http://psychiatry.medscape.com/22245.rhtml

Most Children Who Die in
Drunk-Driving Accidents Were Riding
With The Drinking Driver


WESTPORT, May 30 (Reuters Health) - In the May 3rd issue of
The Journal of the American Medical Association, two articles
highlight the continuing need for education and policy
interventions to reduce the number of alcohol-related deaths and
injuries of children.

Dr. Lewis H. Margolis and colleagues from the University of
North Carolina at Chapel Hill analyzed data from the 1991 to
1996 Fatality Analysis Reporting System, a nationwide registry
of motor vehicle deaths. The researchers looked at a cohort of
16,676 children younger than 16 whose death resulted from a
motor vehicle accident. The subjects were passengers, cyclists or
pedestrians.

The results indicated that 3,310 deaths (19.9%) were linked to
alcohol use by the driver of the motor vehicle. "Of the
alcohol-related deaths, 79.5% involved children as passengers,
and the remainder involved pedestrians or bicyclists struck by
drivers who had been drinking alcohol." Drivers under the legal
age to purchase alcohol accounted for 30.3% of the fatalities.

Dr. Margolis and his team say that in light of the latter finding,
"laws governing availability of alcohol to this age group should
be more rigorously enforced." In addition, the researchers
recommend increasing the tax on alcoholic beverages to
discourage teenagers from purchasing them.

In the second study, Dr. Kyran P. Quinlan and associates from
the Centers for Disease Control and Prevention, Atlanta, Georgia
reviewed 1985 to 1996 data from the same database that Dr.
Margolis' group used, as well as 1988 to 1996 data from the
General Estimates System on nonfatal injuries.

They found that between 1985 and 1996, a total of 5,555 children
died in car accidents in which the driver had been drinking. Of
these, 3,556 (64%) were passengers riding with a "drinking"
driver. The researchers note that "child restraint use decreased as
both the child's age and the blood alcohol concentration of the
child's driver increased."

Dr. Quinlan's group reports that between 1988 and 1996, a total
of 149,000 children sustained nonfatal injuries in automobile
accidents involving drunk drivers. "Of these, 58,000 (38.9%) were
riding with a drinking driver when injured in the crash."

Dr. Quinlan and his colleagues recommend stricter laws and
punishment for drunk driving, including license suspension,
mandatory substance abuse assessment and treatment, and "zero
tolerance for alcohol use by drivers younger than 21 years." They
also call for counseling by healthcare providers on the dangers of
drunk driving and "stricter enforcement of child safety seat laws."

In an editorial in the same issue, Dr. Guohua Li calls for the
adoption of a federal zero-tolerance policy for drunk driving. Dr.
Guohua says, "Tolerance of drinking and driving implies
tolerance of more than 15,000 alcohol-related deaths in the United
States this year, next year and as long as drivers and passengers
share the road with others who drink and drive."

JAMA 2000;283:2245-2252,2291-2292.


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