Rationale
Alcohol-related traffic crashes are a significant contributor to alcohol-related harm. A number of countries have experienced rapid increases in numbers of vehicles, including motorcycles, together with rising traffic injury rates to which increased or changing patterns of drinking have contributed.
There is a measurable increase in driving impairment at low levels of alcohol in the blood.
Compared to drivers with zero blood alcohol, drivers with a blood alcohol content (BAC of 0.05gm/100ml) are 38% more likely to be involved in a crash and drivers with 0.08gm/100ml are almost 2.7 times more likely to be involved in a crash (Dubowski 2007).
Worldwide, drink-drive legislation in 60 out of 83 countries (excluding countries with religiously mandated zero limits) now set a BAC limit of 0.05 g or less per 100 ml. In the Western Pacific Region, Fiji, Malaysia, Singapore and New Zealand have limits of 0.08 g/100 ml (although New Zealand’s Land Transport Safety Authority has recommended a change to 0.05 g/100 ml). The Republic of Korea has a BAC of 0.05 g/100 ml, as have all states and territories of Australia since 1989. China and Japan have a BAC of 0.03 g/100 ml. Not all countries in the Western Pacific Region have established legal BACs. However, countries with otherwise limited policy or law on alcohol have in the last few years been making progress on drink-driving legislation.
Viet Nam’s 2008 Traffic Laws, implemented in July 2009, prohibit driving of cars or trucks with any alcohol in the blood, subject to a fine and two months suspension of licence, or a fine and a one month suspension for motorcyclists with more than 50 mg/100ml of blood (Hanh 2009).
Accidents due to alcohol use are not covered by health insurance or state compensation.
The Organization for Economic Cooperation and Development (OECD) and the European Union now recommend a BAC of 0.02 g/100 ml or less for novice drivers or young drivers, who are more susceptible to alcohol than older drivers. For example, in 2006 the Netherlands lowered its BAC for the first five years of driving, based on evidence that young male drivers in particular were involved in a quarter of all crashes and were not responding to existing measures.
Blood alcohol level provides accurate evidence for impairment. Modern breath-testing equipment, however, gives traffic police a practical means of check for impairment at the roadside and the law should allow such test results to be used as evidence in court. The usefulness of the BAC level as a strategy is reduced if breath/blood analysis technology is not readily available to police. Once the BAC level is established in law and the technology is available, a commitment to enforcement is needed. Several countries, such as Viet Nam and Mongolia, report a need for capacity-building with breathalyser equipment and police training. The Lao People’s Democratic Republic reports receiving breathalysers as part of an aid package, but there is no current budget for random breath testing work by police, although a third of injury admissions to Vientiane’s largest hospital relate to drink-driving.
Random breath testing (RBT) is an effective means of ensuring compliance with drink-driving laws. The key element of RBT is random but highly visible police enforcement. “The community must understand and believe that if they drink and drive there is a strong likelihood of both detection and prosecution” (Global Road Safety Partnership 2007).
The speed with which a penalty is applied also affects its effectiveness. Legislation which provides for automatic administrative suspension of driver’s licences allows immediate action when drivers are detected with BAC levels beyond the legal limit.
The World Health Organization’s publication Drinking and Driving: A Road Safety Manual for Policy Makers and Practitioners provides detailed evidence and information for development of drink-driving policy (Global Road Safety Partnership 2007).
Issues to consider
Defining both breath and blood alcohol limits
In some countries there appears to be confusion about how blood and breath alcohol concentrations are defined. Sometimes, the concentrations do not match accurately. The ratio of alcohol concentration between blood and breath is approximately 1:2100. That is, the weight of alcohol in 100ml of blood is the same as in 210 litres of breath. A number of jurisdictions, including Victoria, Australia, and New Zealand, set a double definition in law of 50mg per 100ml blood or 210 litres of breath.
Implementation of Random Breath Testing
The aim of the Random Breath Testing (RBT) is to create a sense of unease about drinking and driving among potential offenders, by giving the impression that monitoring and enforcement of the drink-driving laws is unpredictable, unavoidable and ubiquitous. RBT is performed at
selected, highly visible checkpoints – often on main roads. The checkpoints are not announced publicly and locations vary from day to day and from week to week. All motorists passing a checkpoint are stopped for a preliminary roadside breath test, regardless of personal or vehicle characteristics. Drivers returning a negative breath test result are not detained and usually drive away after a delay of less than one minute. Those who fail may be prosecuted on that result or asked to undertake an evidential blood test.
To be effective, the law must require random breath-testing of any and all drivers on request by an authorized officer. Refusal to take a breath or blood test should be an offence, with sanctions equal to those which would have been incurred if the person failed the text and had a previous drink-driving conviction.
Administrative suspension of licence
An automatic administrative suspension of a driver’s licence for drink-driving avoids slow and expensive court processes to bring the penalty closer to the teachable moment of being apprehended for Blood Alcohol Content (BAC) levels above the legal limit. As a deterrent, it may be particularly effective with young males.
In Ontario, Canada, the government introduced administrative licence suspensions for drink-driving in 1996. This required that anyone charged with having a BAC over 0.08 g/100 ml or refusing a breath test would have their licence suspended for 90 days from the time the charge was laid. This change was followed by an estimated 17.3% reduction in fatally injured drivers who were over the legal alcohol limit.
In 2003, France strengthened its penalties for drink-driving, including suspension of licence, and increased BAC testing. For example, a BAC of 0.05-0.08 gm per 100 ml results in a loss of six points (on a points system leading to loss of licence), suspension of licence for three years, and a fine of Euro €135-750 [U.S. $179-$993]. A BAC above 0.08 gm per 100 ml adds two years in prison and raises the fine to Euro €4,500 [U.S. $5,959]. A repeat conviction increases imprisonment to three years and doubles the fine. In 2003, alcohol-related fatalities dropped from 38% to 20% of all traffic fatalities compared to 2002, and alcohol-related traffic injuries fell by 60%. In 2004, 60% of drivers reported not drinking and driving compared to 45% in 1999 (Riviere 2004).
A few countries currently based drink-drive penalties on whether a resulting accident has caused injury or death. However, the research evidence is clear that above 0.05gm/100ml levels of blood alcohol, driving is impaired and risk of accident increases markedly (Global Road Safety Partnership 2007; Land Transport Safety Authority 2003). This risk to the public is
why drink-driving is an offence in itself. Many countries’ traffic laws include offences such as dangerous driving or driving causing injury, which may apply together as aggravating factors with a charge of drink-driving, increasing the penalties. In some countries, including New Zealand and Australia, a drunk driver who causes a fatality may be charged with manslaughter.