Division of Social and Behavioral Sciences, School of Public Health, University of Memphis, Memphis, Tennessee.
Center for Health System Improvement, College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee.
Traffic Inj Prev. 2023;24(5):379-386. doi: 10.1080/15389588.2023.2188435. Epub 2023 Apr 27.
This study examines contribution of substance use (including alcohol, cannabinoids, stimulants, narcotics, depressants, and hallucinogens) on the probability of drivers being at-fault for a crash on U.S. public roads, with specific emphasis on older adult drivers.
Data from the National Highway Traffic Safety Administration's Fatality Analysis Reporting System (FARS) for the years 2010-2018 were employed for 87,060 drivers (43,530 two-vehicle crash pairs) involved in two moving vehicle crashes. The quasi-induced exposure (QIE) method was used to compute the relative crash involvement ratios (CIRs) for each relevant substance and illicit drug. Mixed-effect generalized linear regression models were fit to examine the effect of substance use on the probability of a driver being at-fault for a crash.
There were 75.51% males and 73.88% Non-Hispanic Whites in our sample. The CIR for those aged 70-79 years was 1.17, and more than double (2.56) for the ≥80 years old drivers, while being relatively low among drivers of ages 20 to 69. Substance use, in general, disproportionately increased the probability of being at-fault during a crash, regardless of driver's age. Though older drivers are less likely than other age groups to report substance use, presence of substances among older drivers increased the probability of their being at-fault two to four times during a crash across almost all substances. The regression models, after adjusting for driver's sex, road grade, weather, light conditions, distraction, and speeding at time of crash, revealed that older drug-impaired drivers were twice as likely to be at fault in a fatal crash (aOR = 1.947; 95% CI = 1.821, 2.082; <0.0001) compared to their middle-aged counterparts. Similarly, most substance use categories were responsible for the probabilities of higher CIRs among the drivers.
These findings necessitate continued efforts to bring awareness to the deadly consequences of "drugged driving," especially among older adult drivers.
本研究考察了物质使用（包括酒精、大麻类药物、兴奋剂、麻醉剂、镇静剂和迷幻剂）对美国公共道路上驾驶员事故责任概率的影响，重点关注老年驾驶员。
使用国家公路交通安全管理局的伤亡分析报告系统（FARS）在 2010 年至 2018 年期间的数据，对涉及 87060 名驾驶员（43530 对两车事故对）的 87060 名驾驶员（43530 对两车事故对）进行了调查。采用准诱发暴露（QIE）法计算每种相关物质和非法药物的相对碰撞卷入率（CIR）。混合效应广义线性回归模型用于检验物质使用对驾驶员发生碰撞事故责任概率的影响。
样本中男性占 75.51%，非西班牙裔白人占 73.88%。70-79 岁年龄组的 CIR 为 1.17，≥80 岁年龄组的 CIR 则超过两倍（2.56），而 20-69 岁年龄组的 CIR 相对较低。一般来说，物质使用会不成比例地增加驾驶员在碰撞事故中的过错概率，而不论驾驶员的年龄大小。尽管老年驾驶员比其他年龄组更不可能报告物质使用，但在几乎所有物质中，老年驾驶员体内存在物质会使他们在碰撞事故中承担责任的概率增加两到四倍。在调整了驾驶员性别、道路坡度、天气、光线条件、分心和碰撞时超速等因素后，回归模型显示，与中年驾驶员相比，老年药物损害驾驶员在致命碰撞事故中承担责任的可能性增加了两倍（OR = 1.947；95%CI = 1.821，2.082；<0.0001）。同样，大多数物质使用类别也导致了驾驶员 CIR 更高的概率。
这些发现需要继续努力，让人们意识到“毒驾”的致命后果，尤其是在老年驾驶员中。
