Lowenstein S R, Koziol-McLain J
Division of Emergency Medicine, Department of Surgery, University of Colorado Health Sciences Center, 4200 E. 9th Avenue, Box B215, Denver, CO 80262, USA.
J Trauma. 2001 Feb;50(2):313-20. doi: 10.1097/00005373-200102000-00019.
Alcohol is a contributing factor in a large proportion of traffic crashes. However, the role of other drugs is unknown. The objectives of this study are to determine the prevalence of recent drug use among drivers injured in traffic crashes, and to determine the extent to which drugs are responsible for crashes.
We studied 414 injured drivers who presented to an urban emergency department within 1 hour of their crash. Demographic and injury data were collected from medical records. Urine toxicologic assays were conducted for legal and illegal drugs. Traffic crash reports were analyzed for crash responsibility by a trained crash reconstructionist. The causal role of drugs in traffic crashes was measured by comparing drug assay results in drivers judged responsible for their crashes (cases) and those not responsible (controls). Odds ratios and 95% confidence intervals (CIs) were calculated.
Thirty-two percent (95% CI = 27-37) of the urine samples were positive for at least one potentially impairing drug. Marijuana was detected most frequently (17%), surpassing alcohol (14%). Compared with drug- and alcohol-free drivers, the odds of crash responsibility were higher in drivers testing positive for alcohol alone (odds radio [OR] = 3.2, 95% CI = 1.1-9.4) and in drivers testing positive for alcohol in combination with other drugs (OR = 3.5, 95% CI = 1.2-11.4). Marijuana alone was not associated with crash responsibility (OR = 1.1, 95% CI = 0.5-2.4). In a multivariate analysis, controlling for age, gender, seat belt use, and other confounding variables, only alcohol predicted crash responsibility.
Alcohol remains the dominant drug associated with injury-producing traffic crashes. Marijuana is often detected, but in the absence of alcohol, it is not associated with crash responsibility.
酒精是导致很大一部分交通事故的一个因素。然而，其他药物所起的作用尚不清楚。本研究的目的是确定在交通事故中受伤的驾驶员近期药物使用的流行情况，并确定药物对交通事故的责任程度。
我们研究了414名在事故发生后1小时内前往城市急诊科就诊的受伤驾驶员。从医疗记录中收集人口统计学和损伤数据。对合法和非法药物进行尿液毒理学检测。由一名训练有素的事故重建专家分析交通事故报告以确定事故责任。通过比较判定对其事故负责的驾驶员（病例）和不负责的驾驶员（对照）的药物检测结果，来衡量药物在交通事故中的因果作用。计算优势比和95%置信区间（CI）。
32%（95%CI = 27 - 37）的尿液样本至少对一种可能产生损害的药物呈阳性。大麻检测频率最高（17%），超过了酒精（14%）。与未使用药物和酒精的驾驶员相比，仅酒精检测呈阳性的驾驶员（优势比[OR] = 3.2，95%CI = 1.1 - 9.4）以及酒精与其他药物联合检测呈阳性的驾驶员（OR = 3.5，95%CI = 1.2 - 11.4）发生事故责任的几率更高。仅大麻与事故责任无关（OR = 1.1，95%CI = 0.5 - 2.4）。在多变量分析中，控制年龄、性别、安全带使用情况和其他混杂变量后，只有酒精可预测事故责任。
酒精仍然是与导致人员受伤的交通事故相关的主要药物。大麻经常被检测到，但在没有酒精的情况下，它与事故责任无关。
