Poulsen Helen, Moar Rosemary, Pirie Ruth
Environmental Science and Research, Porirua, New Zealand.
Environmental Science and Research, Porirua, New Zealand.
Accid Anal Prev. 2014 Jun;67:119-28. doi: 10.1016/j.aap.2014.02.019. Epub 2014 Mar 2.
Over a period of five years, blood samples were taken from 1046 drivers killed as a result of a motor vehicle crash on New Zealand roads. These were analysed for the presence of alcohol and a range of both illicit drugs and psychoactive medicinal drugs. Driver culpability was determined for all crashes. The control group of drug- and alcohol-free drivers comprised 52.2% of the study population. Drivers positive for psychoactive drugs were more likely to be culpable (odds ratio (OR) 3.5, confidence interval (CI) 95% 2.4-5.2) than the control group. Driver culpability exhibited the expected positive association with alcohol use (OR 13.7, 95% CI 4.3-44) and with combined alcohol and cannabis use (OR 6.9, 95% CI 3.0-16). There was only a weak positive association between cannabis use (with no other drug) and culpability (OR 1.3, CI 95% 0.8-2.3). Furthermore, the OR for drivers with blood tetrahydrocannabinol (THC) concentrations greater than 5 ng/mL was lower (OR 1.0, CI 95% 0.4-2.4) than drivers with blood THC concentrations less than 2 ng/mL (OR 3.1, CI 95% 0.9-10). This is inconsistent with results reported by other studies where a significant increase in crash risk was found with blood THC levels greater than 5 ng/mL. In this study, there were very few drivers who had used a single drug, other than cannabis or alcohol. Therefore, from this study, it is not possible to comment on any relationship between opioid, stimulant or sedative drug use and an increased risk of being killed in a crash for the drivers using these drugs. The results from a multivariate analysis indicate that driver gender, age group and licence status, (P=0.022, P=0.016, P=0.026, respectively), the type of vehicle being driven (P=0.013), the number of vehicles in the crash (P<0.001), the blood alcohol concentration of the driver (P<0.001) and the use of any drug other than alcohol and cannabis (P=0.044), are all independently associated with culpability.
在五年时间里，从新西兰道路上因机动车碰撞事故死亡的1046名司机身上采集了血样。对这些血样进行了酒精以及一系列非法药物和精神活性药物的检测。确定了所有事故中司机的责任归属。未使用药物和酒精的司机对照组占研究人群的52.2%。与对照组相比，精神活性药物检测呈阳性的司机更有可能负有责任（优势比（OR）为3.5，95%置信区间（CI）为2.4 - 5.2）。司机责任与酒精使用（OR为13.7，95% CI为4.3 - 44）以及酒精和大麻联合使用（OR为6.9，95% CI为3.0 - 16）之间呈现出预期的正相关。大麻使用（未使用其他药物）与责任之间仅有微弱的正相关（OR为1.3，95% CI为0.8 - 2.3）。此外，血液中四氢大麻酚（THC）浓度大于5 ng/mL的司机的OR（OR为1.0，95% CI为0.4 - 2.4）低于血液中THC浓度小于2 ng/mL的司机（OR为3.1，95% CI为0.9 - 10）。这与其他研究报告的结果不一致，其他研究发现血液中THC水平大于5 ng/mL时碰撞风险显著增加。在本研究中，除大麻或酒精外，使用单一药物的司机极少。因此，从本研究中无法评论使用阿片类药物、兴奋剂或镇静药物与使用这些药物的司机在碰撞中死亡风险增加之间的任何关系。多变量分析结果表明，司机性别、年龄组和驾照状态（分别为P = 0.022、P = 0.016、P = 0.026）、所驾驶车辆类型（P = 0.013）、事故中的车辆数量（P < 0.001）、司机的血液酒精浓度（P < 0.001）以及酒精和大麻以外任何药物的使用（P = 0.044），均与责任独立相关。
