Objective. Road injuries are the leading injury-related cause of death among people aged 15-44. A clear dose-effect relationship has been demonstrated for drug and alcohol use and road traffic accidents. The objective of our study was to estimate the prevalence of drug and/or alcohol use in subjects admitted for road traffic accidents to an Emergency Department.
Methods. In this study, conducted between January and April
2006, 100 patients of both sexes (age 18-65) examined after
road traffic accidents were consecutively enrolled. A commercial
rapid urine test was used to detect drugs by the Emergency
Department staff. The alcohol concentration was determined
from a blood sample at the central laboratory.
Results. Most of the patients were drivers under 35 years of age.
67/100 road traffic accidents occurred at the weekend (Friday-
Sunday), nearly 60% between 24:00-09:00 hrs; on non-weekend
days about 80% of road traffic accidents were recorded between
14:00-24:00 hrs (p inf. 0.0001). With the alcoholemia test and
urine test for drugs detection 43/100 patients showed a single
or multiple positivity. Alcohol and drug presence is relevant
during the weekend (37/43 cases), in contrast with non weekend
(6/43 cases) [OR 3.04 (95% CI 1.43; 6.46)]. Alcohol was
the most frequently detected abuse substance (72%), followed
by benzodiazepines (42%), tetrahydrocannabinol (21%) and
cocaine (14%).
Discussion. 43% of patients examined were under the influence
of psychotropic substances (alcohol, drugs or both). The
greater part of road traffic accidents in positive test patients
occurred during the week-end, in particular during the late
night/early morning hours, probably after recreational time.
The high incidence of alcohol and/or drug abuse may have
caused physical and/or psychological problems, therefore the
high number of road traffic accidents, especially if taken in
combination.
Conclusion. The rapid urine test used cannot represent a diagnosis,
and requires a confirmation test. It can be used for medical
purposes as an easy and fast preliminary response which
enables a faster diagnostic and therapeutic guideline, but it
cannot be used for sanctions. Further studies are advisable with
an increase of number of patients, in a wider temporal range,
including control subjects, and using confirmation tests.

/pdf/prevalence-of-alcohol-and-drugs-in-urine-of-patients-q0sp2cdc67.pdf

Prevalence of alcohol and drugs in urine of patients involved in road accidents

An Evaluation of Pocket-Model, Numerical Readout Breath Alcohol Testing Instruments. (August 2003) William Edward Van Tassel, B.B.A., Texas A&M University; M.B.A., Texas A&M University; M.A. University of Central Oklahoma Chair of Advisory Committee: Dr. Maurice E. Dennis Eight small-scale breath alcohol measurement devices were tested for accuracy, precision and the ability to not yield false positive and false negative readings. These pocket-sized breath testers (PMBTs), which provided numerical readout of BrAC to the 100 of a percent, were smaller than evidential and preliminary breath test instruments (EBTs and PBTs). The smallest devices were approximately the same size as a cigarette lighter. Designed to provide drinkers feedback about their individual alcohol levels, the PMBTs ranged in price from $40-100 USD. The devices were first tested under laboratory conditions with alcohol solution simulators providing the alcoholic samples. They were then tested with human drinkers, under controlled field conditions. Each device was tested at multiple alcohol levels. Two of the eight PMBTs failed to complete all levels of testing and were excluded from the study. All PMBTs demonstrated the ability to not yield false positive and false negative readings. No device met NHTSA performance criteria for accuracy (systematic error) in testing EBTs at every alcohol level tested. An interaction between PMBTs and the alcohol test levels was found. Thus, accuracy was found to be dependent upon the

An evaluation of pocket-model, numerical readout breath alcohol testing instruments

This work compares the results of roadside use of the breathalyser test with those from contemporary blood samples, carried out within the framework of a program of weekend night-time checks on drivers. Italian law requires the police to use breathalysers as the only instrument for screening and confirming a state of intoxication due to ethyl alcohol intake in drivers. Analysis, which is used as evidence, is carried out on the roadside by means of instrumentation run off a car engine. Current Italian legislation does not require the use of confirmatory analyses carried out on blood samples or expired air in standard environmental conditions, as is the case in other countries. Drivers are considered to be in a state of drunkenness if their BAC, extrapolated from analysis of expired air with a conversion factor of 2300:1, is greater than or equal to 80 mg/100 mL in two successive measurements, the second being made 5 minutes after the first. With the aim of verifying in situ the suitability of the procedure and the instruments used, a comparison was made between results obtained at the roadside using the breathalyser and those on venous blood samples taken at the same time. This research formed part of a program of night-time checks on drivers in the Veneto Region on weekend nights in the period l997-1999. For the covering abstract see ITRD E106992.

Use of breath test as evidence. comparison between bracs and bacs in a driving population

The international literature reveals discrepancies regarding experimental and epidemiological evidence on the disabling role of blood alcohol concentration less than 50 mg per 100 mL, and variation is more pronounced in the case of subjects with different metabolisms. To obtain experimental evidence, the effects of low BACs on driving ability were investigated using 16 alcohol tolerating and non tolerating healthy volunteers, whose mean intake of ethyl alcohol was less than 0.5 and more than 1.5 g per kg per week. Neuropsychomotor functions were examined by correlation of GLC-HS serial dosages of ethyl alcohol in blood and saliva and computerized tests administered 15, 30, 60, 90, 120 and 180 minutes after intake of lorazepam, alcohol or placebo. The tests explored various functions such as cerebral activation, eye-hand coordination, short-term serial memory, vigilance and discrimination of deviant stimuli. Results showed: alteration of some neuro-psychomotor functions which are important for driving, in both sample groups; significant functional variations between subjects tolerating and not tolerating ethyl alcohol; and good correlation of blood and saliva levels of ethyl alcohol. (a) For the record of the covering entry of this conference, please see IRRD abstract no 868581.

Low blood alcohol concentrations and psychomotor performance in tolerating and non-tolerating subjects

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Use of breath test as evidence. comparison between bracs and bacs in a driving population

Low blood alcohol concentrations and psychomotor performance in tolerating and non-tolerating subjects