In 2004, 4,008 motorcyclists were killed and an additional 76,000 were injured in traffic crashes (NHTSA Traffic Safety Facts, 2004). Motorcyclist fatalities have been steadily increasing since 1997, when 2,116 fatalities were recorded. It is apparent that alcohol use continues to be a significant problem in motorcycle crashes. In fatal crashes in 2004, motorcycle operators had higher blood alcohol concentration (BAC) levels ( .08 grams per deciliter [g/dL] or higher) as compared to other types of motor-vehicle operators. The percentages for vehicle operators involved in fatal crashes were 27 percent for motorcycles, 22 percent for passenger cars, 21 percent for light trucks, and 1 percent for large trucks. In 2004, there were 1,264 motorcycle operators killed who had been drinking (BAC .01+), of whom 1,025 (81%) were intoxicated (BAC .08+). Drinking and driving has been researched extensively, and the association between drivers' BAC and crash risk is well-understood. On the other hand, there is insufficient research to understand the effects of BAC on motorcycle operation, which is very different from automobile operation due to issues of balance, coordination, and vulnerability. Though there are BAC data available for some crash-involved riders, there are essentially no data available on the incidence of alcohol involvement in the on-road motorcycle-riding population. The National Highway Traffic Safety Administration sponsored a project to investigate alternative methodological approaches for determining: (1) the relative risk of alcohol impaired motorcycle riders being involved in a crash and, (2) rider impairment at different BAC levels. This project was conducted in two steps: first by reviewing the literature, and second, by inviting a panel of national experts in alcohol and field data collection to a workshop to discuss, compare, contrast, and rate various methods of data collection. The results of this project are reported in two volumes: * Volume I: Synthesis Report on Alternative Approaches with Priorities for Research – This report summarizes the project findings, including a detailed account of information discussed at an expert panel workshop convened for this project. Among the topics discussed at the workshop were the advantages, disadvantages, scientific validity, and costs related to each alternative methodology. In addition, each methodology was prioritized as to its future research potential. * Volume II: Literature Review Report – This report discusses past research on impaired motorcycle operation, past research methodologies used to understand alcohol’s effects on human performance, and methodologies used to measure exposure in populations-at-risk. This report was provided to panel participants in support of the expert panel meeting. Two appendices are included. The first contains detailed descriptions of documents referenced in the report. The second contains detailed descriptions of documents reviewed for the report, but not referenced. A literature search was performed that focused on: (1) past research on impaired motorcycle operation; (2) past research methodologies used to understand alcohol’s effects on human performance, including laboratory simulation, closed-course operation, self-report surveys, crash investigation, and analysis of archival crash data; and (3) methodologies used to measure exposure in populations-at-risk, including roadside surveys. The literature review revealed a dearth of relevant research on impaired motorcycle operation. The most significant problem identified was the lack of scientifically valid information on BAC levels among on-road non-crash-involved motorcycle riders (i.e., the motorcycling population at risk). A total of 143 reports and Web sites were reviewed for this project; 61 of these are cited in the Reference sections of Volumes I and II, and described in detail in Appendix A. Appendix B provides detailed descriptions of documents reviewed but not cited in either Volume I or Volume II of this report. In addition, an in-house study of fatal motorcycle crashes was also conducted and discussed in this report. An expert panel was assembled. Panel members were specialists in motorcycle safety, alcohol, and survey research, as well as law enforcement and other related fields. For each methodology under consideration, advantages, disadvantages, cost, and other issues were discussed. At the end of discussion, panellists provided their personal opinions as to which methodologies should be considered the highest priority for future research, based on feasibility and validity of the research methodologies. The following methodologies were considered as being potentially capable of contributing to a better understanding of crash risk and alcohol impairment among motorcycle operators. Some of the methodologies listed provide data from crashes. Some provide comparison data from the population at risk. Some would provide both. Most would require collecting new data, though the last method listed could be done with existing data. - Studies Providing Data on the Impairing Effects of Alcohol. * Simulation Study— Using a laboratory-based motorcycle simulator with alcohol-dosed subjects, impairment can be determined by comparing performance of each rider at various positive BAC levels. Performance at different BAC levels are compared to the same rider’s performance when sober (.00 BAC) on different measures, such as rider balance, steering control and other rider tasks. * Closed-Course Study— Alcohol-dosed subjects would ride a motorcycle at low speeds on a closed (off-road) course outdoors. Performance of riders at various BAC levels would be measured and compared to their performance at the .00 g/dL BAC level. - Field Studies Providing Both Crash and Comparison Data. * Contemporary Case Control— Data associated with crashes (including BACs of riders) is recorded and compared to similar data from non-crash-involved riders at or near the same location as the crash. Factors such as time of day and day of week would be matched carefully between crash and comparison cases. * Cohort Study— A sample of riders would be selected and alcohol use (e.g., BAC while riding) would be recorded over time, under naturalistic riding conditions along with data on any crashes that occur. Data would be collected using an instrumented motorcycle (to obtain BAC data, etc.) and other methods, including surveys and diaries. * Emergency Department— Similar to Contemporary Case Control study except that the interview with the crash-involved rider and BAC testing take place at a hospital. * Survey Study— Traditional survey techniques (e.g., phone, mail, or in-person surveys) would be used to collect self-reported data from riders concerning alcohol use and crash histories. Survey respondents would answer questions about past drinking and riding incidents which may or may not have resulted in a crash. Height, weight, gender, and number of drinks consumed would be used to estimate BAC of riders during these drinking and riding incidents. Crash risk would be determined from these self-reports. - Studies Providing Crash Case Data. * Fatal Crash Records— BAC data from motorcycle rider cases in the Fatality Analysis Reporting System (FARS) would be obtained and compared to BAC data from motorcycle population-at-risk (exposure) data from a different source. Injury Crash Records— BAC data on motorcycle riders from hospital records of motorcycle nonfatal injury crashes would be compared to population-at-risk data from a different source. - Studies Providing Comparison Data. * Geo-General Comparison Data— Population-at-risk BAC data would come from general roadside surveys of motorcyclists, not from specific sites of previous crashes. Crash data would come from a different source (e.g., FARS). * Geo-Specific Comparison Data— Population-at-risk BAC data would be collected from visits to specific sites of previous motorcycle crashes found in archival data, such as FARS, which serves as the crash data source. * Fuel Station Survey— This would be similar to the roadside collection of BAC and other data except that the survey takes place when riders stop to refuel. Data is then compared to data from another source (e.g., FARS). - Study Using Existing Data for Crash and Comparison Cases. * Induced Exposure— Using archival data (e.g., FARS), the BACs of crash-involved riders deemed not to be at fault would be used for the population-at-risk and compared to BAC data for at- fault riders. Based on input from the expert panel, each methodology was assigned to one of the three following cost categories: Low Cost = <$250K, Medium Cost = $250K-$500K, and High Cost = >$500K. Within each of these cost categories, methodologies were assigned to one of three levels of scientific validity (high, medium, and low), that is, the expected scientific validity of findings from the methodologies, given the barriers to collection of complete and accurate data. The assessment of scientific validity was determined by the contractor’s project team, based on input from the expert panel, results of the literature review, and past experience of the project team. With some exceptions, the methodologies rated highest for scientific validity were considered to be highest priority within their cost categories. Assigning priorities within cost categories will make it possible to select different promising methodologies depending on the funds available for future research. In one case, a methodology that would be highly valid scientifically (the cohort study) was rated a low priority because it would likely be so costly and time consuming as to be prohibitive to conduct. In another case, a methodology of relatively low scientific validity (induced exposure) was given a high priority by the project team because it would likely be very inexpensive to conduct. The authors point out that the cost categories are fairly broad, and that relative priorities could change as more exact cost information for each methodology becomes known. The highest priority methodologies determined by the project team are as follows: *Lowest Cost Category— Simulation, Induced Exposure *Medium Cost Category— None *Highest Cost Category— Contemporary Case Control Medium Priority Methodologies *Lowest Cost Category— Closed-Course Study *Medium Cost Category— Fuel Station Survey paired with Fatal Crash Records, Fuel Station Survey paired with Injury Crash Records *Highest Cost Category— Emergency Department, Geo-Specific paired with Fatal Crash Records The lowest Priority Methodologies determined by the project team are as follows: *Lowest Cost Category— None *Medium Cost Category— Survey Study *Highest Cost Category— Geo-General paired with Fatal Crash Records, Cohort Study Compared to drinking and driving, relatively little is known about the effects of alcohol on motorcycle operation. There are many methodologies that could be used to better understand these effects, each with its own set of advantages, disadvantages, and issues to be considered. None of the methodologies considered as part of this project were completely ruled out by the project team, although three methodologies were deemed highest priority: the Simulation and Induced Exposure studies, from the low-cost category, and the Contemporary Case Control study from the highest cost category. This is the second volume of a two-volume report entitled “Methodology for Determining Motorcycle Operator Crash Risk and Alcohol Impairment.” Volume I of this report is a “Synthesis Report on Alternative Approaches With Priorities for Research.” The continuing concern with the high level of motorcycle fatalities led to a recent collaboration between the Motorcycle Safety Foundation and the National Highway Traffic Safety Administration to support a nationally selected Technical Working Group tasked with creating a National Agenda for Motorcycle Safety (NAMS). This document provides a blueprint for possible motorcycle safety activities for the next decade. The authors of the NAMS noted the continuing problem of alcohol in motorcycle crashes and recommended that a study of the alcohol, drug, and other substance abuse patterns of motorcyclists should be conducted. Such a study should not be limited to those injured or killed, but should include all riders in the population at risk (NAMS, 2000). The NAMS noted that it is not known at what blood alcohol levels motorcycle-specific skills are impaired. Based in part on the findings from the NAMS document, NHTSA awarded a contract to the Pacific Institute for Research and Evaluation (PIRE) and the Head Protection Research Laboratory (HPRL) to determine the current state of knowledge regarding the crash risk of alcohol-impaired motorcycle operation and make recommendations for a research program to address that problem. A key element of the award was organizing a workshop of experts to review research needs and opportunities and make recommendations for studies needed to better determine rider crash-risk and impairment related to alcohol consumption. This report contains key background information provided to participants attending the workshop. This literature review was conducted to help the contractor’s project team and the expert panel: *Review what is known about the relationship of alcohol to motorcycle crashes. *Determine the limits of our knowledge of the crash risk of alcohol-impaired riders. *Identify the relative strengths and weaknesses of the various procedures for determining rider alcohol-related crash risk. The initial literature review identified 119 references which were reviewed. The literature review included searches of the Transportation Research Information Service, the NHTSA Web site, Dialog, Medline, Lexis-Nexis, Human Factors and Ergonomics Society Journal, Accident Analysis and Prevention, Injury Control and Safety Promotion, Injury Prevention, Journal of Safety Research, Prevention Science, Traffic Injury Prevention, the AAA Foundation for Traffic Safety, reference sections of applicable reports, and general searches of the Internet. Also searched was PIRE’s extensive library of transportation safety publications, and our “End Notes” digital reference list containing over 10,000 entries. The search included any reports on the effects of alcohol on motorcycle operation, plus general studies of measurement of motorcycle operator performance, effects of alcohol on operation in modes of transportation other than motorcycles, effects of alcohol on general human performance, methodologies for collecting all data to be used in determining drinking and driving crash risk and impairment, and methods for collecting motorcycle exposure data. This document summarizes information collected in preparation for the workshop meeting and includes abstracts of the most significant articles related to alcohol-impaired riders. Because the literature review report was prepared prior to the expert panel meeting, it does not discuss some of the methodologies which were discussed at the panel meeting. It does contain more detail about the background of the drinking and riding problem, and discusses some issues of conducting alcohol research in greater detail than is found in the Synthesis Report (Vol. I). (Author/publisher)
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