The incidence of drugs in drivers killed in Australian road traffic crashes

The incidence of alcohol and drugs in fatally injured drivers were determined in three Australian states; Victoria (VIC), New South Wales (NSW) and Western Australia (WA) for the period of 1990-1999. A total of 3398 driver fatalities were investigated which included 2609 car drivers, 650 motorcyclists and 139 truck drivers. Alcohol at or over 0.05 g/100ml (%) was present in 29.1% of all drivers. The highest prevalence was in car drivers (30.3%) and the lowest in truckers (8.6%). WA had the highest rate of alcohol presence of the three states (35.8%). Almost 10% of the cases involved both alcohol and drugs. Drugs (other than alcohol) were present in 26.7% of cases and psychotropic drugs in 23.5%. These drugs comprised cannabis (13.5%), opioids (4.9%), stimulants (4.1%), benzodiazepines (4.1%) and other psychotropic drugs (2.7%). 8.5% of all drivers tested positive for Delta(9)-tetrahydrocannabinol (THC) and the balance of cannabis positive drivers were positive to only the 11-nor-Delta(9)-tetrahydrocannabinol-9-carboxylic acid (carboxy-THC) metabolite. The range of THC blood concentrations in drivers was 0.1-228 ng/ml, with a median of 9 ng/ml. Opioids consisted mainly of morphine (n=84), codeine (n=89) and methadone (n=33), while stimulants consisted mainly of methamphetamine (n=51), MDMA (n=6), cocaine (n=5), and the ephedrines (n=61). The prevalence of drugs increased over the decade, particularly cannabis and opioids, while alcohol decreased. Cannabis had a larger prevalence in motorcyclists (22.2%), whereas stimulants had a much larger presence in truckers (23%).     

Blood alcohol in fatally injured drivers and the minimum legal drinking age

Although most research on the effect of minimum legal drinking age (LDA) laws on proxies for alcohol-related fatalities find effects of higher LDAs in reducing such fatalities, recent research that supposedly controls for drinking experience claims that higher LDAs have little or no effect. This study examines the actual amount of alcohol in the blood of fatally injured drivers per licensed driver in states where more than 80 percent of such drivers were tested for alcohol and where licensure data were available for the period 1982-1986. The involvement of alcohol in fatal crashes increases with age as the LDA is approached. A higher LDA is associated with fewer alcohol-related crashes among those younger than the LDA. No effect of drinking experience was evident, but this study finds an age-related bias in previously used proxies for alcohol involvement that results in overestimates of alcohol levels in younger drivers.     

Alcohol and drugs in drivers fatally injured in traffic accidents in Sweden during the years 2000-2002

During the years 2000-2002, alcohol, pharmaceuticals and illicit drugs were analysed in blood samples from fatally injured drivers in Sweden. The total number of drivers was 920 and in 855 of these, corresponding to 93%, a toxicological investigation was performed. About 85% of the drivers were men and 15% were women. All but three women (96%) were car drivers while the corresponding figure for men was about 78% and about 13% were motorcyclists. The number of positive cases increased from 38.9% in year 2000 to 45.9% in year 2002 and alcohol was the most common drug with frequencies of 19.8%, 25.0% and 21.8% for the studied years 2000, 2001 and 2002, respectively. The median blood alcohol concentration ranged from 1.6 to 2.0mg/mL for men and from 1.2 to 1.8 mg/mL for women. There was a decrease in cases where alcohol was the only drug detected, from 52 out of 58 cases (90%) in year 2000 to 41 out of 61 cases (67%) in 2002. At the same time there was an increase, from 5.4% to 10.0% of illicit drugs, mainly amphetamine, and the cases with multiple drug intake increased from 10% to 26%. The prevalence of pharmaceuticals as the only drug or drugs detected decreased from 14.0% to 10.4% and in the majority of these cases the drug concentrations were within the therapeutic range.     

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.     

A large-scale study of the relationship between blood and breath alcohol concentrations in New Zealand drinking drivers

Blood alcohol concentrations (BAC) and corresponding breath alcohol concentrations (BrAC) were determined for 21,582 drivers apprehended by New Zealand police. BAC was measured using headspace gas chromatography, and BrAC was determined with Intoxilyzer 5000 or Seres Ethylometre infrared analysers. The delay (DEL) between breath testing and blood sampling ranged from 0.03 to 5.4 h. BAC/BrAC ratios were calculated before and after BAC values were corrected for DEL using 19 mg/dL/h as an estimate of the blood alcohol clearance rate. Calculations were performed for single and duplicate breath samples obtained using the Intoxilyzer (groups I-1 and I-2) and Seres devices (groups S-1 and S-2). Before correction for DEL, BAC/BrAC ratios for groups I-1, I-2, S-1, and S-2 were (mean+/-SD) 2320+/-260, 2180+/-242, 2330+/-276, and 2250+/-259, respectively. After BAC values were adjusted for DEL, BAC/BrAC ratios for these groups were (mean+/-SD) 2510+/-256, 2370+/-240, 2520+/-280, and 2440+/-260, respectively. Our results indicate that in New Zealand the mean BAC/BrAC ratio is 19-26% higher than the ratio of the respective legal limits (2000).     

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.     

Drugs and chronic alcohol abuse in drivers

Blood specimens from 210 drivers (179 male and 31 female) apprehended in Luxembourg from autumn 2001 to spring 2002 and requested for the determination of their blood alcohol concentration (BAC) were tested for medicinal drugs, illicit drugs, and chronic alcohol abuse (by quantification of the carbohydrate-deficient transferrin: CDT). These additional analyses were performed anonymously and with permission of state prosecutor. The 22.8% had consumed medicinal drugs, with benzodiazepines and antidepressants (10.9 and 7.6%, respectively) as main psychoactive classes. Cannabis was the most detected illicit drug (9.5%) but only one in three had THC detectable in their blood. Association of two or more psychoactive substances (poly-drug use) was observed in 27.6% of drivers (90.6% of drug consumers). On the basis of CDT values, 29.5% of drivers investigated were assumed to be chronic alcohol abusers. Statistical analysis revealed that chronic alcohol abuse and medicinal psychoactive drugs were associated with significantly higher BAC. Medicinal psychoactive drugs were clearly associated with poly-drug use, and were furthermore detected at supra-therapeutic levels in 34.9%.     

交通事故中摩托车司乘人员致伤方式分析

通过对3例摩托车交通事故中司乘人员的损伤特征及车辆痕迹的检验结果比对,分析事故过程中摩托车司乘人员的运动过程及致伤方式,发现因其位置、姿势和应激状态不同,摩托车驾驶位乘员与后座乘员在碰撞、运动过程中损伤形成不同,其人体成伤机制、部位及程度与车辆相关部位的损害痕迹可以相互佐证,对于推断摩托车司乘人员的行为方式(谁是摩托车驾驶员)具有重要价值。进一步总结此类事故鉴定的共同特点,可为事故责任认定提供参考。     

两轮摩托车道路交通事故驾驶员损伤特点的观察

目的 观察两轮摩托车驾驶员发生道路交通事故时的损伤形成规律,探讨此类事故确定驾驶人员的法医学依据。方法 对2000年至2002年北京地区408例2人同乘一辆两轮摩托车发生事故造成摩托车人员伤亡的损伤情况进行回顾性研究。结果 两轮摩托车发生道路交通事故时,在驾驶员腹部、会阴部、大腿内侧、胸部、面颈部、小腿胫前会形成能反应摩托车特定致伤部件的特征性损伤,而乘员在这些部位的损伤多为摔跌形成,难以反应摩托车特定部件的特征。结论 在两轮摩托车道路交通事故中,伤者身上反应的摩托车特定部件的特征性损伤,可作为判断两轮摩托车道路交通事故驾驶员的依据。     

Injuries of the occipital condyles in fatal traffic accidents

Among 600 deaths of traffic accidents we found injuries of the occipital condyles in 10 cyclists, 12 car drivers and 3 pedestrians. In most cases the collision speed ranged from 70 to 100 km/h. In 18 cases of direct head impact the more severe injury was on the opposite side, in 4 cases of indirect side impact (whiplash injury) on the same side. Most types of fractures were 12 horizontal disconnections and 4 fractures of the inner edges. In 9 cases the condyle fractures were on one side, in 16 cases on both sides.     

道路交通事故法医检验技术的研究进展

近年来,经济快速发展和机动车数量急剧增多,道路交通事故频发和伤亡人数不断上升已经成为备受关注的全球性问题。法医检验作为交通事故处理中重要的证据,其鉴定意见直接影响着当事方的权益和事故处理。不容置疑,法医检验技术的运用对鉴定意见有十分重要的影响作用。本文对国内外法医检验技术的最新研究进展和应用进行综述,供同行实践工作中参考。     

Drug and alcohol involvement in railroad accidents

Postaccident testing of railroad employees for drugs and alcohol was performed in 175 qualifying accidents or incidents (events) from April 1987 through March 1988. Initial tests for drugs were performed on urine, and for alcohol on blood. Presumptive positives were confirmed and quantitated using both blood and urine when available. In 42 of these events (24%), at least 1 employee tested positive (6.7% of 736 employees) for drugs or alcohol. A higher proportion of drug or alcohol-positive events, or both, 40 versus 21%, was found when a fatality was involved. In 11 of the 32 fully investigated drug or alcohol-positive events (involving 14 employees), the investigating agencies determined that substance use was determined to be a probable cause of, or a factor relating to, the accident. Cannabinoids, ethanol, cocaine, or multiple-drug use were found in 5, 3, 3, and 3 of those employees, respectively. Detectable drug and alcohol use occurs among railroad employees; occasionally it has resulted in accidents.     

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。     

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l％非酒后驾车交通事故73l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&lt;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。     

交通事故颅脑损伤233例法医学鉴定分析

通过对233例交通事故颅脑损伤案例的分析,对受伤者的性别、年龄及损伤程度进行了统计。并对其颅脑外伤后遗症和伤残等级的关系、评定时间及脑外伤后神经功能障碍的认定进行了探讨。     

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.     

上海市道路交通事故受伤人员伤残分析

目的分析道路交通事故伤残的特征,为制定和修改伤残鉴定标准和相关法规提供参考。方法对上海市因道路交通事故受伤,2005年经法医评定构成伤残的案例资料进行回顾性分析。结果伤残部位以肢体最多（53.3%）,其次为头部（23.3%）,脊柱（9.7%）,胸部（5.8%）和腹部（4.4%）。2005年上海市交通事故年累积致残率为414.8/10万,男性（505.7/10万）高于女性（318.7/10万）,以35～59岁的致残率最高（538.2/10万）,60岁以上致残率呈现下降趋势（30.2/10万）。伤残者中交通方式以非机动车最多,其次为行人。结论2005年上海市道路交通伤致残率青壮年（35～59岁）最高,对社会经济和劳动力损失大。