Biomedical subjects

Paul R Marques

Publications and source records attributed to Paul R Marques.

6 recordsLinked to original sources

PubMed2004

Emerging technological approaches for controlling the hard core DUI offender in the U.S.

Drivers convicted of impaired driving are substantially overrepresented in alcohol-related fatal crashes. Because many such offenders continue to drive with suspended operators' licenses, monitoring their postconviction driving is a significant problem for the criminal justice system. Technology for tracking the location and drinking of such offenders is a rapidly developing field, which promises to provide methods for monitoring offenders on a 24/7 basis. The status of traditional monitoring methods is reviewed and contrasted with the new technologies that are being implemented. Although those technologies offer considerable promise, they have not yet been evaluated in programs for impaired driving offenders. Eight issues related to the probability of rapid implementation of the new technologies are discussed.

Alcohol Drinking↗

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 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

Barriers to interlock implementation.

This commentary reviews current and past vehicle interlock programs for impaired driving offenders with a focus on the challenges that courts and motor vehicle departments face in attempting to implement mandatory programs as required by current federal legislation. There are few offenders in interlock programs compared to the large number of impaired drivers arrested each year. This suggests that, to increase participation, courts will have to threaten more severe sanctions for those offenders who reject interlock programs. A combination of electronic house arrest with interlock programs is suggested as a method of maximizing interlock use.

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↗