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Drinking and

Driving: Global
Status
Ward Vanlaar, Ph.D.
Vice President Research
Traffic Injury Research Foundation
Bogot, Colombia
November 19th, 2013
1
One million dollar
question

How is Colombia
doing compared to
other countries with
respect to drinking
and driving?

2
Overview
> Monitoring &
Evaluation:
Conceptual Model
Challenges
> Global and regional
data:
Self-reported data
Crash data
Monetary indicators
> Roadside surveys:
Country cases
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Data Costs:
Medical costs, material &
Social intervention costs,
Costs productivity losses, traffic
(direct and jams (lost time), loss of
indirect) life/quality of life

Data Outcome indicators:


Crashes, injuries Crashes, injuries, deaths
and deaths (combined with exposure
(final outcomes) data)

Operational conditions of Data


Safety performance indicators:
the road traffic system
Speed, alcohol, restraints, helmets, roads,
(intermediate outcomes)
vehicle safety, trauma management

Outputs Data Process/implementation indicators:


(interventions implemented) Road safety policies, plans, programmes,
implementation of interventions

Road safety management


(policies, interventions)

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Who tracks and analyzes?
> International:
World Health Organization (WHO);
Organization for Economic Co-operation and
Development (OECD) maintains International
Road Traffic and Accident Database (IRTAD);
International Council on Alcohol, Drugs and
Traffic Safety (ICADTS).
> Regional:
European Transport Safety Council (ETSC).
> National:
Government, organizations, interest groups.

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Who tracks and analyzes?
> Colombia:
Traffic control authority and traffic police collect
data;
Instituto Nacional de Medicina Legal y Ciencias
Forences (National Institute of Legal Medicine
and Forensic Sciences, NILMFS) publishes
annual report;
Departamento Administrativo Nacional de
Estadsticas (National Administrative
Department of Statistics) provides information
on death certificates;
Corporacin Fondo de Prevencin Vial (Road
Safety Fund, CFPV) serves as conduit and
disseminates information (e.g., to IRTAD).
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Data comparison challenges
>Lack of standardized definitions:
Do we measure drink driving with any
amount of alcohol or only over legal limit?
>Differentiation between national
BAC limits:
Different countries have different BAC limits.
>Drink driving not tracked:
Knowledge about risks of drink driving varies
so relevance not always understood;
Proper tools to measure may not be
available.
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Data comparison challenges
>Drink driving tracked and/or
reported in different ways.
Testing all fatalities versus using sample of
hospitalized victims, fatally injured or not.
>Differences in legislation:
Many countries use per se legal limit (for
example 0.5g/L) but some countries use
more subjective measures (assessment of
impairment).
Canada has legal BAC limit of 0.8 but at
provincial level there are administrative
limits that are lower (0.5 and 0.4).
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Data comparison challenges
>Injuries are poorly reported:
While fatalities and injuries are
considered the ultimate indicator, they
may not always be reliable.
>Collecting data across the globe
takes a lot of effort:
For example, IRTAD provides data for
Argentina and Colombia while WHO
provides data for Argentina, Brazil,
Colombia, Venezuela, etc.

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Data comparison challenges
>Contextual differences such as
alcohol consumption
In 2005, globally, adult per capita
consumption is 6.13 litres per person.
Alcohol consumption varies significantly
by country income:
High-income = 10.55 L/person
Upper middle = 9.46 L/person
Lower middle = 4.41 L/person
Low-income = 2.97 L/person
Colombia = 4.47 L/person
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The world is a village and we want to
compare but

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Snapshot of Colombia (WHO)
> Reported road crash
deaths: 5502 (2010)
> Alcohol-related
deaths: 990 (18%)
> Estimated financial
loss: 1.2% of GDP
> Fatalities mostly
vulnerable road users:
motorized 2- or 3-
wheelers and
pedestrians.
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Snapshot of Colombia (IRTAD)
> Reported road crash deaths: 5528 in 2011,
5922 in 2012 (2012 preliminary data).
> Deaths per 100,000 population from 16.5
in 2000 to 12 in 2011 and 12.7 in 2012
(2012 preliminary data).
> Despite rapid motorization (120%
increase in registered vehicles between
2005 and 2012)
> decrease from 35.9 fatalities per 10,000
vehicles in 1995 to 15.1 in 2004 to 6.6 in
2012.
> Legal BAC limit in 2012: increasing
penalties for BACs of 0.2 and higher.
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Public opinion polls
>TIRF 2012 Canadian poll (RSM):
17.3% of drivers reported driving
after drinking any amount of alcohol.
3.6% admitted to driving when they
thought they were over the legal limit.
81.5% feel drink driving is extremely
serious problem.

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Public opinion polls
>SARTRE (Social Attitudes to Road
Traffic Risk in Europe 4, 2010)
15% of drivers reported driving while
over the legal limit.
28% who drive over the limit are 25-34
years old.
13% of two-wheel drivers reported
driving after drinking.
Drivers believe unlikely to be stopped for
drunk driving.

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Road traffic deaths - global
>1.24 million road traffic deaths
occur annually.
>Traffic deaths have fallen in 88
countries and risen in 87
countries, thus global road traffic
deaths have remained constant.
>When considering 15% increase in
registered vehicles, interventions
appear to have mitigated expected
rise.
>Over 75% of deaths are young
males.
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Road traffic deaths - global
Deaths per 100,000 population
30,0

25,0

Globally,
Deaths per 100,000

middle-income
20,0

15,0 countries have


10,0
the highest
traffic fatality
rates.
5,0

0,0

Region

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Road traffic deaths - South Am.
Deaths per 100,000 population
40
> Avg. death rate =
20.7.
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> Primary victims are


30
pedestrians,
Deaths per 100,000

25 motorcyclists and
20
bicyclists.
15 > Traffic injuries are
10
leading cause of
death in 5-14 years
5
old children and
0 second leading
cause in 15 to 44
years old.
Country

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Alcohol related road deaths
Country % of road deaths involving Income
alcohol

Brazil ----- MI
Venezuela 8% MI
Cambodia 16% LI
Republic of Korea 17% HI
Colombia 18% (WHO) or 8% (NILMFS)? MI
UK 19% HI
Belgium 25% HI
Canada 33% HI
South Africa 55% MI
Kyrgyzstan 59% LI

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Canada versus Colombia (2010)
> Canada: 33.6% of 2211=744
> Colombia: 18% of 5502=990
> Colombia: 8% of 5502=440

> Who is doing better?


33.6% versus 18% versus 8%
744 versus 990 versus 440
What about considering trends over
time?

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Per population vs. per mileage
>Colombia 2012: 12.7 fatalities
per 100 thousand population, 6.6
per 10 thousand vehicles.
>What about per mileage?
Are there many drivers passing
through Colombia who do not reside
in Colombia?
If yes, this would increase exposure
and per population estimate may be
skewed.

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Costs of road crashes
> Road crashes cost USD $518 billion
globally, or 1-2% of a countrys
gross national product.
> Colombia: 1% of GDP.
> Cost to low and middle-income
countries is USD $100 billion
annually, which exceeds
developmental assistance.
> Road traffic injuries are predicted
to become the fifth leading cause
of death by 2030.

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Roadside surveys
>Better understanding of
prevalence of drinking and driving.
>Assess trends.
>Measure impact of alcohol-related
policies, campaigns, enforcement
practices.
>Gain insights into characteristics,
attitudes and behaviours of drink
drivers.
>Make comparisons.
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Roadside survey Brazil
>Survey results based on
data from 4182 randomly
selected drivers collected
between 2005 and 2007;
>BAC legal limit=0.6g/L.
>24.6% had a detectable
BAC and 15.9% were
above the legal limit.

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Roadside survey Belgium
>Survey results based on data
from 12891 randomly selected
drivers collected in 2003;
>BAC legal limit=0.5g/L
>Percent over legal limit:
Weekend nights: 7.68%
Weekend days: 2.98%
Week nights: 2.99%
Week days: 1.76%
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Roadside survey Canada
> Survey results based on data
from 1533 randomly selected
drivers collected in 2008.
> BAC legal limit=0.8g/L (criminal
sanctions)
> BAC provincial limit=0.5g/L or
0.4g/L (administrative sanction
of 12-24 hour suspension)
> 8.1% had been drinking; about
30% of these over the legal
limit.
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Roadside survey US
> Survey results based on data
from 11000 randomly selected
drivers collected in 2007.
> BAC legal limit=0.8g/L
> Downwards trend in drink
driving for drivers at or above
legal limit: from 7.5% in 1973 to
2.2% in 2007.
> Motorcycle riders twice as likely
to be over the limit than car
drivers.
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Roadside survey Norway
> Survey results based on data
from 10000 randomly selected
drivers collected in 2008-2009.
> BAC legal limit=0.2g/L
> Overall, the prevalence of drink
drivers over the legal limit was
very low: 0.2%.
> Illegal drugs (0.6%) and
medicinal drugs (1.3%) were
significantly more prevalent
than alcohol (0.2%).

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Conclusion
>How is Colombia doing compared
to the rest of the world?
Comparison is not straightforward.
Many challenges, especially when
focusing on problem areas like drinking
and driving. Even when using same
methodology like roadside surveys.
>Use of different indicators is
necessary for robust comparisons.
>And, measuring of trends within
country is also important.
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Conclusion
>Overall, data suggest Colombia has
made progress in past decade.
>Data also suggest Colombia is
performing better than average in
its region.
>Based on preliminary 2012 data, it
seems progress may have slowed
down and fatalities may be on the
risefurther monitoring essential.
>This may be related to a rise in
vehicles and mileage.
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Conclusion
> Will there also be a rise in alcohol
consumption? If yes, what needs to be
done to ensure this does not translate
in more alcohol related crashes?
> Multi-sectoral role: important role for
all stakeholders, notably alcohol
industry (cf. TIRFs DWI Working
Group, ICAP).
> Regarding drinking and driving, only
limited data are available.
> While comparisons are difficult, it is
clear that there is room for
improvement!
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Staying informed

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