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Reduction in Fatalities, Ambulance Calls and Hospital Admissions For RESEARCH AND PRACTICE Reduction in Fatalities, Ambulance Calls, and Hospital Admissions for Road Trauma After Implementation of New Traffic Laws Jeffrey R. Brubacher, MD, MSc, Herbert Chan, PhD, Penelope Brasher, PhD, Shannon Erdelyi, BSc, Edi Desapriya, PhD, Mark Asbridge, PhD, Roy Purssell, MD, Scott Macdonald, PhD, Nadine Schuurman, PhD, and Ian Pike, PhD Motor vehicle crashes (MVCs) are a major Objectives. We evaluated the public health benefits of traffic laws targeting public health problem that disproportionately speeding and drunk drivers (British Columbia, Canada, September 2010). affects youths and young adults.1 Worldwide, Methods. We studied fatal crashes and ambulance dispatches and hospital more than 3300 people per day are killed in admissions for road trauma, using interrupted time series with multiple non- 2 road trauma, and many more are disabled. equivalent comparison series. We determined estimates of effect using linear Crashes are caused by numerous factors, in- regression models incorporating an autoregressive integrated moving average cluding faulty vehicles and poor road design, error term. We used neighboring jurisdictions (Alberta, Saskatchewan, Washington but the majority are attributed to driver-related State) as external controls. factors, especially alcohol-impaired driving,3,4 Results. In the 2 years after implementation of the new laws, significant speeding,5,6 and driver distraction.7,8 In Canada, decreases occurred in fatal crashes (21.0%; 95% confidence interval [CI] = 15.3, driving with a blood alcohol concentration 26.4) and in hospital admissions (8.0%; 95% CI = 0.6, 14.9) and ambulance calls (BAC) of 0.08% or more is a federal criminal (7.2%; 95% CI = 1.1, 13.0) for road trauma. We found a very large reduction in alcohol-related fatal crashes (52.0%; 95% CI = 34.5, 69.5), and the benefits of offense. Most provinces have regulations that the new laws are likely primarily the result of a reduction in drinking and allow for administrative sanctions (fines or driving. license suspension) for drivers with a BAC of Conclusions. These findings suggest that laws calling for immediate sanctions 0.05% or more. Speed limits are set by the for dangerous drivers can reduce road trauma and should be supported. (Am J provinces and enforced through administrative Public Health. 2014;104:e89–e97. doi:10.2105/AJPH.2014.302068) sanctions. Before September 2010, drunk drivers in British Columbia were subject to fines and which add to but do not replace the older laws, and for speeding and related offenses under administrative driving prohibitions of 24 hours drivers with a BAC of 0.05% or more may the old versus new traffic laws. for a BAC of 0.05% or more and of 90 days for be subject to license suspension of 3, 7, or 30 British Columbia’s laws were designed to a BAC of 0.08% or more or failure to provide days; vehicle impoundment of 3, 7, or 30 days deter drinking and driving by increasing the a breath sample. The 90-day driving ban came (discretionary with 3- or 7-day license suspen- severity, certainty, and speed of punishment for into effect after a 21-day period that allowed sions, mandatory for 30-day license suspen- drunk drivers with a BAC of 0.05% or more. the driver to find alternative means of trans- sions); and possible referral to remedial programs Deterrence is effective in laws against traffic portation or to appeal the decision. There were (including ignition interlock) for third-time violations,11 and increased likelihood of pun- no vehicle impoundments for drunk drivers. In offenders. Drivers with a BAC of 0.08% or ishment acts as a greater deterrent than in- addition to administrative penalties, drivers more are subject to 30-day vehicle impound- creased severity.12,13 The speed with which with a BAC of 0.08% or more and those who ment, 90-day license suspension, and possible a punishment is applied is an additional de- refused to provide a breath sample were sub- referral to remedial programs (including igni- terrent.14 For drivers with a BAC of 0.08% or ject to possible penalties under the Criminal tion interlock). In addition, drunk drivers are more, the administrative sanctions under the Code of Canada. Before September 2010, the subject to fees that include towing costs, vehicle new laws are actually less severe than those penalty for street racing was vehicle impound- storage costs, and a processing fee to have their associated with a criminal code conviction for ment for 2 days for a 1st offense and for 30 license reinstated. License prohibitions and drunk driving. However, the new sanctions are days for 2nd and subsequent offenses in addi- vehicle impoundments are issued immediately applied immediately at roadside and are less tion to fines and possible criminal code charges. at the roadside on the basis of results of subject to legal challenge, making punishment In September 2010, British Columbia in- a handheld breathalyzer. The penalties for more swift and certain. Not all drunk drivers troduced harsher penalties for drunk drivers excessive speeding, street racing, and stunt are deterred by threat of punishment,15 but and for excessive speeding (> 40 km/h over driving include fees and mandatory vehicle through vehicle impoundment and license the speed limit) as well as for drivers caught impoundment of 7 to 60 days.9,10 Table 1 suspension, British Columbia’s new laws re- street racing or stunt driving. Under these laws, summarizes penalties for drinking and driving move more dangerous drivers from the roads October 2014, Vol 104, No. 10 | American Journal of Public Health Brubacher et al. | Peer Reviewed | Research and Practice | e89 RESEARCH AND PRACTICE TABLE 1—Comparison of British Columbia’s Old and New Speeding and Street Racing Laws Penalties Driving Offense Before September 2010a After September 2010b,c BAC level 0.0–0.049 12-h driving prohibition for drivers with restricted license 0.05–0.079 (1st offense) 24-h driving prohibition 3-d driving prohibition Possible 3-d vehicle impoundment Fees (£ $600) 0.05–0.079 (2nd offense within 5 y) 24-h driving prohibition 7-d driving prohibition Possible 7-d vehicle impoundment Fees (£ $780) 0.05–0.079 (3rd offense within 5 y)d 24-h driving prohibition 30-d driving prohibition 30-d vehicle impoundment Fees (£ $1330) ‡ 0.08 or refuses breath testd 90-d driving prohibition beginning 21 d after the offense 90-d driving prohibition (immediate) (this 21-d period was to allow driver to arrange alternate 30-d vehicle impoundment transportation or to appeal the decision) Fees (£ $1450) Possible Criminal Code of Canada charges Speeding and stunt driving Speeding £ 40 km over limit Fines and demerit points No change Speeding > 40 km per hour or stunt drivinge Fines and demerit points 7-d vehicle impoundment (first offense) Fees £ $210 Speeding > 40 km per hour or stunt drivinge Fines and demerit points 30-d vehicle impoundment (second offense within 2 y) Fees £ $700 Speeding > 40 km per hour or stunt drivinge Fines and demerit points 60-d vehicle impoundment (third offense within 2 y) Fees £ $1200 Street racing 1st offense Fines and demerit points (street racing only) 7-d vehicle impoundment 48-h vehicle impoundment Fees £ $210 2nd offense within 2 y Fines and demerit points (street racing only) 30-d vehicle impoundment 30-d vehicle impoundment Fees £ $700 3rd and subsequent offense within 2 y Fines and demerit points (street racing only) 60-d vehicle impoundment 30-d vehicle impoundment Fees $1200 Note. BAC = blood alcohol concentration; IRP = immediate roadside prohibitions. aAll penalties that existed before September 2010 remain in effect. Starting September 2010, IRPs provided an additional tool for police to use at their discretion. bSince September 2010, police usually apply immediate penalties under the new laws. However, they still have the option of using the preexisting laws instead. Therefore, the 3 typical outcomes for drivers with BAC ‡ 0.05% or who refuse a breath test are as follows: (1) most get an IRP, (2) some get a 24-h (or 12-h) driving prohibition, and (3) some get a 90-d driving prohibition plus criminal code charges. cNote that the penalties for excessive speeding (> 40 km over limit), street racing, and stunt driving are identical under the new laws. dDrivers with 3 offenses for BAC = 0.05%–0.079% or 1 offense for BAC > 0.08% may be referred to the responsible driver program, the ignition interlock program, or both. eThe new laws expanded the vehicle impound program to introduce and define “stunt driving,” something that was not specifically covered under the old laws. quicker. High-risk drunk drivers can also be measures16 and that public perception of police 5 years preceding the new laws to 1853 in the mandated to undergo therapy, install an alco- commitment to traffic enforcement had in- subsequent 12 months (Figure1). The new laws hol interlock device on their vehicle, or both. creased.17 During the first 12 months, British were associated with change in driver behav- These laws were promoted through public Columbia police used the new laws to issue ior. In the 2012 British Columbia roadside awareness and educational campaigns and re- 22 734 roadside license prohibitions for surveys, 6.5% of evening and nighttime drivers ceived considerable media coverage. Opinion drinking and driving. At the same time, the tested positive for BAC compared with 9.9% in and roadside surveys in 2012 found that number of criminal code convictions for im- 2010 before the new laws were introduced.16 majority of drivers were aware of the new paired driving fell from 8221 per year in the Telephone surveys found that the percentage e90 | Research and Practice | Peer Reviewed | Brubacher et al.
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