Risk factors associated with recurrent DUI offenses in Brazil

Transcription

1 Risk factors associated with recurrent DUI offenses in Brazil Schmitz, A. R; Guimarães, L.P; Gonçalves, V. M.; Goldim, J.R; Sousa, T. R; Pechansky, F Center for Drug and Alcohol Research/ Federal University of Rio Grande do Sul/Brazil Abstract Background: Alcohol in blood is a major factor for traffic accidents; high blood alcohol concentrations (BAC) increase the risk of involvement in offenses, and it is hypothesized that traffic injuries and casualty rates are partly attributed to recurrent offending behavior. Aim: To analyze and compare risk and protective factors among Brazilian repeat DUI offenders in 2009/2010. Methods: Cross-sectional study with 12,204 DUI offenders from the State Traffic Department, using descriptive statistics and Poisson regression analysis. Drivers, age, sex, education level, time license to drive and license category were assessed. Drivers were considered repeat offenders if convicted of DUI more than once among 2009/2010. Results: 538 drivers (4.41%) were repeat offenders. The risk factors with the highest rates were age between 41 and 50 (PR=3.41), being licensed for 12 years or more (PR=1.86), having a motorcycle/car/truck license (PR=1.36), having a restricted license for psychological reasons (PR=1.33), and driving a truck or similar at the moment of notification (PR=1.08). Protective factors were female sex (PR=0.64), professional driver (PR=0.95), and high levels of education (PR=0.68). Discussion and conclusion: Age as a risk factor may be linked to licensure duration, as well as to the implementation of a new traffic law whereby driving after drinking is a crime. License restriction based on psychological issues as a risk factor reinforces the need for new assessments before license renewal. Protective factors corroborate previous findings. An inverse relation was observed between repeat offending and education level, suggesting that mass media

2 dissemination of the new law is not reaching the lowest education strata. As for professional drivers, the fear of losing a job may be an influence on driving behavior. Internationally reported rates of one-time and repeat DUI offenses are higher than here reported, probably as a result of the poor law enforcement in Brazil. Introduction: For decades, studies have warned against the combination of drinking and driving, mainly because of the resulting increase in the risk of accidents, severe injuries, and mortality (Ahlm, 2009). Alcohol consumption impairs the abilities required for driving a vehicle: reflexes, perception of speed and obstacles, ability to control the vehicle, and visual acuity. Other effects include impaired judgment and more impulsive and aggressive behaviors (Kelly,2004). No Brazilian study so far attempted to describe the profile of repeat offenders convicted of drinking and driving Method: We conducted a cross-sectional study with all drivers licensed in the state of Rio Grande do Sul (RS), southern Brazil. Data provided by the RS State Traffic Department for 3,949,693 licensed drivers were analyzed from January 2009 to December 2010 to identify DUI offenders. Drivers convicted of DUI more than once over a period of 24 months were considered recidivists. Results: Of all the 3,949,693 drivers licensed in the state of Rio Grande do Sul, 12,204 (0.3%) had been convicted of DUI in the past two years (approximately 3 per 1,000 drivers). Of these, 11,666 (95.59%) had committed one violation, and 538 (4.41%) were recidivists. Our findings revealed that the main characteristics of DUI recidivists were being male, aged 41 to 50 years, licensed for over 12 years, having a low education level, and considered able to drive with psychological restrictions. The results of the psychological assessment with restrictions are applied when the driver has a psychological disorder, but it is temporarily under control. In this

3 case, the driver is submitted to another psychological assessment after a determined period (from 1-5 years).(see Table 1) Table 1-Sociodemographic characteristics of recidivist and non-recidivist in the state of Rio Grande do Sul Years Sex Recidivist Yes No n=538 n=11,666 N % N % Male , Female Age range (years) 18 to to , to , to , to , Mean age* 41 (11.2) 37 (12.5) Education level Elementary school , High school , Under graduate N/A 4 34 License duration (years) PR Adjusted PR** , to , to , to , > , Mean license duration 16 (10.7) 13 (10.9) Type of vehicle driven upon notification Car/utility , Motorcycle/motor scooter/moped , Pickup/van/truck/motor home/semitrailer/tractor Bus/minibus N/A Professional driver Yes , No , Psychological assessment***(n= 8,646) Able to drive , Able to drive with psychological restriction

4 Reference categories have prevalence ratio (PR) = 1 ** Variables represented by the mean (SD) * PR adjusted for age, sex and education ***Missing data PR values for license category ranged from 0.76 for E category (trucks weighing 6,500 kg) to 1.36 for AC category (motorcycles and trucks between 3,500 and 6,000 kg) (reference category: B). A Category (motorcycles) showed a PR of 0.92, and C category (midsized trucks), of 1.14; individual categories showed lower PRs when compared with combined categories. When comparing psychological assessment results and professional driver status among recidivist, both professional and non-professional drivers showed a similar distribution of psychological assessment outcomes (able or able with psychological restrictions). Among nonrecidivist, the number of professional drivers considered able to drive with psychological restrictions was 8% higher than the number of drivers able to drive (See Figure 1). Figure 1 - Comparison between professional (n = 3,224) and non-professional (n = 8,978) drivers in relation to psychological assessment results among recividist (n = 330) and non-recidivist (n = 8,315). Discussion The predominance of males among both DUI recidivists (98%) and non-recidivists (97%) was nearly absolute. This high percentage of males may reflect alcohol consumption patterns among

5 Brazilian men, which exceed female consumption in quantity, frequency, and intensity, even when driving motor vehicles (Laranjeira, 2007). Our results indicate as the majority of DUI recidivists were aged between 41 and 50 years; one possible explanation for this could be the fact that drivers in this age group were trained in the old traffic regulation system, and that enrollment in courses or tests to adapt to the new system were not enough to prevent this type of behavior. Present study also found that drivers licensed for over 12 years were the most common recidivists, which reinforces the hypothesis raised earlier about drivers trained in the old traffic regulation system. Another possible assumption is that, as older age tends to be related to higher family income and financial independence, the application of fines may not have the necessary impact to prevent drinking and driving behaviors in this population. Another hypothesis would be at a greater risk for being diagnosed with alcohol dependence disorder, leading to an increased consumption, the need to use it, and loss of control, regardless of the risks involved. In addition, older individuals come from a culture where drinking and driving was socially accepted, and could have a greater resistance to accept changes in the current legislation. The recurrence rate of DUI violations found in our study was lower than the rates reported in other international studies, probably as a result of a poor enforcement of traffic laws in Brazil. Educational data collected for our DUI offenders were similar to those reported in international study, suggesting an association between low education levels and drinking and driving behavior (Impinen, 2011). Related to license categories, our data indicate that categories A, E, and AE were protective factors. This can be partially explained by the perceived potential risk associated with these vehicle types, namely motorcycles show a higher risk for motorcyclist injuries, whereas heavy vehicles are generally involved in large accidents (Chuc,2012). Regarding the type of vehicle being driven at the time of notification, buses and minibuses were considered a protective factor in relation to other vehicles approached. This may be explained by the higher probability of being monitored by employers and the impact of penalties on the driver s life. In our sample, most DUI recidivists

6 were considered able to drive with psychological restrictions. These data suggest an important role of psychological assessments to detect the presence of psychological problems potentially related to drinking and driving, and underscore the need to investigate such assessments in more detail. This is also the case with non-recidivist. In Brazil, when candidates are considered able to drive in obtaining their first license, it is likely that they will never undergo a new psychological assessment, because reassessment is mandatory only for professional drivers (every 5 years). This allows non professional conductors to drive without a periodic monitoring by expert psychologists. Conclusions Our findings revealed that the main characteristics of DUI recidivists. These new data on the profile of DUI offenders can help determine changes in strategic campaigns aimed at the prevention, education, and rehabilitation of drivers, representing an important epidemiological tool to assist in reducing drinking and driving in Brazil. Moreover, public policies can be developed with specific behavioral strategies for these drivers. References: Ahlm K, Björnstig U, Oström M. Alcohol and drugs in fatally and non-fatally injured motor vehicle drivers in northern Sweden. Accid Anal Prev. 2009;41(1): Kelly E, Darke S, Ross J. A review of drug use and driving: epidemiology, impairment, risk factors and risk perceptions. Drug Alcohol Rev. 2004;23(3): Laranjeira R, Pinsky I, Zaleski M, Caetano R. I Levantamento Nacional sobre os padrões de consumo de álcool na população brasileira. Brasília: Secretaria Nacional Antidrogas; Impinen A. Arrested Drunk Drivers. Trends, social background, recidivism and mortality. Academic Dissertation. University of Helsinki. The Hjelt Institute, Department of Public Health Helsinki; Chuc HC. An investigation of the risk factors causing severe injuries in crashes involving gravel trucks.traffic Inj Prev. 2012;13(4):