Alcohol Involvement in Pedestrian Fatalities -- United States, 1982-1992

Pedestrian deaths constitute the second largest category of motor-vehicle-related fatalities (following vehicle-occupant deaths) and account for 14% of all traffic-associated deaths and approximately 3% of all traffic-associated injuries. In 1992, 5546 pedestrians were killed and 96,000 were injured in traffic crashes (1,2). Alcohol is an important determinant for both the likelihood of a motor vehicle colliding with a pedestrian and the outcomes for pedestrians in crashes (3). This report summarizes data from the Fatal Accident Reporting System of the National Highway Traffic Safety Administration (NHTSA) on trends in alcohol use in traffic fatalities involving pedestrians in the United States during 1982- 1992.

NHTSA considers a fatal crash to be alcohol-related if either a driver or a nonoccupant (e.g., pedestrian) had a blood alcohol concentration (BAC) of greater than or equal to 0.01 g/dL in a police-reported traffic crash. NHTSA defines a BAC greater than or equal to 0.01 g/dL but less than or equal to 0.09 g/dL as a low alcohol level. A BAC of 0.10 g/dL is the statutory level of intoxication for drivers in most states, although 10 states have established lower levels (e.g., 0.08 g/dL) as defining driver intoxication. There is no statutory level of intoxication for pedestrians. Because BACs are not available for all drivers and nonoccupants involved in fatal crashes, NHTSA uses statistical models, based on discriminant function analysis, to estimate BACs of drivers and pedestrians where driver or nonoccupant BAC data are not available (4).

From 1982 through 1992, the number of pedestrians aged greater than 14 years who were killed decreased 22%, from 6079 to 4770, with decreases during 1990-1992 accounting for most of this decline (Table_1). Each year, the percentage of drivers in these crashes who had consumed alcohol was substantially lower than the percentage of pedestrians who had consumed alcohol. In 1982, a BAC greater than or equal to 0.10 g/dL (i.e., intoxication) was detected in 20% of the drivers involved in fatal pedestrian crashes, compared with 39% of the fatally injured pedestrians. By 1992, the percentage of drivers who were legally intoxicated decreased to 12%, and the percentage of pedestrians with BACs greater than or equal to 0.10 g/dL had decreased to 36%.

Because NHTSA's models estimate BACs in only three ranges (0.00 g/dL, 0.01-0.09 g/dL, and greater than or equal to 0.10 g/dL), additional data regarding BACs were obtained from individual states. In the 23 states that tested at least 75% of all fatally injured pedestrians aged greater than 14 years during 1992, 40% of the pedestrians had consumed alcohol; the national prevalence estimate based on NHTSA's statistical models was 43% (Table_1). Of the fatally injured pedestrians who were tested in these states, BACs were low (0.01-0.09 g/dL) in 6%, high (0.10-0.19 g/dL) in 12%, and very high (greater than or equal to 0.20 g/dL) in 22%. Of the fatally injured pedestrians with BACs greater than or equal to 0.01 g/dL, 55% had a BAC greater than or equal to 0.20 g/dL, 30% had a BAC of 0.10-0.19 g/dL, and 15% had a BAC of 0.01-0.09 g/dL. Reported by: D Curtin, J Syner, M Vegega, PhD, Traffic Safety Programs; National Center for Statistics and Analysis, Research and Development, National Highway Traffic Safety Administration. Epidemiology Br, National Center for Injury Prevention and Control, CDC.

Editorial Note

Editorial Note: The findings in this report indicate that, since 1982, the percentage of drivers involved in fatal pedestrian crashes in whom alcohol was detected has decreased substantially; in comparison, the percentage of pedestrians involved in fatal crashes in whom alcohol was detected has decreased only slightly. These findings are similar to those reported by the American College of Surgeons' Major Trauma Outcome Study, in which 49% of seriously or fatally injured pedestrians consumed alcohol, and 24% had BACs greater than 0.20 g/dL (NHTSA, US Department of Transportation, unpublished data, 1992). Substantial progress has been made in reducing drinking and driving in the United States (5), and the national health objectives for the year 2000 for reducing alcohol-related fatalities had already been surpassed by 1991 (objective 4.1) (6). Risk factors for death for alcohol-impaired pedestrians are not yet well defined (7,8).

Public health strategies that may assist in reducing alcohol-related pedestrian fatalities include increasing the priority of preventing pedestrian injuries for public health agencies, traffic safety offices, and law enforcement officials; separating pedestrians from traffic lanes using guard rails or overpasses; providing public education in high-risk locations such as center-city nightspots; increasing the availability of buses, taxis, and other forms of public transportation; and increasing training in responsible alcohol service for establishments that serve alcohol.

References

1. National Highway Traffic Safety Administration. Fatal Accident Reporting System, 1992. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration (in press).

2. National Highway Traffic Safety Administration. General estimates system, 1992. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration (in press).

3. Jehle D, Cottington E. Effect of alcohol consumption on outcome of pedestrian victims. Ann Emerg Med 1988;17:953-6.

4. Klein TM. A method of estimating posterior BAC distribution for persons involved in fatal traffic accidents: final report. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration, 1986; report no. DOT-HS-807-094.

5. National Institute on Alcohol Abuse and Alcoholism. Eighth special report to the U.S. Congress on alcohol and health. Washington, DC: US Department of Health and Human Services, National Institutes of Health, 1993.

6. CDC. Factors potentially associated with reductions in alcohol-related traffic fatalities -- United States, 1990 and 1991. MMWR 1992;41:893-9.

7. Transportation Research Board. Alcohol and other drugs in transportation: research needs for the next decade. Washington, DC: National Research Council, Transportation Research Board, 1993; transportation circular no. 408.

8. Transportation Research Board. Safety research for a changing highway environment. Washington, DC: National Research Council, Transportation Research Board, 1990; special report no. 229.

Table_1
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TABLE 1. Estimated total number of pedestrian * fatalities in motor-vehicle crashes and
estimated number and percentage in whom alcohol was detected, and estimated total
number of drivers in fatal pedestrian * crashes and estimated number and percentage
in whom alcohol was detected, by year and blood alcohol concentration (BAC) level
-- United States, 1982-1992
=================================================================================================================
                     Pedestrian fatalities                       Drivers involved in pedestrian fatalities
       --------------------------------------------------    --------------------------------------------------
                     BAC=0.01-0.09 g/dL    BAC>=0.10 g/dL                  BAC=0.01-1.09 g/dL    BAC>=0.10 g/dL
          No.        ------------------    --------------       No.        ------------------    --------------
Year   fatalities +      No.    (%)         No.     (%)      fatalities +      No.    (%)         No.     (%)
---------------------------------------------------------------------------------------------------------------
1982      6079           476   (7.8)       2395   (39.4)        5456           478   (8.8)       1089   (20.0)
1983      5645           451   (8.0)       2196   (38.9)        5107           417   (8.2)        950   (18.6)
1984      5830           427   (7.3)       2230   (38.3)        5363           404   (7.5)        938   (17.5)
1985      5639           474   (8.4)       2097   (37.2)        5169           381   (7.4)        794   (15.4)
1986      5636           460   (8.2)       2060   (36.6)        5210           394   (7.6)        804   (15.4)
1987      5667           459   (8.1)       2023   (35.7)        5224           387   (7.4)        754   (14.4)
1988      5767           422   (7.3)       2022   (35.1)        5291           391   (7.4)        758   (14.3)
1989      5604           446   (8.0)       2028   (36.2)        5155           369   (7.2)        725   (14.1)
1990      5544           381   (6.9)       2002   (36.1)        5127           348   (6.8)        734   (14.3)
1991      4948           331   (6.7)       1795   (36.3)        4609           335   (7.3)        610   (13.2)
1992      4770           332   (7.0)       1727   (36.2)        4468           284   (6.4)        533   (11.9)
---------------------------------------------------------------------------------------------------------------
* Aged >14 years.
+ Includes those with 0.00 BAC.

Source: Fatal Accident Reporting System, National Highway Traffic Safety Administration,
1982-1992.
=================================================================================================================

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