成人员死亡的危险度是非酒后驾车的1.72倍,两类事故的24小时分布基本呈相反趋势,酒后驾车非职业驾驶员和非驾驶员所占比例明显高于其他原因导致的交通事故(P<0.001),酒后驾车造成车辆的损害程度强于非酒后驾车,两类事故机动车的出行目的亦明显不同。结论酒后驾车交通事故较非酒后驾车交通事故后果严重,酒后驾车交通事故有不同于非酒后驾车交通事故的流行规律。     

贵州省 1 000 例涉嫌酒后驾驶者的鉴定结果分析

目的通过对贵州省2012年1000例涉嫌酒后驾驶、道路交通事故酒精检案的特点进行分析,为预防和控制酒后驾车提供科学数据。方法在利用Excel及Spss统计软件对涉嫌交通事故肇事者性别、年龄、肇事时间、肇事车型以及对肇事者血中乙醇质量浓度（BAC）等数据进行统计分析。结果涉嫌酒后驾驶者男性居多,年龄在20~50岁间占92%。事故多发生于20~24时,以县市区干道为主,肇事车辆为摩托车占46.72%。在1000例乙醇检案中,28.7%为未检出,9.3%为酒后驾车,59.5%为醉酒驾车。结论 2012年贵州省发生的1000例涉嫌酒后驾驶案件中有一定相关特征,可为＂酒驾＂的预防与控制提供准确的科学依据。     

Driving under the influence in Greece: a 7-year survey (1998-2004)

Alcohol is one of the main causes of traffic accidents worldwide. Its use decreases significantly the driving ability of an individual increasing in this way the possibilities of their involvement in motor-vehicle accidents. The above possibilities are increased when a psychoactive substance has been taken in combination with alcohol due to their synergistic effect. The Laboratory of Forensic Medicine and Toxicology of the University of Athens is authorized to perform the toxicological investigation of traffic accidents that happen in the southern part of Greece. The objective of the present study was to identify the prevalence of alcohol and other psychoactive substances among drivers involved in road traffic accidents in Greece during the period 1998-2004. Alcohol was detected in the blood of about 37% of the drivers involved in traffic accident during the years 1998-2000. The detection of alcohol was lower (29%) in the years 2001-2004. Cannabis, benzodiazepines, opiates, and cocaine were found in 4%, 4%, 4% and 1% of the total number of cases, respectively. The above values were compared with those of a previous study concerning the period 1995-1997 and the reasons for the reduction of the number of alcohol-related traffic accidents during the last years are discussed.     

The use of alcohol and other psychoactive substances by victims of traffic accidents in Greece.

Alcohol is one of the main causes of traffic accidents worldwide. Its use decreases significantly the driving ability of an individual as well as the reflexes of a pedestrian increasing in this way the possibilities of their involvement in motor-vehicle accidents. The above possibilities are increased when a psychoactive substance has been taken in combination with alcohol due to their synergistic effect. The Laboratory of Forensic Medicine and Toxicology of the University of Athens is authorized to perform the toxicological investigation of traffic accidents that happen in the major part of Greece. The findings of the toxicological analyses that were performed in our laboratory during the years 1995 to 1997 are classified according to the alcohol concentration and the kind of psychoactive substance detected as well as to the gender and the age of the victims, drivers or pedestrians. The results of the above classification are evaluated and the conclusions regarding alcohol, drugs and traffic accidents in Greece are discussed thoroughly.     

Study of rearrests for drunken driving in Norway

The National Institute of Forensic Toxicology (NIFT) in Oslo receives blood samples from all Norwegian drivers suspected of driving under the influence of alcohol. It is well known that a large proportion of the arrested drunken drivers are repeat offenders. The purposes of this investigation was to find the arrest rates (the percentage of subjects arrested once or more) among drunken drivers followed retrospectively and prospectively during the 11-year period 1984–1994 and the probability of `abstaining' from becoming a recidivist during the 9 years subsequent to the year of selection. By examining the rearrest rates during the 3 following years for drivers selected in 1986, 1989, 1991 and 1992 we tried to look for major effects due to the change in the Norwegian road traffic act of 1988. Altogether 45% of the selected drunken drivers were arrested two or more times. Totally the `9-year survival rate' (i.e. not being rearrested) was 60% for drivers with blood alcohol concentration (BAC) selected from the interval 0.06–0.09%; 56% from BAC 0.13–0.16% and 51% from 0.26–0.29%. The data were further evaluated with respect to frequency of rearrest during 3 years after selection, and was around 30% in 1986, while it was lower for drivers selected in 1992 (19%). An explanation for the reduction in rearrest rate may be the changes in the road traffic act which took place in 1988.     

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.     

The Horizontal Gaze Nystagmus test: fraudulent science in the American courts.

The Horizontal Gaze Nystagmus (HGN) test was conceived, developed and promulgated as a simple procedure for the determination of the blood alcohol concentration of drivers suspected of driving while intoxicated (DWI). Bypassing the usual scientific review process and touted through the good offices of the federal agency responsible for traffic safety, it was rushed into use as a law enforcement procedure, and was soon adopted and protected from scientific criticism by courts throughout the United States. In fact, research findings, training manuals and other relevant documents were often held as secrets by the state. Still, the protective certification of its practitioners and the immunity afforded by judicial notice failed to silence all the critics of this deeply flawed procedure. Responding to criticism, the sponsors of the test traveled the path documented in this paper that led from mere (if that word can ever truly apply to a matter of such gravity) carelessness in research through self-serving puffery and finally into deliberate fraud--always at the expense of the citizen accused.     

Cannabis and driving: Results from a general population survey

The role of illicit drugs on driving, and particularly of cannabis and driving, is the object of increasing awareness. While there is increasing evidence of their effect on psychomotor performance and increased risk of involvement in traffic accidents, limited information is available concerning factors that can predict the likelihood of driving under the influence of cannabis. The present study aims to determine the past year prevalence of driving under the influence of cannabis, and of being a passenger in a vehicle driven by a person under the influence of cannabis, as well as to examine the correlations with a broad range of potential risk factors. A total of 2500 people, aged between 14 and 70 and living in Castille and Leon (Spain), were surveyed in 2004 with regard to their consumption of alcohol and illicit drugs. Among those who reported cannabis use in the previous year, further assessment was carried out. 15.7% of those surveyed reported cannabis consumption in the previous 12 months, of whom 9.7% reported driving a vehicle under the influence of cannabis during this period, on average eight times. One out of five (19.9%) reported being a passenger in a vehicle driven by a person under the influence of cannabis, on average five times in the previous 12 months. The predictors of driving under the influence of cannabis were the population size of community, the number of drugs consumed, reference to cannabis-related problems and to being a passenger in a vehicle driven by a person under the influence of alcohol. The data show that cannabis consumption and driving is common, and requires more attention from policy makers.     

Role of drugs and alcohol in impaired drivers and fatally injured drivers in the Strathclyde police region of Scotland, 1995–1998

During the 4-year study period, 1995–1998, the Department of Forensic Medicine and Science, University of Glasgow received a total of 752 biological samples from drivers suspected of driving under the influence of drink and/or drugs in the Strathclyde region of Scotland. The majority of samples were blood and had been primarily obtained from males. Drugs were detected in 68 and 90% of blood and urine samples, respectively. Toxicological analyses revealed that cannabis was the most frequently encountered illegal drug which was detected in 39% of all drug positive blood samples. Benzodiazepines were detected in the majority of drug positive samples with 82% containing at least one member of this group. Polydrug use was prevalent, with the average number of drugs detected per sample increasing from 2.0 in 1995 to 3.1 in 1998. For comparison, the results of toxicological analyses from 151 fatally injured drivers are described. Although the majority of samples tested negative for the presence of drugs and alcohol, drugs were found to be present in 19% and alcohol was detected in 33%. As the majority of drugs had been prescribed or administered post-accident, this study shows that alcohol was the main causative factor conducive to fatal road traffic accidents.     

上海市浦东新区1050例涉嫌酒后驾驶鉴定的统计分析

目的通过对上海市浦东新区2008年1050例道路交通违章、事故酒精检案特点分析，为减少和防止交通事故的发生提供有力的参考信息。方法在Excel表中对肇事者性别、年龄、出事日期、时间以及对肇事者血液中乙醇质量浓度（BAC）等作统计分析。结果酒后驾车中男性明显多于女性，年龄以20～50岁居多。事故发生在20：00～22：00最多．以郊区主干道为主。1050例酒精检案中，BAC检测结果14．19％为阴性，2．00％酒精含量未超出法定范围，11．14％为酒后驾车，72．48％为醉酒驾车。结论2008年上海市浦东新区酒后违章、事故案例具有明显的分布特征，可为酒后驾驶的及时监测及制定有效预防措施提供依据。     

Drugs and alcohol consumption amongst Spanish drivers.

We have analysed patterns of alcohol and regular drug consumption by Spanish drivers. Six hundred and seventy five properly completed questionnaires were received from drivers attending three medical traffic centres in Valladolid (Spain) for medical examination prior to obtaining or renewing their driving licence in 1990. Among those surveyed, 24% were 'daily' drinkers and 56.7% were 'weekly' drinkers, the majority (55.5%) being 'light' drinkers (1-39 g/day of pure alcohol). Of those surveyed 28.9% took drugs. The most commonly consumed drugs were analgesics (6.5%), anti-allergic drugs (5.2%) and oral contraceptives (4.6%). Of those drivers taking drugs 28.2% were 'daily' drinkers and 53.8% were 'weekly' drinkers. The study indicates widespread consumption of alcohol and drugs by Spanish drivers.     

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).