Everybody knows that drinking alcoholic beverages and then driving a motor vehicle can be a deadly mix. What is surprising is that the role of alcohol in traffic deaths here and elsewhere may be substantially underreported on death certificates. That's part of the findings in a study found in the March issue of the Journal of Studies on Alcohol and Drugs.
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Between 1999 and 2009, more than 450,000 Americans were reported killed in traffic crashes. However, in situations where alcohol was involved, death certificates frequently failed to list alcohol as a cause of death.
It is appropriate to ask why that oversight matters. According to the Centers for Disease Control and Prevention, injuries are the leading cause of death for Americans younger than 45. Thus, it's important to have a clear idea of the role played by alcohol in those deaths. "We need to have a handle on what's contributing to the leading cause of death among young people," explained Ralph Hingson, Sc.D., of the U.S. National Institute on Alcohol Abuse and Alcoholism.
Hingson noted that researchers need reliable data to study the effects of policies aimed at reducing alcohol-related deaths. "You want to know how big the problem is, and if we can track it," he said. "Is it going up, or going down? And what policy measures are working?"
For the new study, a team focused on all types of accidental fatalities because that's where researchers have the best data. About half of states require that fatally injured drivers be tested for blood alcohol levels, and nationwide about 70 percent of those drivers are tested. Hingson's team used a database maintained by the National Highway Traffic Safety Administration (NHTSA), called the Fatality Analysis Reporting System (FARS), which contains the blood alcohol concentration levels of Americans killed in traffic crashes.
They compared that information with deaths certificate data from all U.S. states finding that death certificates greatly underreported the role of alcohol in traffic deaths between 1999 and 2009, just over 3 percent listed alcohol as a contributing cause. But, based upon the FARS figures, 21 percent of those deaths were legally drunk.
The picture varied widely from state to state. In some states, such as Maryland, Nevada, New Hampshire, and New Jersey, alcohol was rarely listed on death certificates. Certain other states did much better, including Delaware, Iowa, Kansas, and Minnesota. In the state of Arizona accidents involving death to drivers, testing for alcohol concentration levels is mandated by state statute. According to state law, "a peace officer who investigates an accident that involves the death of one or more drivers shall promptly notify the county medical examiner of the death or deaths. If probable cause exists to believe that a deceased driver committed an alcohol related traffic offense, the county medical examiner shall test the deceased driver to determine the driver's alcohol concentration."
The study found that states that mandate alcohol testing for deceased drivers did not always do better when it came to reporting alcohol as a contributor on death certificates. Thus, the role played by alcohol in injury deaths appears to be seriously underestimated on death certificates across the country.
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