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Biomedical subjects

D J Beirness

Publications and source records attributed to D J Beirness.

15 recordsLinked to original sources
PubMed2004

Hard core drinking drivers.

The term "hard core" has been used extensively over the past 15 years to identify persons who drink and drive regularly, typically at high blood alcohol levels. This article discusses how the term arose and clarifies what it means, both as a concept and in practice. It describes the characteristics of hard core drinking drivers and estimates their contribution to drinking driver trips, arrests, and crashes. It summarizes current knowledge and recommendations on the most effective means to affect their behavior and reduce their drinking and driving.

Accidents, Traffic↗
PubMed2004

Alcohol ignition interlock programs.

The alcohol ignition interlock is an in-vehicle DWI control device that prevents a car from starting until the operator provides a breath alcohol concentration (BAC) test below a set level, usually .02% (20 mg/dl) to .04% (40 mg/dl). The first interlock program was begun as a pilot test in California 18 years ago; today all but a few US states, and Canadian provinces have interlock enabling legislation. Sweden has recently implemented a nationwide interlock program. Other nations of the European Union and as well as several Australian states are testing it on a small scale or through pilot research. This article describes the interlock device and reviews the development and current status of interlock programs including their public safety benefit and the public practice impediments to more widespread adoption of these DWI control devices. Included in this review are (1) a discussion of the technological breakthroughs and certification standards that gave rise to the design features of equipment that is in widespread use today; (2) a commentary on the growing level of adoption of interlocks by governments despite the judicial and legislative practices that prevent more widespread use of them; (3) a brief overview of the extant literature documenting a high degree of interlock efficacy while installed, and the rapid loss of their preventative effect on repeat DWI once they are removed from the vehicles; (4) a discussion of the representativeness of subjects in the current research studies; (5) a discussion of research innovations, including motivational intervention efforts that may extend the controlling effect of the interlock, and data mining research that has uncovered ways to use the stored interlock data record of BAC tests in order to predict high risk drivers; and (6) a discussion of communication barriers and conceptual rigidities that may be preventing the alcohol ignition interlock from taking a more prominent role in the arsenal of tools used to control DWI. Whether interlock programs can help public policymakers achieve their expressed goals of substantially reducing the level of impaired driving will remain uncertain until procedural barriers and intransigent judiciary practices can be overcome that provide for more systematic routine use of interlock programs. Despite strong effectiveness evidence in all studies to date, the real potential of this technology to reduce the road toll cannot be estimated until they are more widely adopted.

Alcohol Drinking↗
PubMed2003

The impact of mandatory versus voluntary participation in the Alberta ignition interlock program.

Research has demonstrated that participation in an interlock program significantly reduces the likelihood of subsequent driving while intoxicated (DWI) convictions at least so long as the interlock device is installed in the vehicle. Despite the growing number of jurisdictions that allow interlock programs and the demonstrated success of these programs, the proportion of DWI offenders who actually have the device installed is minimal. In an effort to increase the proportion of offenders using interlocks, some jurisdictions require offenders to install an interlock as a condition of license reinstatement whereas others merely offer offenders a reduction in the period of hard suspension if they voluntarily participate in an interlock program. The objective of the present study was to determine the extent to which voluntary interlock participants are more or less successful in terms of subsequent recidivism than those for whom interlock program participation has been mandated. The issue was addressed using data from the interlock program in Alberta, Canada, which provides for both mandatory and voluntary participation. The recidivism experience of voluntary and mandatory interlock participants was examined both during and after the period of interlock installation. Cox regression revealed that, after controlling for (or equating) the number of prior DWI offenses, the survival rates of DWI offenders who were ordered to participate in the interlock program did not differ from those of voluntary participants. These results suggest that further use of mandatory interlock programs should be just as successful as voluntary programs when offenders share characteristics with those studied in Alberta.

Accidents, Traffic↗
PubMed2001

Predicting repeat DUI offenses with the alcohol interlock recorder.

The aim of this report has been to use information contained in the alcohol ignition interlock recorder to determine whether systematic analysis of it can be used to predict which DUI offenders will recidivate during the first 2 years after the interlock is removed. The interlock record was accumulated during a 4-year intervention study in Alberta, Canada. Data from more than 5.5 million breath tests collected during interlock use were analyzed retrospectively after allowing repeat DUI offenses to accumulate for up to 2 years post-interlock. The rate of interlock warns at low BAC (0.02-0.04%) and fails at higher BAC ( > 0.04%) were found to be predictive of later repeat DUI. The interlock record was used along with selected driver record variables and questionnaire data to identify predictor sets. CHAID segmentation analysis was used to identify combinations of predictor variables; these were joined with sensitivity analysis to compare different predictor combinations. Several variables, but primarily more prior DUIs and more interlock warns and fails logged during the first 5 months of interlock usage predict greater than 60% of repeat DUI with a false positive rate of less than 10%.

Adult↗
PubMed2001

Use of protective equipment by in-line skaters: an observational study.

OBJECTIVE: To determine the extent of protective equipment use (that is, helmets, wrist guards, elbow pads, knee pads) in a representative sample of in-line skaters. SETTING: Fifteen municipalities throughout the province of British Columbia. METHOD: A province-wide observational survey was conducted in the summer of 1999. Skaters were observed at four types of sites (commuter, recreational, neighbourhood, general community) in 15 municipalities to provide a representative sample of in-line skaters. RESULTS: The observed use of protective equipment by the 877 in-line skaters was relatively low: wrist guards 25%, helmets 13%, elbow pads 14%, and knee pads 10%. CONCLUSION: Despite the availability of relatively inexpensive protective equipment, few in-line skaters take advantage of the opportunity to protect themselves from injury. Policies and programs that serve to increase the use of protective equipment by in-line skaters are needed to help reduce the frequency of skating related injuries.

Adolescent↗
PubMed1999

The Alberta Interlock Program: the evaluation of a province-wide program on DUI recidivism.

AIMS: This study was designed to determine the efficacy of alcohol safety interlocks in reducing recidivism among first and second driving-under-the-influence (DUI) offenders. It also evaluates the overall effectiveness of interlock programs where typically only a small portion of DUI offenders elect to install interlocks. DESIGN: The driving records of DUI offenders participating in interlock programs for 6 months for first offenders and 2 years for second offenders were compared with similar offenders who chose not to participate. SETTING: A province-wide program in Alberta, Canada. PARTICIPANTS: Records of 35,132 drivers convicted of DUI between 1 July 1998 and 30 September 1996 were analyzed MEASUREMENTS: Repeat DUI offenses during and after the interlock period. FINDINGS: While the offenders had interlocks on their vehicles, DUI recidivism was substantially reduced. Once the interlock had been removed and the participants had been reinstated, their DUI rate was the same as other offenders indicating that the interlock reduced recidivism while in place. Because only 8.9% of eligible drivers elected to participate in the interlock program, the program did not significantly increase the overall effectiveness of the province's management of DUI offenders. CONCLUSIONS: Interlocks are associated with a major reduction in DUI recidivism while on the vehicle of the offender. However, because few offenders elect to participate, the program produces only a small (5.9%) overall reduction in the recidivism rate of all DUI offenders.

Alberta↗
PubMed1999

Behavioral monitoring of DUI offenders with the Alcohol Ignition Interlock Recorder.

AIMS: To evaluate patterns of blood alcohol concentration (BAC) and driving logged on the ignition interlock recorder and to assess whether this event record is a useful outcome measure for a behavioral intervention. DESIGN: Descriptive analyses of recorder data and multivariate analysis of the predictors of high BACs associated with a motivational intervention for driving-under-the-influence (DUI) offenders using an interlock. SETTING: Two interlock service centers in Alberta, Canada. PARTICIPANTS: 1309 first-time and multiple DUI offenders who agreed to participate during interlock installation. INTERVENTION: A human-services (supportive guidance) intervention based on motivational interviewing and pragmatic counseling was delivered to interlock users in Calgary, but not to interlock users in Edmonton, Canada. MEASUREMENTS: This report summarizes the patterns and predictors of BAC warnings (0.02-0.039%) (20-39 mg/dl) and failures (> or = 0.04) (> or = 40 mg/dl) from more than 3 million in-vehicle breath tests. Data come from three sources: driver records, questionnaires and the interlock. FINDINGS: From the beginning to the end of the interlock use period, there was a significant linear decline in the proportion of positive BAC driving to total driving. After controlling for prior offenses, demographics and reported drinking levels, offenders in the intervention site (Calgary) were less likely to have recorded fail BACs than were offenders in the control site (Edmonton). The temporal patterns of BAC fails with the interlock mimic the high-risk periods for DUI arrests and alcohol-involved fatal crashes. CONCLUSIONS: The interlock successfully blocks drinking and driving during high-risk periods. Preliminary recorder data suggest the services intervention may be affecting DUI behavior.

Alberta↗
PubMed1994

Seat belt use among drinking drivers in Minnesota.

OBJECTIVES: Among the reasons cited for recent declines in alcohol-related traffic fatalities is the enactment of seat belt use laws by most states. It is suspected that drinking drivers are less likely to comply with such laws, although evidence on the relationship between belt use and drinking by drivers is sparse and conflicting. The purpose of this study was to examine the relationship of drinking to driver seat belt use. METHODS: Observational, self-report, and chemical breath test data were collected on nighttime drivers in 16 Minnesota communities during September, 1990. RESULTS: Drivers with an illegal blood alcohol concentration (> or = 100 mg/dL) were substantially less likely to be wearing a seat belt (odds ratio [OR] = 2.17). Belt use was also more common among females (OR = 2.02) and before midnight (OR = 1.47). Males who had been drinking were less likely to be belted. Belt use was related to drinking before, but not after, midnight. Belt use was not related to drinking status among college graduates, but it was strongly related to drinking status among those with less education. CONCLUSIONS: The present findings provide further argument for rapid implementation of passive countermeasures (airbags) and for development of creative, carefully focused interventions to target high-risk populations.

Accidents, Traffic↗
PubMed1993

Using a passive alcohol sensor to detect legally intoxicated drivers.

OBJECTIVES: We examined whether a passive alcohol sensor could be used for mass screening of motorists to accurately and quickly detect drivers whose blood alcohol concentration exceeded a variety of levels often established as per se evidence of legal intoxication. METHODS: In a voluntary roadside survey, 1181 late-night drivers in Minnesota were interviewed. Breath measurements were taken with both a passive alcohol sensor and an evidentiary quality portable breath-test device. RESULTS: Measurements could be taken much more easily and quickly with the passive sensor, whose readings correlated very strongly (r = .87) with the evidentiary device. Moreover, for criterion blood alcohol concentration levels ranging from 100 mg/dL to 20 mg/dL, a large proportion of motorists could be accurately identified as being above or below the criterion, with relatively few false-negative or false-positive identifications. CONCLUSIONS: The use of passive alcohol sensors at sobriety checkpoints should allow motorists to be processed very quickly with minimal inconvenience. At the same time, detection of legally intoxicated motorists will probably be substantially increased and the general deterrent value of per se alcohol-impaired driving laws enhanced.

Alcohol Drinking↗
PubMed1987

Self-estimates of blood alcohol concentration in drinking-driving context.

A total of 72 social drinkers between the ages of 20 and 57 years participated in an ad lib social drinking session. At various intervals throughout the session participants provided estimates of their blood alcohol concentration (BAC) along with breath samples for objective determination of their BAC. Participants were classified into three groups, based on the pattern of their BAC estimation errors-Underestimators, Overestimators, or Mixed Pattern estimators. Underestimators consumed more alcohol and attained higher BACs during the drinking session than the other two groups. Underestimators also rated their level of intoxication significantly lower than other groups and were most likely to judge themselves fit to drive when their actual BAC was in excess of the statutory limit.

Accidents, Traffic↗
PubMed1986

Youth, alcohol and relative risk of crash involvement.

Deaths and injuries due to road-crash involvement are a major health and safety problem, especially among youth. Numerous factors can account for the overrepresentation of young drivers in road crashes and one of these--alcohol--has received renewed attention. This paper examines evidence pertaining to drinking and driving among youth to determine the extent to which alcohol has special significance for crashes involving young drivers. Three sets of studies are reviewed: those providing data on the extent of drinking and drinking-driving among youth, those that examine alcohol use among youth involved in road crashes and those that estimate the relative risk of a road crash for young drinking drivers. Findings show that frequent and heavy alcohol consumption among teenagers and young adults is not unusual, although they are less likely than older age groups to drive after drinking. Nonetheless, those young people who drive after drinking have a greater risk of crash involvement than older drinking drivers at all blood alcohol concentrations. One explanation of this finding assumes that young people are "inexperienced" with drinking and with driving. Limited behavioural research done to date supports some but not all assumptions implicit in this reasoning. There is also evidence in favour of an alternative hypothesis, namely, that the comparatively higher crash-risk among young drinking drivers is attributable to a subset of this group, those that engage in risky driving behaviour and who also happen to use alcohol. Further investigation into the personal and social characteristics of young people who drive after drinking would provide a sounder empirical basis for policies and programmes to reduce crash involvement among youth.

Accidents, Traffic↗
PubMedDate not supplied

Trends in drinking driver fatalities in Canada.

Public and political concern and action focussed on the problem of drinking and driving during the 1980s was unprecedented. This paper examines the impact of these collective efforts by analyzing trends in the magnitude of the alcohol crash problem in Canada as reflected by drinking driver fatalities. After many years of little or no change in the magnitude of the drinking-driving problem, beginning in the early 1980s, both the number and percent of drinking driver fatalities began to decline. This trend continued over the entire decade. Despite these gains, a significant problem remains, in particular drivers with very high blood alcohol concentrations who appear to be relatively unaffected by countermeasures based on traditional measures such as deterrence and persuasion. New, innovative programs will be necessary to deal effectively with this "hard core" heavy drinking group.

Accidents, Traffic↗