Drinking and Driving: Global Status Ward Vanlaar, Ph.D. Vice President Research Traffic Injury Research Foundation Bogotá, 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 3
Social Costs (direct and indirect) Data Costs: Medical costs, material & intervention costs, productivity losses, traffic jams (lost time), loss of life/quality of life Crashes, injuries and deaths (final outcomes) Data Outcome indicators: Crashes, injuries, deaths (combined with exposure data) Operational conditions of the road traffic system (intermediate outcomes) Data Safety performance indicators: Speed, alcohol, restraints, helmets, roads, vehicle safety, trauma management Outputs (interventions implemented) Data Process/implementation indicators: Road safety policies, plans, programmes, implementation of interventions Road safety management (policies, interventions) 4
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. 5
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 Estadísticas (National Administrative Department of Statistics) provides information on death certificates;» Corporación Fondo de Prevención Vial (Road Safety Fund, CFPV) serves as conduit and disseminates information (e.g., to IRTAD). 6
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. 7
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). 8
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. 9
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 10
The world is a village and we want to compare but 11
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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. 13
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. 14
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. 15
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. 16
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. 17
30,0 Road traffic deaths - global Deaths per 100,000 population Deaths per 100,000 25,0 20,0 15,0 10,0 5,0 Globally, middle-income countries have the highest traffic fatality rates. 0,0 Region 18
Deaths per 100,000 40 35 30 25 20 15 10 Road traffic deaths - South Am. 5 0 Deaths per 100,000 population Country > Avg. death rate = 20.7. > Primary victims are pedestrians, motorcyclists and bicyclists. > Traffic injuries are leading cause of death in 5-14 years old children and second leading cause in 15 to 44 years old. 19
Alcohol related road deaths Country % of road deaths involving alcohol Income 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 20
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? 21
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. 22
Costs of road crashes > Road crashes cost USD $518 billion globally, or 1-2% of a country s 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. 23
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. 24
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. 25
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% 26
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. 27
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. 28
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%). 29
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. 30
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 rise further monitoring essential. >This may be related to a rise in vehicles and mileage. 31
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. TIRF s 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! 32
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Staying informed 34