Written evidence from the Parliamentary
Advisory Council for Transport Safety (PACTS) (DDD 16)
The Parliamentary Advisory Council for Transport
Safety (PACTS) is a registered charity and an associate Parliamentary
Group. Its charitable objective is "To protect human life
through the promotion of transport safety for the public benefit".
Its aim is to advise and inform members of the House of Commons
and of the House of Lords on air, rail and road safety issues.
(1) Should the permitted blood alcohol limit
be reduced as proposed?
Yes. Although the evidence around drink-related
road death and injury could be improved through more accurate
data collection and use, there is a strong evidence base to support
a reduction in the BAC limit from 80mg/100ml to 50mg/100ml. Drinking
and driving is related to a significant number of deaths and injuries
each year in Great Britain both above and below the current Blood
Alcohol Content (BAC) Limit.
OVER THE
CURRENT BAC LIMIT
Without factoring in the high level of underreporting
which has been acknowledged by the Department for Transport (DfT)[2]
and which may or may not be of greater importance with regards
to illegal levels of alcohol in the blood whilst driving, a high
number of road deaths and injuries occur when drivers have a BAC
over the current limit. The most recently confirmed figures (2008)
show that 400 people were killed and 1,620 people were seriously
injured as a result of drink drive collisions.
The provisional estimates for 2009 show that
road deaths resulting from drink and drive collisions fell by
5% from 400 in 2008 to 380 in 2009, whilst seriously injured casualties
fell by 9% from 1,620 to 1,480. Slight casualties resulting from
drink drive collisions fell by 8% from 10,960 to 10,130. The value
of prevention of all casualties resulting from drink drive collisions
in 2009 is provisionally estimated to be £1.1 billion.[3]
It is reassuring to see a 5% fall in the number
of deaths and more than an 8% reduction in the number of serious
injuries in collisions involving illegal alcohol levels from 2008
to 2009, particularly as the figures for 2009 show a consistency
with the overall trend of significant reductions in death and
injury on British roads.
The steady decrease since 2002 in numbers seriously
injured in collisions involving illegal alcohol levels has continued
for another year. A third successive year with around 400 deaths
in collisions involving illegal alcohol levels confirms that such
deaths are now clearly fewer than the numbers in the 500s that
prevailed for a decade previously. However, these deaths fell
by only 2.5% between 2007 and 2008 (final figures) and only 5%
between 2008 and 2009 (provisional figure), whereas the corresponding
falls in all road deaths were 14% and 12%. Road deaths involving
illegal alcohol levels had leveled earlier in the decade at around
18% of all road deaths. The large reduction in alcohol-related
deaths in 2007 brought the percentage down to 14, but small reductions
in the last two years mean that illegal levels of alcohol featured
in an estimated 17% of all road deaths in 2009. So deaths related
to illegal drink driving once again represent a rising proportion
of all road deaths.
This rising proportion reinforces the importance
of acting promptly and positively on the recommendations made
in Sir Peter North's recently published report which recommended,
among other things, a reduction in the current prescribed blood
alcohol limit in section 11(2) of the Road Traffic Act 1988 of
80 mg of alcohol in 100 ml of blood to 50 mg of alcohol in 100
ml of blood and the equivalent amounts in breath and urine.
The provisional figures for 2009 underline the
significant relationship between drink-drive and road death. It
is vital that the government prioritizes a commitment to reducing
levels of drinking and driving and thus levels of alcohol-related
road death and injury as part of a wider commitment to improving
road safety beyond 2010. However, some people driving within the
current legal BAC limit also incur increased risk as a result
of consuming alcohol.
UNDER THE
CURRENT BAC LIMIT
In 1998, the DETR showed that between 50mg and
80 mg drivers are 2-2.5 times more likely to be involved in a
collision than drivers with no alcohol, and up to 6 times more
likely to be involved in a fatal crash.[4]
In 2005 PACTS asked Professor Richard Allsop
to assess the potential casualty savings which would occur if
the legal limit were reduced from 80mg/100ml to 50mg/100ml. His
work explored both the likely behavioural elements of such a change
based on a broad segmentation of drink-drive behaviours, and replicated
the methodologies used by in Maycock in TRL Report 232 (1997)
estimating that such a change would result in a reduction of 65
deaths and 230 serious injuries.
Professor Allsop updated these figures for the
evidence which he submitted to Sir Peter North during his review
of Drink and Drug Driving Law[5]
again applying Maycock's exponential formulae for risk as a function
of BAC to current DfT statistics on drink drive casualties, estimating
that approximately 43 deaths and 280 serious injuries would be
prevented each year if the BAC limit were today reduced as proposed.
In the 2005 briefing for PACTS, Allsop outlines
three broad groups with regards to the drink drive behaviours
of the British driving public:
Group one would never drive with a BAC of 50
or over. This majority group are aware of the message "do
not drink and drive" and comply. There are few people in
this group who would be affected by a reduction in the BAC limit.
Group two, estimated at 1% of drivers on weekend
evenings and nights, already drive with a BAC well over 80 milligrammes.
This group are responsible for over 70% of drink-drive deaths
each year. Based on the behaviours already undertaken by this
group, it is unlikely that a change in the BAC limit would be
effective. Evidential roadside breath testing would have the greatest
effect on this group and thus make the greatest reduction in numbers
of KSI.
Group three, to whom a change in the limit is
most relevant, are those people who try to stay within the limits
(ie BAC of 30-100 milligrammes). This group make up around 2%
of drivers on weekend evenings and nights.
Allsop suggests therefore that a change in the
BAC limit from 80mg/100ml to 50mg/100ml would be specifically
relevant to group three in this segmentation. His casualty reduction
estimates are as a result more conservative than those provided
to the North review by researchers at Sheffield University[6]
which additionally assume a behavioural change in other groups.
PACTS has been informed that Professor Allsop
will be submitting evidence to the committee including a discussion
about the variation in KSI reduction estimates which result from
alternative methodologies. Even using this conservative estimate,
it is clear that a reduction in the BAC limit to 50mg/100ml will
bring about a substantial reduction in KSI each year. Both estimates
indicate the significant potential of a change in legislation,
with benefits far outweighing costs. The value of prevention of
43 lives and 280 serious injuries is estimated to be around £125
million per annum based on 2008 figures from DfT.[7]
Additionally, in paragraphs 3.81 to 3.105 of The North Report,
public support for a change in legislation is made evident.
(2) If so, is the mandatory one year driving
ban appropriate for less severe offenders, at the new (lower)
level?
PACTS would be supportive of an identical punishment
for those drivers caught at the new (lower) level.
LEGISLATION-EDUCATION
GAP:
Although the safety implications of drinking
and driving are clear cut and comprehended in Britain and we have
achieved a significant reduction in the occurrence of drink-drive
death (all road death fell by around 50% whilst drink-drive road
death fell by around 71% between 1980 and 2007,[8])
legislation does not support the educational and promotional messages.
The educational message is "don't drink
and drive" and yet the legislation implies that some alcohol
before driving is acceptable.
Great Britain continues to suffer from a significant
number of drink-drive deaths and injuries each year (see response
to question 1). Even with the reduced BAC limit, this firm penalty
is appropriate to maximise public comprehension of the impact
of behavioural choices surrounding drinking and driving.
There is no reason to suggest that the imposition
of a lesser punishment for drivers found to be between 50mg/100ml
and 80mg/100ml would be a positive step towards improving awareness,
understanding, behaviours or risk around drinking and driving.
FURTHER EVIDENCE
IDENTIFIED IN
THE NORTH
REVIEW PROCESS
AND PUBLISHED
IN THE
NORTH REPORT
WHICH SUPPORTS
AN IDENTICAL
PUNISHMENT FOR
THOSE DRIVERS
CAUGHT AT
THE NEW
(LOWER) LEVEL
Paragraphs 3.65, 3.68, 3.113 and 4.19 of The
North Report show a lack of public understanding about what
the current BAC limit is, what amount of alcohol will result in
that limit being reached and what the morning after effect
is. Furthermore, these issues are shown in the same paragraphs
to be better understood in neighboring European counties than
they are in Britain. As such, those caught over the new limit
must observe the same punishment as those above 80mg/100ml to
ensure that behavioural messages are replicated by legislation
and enforcement.
In paragraph 3.66 of The North Report,
it is shown that group three drinkers (as identified in the PACTS
response to question 1)[9]
are likely to drink to achieve a desired state and then balance
their consumption against its elimination. They drink and drive
whilst aiming to stay within the legal limit using a habitual
approach. As such, the habit will need to be altered to ensure
that this group stays within the new law.
Habit creation/alteration is dependent on an
integrated model which delivers educational and behavioural messages
from a range of sources. It is therefore vital that the legislation
matches the behavioural messages. Additionally, evidence from
Sweden identified in paragraph 4.10 of The North Report
shows that creating a two-tiered system of punishment for different
levels of impairment has resulted in the lesser offence being
treated by the public as a minor misdemeanor. Any similar outcome
in the UK would simply undermine the message that drinking and
driving kills.
(3) How severe is the problem of drug driving
and what should be done to address it?
TRL report 495,[10]
published in 2001, analyzed data collected between October 1996
and June 2000. The report showed that at least one medicinal or
illicit drug was detected in 24.1% of the 1,184 casualties, increasing
by a factor of around three since a similar study carried out
during the 1980s. The report which offers some insight into drug
consumption patterns and risk impact concluded that the increase
in incidence of legal or illicit drugs in KSI casualties was an
area of concern for road safety.
The scale of the problem today is relatively
unknown but it is likely to have grown in line with the general
increase in the consumption of illicit drugs. As part of a wider
approach to understand more about the severity and the implications
of the problem of drug-driving we propose testing of all KSI casualties
in combination with a coordinated research strategy which should
be funded by Government.
Much closer working with the medical profession,
locally and nationally, will improve our understanding of this
area. Furthermore, it is essential that Great Britain is better
represented in International research approaches such as the DRUID
study which aimed to give scientific support to the EU transport
policy by establishing guidelines and measures to combat impaired
driving.[11]
The DRUID study aims include:
— conduct reference studies of the impact
on fitness to drive for alcohol, illicit drugs and medicines and
give new insights to the real degree of impairment caused by psychoactive
substances and their actual impact on road safety,
— generate recommendations for the definition
of analytical and risk thresholds,
— analyse the prevalence of alcohol and
other psychoactive substances in accidents and in general driving,
set up a comprehensive and efficient epidemiological database,
— evaluate "good practice" for
detection and training measures for road traffic police allowing
a legal monitoring of drivers,
— establish an appropriate classification
system of medicines affecting driving ability, give recommendations
for its implementation and create a framework to position medicines
according to a labelling system,
— evaluate the efficiency of strategies
of prevention, penalisation and rehabilitation, considering the
difficulties of appropriate evaluation strategies for combined
substance use and recommend "good practice",
— define strategies of driving bans, combining
the road safety objectives with the individual´s need for
mobility, and
— define the responsibility of health care
professionals for patients consuming psychoactive substances and
their impact on road safety, elaborate guidelines and make information
available and applicable for all European countries.
DRUID Study Overview of international research:
Only a few surveys have been carried out in Europe as well as
in Australia regarding the prevalence of drugs in the driving
population, one in Australia,a the other one in Germany.b Both
studies are based on saliva samples and indicate similar results
for passenger car drivers. About 1% took illicit drugs, primarily
cannabis/stimulants, and about 4-6% took licit drugs, primarily
stimulants, hypnotic or anxiolytic drugs, or drugs without impairing
effect. Recent studies have been carried out in Denmark,c the
Netherlands and United Kingdom,d the latter two studies were part
of the project IMMORTAL of 5th Framework Programme.
Some of the studies also aim at enlightening
the problem of an increased risk for driving while impaired, despite
the fact that calculations of accident risks are subject to great
uncertainties.e These calculations indicate that the relative
risk of being killed in a fatal accident is significantly increased
for drug-impaired drivers compared to drug-free drivers, especially
for drivers impaired both by drugs and alcohol.
In some countries a different approach to reveal
the size of the problem has been taken. In Australia,f Belgium,g
Spainh and Swedeni drivers have been interviewed at rest areas
or emergency rooms about their drug consumption. Results indicate
that 5-10% of the drivers admit use of drugs "hazardous"
to road safety, primarily benzodiazepines, and 3-5% admit use
of illicit drugs, primarily cannabis or amphetamines.
Even this short overview reveals that our knowledge
about prevalence and risk is fragmentary. Neither the situation
in each member country is known nor do we have information whether
the problems and solutions can be generalised for other countries.
The same holds true for legislative and preventive measures, established
up to now. Some countries have introduced a zero tolerance law
for illegal substances irrespective whether the impairing effect
is known or unknown. Other countries pursue a clear impairment
approach.
a Starmer, G A et al (1997). Drug Usage by
Australian Drivers. Proceedings from the 14th International Conference
on Alcohol, Drugs and Traffic Safety, Annecy 1997.
b Krüger H P, Schulz, E and Margerl,
H (1995). The German Roadside Survey 1992-94. Saliva Analyses
from an Unselected Driver Population. Licit and Illicit drugs.
Proceedings from the 13th International Conference on Alcohol,
Drugs and Traffic Safety, Adelaide 1995.
c Behrensdorff, I (2001). Medicin og narkotika
blandt bilister. Report 3/2001. Danmarks TransportForskning. Kgs.
Lyngby.
d IMMORTAL D-R4-2 (in press).
e Parliament of Victoria, Road safety Commission
(1996). Effects of drugs other than alcohol on road safety in
Victoria. Melbourne, Victoria.
f Starmer, G A et al (1997). Drug Usage by
Australien Drivers. Proceedings from the 14th International Conference
on Alcohol, Drugs and Traffic Safety, Annecy 1997.
g Belgian Toxicology and Trauma Study Research
Group (1997). A study on alcohol, medication and illicit drugs
in driver-victims of road traffic accidents.
h Rio, M C & Alvarez, F J (1995): Illegal
drugs and driving. Journal of traffic medicine, Vol 23 No 1, 1-5.
i Törnros, J (1997). Benzodiazepiner,
alcohol och trafiksäkerhet. Experimentelle studier—litteraturöversigt.
Väg—och Transportforskningsinstituttet. VTI Meddelande
nr. 805. Linköping
Enforcement of Drug Driving Offences should
focus on identifying impairment, rather than identifying the presence
of drugs in the body. A further simplification of the system could
involve the carrying out of blood tests by nurses rather than
requiring the often lengthy and costly presence of a doctor.
(4) What wider costs and benefits are likely
to result from changes to drink and drug driving law?
The value of prevention of drink drive deaths
and casualties which would be brought about by a reduction in
the BAC limit to 50mg/100ml is considerable, even using the most
conservative estimates. Based on estimates provided to the North
review by Professor Allsop, the value of prevention of KSI as
a result of the proposed reduction in the BAC limit would be around
£125 million based on 2008 figures from DfT.
Wider benefits may include reductions in costs
to employers based on the Driving for Better Business model,[12]
plus wider health benefits associated with greater understanding
about the effects of alcohol on the body which may come about.
As explored in our response to question 2 of
this submission, The North Report identified high levels of misunderstanding
and detachment about the current BAC limit and the relationship
between drinking and driving. A change in legislation accompanied
by ETP measures and adjustments to enforcement can be used to
generate greater awareness about these issues and further communicate
the drink-drive message.
Possible knock-on effects of a change in legislation
include improved compliance of British citizens when travelling
abroad, particularly within neighboring EU countries and improved
understanding and control of wider alcohol-related problems in
society.
Paragraph 3.133 of the North Report summarizes
wider costs which may concern the drinks industry including loss
of custom and thus loss of revenue. The evidence in this area
is inadequate and would benefit from a monitored trial which took
the full range of costs and benefits into account.
(5) What would be the implications of such
changes for enforcement?
The proposed reduction has important implications
for enforcement and will require a joined-up and strategic approach
to improve knowledge, understanding and behaviours around drinking
and driving.
Enforcement will need to be more vigorous in
order to raise awareness about changes made and to ensure that
public messages are backed up by activity. In order assist enforcement
of this level, drink driving should be included among the "Offences
Brought to Justice"[13]
which police forces across England and Wales are required to report
on.
The proposed change in legislation will require
at least short-term and costly increases in visible enforcement
of drinking and driving. However, the following actions could
ease the additional burden to the Police:
(1) Drink driving should be included among the
"Offences Brought to Justice"[14]
which police forces across England and Wales are required to report
on according to Recommendation (25) of the North Report.
(2) Completion of type approval of evidential
roadside breath-testing equipment according to Recommendation
(27) of the North Report.
(3) Removal of the statutory option for a blood
or urine test where a recorded breath alcohol concentration is
within a certain margin above the threshold for prosecution, according
to Recommendation (11) of the North Report and the power to require
anyone who is actually driving to cooperate with a preliminary
breath test.
(4) Intelligence-led targeted breath testing
should be made feasible by granting the police the power to require
any driver to cooperate with a preliminary breath test.
(5) Wider investment in Field Impairment Testing
(FIT) to ensure that all police forces have the required knowledge
and equipment that will allow them to more effectively identify
impairment.
August 2010
2 http://www.dft.gov.uk/pgr/statistics/datatablespublications/accidents/casualtiesgbar/rrcgb2008 Back
3
Based on values provided by DfT in Reported Road Casualties 2008
http://www.dft.gov.uk/pgr/statistics/datatablespublications/accidents/casualtiesgbar/rrcgb2008 Back
4
Combating Drink Driving: Next Steps: A Consultation Paper, DETR,
1998 Back
5
http://northreview.independent.gov.uk/ Back
6
R Rafia, A Brennan. Modelling methods to estimate the potential
impact of lowering the blood alcohol concentration limit from
80 mg/100 ml to 50 mg/100 ml in England and Wales. Report to the
National Institute for Health and Clinical Excellence. School
of Health and Related Research (ScHARR), University of Sheffield.
2010.38 Back
7
In 2008 figures as provided by DfTin RRCGB 2008 http://www.dft.gov.uk/pgr/statistics/datatablespublications/accidents/casualtiesgbar/ Back
8
Reporting inequality and external influences will have affected
the reliability of these numbers. http://www.dft.gov.uk/pgr/statistics/datatablespublications/accidents/casualtiesgbar/ Back
9
This is not stated in The North Report but the characteristics
of the two sets are similar. Back
10
TRl Report 495 (2001) The Incidence of Drugs and Alcohol in
Road Accident Fatalities, Prepared for the Road Safety Division,
DETR, TRL, Crowthorne Back
11
http://www.druid-project.eu/cln_007/nn_112422/Druid/EN/partner/partner-node.html?__nnn=true Back
12
http://www.drivingforbetterbusiness.com/why/businesscase.aspx Back
13
http://www.justice.gov.uk/docs/crim-stats-2007-tag.pdf Back
14
http://www.justice.gov.uk/docs/crim-stats-2007-tag.pdf Back
| 
