Reports suggest that people who drive while intoxicated by alcohol may do so repeatedly. The authors hypothesized that persons arrested for driving while impaired might be at increased risk for death in an alcohol-related motor vehicle crash. To evaluate this possibility, the deaths of drivers in alcohol-related motor vehicle accidents were studied in North Carolina over a 10-year period. The authors compared drivers who died in motor vehicle crashes from 1980 through 1989 and who had blood alcohol concentrations (BACs) of at least 20 mg per deciliter (4.3 mml per liter), referred to as the case drivers, with those who died in crashes but had below 20 mg per deciliter, referred to as the control drivers. The authors identified case drivers and control drivers through the state Medical Examiner System. They than searched North Carolina driver-history files for the five years before each death to identify arrests for driving while impaired. A total of 1646 case drivers and 1474 control drivers were linked to their driver-history files. Case drivers were more likely than control drivers to have been arrested for driving while impaired (26 percent versus 3 percent). After potential confounding variables were controlled, case driver 21 to 34 years of age were 4.3 times more likely (95 percent confidence interval, 2.7 to 6.8) than control drivers to have been arrested for driving while impaired; case drivers 35 years of age or older were 11.7 times more likely (95 percent confidence interval, 6.8 to 20.1). The strength of the association appeared to increase with the number of prior arrests. Case drivers were also more likely than the general population of currently licensed drivers to have been arrested. It is concluded that arrests for driving while impaired substantially increase the risk of eventual death in an alcohol-related crash. Aggressive intervention in the cases of people arrested for driving while impaired may decrease the likelihood of a future fatal alcohol-related crash. (A)
Abstract