Introduction
Motor vehicle crashes are a leading cause of injury death in the U.S. Restrictive
alcohol policies protect against crashes involving alcohol above the legal blood alcohol
concentration of 0.08%. Characteristics of motor vehicle crash fatalities involving
blood alcohol concentrations below the limit and their relationships to alcohol control
policies have not been well characterized.
Methods
Motor vehicle crash fatality data and crash and decedent characteristics from 2000
to 2015 came from the Fatality Analysis Reporting System and were analyzed in 2018–2019.
Alcohol Policy Scale scores characterized alcohol policy environments by state-year.
Generalized estimating equation alternating logistic regression models assessed these
scores and the odds that a fatality involved alcohol below the legal threshold.
Results
Of 612,030 motor vehicle crash fatalities, 223,471 (37%) died in alcohol-involved
crashes, of which 33,965 (15% of alcohol-involved fatalities or 6% of all fatalities)
had a blood alcohol concentration <0.08%. A 10 percentage point increase in Alcohol
Policy Scale score, approximating the interquartile range among states, was associated
with reduced odds of fatalities involving alcohol <0.08% vs 0.00% (AOR=0.91, 95% CI=0.89,
0.93). These findings held across multiple subgroup analyses by decedent and crash
characteristics. Similar results were found for odds of alcohol involvement <0.05%
vs 0.00% (AOR=0.90, 95% CI=0.88, 0.93), and ≥0.05% but <0.08% vs <0.05% (AOR=0.93,
95% CI=0.89, 0.96).
Conclusions
The number of lower blood alcohol concentration fatalities is substantial. States
with more restrictive alcohol policies tend to have reduced odds of lower blood alcohol
concentration motor vehicle crashes than states with weaker policies.
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Article info
Publication history
Published online: March 15, 2020
Identification
Copyright
© 2020 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
