Memorandum from the Royal College of Physicians
(RCP) (DDD 25)
The Royal College of Physicians (RCP) plays
a leading role in the delivery of high quality patient care by
setting standards of medical practice and promoting clinical excellence.
We provide physicians in the United Kingdom and overseas with
education, training and support throughout their careers. As an
independent body representing over 25.000 Fellows and Members
worldwide, we advise and work with government, the public, patients
and other professions to improve health and healthcare.
1. Should the permitted blood alcohol limit
be reduced as proposed?
The RCP has consistently called for the blood
alcohol limit to be reduced to 50mg/dl. The data confirming BAC
of 50mg/dl as a suitable level for legislation has been accepted
by all EU countries with the exception of the UK. Ireland has
recently passed a Bill reducing the level to 50mg/dl. There is
clear evidence that a reduction in the drink drive limit will
reduce the number of deaths and serious injury caused by drink
driving. Reaction times and motoring skills of drivers begin to
deteriorate after even a small amount of alcohol, with the effects
becoming more marked with increasing alcohol consumption.
With blood alcohol levels (BAC) between 50mg/dl
and 80mg/dl the risk of accident increases by 400%, this data
is quoted by the Dept of Transport in a previous consultation
document.i When blood alcohol levels were reduced from 80 to 50mg/dl
in New South Wales, fatal accidents reduced by 8% and single vehicle
night time crashes by 11%.ii When Denmark reduced BAC from 80mg%
to 50mg% in 1998, overall accidents were reduced although there
was no significant change in fatal accidents. iii Furthermore
introduction of BAC of 20mg/dl for inexperienced drivers led to
reduction in fatal crashes of between 9% and 24% in California.
iv
If there is to be a BAC prescribed limit, we
believe that 50mg limit is the simplest message for drinkers to
understand. The current level is complex and difficult for people
to calculate what they are likely to be able to drink. This is
dependent on body size, gender, age and whether food is consumed.
One pub measure of alcohol (a 175ml glass of standard-strength
wine or half a pint of strong beer) is all that would be allowed;
compliance would increase as it would be easier to understand.
A survey by the Automobile Association in conjunction
with Populus in 2008 found that two thirds of the Association's
members were in support of a reduction in the drink driving limit.
Almost a third of respondents felt that a "zero tolerance"
approach would be preferable.v Clearly there is strong public
support for action on drink driving. Responses to the Government's
consultation, "Combating Drink Driving", published
in 2000, revealed a clear majority in favour of a lower limit,
including 79% of the local authorities which responded. vi
2. How severe is the problem of drug driving
and what should be done to address it?
The RCP believes that there are good grounds
for believing that driving under the influence of drugs, both
recreational and prescription may be a factor in traffic fatalities
and injuries, and we regret the paucity of good data that would
enable policy in this area to be evidence based. In view of the
lack of good data we strongly support the proposal that the routine
assessment of alcohol levels in fatal accidents is extended to
the presence of both prescription and recreational drugs. All
fatal or near fatal traffic accidents should be fully investigated
with samples taken for the assay of alcohol and levels of recreational
and prescription drugs.
3. What are the wider costs and benefits
that are likely to result from changes to the drink and drug driving
law?
Between 50mg and 80mg drivers are 2-2.5 times
more likely to be involved in an accident than drivers with no
alcohol, and up to 6 times more likely to be involved in a fatal
crash. vii In 2000, the Government's Road Safety Strategy estimated
that reducing the limit to 50mg could save 50 lives, and prevents
250 serious injuries and 1,200 slight injuries each year. A more
recent examination of the figures suggests that reducing the legal
limit could save 65 lives each year and prevents 230 serious injuries.
viii Given an average cost of over £1.6 million per fatality;
the economic benefits would be very significant. Changes to drink
driving laws, and the public attention that is likely to accompany
such changes, may contribute to the wider public health debate
about sensible drinking.
August 2010
REFERENCESi Dept
of Transport, Relative probablity of causing an accident in relation
to blood alcohol; Road Safety Compliance Consultation. 2008
http://www.dft.gov.uk/consultations/open/compliance/
ii Hendsridge J, Homel R, Mackay P. The long-term
effects of random breath testing in four Australian states; a
time series analysis. Canberra: Federal Office of Road Safety;
1997.
iii Bernhoft I M, Behrensdorff I. Effect of lowering
the alcohol limit in Denmark. Accid Anal Prev 2003, Jul;
35:515-25.
iv Voas R B, Hause J M. Deterring the drinking
driver: the Stockton experience. Accid Anal Prev 1987 Apr;
19:81-90.
v Automobile Assocation. Call for Cut to Drink
Drive Limit,2008.
vi Department for Transport. Next Steps: Combating
drink driving, 2000.
vii Tomorrow's Roads: Safer for Everyone, DETR,
2000.
viii R Allsopp. Reducing the BAC level to 50
mg—What Can We Expect to Gain?, PACTS Research Briefing,
2005.
| 
