Oslo University Hospital, Department of Forensic Sciences, P.O. Box 4950 Nydalen, NO-0424 Oslo, Norway; University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, P.O box 1171 Blindern, NO-0318 Oslo, Norway.
Oslo University Hospital, Department of Forensic Sciences, P.O. Box 4950 Nydalen, NO-0424 Oslo, Norway; University of Oslo, Faculty of Medicine, Institute of Health and Society, Department of Nursing Science, P.O. Box 1130 Blindern, NO-0318 Oslo, Norway.
Accid Anal Prev. 2019 Oct;131:191-199. doi: 10.1016/j.aap.2019.06.014. Epub 2019 Jul 12.
Fatal road traffic crashes are often related to speeding, non-use of a seatbelt, and alcohol/drug-impaired driving. The aim of this study was to examine associations between driving under the influence of drugs and/or alcohol and driver-related risk factors that have been reported as significantly contributing causes of fatal road traffic crashes. The data were extracted from Norwegian road traffic crash registries and forensic toxicology databases. Drug/alcohol investigated car and van drivers and motorcycle riders fatally injured in road traffic crashes in Norway during 2005-2015 were included in this study (n = 772). Drug and alcohol concentrations corresponding to 0.5 g/kg alcohol in blood were used as the lower limits for categorising drivers/riders as impaired; 0.2 g/kg was the upper limit for being categorised as sober. Associations between driver-related risk factors and impairment from specific substance groups were calculated using multivariable logistic regression, adjusted for other substance groups, age, and sex, and were reported when the confidence intervals did not contain the value 1 or lower. Substances found in concentrations above the impairment limits were mainly alcohol (20%), medicinal drugs (10%: benzodiazepines, opioids, z-hypnotics), stimulants (5%: amphetamines, methylphenidate, and cocaine), and cannabis (4%: THC). The drug/alcohol-impaired drivers had compared to the sober drivers more often been speeding (68% versus 32%), not used a seatbelt (69% versus 30%), and been driving without a valid driver license (26% versus 1%). Logistic regression analysis showed that impairment from alcohol or stimulants (mainly amphetamines) was associated with all three risk factors, medicinal drugs with all except speeding, and impairment from cannabis (THC) with not having a valid driver license. Among motorcycle riders, drug/alcohol impairment was associated with not having a valid driver license and non-use of a helmet. At least one of the risk factors speeding, non-use of a seatbelt/helmet, and driving without a valid license were present among the vast majority of the drug/alcohol-impaired fatally injured drivers and riders, and also among more than half of the fatally injured sober drivers.
致命的道路交通事故通常与超速、不系安全带和酒后/毒后驾驶有关。本研究的目的是检验药物和/或酒精影响下的驾驶与已被报道为造成致命道路交通事故的重要原因的驾驶员相关风险因素之间的关联。数据来自挪威道路交通事故登记处和法医毒理学数据库。本研究纳入了 2005 年至 2015 年期间在挪威因道路交通事故致命受伤的汽车和厢式货车驾驶员及摩托车骑手（n=772），并对其进行药物和酒精检测。血液中 0.5g/kg 酒精对应的浓度被用作将驾驶员/骑手归类为受影响的下限；0.2g/kg 为归类为清醒的上限。使用多变量逻辑回归计算了特定物质组的驾驶员相关风险因素与损伤之间的关联，并对其他物质组、年龄和性别进行了调整，并在置信区间不包含 1 或更低的值时报告了关联。在损伤限制浓度以上发现的物质主要是酒精（20%）、药用药物（10%：苯二氮䓬类、阿片类、唑催眠药）、兴奋剂（5%：安非他命、哌甲酯和可卡因）和大麻（4%：THC）。与清醒的驾驶员相比，药物/酒精影响下的驾驶员更经常超速（68%比 32%）、不系安全带（69%比 30%）、且无有效驾驶执照（26%比 1%）。逻辑回归分析表明，酒精或兴奋剂（主要是安非他命）的损伤与所有三个风险因素相关，药用药物与除超速外的所有因素相关，而大麻（THC）的损伤与无有效驾驶执照相关。在摩托车骑手方面，药物/酒精损伤与无有效驾驶执照和不使用头盔有关。在受药物/酒精影响而致命受伤的驾驶员和骑手当中，绝大多数都至少存在一个风险因素（超速、不系安全带/头盔、无有效驾照），在致命受伤的清醒驾驶员当中，也有超过一半的人至少存在一个风险因素。
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