Prevalence of therapeutic drugs in blood of drivers involved in traffic crashes in the area of Bologna, Italy

Pelletti, Guido; Verstraete, Alain G.; Reyns, Tim; Barone, Rossella; Rossi, Francesca; Garagnani, Marco; Pelotti, Susi

doi:10.1016/j.forsciint.2019.109914

Cited by 28 publications

(14 citation statements)

References 24 publications

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“…These data are slightly lower than that reported in other studies over the last 20 years, in which the percentage of alcohol-related crash accidents ranges between 22% and 25% of total accidents. 2,11,13,15 Of note, approximately 50% of positive subjects showed a BAC >1.5 g/L. The data confirm a strict correlation between BAC levels and accident risk, which is consistent with data reported in other studies.…”

Section: Discussionsupporting

confidence: 91%

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Alcohol-associated traffic injuries in Verona territory: A nine-year survey

et al. 2021

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According to the World Health Organization, as many as 25% of traffic accidents are linked to alcohol abuse. This study describes the results of a nine-year study performed on injured drivers ( N = 12,806) in the Verona area of Northern Italy. Blood samples were mandatorily collected on injured drivers who were admitted to the Emergency Health Care Unit of Verona Hospital between 2009 and 2017, after they had been involved in a traffic accident. Blood alcohol concentration (BAC) determination was then undertaken using a validated head space–gas chromatography–flame ionisation detector (HS-GC-FID) method. We found that 21% of drivers tested positive for alcohol (BAC ≥0.01 g/L), while 16.8% presented with BAC levels above the Italian legal limit (>0.5 g/L). Of those who had positive BACs, about 50% presented with very high BAC levels (>1.5 g/L). Daily time distribution analyses, involving 2031 alcohol-positive drivers, showed a surge between 18:00 hours and 06:00 hours (74.3%), with a specific rise during the weekend (58.9%). The percentage of alcohol-related road accidents was 20.6%, which is lower than results reported in other international studies performed over the last 20 years. However, evidence that around 50% of the positive subjects showed a BAC >1.5 g/L confirms the correlation between BAC and accident risk, which becomes even more significant at progressively increasing levels of BAC. The study highlights the need to implement further strategies to both prevent and deter the use of alcohol while driving.

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Section: Discussionsupporting

confidence: 91%

“…12 Very similar results were reported in a study carried out in Italy, in the area of Bologna, over a 14-month period (January 2017–March 2018), including 1130 car accidents, in which the percentage of cases with a BAC >0.5 g/L was reported to be 17.3%. 13…”

Section: Introductionmentioning

confidence: 99%

Alcohol-associated traffic injuries in Verona territory: A nine-year survey

et al. 2021

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“…To date, a limited number of studies assessing the relevance of psychotropic medications in medico-legal issues have been published in Europe, except for studies analyzing drivers involved in road fatalities [29][30][31]. Nevertheless, it should be noted that most studies on drivers only assessed the prevalence of drugs belonging to the core list of substances included in the project "Driving Under the Influence of Drugs, Alcohol and Medicines in Europe" (DRUID Project) [32,33].…”

Section: Discussionmentioning

confidence: 99%

Medical Psychotropics in Forensic Autopsies in European Countries: Results from a Three-Year Retrospective Study in Spain

Almeida-González

Boada

Hernández

et al. 2022

Toxics

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Medical psychotropics are widely used and prescribed in developed countries. These medications may have an impairing effect on mood or perception and may induce harmful behaviors. Nevertheless, in Europe, studies on their importance from a medico-legal perspective are scarce. To fill this gap, we evaluate the determinants of these drugs in a retrospective study based on data obtained from forensic autopsies. Toxicological analyses were performed on 394 blood samples from compulsory autopsies at the Institute of Legal Medicine of Las Palmas. Of the samples, 41% (159) were positive for at least one psychotropic, with benzodiazepines being the most frequently detected (24.1%), followed by opiates and antidepressants. Benzodiazepines, opiates, and antidepressants were detected more frequently in men who suffered a violent death. More than 30% of the positive samples showed two or more drugs, suggesting a prevalence of polypharmacy among forensic autopsy subjects, with the most frequently combination found being benzodiazepines plus opiates (28.3% of positive samples). A combination of opiates plus antidepressants was also found in subjects involved in violent deaths. Our results suggest that more than 40% of the adult European population involved in medico-legal issues may be under the influence of legal psychotropics. The link between violent deaths and the use of medical psychotropics is particularly worrisome and indicates that these drugs should be carefully monitored in developed countries, in all forensic autopsies, in a similar way to illegal psychotropics.

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“…A general enzyme immunoassay screening and a specific research for cannabinoids and alcohol by GC-MS [14] tested positive for 11-Nor-9-carboxy-Δ9tetrahydrocannabinol (THC-COOH) in urine and central blood (112 ng/mL). A quali-quantitative screening for psychoactive drugs and for 150 novel psychoactive substances (NPS, listed in Supplementary material 1) was additionally performed on blood samples by means of ultra-performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS) with fully validated methods according to International Guidelines [15][16][17]. Samples were found negative for all tested compounds.…”

Section: Toxicological Analysesmentioning

confidence: 99%

Importance of dashboard camera (Dash Cam) analysis in fatal vehicle–pedestrian crash reconstruction

Giovannini

Giorgetti

Pelletti

et al. 2021

Forensic Sci Med Pathol

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The reconstruction of dynamic of traffic injuries remains a challenge in forensic pathology and is often based on circumstantial data. Dash Cams are digital video recorders which can be located inside a vehicle and continuously record the view through the windscreen, thus providing objective evidence. Here we present the case of a traffic crash in which a pedestrian was hit by an articulated lorry. The analysis of a video recorded from a Dash Cam retrieved inside the vehicle during the death scene investigation (DSI) was crucial in the reconstruction of the manner of death. Indeed, the death, which was initially assumed to be accidental, was finally deemed as a suicide on the basis of the video recording, which showed an intentional and sudden rush of the victim to the middle of the roadway. Advantages and disadvantages of the use of Dash Cams will be discussed, focusing on the profound differences in the related national and international regulations. Based on the present case, in traffic crashes, the search for Dash Cams during the DSI may be recommended and the video recordings should be analyzed in the setting of a multidisciplinary and multimodal evaluation of the case, for a proper reconstruction of the facts.

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Prevalence of therapeutic drugs in blood of drivers involved in traffic crashes in the area of Bologna, Italy

Cited by 28 publications

References 24 publications

Alcohol-associated traffic injuries in Verona territory: A nine-year survey

Alcohol-associated traffic injuries in Verona territory: A nine-year survey

Medical Psychotropics in Forensic Autopsies in European Countries: Results from a Three-Year Retrospective Study in Spain

Importance of dashboard camera (Dash Cam) analysis in fatal vehicle–pedestrian crash reconstruction

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