The Grand Rapids dip revisited

How Dangerous Are Drinking Drivers?

“…His highrisk estimates, especially at the highest BAC levels, can be explained by 15 To the extent that the drinking drivers, when they are themselves sober, are systematically safer/more dangerous than other sober drivers, this coefficient gives a biased estimate of the incremental effect of alcohol on driver risk. Previous research (Hurst et al 1994) suggests that drinking drivers, when sober, are actually safer than the typical sober driver. If that is the case, then the coefficients in table 2 understate the true impact of alcohol on driver risk.…”

“…Past research has attempted to measure this fraction through the use of random roadblocks and driver stops (Lehman, Wolfe, and Kay 1975;Lund and Wolfe 1991;Hurst, Harte, and Frith 1994). 2 While these studies are extremely valuable, they suffer from a number of important limitations.…”

Multicentre study of acute alcohol use and non-fatal injuries: data from the WHO collaborative study on alcohol and injuries

“…36 Some reports have tried to disen--tangle differences between acute alcohol use and risk of injury according to the participant's usual consumption pat--tern; 17 this is a matter of great interest to public health professionals. 37 Studies of drivers involved in fatal crashes 19 and cross-sectional data from a study of drinking and driving, 38 as well as data from population surveys of drinking and injury, 39 have suggested that episodes of intoxication may have a different im--pact among people who do not usually drink heavily. It has also been suggested that "more frequent drinkers have less risk at all blood alcohol concentration levels, including zero, than less frequent drinkers."…”

“…It has also been suggested that "more frequent drinkers have less risk at all blood alcohol concentration levels, including zero, than less frequent drinkers." 19 An inherent difficulty with most research in this area is the fact that for individuals, there is a correlation be--tween chronic and acute drinking. The case-crossover study design is especially useful in disentangling the effect of both types of exposure, 40,41 and Vinson et al 2 and Borges et al 3 have addressed this issue in studies in emergency depart--ments, but their studies had conflicting results.…”

“…19 Although these issues have been par--tially addressed in prior case-crossover reports, 1,4,20 which have found mixed results, an important factor in a detailed analysis of these issues is the small sample size used in most studies, which affects the power of the analysis of the effects on those who consume only small amounts of alcohol and the comparisons that are made across key modifiers of the effects. The WHO collaborative study on alco--hol and injuries 21 is a large multicentre survey of injured patients presenting in hospitals worldwide; its data can be used to help circumvent these limitations.…”