Romano Eduardo, Voas Robert B, Camp Bayliss
PIRE, United States.
Research & Development California Department of Motor Vehicles, CA, United States.
Accid Anal Prev. 2017 Nov;108:37-43. doi: 10.1016/j.aap.2017.08.003. Epub 2017 Sep 6.
There is a growing interest in how extensively the use of marijuana by drivers relates to crash involvement. While cognitive, lab-based studies are consistent in showing that the use of cannabis impairs driving tasks, epidemiological, field-based studies have been inconclusive regarding whether cannabis use causes an increased risk of accidents. There is ample evidence that the presence of cannabis among drivers with a BAC≥0.08g/dL highly increases the likelihood of a motor vehicle crash. Less clear, however, is the contribution of cannabis to crash risk when drivers have consumed very little or no alcohol. This effort addresses this gap in knowledge. We took advantage of a unique database that merged fatal crashes in the California Statewide Integrated Traffic Records System (SWITRS) and the Fatality Analysis Reporting System (FARS), which allows for a precise identification of crash responsibility. To account for recent increase in lab testing, we restricted our sample to cover only the years 1993-2009. A total of 4294 drivers were included in the analyses. Descriptive analyses and logistic regressions were run to model the contribution of alcohol and drugs to the likelihood of being responsible in a fatal crash. We found evidence that compared with drivers negative for alcohol and cannabis, the presence of cannabis elevates crash responsibility in fatal crashes among drivers at zero BACs (OR=1.89) and with 0<BAC<0.05g/dL (OR=3.42), suggesting that emphasis on curbing impaired driving should not be solely focused on heavy-drinking drivers. Data limitations however caution about the generalizability of study findings. Special efforts to understand the effect of cannabis on fatal crashes, in particular in the absence of alcohol, are needed.
司机使用大麻的广泛程度与撞车事故的关联正受到越来越多的关注。虽然基于实验室的认知研究一致表明，使用大麻会损害驾驶任务，但基于现场的流行病学研究对于大麻使用是否会增加事故风险尚无定论。有充分证据表明，血液酒精浓度（BAC）≥0.08g/dL的司机体内存在大麻会大幅增加机动车撞车的可能性。然而，当司机饮酒极少或未饮酒时，大麻对撞车风险的影响尚不清楚。本研究旨在填补这一知识空白。我们利用了一个独特的数据库，该数据库整合了加利福尼亚州综合交通记录系统（SWITRS）和死亡分析报告系统（FARS）中的致命撞车事故数据，从而能够精确确定撞车责任。为了考虑近期实验室检测的增加，我们将样本限制在1993年至2009年。共有4294名司机纳入分析。进行了描述性分析和逻辑回归，以模拟酒精和药物对致命撞车事故中责任可能性的影响。我们发现，与酒精和大麻检测呈阴性的司机相比，大麻的存在会增加BAC为零的司机（OR = 1.89）以及0 < BAC < 0.05g/dL的司机在致命撞车事故中的责任（OR = 3.42），这表明对遏制酒驾的关注不应仅局限于重度饮酒的司机。然而，数据限制提醒我们要谨慎对待研究结果的普遍性。需要做出特别努力来了解大麻对致命撞车事故的影响，尤其是在没有酒精的情况下。
