Alcohol, psychoactive drugs and fatal road traffic accidents in Norway: a case-control study.

A case-control study was conducted on 204 drivers fatally injured in road traffic accidents in south-eastern Norway during the period 2003-2008. Cases from single vehicle accidents (N = 68) were assessed separately. As controls, 10540 drivers selected in a roadside survey in the same geographical area during 2005-2006 were used. Blood samples were collected from the cases and oral fluid (saliva) samples from the controls. Samples were analysed for alcohol, amphetamines, cannabis, cocaine, opioid analgesics, hypnotics, sedatives and a muscle relaxant; altogether 22 psychoactive substances. Equivalent cutoff concentrations for blood and oral fluid were used. The risk for fatal injury in a road traffic accident was estimated using logistic regression adjusting for gender, age, season of the year, and time of the week. The odds for involvement in fatal road traffic accidents for different substances or combination of substances were in increasing order: single drug < multiple drugs < alcohol only < alcohol+drugs. For single substance use: medicinal drug or THC < amphetamine/methamphetamine < alcohol. For most substances, higher ORs were found when studying drivers involved in single vehicle accidents than for those involved in multiple vehicle accidents, but confidence intervals were wider.

[1]  H. Gjerde,et al.  Determination of amphetamine and methamphetamine in blood by derivatization with perfluorooctanoyl chloride and gas chromatography/mass spectrometry. , 1993, Journal of analytical toxicology.

[2]  B. Ludes,et al.  Testing for zolpidem in oral fluid by liquid chromatography-tandem mass spectrometry. , 2004, Journal of chromatography. B, Analytical technologies in the biomedical and life sciences.

[3]  H. Gjerde,et al.  Screening for drugs in forensic blood samples using EMIT urine assays. , 1990, Forensic science international.

[4]  A. Zwi,et al.  Road traffic injuries in developing countries: a comprehensive review of epidemiological studies , 1997, Tropical medicine & international health : TM & IH.

[5]  Robert B. Voas,et al.  2007 National Roadside Survey of Alcohol and Drug Use by Drivers: Alcohol Results , 2009 .

[6]  Terje Assum,et al.  Prevalence of alcohol and drugs among Norwegian motor vehicle drivers: a roadside survey. , 2008, Accident; analysis and prevention.

[7]  P. Swann,et al.  The involvement of drugs in drivers of motor vehicles killed in Australian road traffic crashes. , 2004, Accident; analysis and prevention.

[8]  B Ludes,et al.  Comparison of the prevalence of alcohol, cannabis and other drugs between 900 injured drivers and 900 control subjects: results of a French collaborative study. , 2003, Forensic science international.

[9]  A. Verstraete,et al.  Relationship Between Oral Fluid and Blood Concentrations of Drugs of Abuse in Drivers Suspected of Driving Under the Influence of Drugs , 2009, Therapeutic drug monitoring.

[10]  H. Gjerde,et al.  Evaluation of a method for simultaneous quantification of codeine, ethylmorphine and morphine in blood. , 1991, Forensic science international.

[11]  Olaf H Drummer,et al.  Postmortem toxicology of drugs of abuse. , 2004, Forensic science international.

[12]  A. Egberts,et al.  Psychoactive substance use and the risk of motor vehicle accidents. , 2004, Accident; analysis and prevention.

[13]  H Gjerde,et al.  Incidence of alcohol and drugs in fatally injured car drivers in Norway. , 1993, Accident; analysis and prevention.

[14]  A. Zwi,et al.  Drinking and driving in an urban setting in Kenya. , 1997, East African medical journal.

[15]  L. Kristoffersen,et al.  An automated alcohol dehydrogenase method for ethanol quantification in urine and whole blood. , 2005, Journal of analytical toxicology.

[16]  P. Lillsunde,et al.  Drug testing in oral fluid-evaluation of sample collection devices. , 2008, Journal of analytical toxicology.

[17]  L. González-Wilhelm.  Prevalence of Alcohol and Illicit Drugs in Blood Specimens from Drivers Involved in Traffic Law Offenses. Systematic Review of Cross-Sectional Studies , 2007, Traffic injury prevention.

[18]  Charles Mock,et al.  A Random, Roadside Breathalyzer Survey of Alcohol Impaired Driving in Ghana , 2001 .

[19]  L. Kristoffersen,et al.  Headspace gas chromatographic determination of ethanol: the use of factorial design to study effects of blood storage and headspace conditions on ethanol stability and acetaldehyde formation in whole blood and plasma. , 2006, Forensic science international.

[20]  R. F. Borkenstein,et al.  The role of the drinking driver in traffic accidents (the Grand Rapids study) , 1974 .

[21]  B A Goldberger,et al.  Alternative specimens for workplace drug testing. , 2001, Journal of analytical toxicology.

[22]  M. Woodward,et al.  Marijuana use and car crash injury. , 2005, Addiction.

[23]  Olaf H Drummer,et al.  Demands on scientific studies in different fields of forensic medicine and forensic sciences. Traffic medicine--impaired driver: alcohol, drugs, diseases. , 2007, Forensic science international.

[24]  E. Cone.  Legal, workplace, and treatment drug testing with alternate biological matrices on a global scale. , 2001, Forensic science international.

[25]  A. Jones.  Inter- and intra-individual variations in the saliva/blood alcohol ratio during ethanol metabolism in man. , 1979, Clinical chemistry.

[26]  S Houwing,et al.  The prevalence of drug driving and relative risk estimations: a study conducted in the Netherlands, Norway and United Kingdom , 2005 .

[27]  Paul Griffiths,et al.  Drug Use, Impaired Driving and Traffic Accidents , 2008 .

[28]  A. Verstraete,et al.  Drugs and Driving , 2004, Traffic injury prevention.

[29]  A. Verstraete,et al.  Can the prevalence of high blood drug concentrations in a population be estimated by analysing oral fluid? A study of tetrahydrocannabinol and amphetamine. , 2010, Forensic science international.

[30]  A. Christophersen.  Tetrahydrocannabinol stability in whole blood: plastic versus glass containers. , 1986, Journal of analytical toxicology.

[31]  J. Ramaekers,et al.  Dose related risk of motor vehicle crashes after cannabis use. , 2004, Drug and alcohol dependence.

[32]  H. Gjerde,et al.  Comparison of zopiclone concentrations in oral fluid sampled with Intercept(®) oral specimen collection device and Statsure Saliva Sampler™ and concentrations in blood. , 2010, Journal of analytical toxicology.

[33]  M. Bédard,et al.  The Impact of Cannabis on Driving , 2007 .

[34]  E. Kelly,et al.  A review of drug use and driving: epidemiology, impairment, risk factors and risk perceptions. , 2004, Drug and alcohol review.

[35]  J. Mørland,et al.  Postmortem drug redistribution--human cases related to results in experimental animals. , 1999, Journal of forensic sciences.

[36]  Raymond C. Peck,et al.  The Long Beach/Fort Lauderdale relative risk study. , 2009, Journal of safety research.

[37]  H. Gjerde,et al.  Comparison of drug concentrations in blood and oral fluid collected with the Intercept sampling device. , 2010, Journal of analytical toxicology.

[38]  A. Christophersen,et al.  Drug screening of preserved oral fluid by liquid chromatography-tandem mass spectrometry. , 2007, Clinical chemistry.

[39]  Jean-Louis Martin,et al.  Cannabis intoxication and fatal road crashes in France: population based case-control study , 2005, BMJ : British Medical Journal.

[40]  P. Suriyawongpaisal,et al.  Alcohol, illicit and non-illicit psychoactive drug use and road traffic injury in Thailand: a case-control study. , 2009, Accident; analysis and prevention.

[41]  M. Huestis,et al.  Oral fluid as a diagnostic tool , 2004, Clinical chemistry and laboratory medicine.