Drummer Olaf H, Gerostamoulos Jim, Batziris Helen, Chu Mark, Caplehorn John, Robertson Michael D, Swann Philip
Department of Forensic Medicine, Victorian Institute of Forensic Medicine, Monash University, 57-83 Kavanagh Street, Vic. 3006, Southbank, Australia.
Accid Anal Prev. 2004 Mar;36(2):239-48. doi: 10.1016/s0001-4575(02)00153-7.
A multi-center case-control study was conducted on 3398 fatally-injured drivers to assess the effect of alcohol and drug use on the likelihood of them being culpable. Crashes investigated were from three Australian states (Victoria, New South Wales and Western Australia). The control group of drug- and alcohol-free drivers comprised 50.1% of the study population. A previously validated method of responsibility analysis was used to classify drivers as either culpable or non-culpable. Cases in which the driver "contributed" to the crash (n=188) were excluded. Logistic regression was used to examine the association of key attributes such as age, gender, type of crash and drug use on the likelihood of culpability. Drivers positive to psychotropic drugs were significantly more likely to be culpable than drug-free drivers. Drivers with Delta(9)-tetrahydrocannabinol (THC) in their blood had a significantly higher likelihood of being culpable than drug-free drivers (odds ratio (OR) 2.7, 95% CI 1.02-7.0). For drivers with blood THC concentrations of 5 ng/ml or higher the odds ratio was greater and more statistically significant (OR 6.6, 95% CI 1.5-28.0). The estimated odds ratio is greater than that for drivers with a blood alcohol concentration (BAC) of 0.10-0.15% (OR 3.7, 95% CI 1.5-9.1). A significantly stronger positive association with culpability was seen with drivers positive to THC and with BAC > or =0.05% compared with BAC > or =0.05 alone (OR 2.9, 95% CI 1.1-7.7). Strong associations were also seen for stimulants, particularly in truck drivers. There were non-significant, weakly positive associations of opiates and benzodiazepines with culpability. Drivers positive to any psychoactive drug were significantly more likely to be culpable (OR 1.8, 95% CI 1.3-2.4). Gender differences were not significant, but differences were apparent with age. Drivers showing the highest culpability rates were in the under 25 and over 65 age groups.
一项针对3398名受致命伤司机的多中心病例对照研究开展，以评估酒精和药物使用对他们应负责任可能性的影响。所调查的车祸来自澳大利亚三个州（维多利亚州、新南威尔士州和西澳大利亚州）。无毒品和酒精的司机组成的对照组占研究人群的50.1%。采用一种先前经验证的责任分析方法将司机分类为应负责任或不应负责任。将司机“导致”车祸的案例（n = 188）排除。采用逻辑回归分析来检验年龄、性别、车祸类型和药物使用等关键属性与应负责任可能性之间的关联。使用精神药物检测呈阳性的司机比未使用药物的司机更有可能应负责任。血液中含有δ-9-四氢大麻酚（THC）的司机比未使用药物的司机应负责任的可能性显著更高（优势比（OR）2.7，95%置信区间1.02 - 7.0）。对于血液中THC浓度为5纳克/毫升或更高的司机，优势比更大且在统计学上更显著（OR 6.6，95%置信区间1.5 - 28.0）。估计的优势比大于血液酒精浓度（BAC）为0.10 - 0.15%的司机（OR 3.7，95%置信区间1.5 - 9.1）。与单独BAC≥0.05%相比，THC检测呈阳性且BAC≥0.05%的司机与应负责任之间存在显著更强的正相关（OR 2.9，95%置信区间1.1 - 7.7）。兴奋剂也呈现出强关联，特别是在卡车司机中。阿片类药物和苯二氮䓬类药物与应负责任之间存在不显著的弱阳性关联。使用任何精神活性药物检测呈阳性的司机更有可能应负责任（OR 1.8，95%置信区间1.3 - 2.4）。性别差异不显著，但年龄差异明显。应负责任率最高的司机在25岁以下和65岁以上年龄组。
