Understanding the context of alcohol impaired driving for fatal crash–involved drivers: A descriptive case analysis

<b>Objective</b>: The objective of this study was to understand the social context and circumstances surrounding alcohol-impaired driving prior to fatal crash involvement for drivers with an illegal blood alcohol concentration (BAC ≥ 0.05 g/100 ml or 0.00 g/100 ml for restricted license holders). <b>Methods</b>: Coroners' case reports investigating fatal crashes in South Australia over a 3-year period (2008–2010) were examined. The personal and crash characteristics of drivers with an illegal BAC were compared with those who had a legal BAC. For each driver with an illegal BAC, information was recorded including characteristics of last trip, location and social context of alcohol consumption, quantity and type of alcohol consumed, BAC level, presence of drugs, perceived alcohol intoxication, and alcohol dependence. Official traffic offense records were also obtained. <b>Results</b>: Of the 284 fatal crashes included in the study, 34% (<i>n</i> = 95) involved a driver or rider with an illegal BAC. Prior to the crash, alcohol was most frequently consumed by drivers in rural areas, within private homes, and was part of normal social activities. Drivers recorded a high level of alcohol impairment, with a mean BAC of 0.173 g/100 ml and a level of alcohol dependence that was above the Australian national average (7.4 vs. 3.9%). In addition, 23% of drivers were known to be experiencing psychological stress at the time of the crash. The results also confirm that drink driving recidivism continues to be a significant problem, with 44% of drivers recording at least one prior alcohol driving offense. <b>Conclusions</b>: Alcohol-impaired driving continues to be a leading cause of fatal crashes. The popularity of drinking at home, particularly in rural areas, has implications for police enforcement strategies and suggests that drink driving interventions that focus on community values and looking after friends might be beneficial. Importantly, the study highlights the need for a broader holistic approach to reduce the high levels of alcohol consumption and alcohol dependence underlying drink driving behavior.

**研究目的**：本研究旨在探究血液酒精浓度（blood alcohol concentration, BAC）超标驾驶员在涉入致命撞车事故前的酒驾相关社会背景与实际情境，其中持受限驾照者的合法BAC阈值为0.00 g/100ml，其余驾驶员为≥0.05 g/100ml。

**研究方法**：本研究梳理了2008至2010年三年间澳大利亚南澳州境内所有涉及致命撞车事故的验尸官案卷报告。研究对比了BAC超标驾驶员与BAC合法驾驶员的个人特征及事故特征。针对每名BAC超标驾驶员，研究人员记录了以下信息：末次出行的相关特征、饮酒地点与饮酒时的社会背景、饮酒量与饮酒品类、血液酒精浓度检测值、是否存在药物影响、自我感知的酒精中毒程度，以及酒精依赖情况。同时还调取了受试驾驶员的官方交通违法记录。

**研究结果**：本次纳入分析的284起致命撞车事故中，34%（n=95）涉及BAC超标驾驶员或摩托车骑手。事故发生前，驾驶员最常于乡村地区的私人住宅内饮酒，且饮酒行为多属于日常社交活动范畴。受试驾驶员的酒精中毒程度普遍较高，平均BAC值达0.173 g/100ml，酒精依赖率高于澳大利亚全国平均水平（7.4% vs 3.9%）。此外，23%的驾驶员被证实事故发生时正经历心理压力。研究结果同时证实，酒驾再犯仍是突出的公共安全问题：44%的受试驾驶员至少有过1次酒驾前科。

**研究结论**：酒驾仍是致命撞车事故的主要诱因之一。居家饮酒（尤其是在乡村地区）的流行趋势，对警方执法策略具有重要参考价值，同时提示聚焦社区价值观倡导与亲友互助的酒驾干预措施或可产生积极效果。值得强调的是，本研究凸显了需采取更全面的整体性手段，以降低酒驾行为背后的高酒精消费与酒精依赖水平。