While the rate of motor vehicle deaths linked to drinking has declined in the United States, alcohol remains a leading killer of child passengers, according to a new study. Often, adolescents under the legal drinking age of 21 were responsible.
Between 1991 and 1996, about 550 U.S. children died each year in crashes involving drinking drivers, the study showed. By comparison, about 208 children younger than age 15 died from unintentional firearm injuries.
A report on the findings appears in the May 3 issue of the Journal of the American Medical Association. Authors are Drs. Lewis H. Margolis, associate professor of maternal and child health at the UNC-CH School of Public Health; Dr. Robert D. Foss, research scientist at the UNC Highway Safety Research Center, and William G. Tolbert, a former research associate.
Information analyzed in the study came from the Fatality Analysis Reporting System, which records U.S. highway traffic deaths. Researchers found 16,676 deaths among children under age 16 in automobile crashes during the six years studied. Of those, 3,310 deaths -- about one in five -- involved alcohol.
"The primary risk to children when it comes to alcohol is as passengers in cars - it's not the usual image people have of children being struck while walking to school or riding their bikes," Margolis said.
"Among crashes involving alcohol, it was the child's own driver who had been drinking in 66 percent of cases," he said. "Drivers younger than the legal drinking age of 21 who had been drinking accounted for 30 percent of alcohol-related passenger deaths among children."
Overall, the percentage of alcohol involvement in children's highway deaths declined slightly over the period studied, Margolis said.
"If you look at 12- to 15-year olds, however, the rate really hasn't changed at all," he said. "It was 23 percent in 1991, dipped to 17.3 percent in 1994 and was back up to 22.3 percent in 1996."
As expected, most of the drinking drivers were males, but still a surprisingly high percentage -- 30 percent -- were females, Margolis said.
In an accompanying journal editorial, Dr. Guohua Li of Johns Hopkins University School of Medicine called for a zero-tolerance policy regarding alcohol among drivers. Margolis disagreed.
"That's not a very good suggestion," he said. "Lowering the blood alcohol level to 0.02 would really amount to prohibition, and there is no good evidence that consumption of one or two drinks has an impact on crash risks in the real world. The danger in that kind of policy is that it would divert resources away from getting the more serious alcohol users off the road.
"Furthermore, 0.02 does not seem to be politically feasible. Just last year, Congress failed in its attempt to establish a national level of 0.08."
Among fatally injured drivers for whom blood alcohol content (BAC) figures were available through FARS, only about 2 percent had positive BAC values that were less than 0.05 percent, Margolis said.
"Despite impressive declines in alcohol-related motor vehicle deaths for adults during the past decade, the risk to children remains substantial, warranting additional attention and carefully targeted action," he said.
More rigorous enforcement of under-age drinking laws and penalties and increasing taxes on beer, the most commonly consumed alcoholic beverage among adolescents, might reduce the number of children killed on U.S. highways each year, Margolis said.
Note: Margolis and Foss can be reached at 919-966-5974 and at 962-8702, respectively.
UNC-CH School of Public Health contact: Lisa Katz, 919-966-7467.
Highway Safety Research Center contact: Emily Smith, 962-7803.
News Services contact: David Williamson, 962-8596.
Journal
JAMA