PSYCHOSOCIAL CHARACTERISTICS AND FOLLOW-UP OF DRINKING AND NON-DRINKING DRIVERS IN MOTOR VEHICLE CRASHES

Eight hundred fifty-four consecutive motor vehicle crash (MVC) victims admitted from August 1, 1986, through August 31, 1989, were prospectively assessed including measurement of blood alcohol concentration (BAC). One hundred six in-hospital interviews were conducted on competent consenting drivers at least 18 years of age; 22.9 percent (n=22) of those who were BAC tested (n=96) were positive for alcohol on admission. The mean age was 33.6 years; 76.7 percent were referred from other medical facilities, and 61.5 percent were admitted within 4 hours of the crash. One hundred thirty-nine drivers (39.4 percent) tested positive for alcohol on admission with a mean admission BAC of 30.0 mmol/L (141.3 mg/dL) and a mean estimated level of 37.6 mmol/L (176.8 mg/dL) at the time of the crash. The two groups in whom BAC results were available differed significantly on driver education with the BAC-positive group having a lower proportion of driver education graduates compared with the BAC-negative group (p<0.01). It is evident from this study that the BAC-positive drivers have characteristics indicative of high risk. The high incidence of previous license suspensions and self-reported drinking and driving behavior is indicative of antecedent high-risk behavior; BAC-positive drivers were not involved in a "one-time event." It is of obvious concern, however, that drinking and driving behavior continues after discharge and that there is a high rate of motor vehicle crashes in the follow-up period after original crash and injury.