Biomedical subjects

A Scott Tippetts

Publications and source records attributed to A Scott Tippetts.

15 recordsLinked to original sources

PubMed2006

Language, income, education, and alcohol-related fatal motor vehicle crashes.

This paper investigates the role of race/ethnicity, language skills (a proxy for acculturation among Hispanics in Arizona, California, New Mexico, and Texas), income, and education level on alcohol-related fatal motor vehicle crashes. Using the Fatality Analysis Reporting System (FARS), we confirmed previous state-based studies showing that high income and education levels have a protective influence on alcohol-related fatal motor vehicle crashes. We also confirmed that language proficiency/acculturation tends to increase the vulnerability of Hispanic women to alcohol-related fatalities. Differences in alcohol-related fatality rates across Hispanic subgroups are observed. Future reductions in alcohol-related traffic fatalities may require prevention policies that take into account existent variations in acculturation, income, and education among racial/ethnic groups and subgroups.

Accidents, Traffic↗

PubMed2006

Drinking status and fatal crashes: which drinkers contribute most to the problem?

OBJECTIVE: The object of this study was to estimate the relative contribution of various classes of drinkers (including those with alcohol-use disorders) to alcohol-related fatal motor vehicle crashes. METHOD: Using the National Epidemiologic Survey on Alcohol and Related Conditions conducted in 2000, the percentage of state residents falling into six nonoverlapping alcohol-user categories-dependent drinkers, abusive drinkers, dependent and abusive drinkers, heavy episodic drinkers, current normative drinkers, and current nondrinkers- was determined based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, classifications. The percentage of residents in each state in each of these user categories and their relationships to the number of drinking drivers involved in fatal crashes in that state were determined through regression analysis using data from the Fatality Analysis Reporting System. RESULTS: The proportion of drinkers in a state in each of the six consumption categories was positively related to the number of drinking drivers in fatal crashes in that state. Conversely, the percentage of the state's population who were current nondrinkers was negatively related to the number of drinking road users in crashes. CONCLUSIONS: Although alcohol abusive and heavy episodic drinkers had substantially higher associations with impaired drivers in fatal crashes, half of such drivers were associated with the percentage of current nominative drinkers in the state. Despite the relevancy of these findings, they must be qualified by statistical limitations associated with the use of state as the unit of analysis.

Accidents, Traffic↗

PubMed2006

A partial ban on sales to reduce high-risk drinking South of the border: seven years later.

OBJECTIVE: On weekend evenings, thousands of youths (ages 20 and younger) and young adults (ages 21-25) residing in communities along the U.S. border cross into Mexico to patronize all-night bars where the drinking age is 18, rather than 21, and where the price of alcohol is considerably less than in the United States. On January 1, 1999, Juárez, Mexico, implemented a 2 AM (instead of 5 AM) bar-closing policy. The number of crossers and their blood alcohol concentration levels on return were reduced in the year following this policy change. The present study's objective was to determine the long-term (7-year) effect of the earlier-closing bar policy on cross-border drinking in Mexico. METHOD: Analyzed data (1998 to August 2005) were from quarterly breath-test surveys at the El Paso (Texas)/Juárez (Mexico) border, bar observations in Juárez, and trauma data in El Paso. RESULTS: Bar surveys in Juárez show that the 2 AM closing policy, initiated 7 years ago, continues to be enforced, as has the reduction (89%) in youthful crossers returning after 3 AM. The number of underage youths returning earlier in the evening (before 3 AM), however, unchanged for 2 years after the policy change, has doubled recently. CONCLUSIONS: The early closing of bars in Juárez has a continuing positive impact on the reduction of the number of those returning after 3 AM. Although initially there appeared to be no displacement of the late returnees into the early hours (before 3 AM), the number of bar visitors crossing and returning earlier has been steadily increasing. Suggestions for reducing cross-border heavy episodic drinking are described.

Adolescent↗

PubMed2005

Minimum purchasing age for alcohol and traffic crash injuries among 15- to 19-year-olds in New Zealand.

OBJECTIVES: In 1999, New Zealand lowered the minimum purchasing age for alcohol from 20 to 18 years. We tested the hypothesis that this increased traffic crash injuries among 15- to 19-year-olds. METHODS: Poisson regression was used to compute incidence rate ratios for the after to before incidence of alcohol-involved crashes and hospitalized injuries among 18- to 19-year-olds and 15- to 17-year-olds (20- to 24-year-olds were the reference). RESULTS: Among young men, the ratio of the alcohol-involved crash rate after the law change to the period before was 12% larger (95% confidence interval [CI]=1.00, 1.25) for 18- to 19-year-olds and 14% larger (95% CI=1.01, 1.30) for 15- to 17-year-olds, relative to 20- to 24-year-olds. Among young women, the equivalent ratios were 51% larger (95% CI=1.17, 1.94) for 18- to 19-year-olds and 24% larger (95% CI=0.96, 1.59) for 15- to 17-year-olds. A similar pattern was observed for hospitalized injuries. CONCLUSIONS: Significantly more alcohol-involved crashes occurred among 15-to 19-year-olds than would have occurred had the purchase age not been reduced to 18 years. The effect size for 18- to 19-year-olds is remarkable given the legal exceptions to the pre-1999 law and its poor enforcement.

Accidents, Traffic↗

PubMed2005

A meta-analysis of .08 BAC laws in 19 jurisdictions in the United States.

More than a dozen studies on the effectiveness of the .08 blood alcohol concentration (BAC) laws have been published; however, those studies have varied both in the statistical methods and the type of outcome measure used, so it is difficult to integrate the findings into an overall estimate of the effectiveness of the law. This study used a consistent outcome measure, drinking drivers in fatal crashes and an identical methodology time-series analysis, to analyze the introduction of the .08 law in 18 states and the District of Columbia from 1982 to 2000. Each analysis accounted for other key safety laws (administrative license suspension/revocation and safety belt laws), as well as economic conditions that might influence the effectiveness of the .08 law. This provided 19 independent evaluations in which the effectiveness (treatment effect) of the law could be measured in the same quantitative terms. The number of drinking drivers in fatal crashes declined in 16 of the 19 jurisdictions after the .08 law was adopted. Nine of the 16 reductions were statistically significant (p < .05). The effect size combined across all 19 locations showed statistically significant decline (p < .005) of 14.8% in the rate of drinking drivers in fatal crashes after the .08 laws were introduced. The reduction was greater in states that had an administrative license suspension/revocation law and implemented frequent sobriety checkpoints. This analysis suggests that 947 lives might have been saved, had all 50 states and the District of Columbia had the .08 law throughout the year 2000.

Accidents, Traffic↗

PubMed2005

Evaluation of four state impaired driving enforcement demonstration programs: Georgia, Tennessee, Pennsylvania and Louisiana.

This study provided a consolidated evaluation of four separate demonstration projects aimed at reducing impaired driving through well-publicized enforcement. Each of the four demonstration projects used different enforcement approaches in an effort to reduce impaired driving crashes in the State. Georgia experienced a significant decrease in drinking-and-driving fatal crashes (14 percent using a ratio measure in a time series analysis). The program in Georgia (2800 checkpoints) saved an estimated 60 lives in the first year. While Louisiana experienced a raw decrease in the ratio of drinking drivers to nondrinking drivers in fatal crashes, when the control parishes and the comparison States were taken into consideration, the apparent decrease was neutralized. Although Pennsylvania's selected counties showed relative decreases across a variety of measures when compared to control counties and surrounding States, these decreases were not significant. In Tennessee, the ratio measure showed a significant decrease (-10.6 percent) compared to surrounding States with an estimated 43 lives saved in the first year. In summary, it appears that if States use a sobriety checkpoint model that includes (a) a statewide effort, (b) numerous sobriety checkpoints conducted each weekend throughout the year, (c) intensive publicity about the enforcement, and (d) properly trained law enforcement officials, significant decreases in impaired driving fatalities can be realized.

Alcoholic Intoxication↗

PubMed2003

Assessing the effectiveness of minimum legal drinking age and zero tolerance laws in the United States.

The objective of this research was to determine the extent to which the decline in alcohol-related highway deaths among drivers younger than age 21 years can be attributed to raising the minimum legal drinking age (MLDA) and establishing zero tolerance (0.02% blood alcohol concentration (BAC) limit for drivers younger than age 21 years) laws. Data on all drivers younger than age 21 years involved in fatalities in the United States from 1982 to 1997 were used in the study. Quarterly ratios of BAC-positive to BAC-negative drivers in each of the 50 states where analyzed in a pooled cross-sectional time-series analysis. After accounting for differences among the 50 states in various background factors, changes in economic and demographic factors within states over time, and the effects of other related laws, results indicated substantial reductions in alcohol-positive involvement in fatal crashes were associated with the two youth-specific laws. The policy of limiting youth access to alcohol through MLDA laws and reinforcing this action by making it illegal for underage drivers to have any alcohol in their system appears to have been effective in reducing the proportion of fatal crashes involving drinking drivers.

Accidents, Traffic↗

PubMed2003

Behavioral measures of drinking: patterns from the Alcohol Interlock Record.

AIMS: This report reviews breath test data captured by the alcohol ignition interlock, a device that prevents a car from starting when BAC (breath alcohol concentration) is elevated. DESIGN: The predictors were elevated BAC test rates from ignition interlock equipped cars of traffic offenders convicted of DUI (driving under the influence of alcohol) and who used interlocks for 6-18 months. Outcome data were future DUI convictions. SETTINGS: Québec and Alberta, Canada. PARTICIPANTS: Approximately 10000 interlock users from these two culturally distinctive English- and French-speaking Provinces. MEASUREMENT: Predictor patterns were analyzed from among 23 million breath tests. Repeat DUI convictions accumulated up to several years after interlock removal were studied as an outcome to be predicted by the rate of BAC tests > or = 20 mg/dl (0.02%) while the interlock was installed. Data were analyzed with sensitivity and survival methods. FINDINGS: A median of eight interlock breath tests per day per driver were logged (a rate of 3000 tests/year). Less than 1% of all tests were over 0.02%, but the rate of elevated BAC tests, particularly those taken at 7-9 a.m., strongly predicts repeat DUI offenses 2 years hence. The interlock record is an unobtrusive measure of drinking behavior and can be used to profile driver risk. CONCLUSIONS: With new legal mandates, North American use of these DUI control devices is increasing rapidly from the current 5% penetration rate. Interlock data may eventually come to serve as a useful adjunct for patient monitoring by alcohol counselors as well as by courts and motor vehicle authorities.

Accidents, Traffic↗

PubMed2003

The alcohol interlock: an underutilized resource for predicting and controlling drunk drivers.

This report summarizes evidence presented during the Third Annual Ignition Interlock Symposium at Vero Beach, Florida, 29 October 2002. The ignition interlock prevents a car from starting when blood alcohol concentration (BAC) is elevated. We review some of our prior work as well as introduce previously unpublished results to demonstrate the manner in which the data recorded by the alcohol ignition interlock device can serve as an advance predictor of future driving under the influence (DUI) of alcohol risks. Data used in this current report represent approximately 2,200 ignition interlock users from Alberta, Canada, and about 8,000 interlock users from Quebec, Canada; the Alberta data set contained 5.5 million breath tests and the Quebec data 18.8 million breath tests. All tests are time and date stamped and this information was used to characterize patterns of BAC and vehicle use, and the relationship between BAC elevations and DUI offenses that accumulated after the interlock was removed from the vehicles. Findings from Cox regression (Marques et al., 2003) show that BAC elevations > .02-.04% are more potent predictors of repeat DUI (p < .0001) than even prior DUI (p < .006), usually found to be the strongest indicator of driver risk. Prior DUI obviously has no use for scaling the risk of first-time offenders. Drivers who are both multiple offenders and who have more than a few elevated interlock BAC tests are much more likely to repeat DUI. The timing and pattern of elevated BAC tests provided during the time drivers were required to use an alcohol ignition interlock device are remarkably similar on both a daily basis and an hourly basis when the interlock programs from the two provinces are compared directly. Both provinces had higher rates of elevated tests on Saturday and Sunday, and the fewest elevated tests on Tuesdays. The absolute rate of elevated tests is similar despite the two provinces adhering to different interlock lockout points (.02% Quebec; .04% Alberta). Charts tracking the Monday-Friday timing of elevated BAC tests by hour are nearly identical for both provinces. The most elevated BAC tests occurred between 7 and 9 A.M. Monday to Friday, even though most vehicle start attempts occurred much later in the day. This higher rate of elevated morning BAC likely represents drinking from the prior evening with alcohol not yet cleared from circulation; those with elevated BAC in the early morning were more likely to have a repeat offense even after accounting for prior DUI and the higher overall rate of elevated BAC tests. This is viewed as evidence of a drinking problem that will lead to impaired driving after the controlling function of the interlock is removed. Policy changes are discussed that might take better advantage of interlock information to improve the public response to drunk driving.

Accidents, Traffic↗

PubMed2003

The alcohol interlock: an underutilized resource for predicting and controlling drunk drivers.

This report summarizes evidence presented during the Third Annual Ignition Interlock Symposium at Vero Beach, Florida, 29 October 2002. The ignition interlock prevents a car from starting when blood alcohol concentration (BAC) is elevated. We review some of our prior work as well as introduce previously unpublished results to demonstrate the manner in which the data recorded by the alcohol ignition interlock device can serve as an advance predictor of future driving under the influence (DUI) of alcohol risks. Data used in this current report represent approximately 2,200 ignition interlock users from Alberta, Canada, and about 8,000 interlock users from Quebec, Canada; the Alberta data set contained 5.5 million breath tests and the Quebec data 18.8 million breath tests. All tests are time and date stamped and this information was used to characterize patterns of BAC and vehicle use, and the relationship between BAC elevations and DUI offenses that accumulated after the interlock was removed from the vehicles. Findings from Cox regression show that BAC elevations >.02-.04% are more potent predictors of repeat DUI (p<.0001) than even prior DUI (p<.006), usually found to be the strongest indicator of driver risk. Prior DUI obviously has no use for scaling the risk of first-time offenders. Drivers who are both multiple offenders and who have more than a few elevated interlock BAC tests are much more likely to repeat DUI. The timing and pattern of elevated BAC tests provided during the time drivers were required to use an alcohol ignition interlock device are remarkably similar on both a daily basis and an hourly basis when the interlock programs from the two provinces are compared directly. Both provinces had higher rates of elevated tests on Saturday and Sunday, and the fewest elevated tests on Tuesdays. The absolute rate of elevated tests is similar despite the two provinces adhering to different interlock lockout points (.02% Quebec;.04% Alberta). Charts tracking the Monday-Friday timing of elevated BAC tests by hour are nearly identical for both provinces. The most elevated BAC tests occurred between 7 and 9 A.M. Monday to Friday, even though most vehicle start attempts occurred much later in the day. This higher rate of elevated morning BAC likely represents drinking from the prior evening with alcohol not yet cleared from circulation; those with elevated BAC in the early morning were more likely to have a repeat offense even after accounting for prior DUI and the higher overall rate of elevated BAC tests. This is viewed as evidence of a drinking problem that will lead to impaired driving after the controlling function of the interlock is removed. Policy changes are discussed that might take better advantage of interlock information to improve the public response to drunk driving.

Accidents, Traffic↗

PubMed2003

Comparative and joint prediction of DUI recidivism from alcohol ignition interlock and driver records.

OBJECTIVE: This work was conducted to find practical predictors that anticipate which driving under the influence (DUI) offenders will continue to drink and drive after a period of alcohol ignition interlock-controlled driving ends. The interlock prevents impaired driving by requiring a low blood alcohol concentration (BAC) breath sample before allowing an engine to start. Each breath test is recorded. The study evaluated the interlock record as a predictor of future DUI offenses relative to driver records and self-report items. METHOD: Subjects were 2,273 DUI offenders in Alberta, Canada, who used an interlock to gain full reinstatement of driving privileges; for 2,134, the installed periods ranged from 5 to 30 months. A median of 8.1 breath tests was logged for each installed day; 9.9 tests were taken on each day of vehicle use (4.3 starts plus 5.6 running retests). Predictors of postinterlock repeat DUI were compared by sensitivity and survival analyses. RESULTS: Although 69% of all interlock users had at least one BAC test > or = .04% (a "fail" test) within the first 5 months, only 9% were reconvicted up to 4 years after interlock removal. Failed interlock tests proportional to all BAC tests taken was the best predictor of driver recidivism risk during the years following interlock removal. CONCLUSION: The interlock record provides new information, particularly about drivers with no prior DUI offenses. Prior moving violations and driving while suspended convictions, although better predictors than questionnaire data, were poorer than interlock records and prior DUI offenses. The alcohol interlock, already recognized as a useful control device, warrants attention for DUI prediction as well.

Adult↗

PubMed2002

Evaluation of a program to motivate impaired driving offenders to install ignition interlocks.

Approximately 30,000 alcohol ignition interlocks, which are designed to prevent the operation of a vehicle if the driver has been drinking, are in use in the US and Canada. Ignition interlock programs are also being initiated in Sweden and Australia. The best-controlled studies that are currently available suggest that ignition interlocks are effective in reducing impaired driving recidivism while on the vehicle. However, in the US, the practical effectiveness of these devices is limited because only a small number of offenders are willing to install them in order to drive legally. This paper reports on a study of a court policy that created a strong incentive for impaired driving offenders to install interlocks by making traditional penalties, such as jail or electronically monitored house arrest, the alternative to participation in an interlock program. Comparison of the recidivism rates of offenders subject to this policy with offenders in similar, nearby courts, not using interlocks, indicated that the policy was producing substantial reductions in DUI recidivism.

Accidents, Traffic↗

PubMed2002

The Illinois .08 law. An evaluation.

Lowering state blood alcohol concentration (BAC) limits to 0.08, though controversial, has been supported by most evaluation studies to date. The Illinois .08 BAC law implemented in 1997 provided a unique opportunity to evaluate the effect of the law without the simultaneous passage of an administrative license revocation (ALR) law, which has clouded some previous evaluations of the .08 laws. The proportion of all drinking drivers in fatal crashes was compared before versus after implementing the .08 law using time-series analysis to evaluate 12 years of fatal crash data for Illinois and five bordering states. The results showed that the proportion of drinking drivers in fatal crashes decreased by 14% in Illinois and increased by 3% in bordering states. The proportion of drinking drivers in fatal crashes in Illinois, though increasing since 1995, was sharply reduced after passage of the .08 law in 1997, saving more than 100 lives in 1998 and 1999 than it would have without the .08 law.

Accidents, Traffic↗

PubMed2002

Operation safe crossing: using science within a community intervention.

AIMS: To evaluate a large drunk-driving enforcement program at the US/Mexican border to reduce the number of youths crossing the border to drink in Tijuana. This paper also describes the research data used to develop and manage the program. Data from a border breath-test survey were used to dramatize the problem and gain public support for action. The data were also used to help design the enforcement effort and measure progress in reducing the cross-border drinking problem. DESIGN: The number of news events generated around the occurrence of special enforcement efforts were used to measure project activity and to predict changes in the numbers of youths crossing into Mexico, their returning BACs and reductions in alcohol-related crashes during a 3-year period. SETTING: An urban county on the Mexican border. PARTICIPANTS: Underage youths aged 18-20 years and young adults aged 21-30 years residing in San Diego County. MEASUREMENTS: Immigration and Naturalization Services provided population counts of the number of individuals crossing each weekend night from Tijuana into the United States through the San Ysidro border facility. Breath-test surveys of a random sample of these returning crossers provided data on the number of US residents visiting bars and nightclubs in Tijuana and on alcohol consumption at Tijuana bars and nightclubs. Night-time had-been-drinking crash data involving young drivers in several California counties served as an outcome measure of public health and safety. FINDINGS: Analysis of data involving more than 2 million pedestrians returning from Tijuana indicated that the Operation Safe Crossing program reduced the number of late-night crossers by 31.6%. CONCLUSIONS: Effective use of data through media advocacy programs to support an enforcement effort can reduce alcohol-related crashes.

Adolescent↗

PubMed2002

Children in fatal crashes: driver blood alcohol concentration and demographics of child passengers and their drivers.

AIMS: This study examines whether differences in two risk factors for crash-related injury for children-riding with a drinking driver and failure to use restraints-are related to various driver characteristics such as age, gender, ethnicity and drinking. DESIGN, PARTICIPANTS, MEASUREMENTS: Data on driver blood alcohol concentration (BAC), use of restraints and certain demographics were drawn from the Fatality Analysis Reporting System. Ethnicity data came from the Multiple Cause of Death File and socioeconomic information from the US Census. The use of restraints by child passengers and the drinking of alcohol by adult drivers are examined as a function of age, gender and membership of five racial/ethnic groups: White American, Black American, Native American, Asian/Pacific Islander American and Hispanic American. This study covers 160,770 drivers and 12,266 children younger than 16 years killed in motor vehicle crashes from January 1,1990 to December 31,1996. FINDINGS: As might be expected, analyses of fatally injured drivers showed that, compared with men, women were more likely to be accompanied by children at the time of their crash, but those children were more likely to be restrained than if travelling with men. Drivers who had been drinking at the time of their crash were less likely to be transporting children and those children were less likely to be restrained. Analyses of killed children indicated that some ethnic groups, compared with White drivers, were more likely to be BAC-positive and children were less likely to be restrained. CONCLUSIONS: These findings underscore the continuing need to understand cultural factors in traffic safety and develop and disseminate culturally appropriate education programs.

Accidents, Traffic↗