umu.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Traffic and drowning incidents with emphasis on the presence of alcohol and drugs
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Worldwide, fatal traffic injuries and drowning deaths are important problems. The aim of this thesis was to investigate the cirumstances of fatal and non-fatal traffic injuries and drowning deaths in Sweden including analysis of the presence of alcohol and drugs, which are considered to be major risk factors for these events. Data where obtained from the database of National Board of Forensic Medicine.

In the first study, we investigated 420 passenger deaths from 372 crashes during 1993-1996. There were 594 drivers involved. In total, 21% of the drivers at fault were alcohol positive compared to 2% of drivers not at fault (p<0.001) (Paper I). During 2004-2007, crashes involving 56 fatally and 144 non-fatally injured drivers were investigated in a prospective study from Northern Sweden (Paper II). The drivers were alcohol positive in 38% and 21%, respectively. Psychoactive drugs were found in 7% and 13%, respectively. Benzodiazepines, opiates and antidepressants were the most frequent drugs found in drivers. Illict drugs were found 9% and 4% respectively, with tetrahydrocannabinol being the most frequent of these drugs (Paper II).

We investigated 5,125 drowning deaths in Sweden during 1992-2009 (Paper III). The incidence decreased on average by about 2% each year (p<0.001). Unintentional drowning was most common (50%). Alcohol was found in 44% of unintentional, 24% of intentional, and 45% of undetermined drowning deaths. Psychoactive substances were detected in 40% and benzodiazepines were the most common substance. Illicit drugs were detected in 10%. Of all drowning deaths, a significantly higher proportion females commited suicide compared with males (55% vs. 21%, p<0.001). Suicidal drowning deaths (n=129) in Northern Sweden were studied further in detail (Paper IV). of these, 53% had been hospitalized due to a psychiatric diagnosis within five years prior to the suicide. Affective and psychotic disorders were the most common psychiatric diagnoses. Almost one third had performed a previous suicide attempt. One fourth had committed suicide after less than one week of discharge from hospital. Alochol was found in 16% and psychoactive drugs in 62% of these cases, respectively. 

In conclusion, alcohol and psychoactive drugs are commonly detected among injured drivers and drowning victims, and probably play a role in these events. Most of the individuals that tested positive for alcohol and high blood concentrations, indicating alochol dependence or abuse. This association warrants futher attention when planning future prevention. 

Place, publisher, year, edition, pages
Umeå: Umeå universitet , 2014. , 62 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1662
Keyword [en]
Traffic incidents, drivers, passenger, drowning, alochol, pharmaceuptical, illicit drugs, suicidal drowning, mental disorder
National Category
Forensic Science
Research subject
Forensic Medicine
Identifiers
URN: urn:nbn:se:umu:diva-91526ISBN: 978-91-7601-095-2 (print)OAI: oai:DiVA.org:umu-91526DiVA: diva2:736895
Public defence
2014-09-19, Hörsal D, Unod T9, Norrlands Universitetssjukhus, Umeå, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2014-08-29 Created: 2014-08-11 Last updated: 2014-09-26Bibliographically approved
List of papers
1. Driver's alcohol and passenger's death in motor vehicle crashes
Open this publication in new window or tab >>Driver's alcohol and passenger's death in motor vehicle crashes
2006 (English)In: Traffic Injury Prevention, ISSN 1538-9588, E-ISSN 1538-957X, Vol. 7, no 3, 219-223 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: Previous studies on alcohol involvement associated with fatal injury in traffic crashes have focused on the drivers, but the passenger's view is not well known. This study (1) analyzes the relationship between passenger's death and alcohol inebriation of the driver and (2) estimates the role of alcohol as the cause of a crash by examining who was at fault, sober, or inebriated.

METHOD: The study includes all motor vehicle passengers (n = 420) who died in crashes in Sweden 1993 through 1996 and were medicolegally autopsied. Autopsy reports from the Departments of Forensic Medicine, including toxicological analyses, and police reports were studied. Presence of alcohol among drivers was based on blood and breath tests.

RESULTS: One-fifth of the fatally injured passengers and one-fifth of the tested drivers were under the influence of alcohol. The youngest drivers had the highest prevalence of drunken driving. Drivers at fault were alcohol positive in 21% of these crashes and drivers were not at fault in 2% of these crashes. In 53% of the crashes where both the passenger and driver were alcohol positive, the passenger had a lower alcohol concentration than the driver. Children (<16 years) comprised 15% of the killed passengers. Notably, the children were riding with a driver who was under influence of alcohol in 13% of these crashes. Alcohol involvement was not tested in half of the surviving drivers.

CONCLUSIONS: The data show that 20% of both passengers and drivers were under the influence of alcohol. Increased testing of surviving drivers regarding alcohol and other drugs is recommended.

Place, publisher, year, edition, pages
Taylor & Francis, 2006
Keyword
Accidents; Traffic/*mortality, Adolescent, Adult, Age Distribution, Aged, Aged; 80 and over, Alcohol Drinking/*mortality, Alcoholic Intoxication/*mortality, Breath Tests, Central Nervous System Depressants/*analysis, Child, Child; Preschool, Ethanol/*analysis, Female, Humans, Infant, Infant; Newborn, Male, Middle Aged, Sweden/epidemiology
National Category
Forensic Science
Identifiers
urn:nbn:se:umu:diva-12801 (URN)10.1080/15389580600727846 (DOI)16990235 (PubMedID)
Available from: 2008-01-08 Created: 2008-01-08 Last updated: 2017-12-14Bibliographically approved
2. Alcohol and drugs in fatally and non-fatally injured motor vehicle drivers in northern Sweden
Open this publication in new window or tab >>Alcohol and drugs in fatally and non-fatally injured motor vehicle drivers in northern Sweden
2009 (English)In: Accident Analysis and Prevention, ISSN 0001-4575, E-ISSN 1879-2057, Vol. 41, no 1, 129-136 p.Article in journal (Refereed) Published
Abstract [en]

Alcohol and drugs are important risk factors for traffic injuries, a major health problem worldwide. This prospective study investigated the epidemiology and the presence of alcohol and drugs in fatally and hospitalized non-fatally injured drivers of motor vehicles in northern Sweden. During a 2-year study period, blood from fatally and hospitalized non-fatally injured drivers was tested for alcohol and drugs. The study subjects were recruited from well-defined geographical areas with known demographics. Autopsy reports, medical journals, police reports, and toxicological analyses were evaluated. Of the fatally injured, 38% tested positive for alcohol and of the non-fatally 21% tested positive; 7% and 13%, respectively, tested positive for pharmaceuticals with a warning for impaired driving; 9% and 4%, respectively, tested positive for illicit drugs. The most frequently detected pharmaceuticals were benzodiazepines, opiates, and antidepressants. Tetrahydrocannabinol was the most frequently detected illicit substance. No fatally injured women had illegal blood alcohol concentration. The relative proportion of positively tested drivers has increased and was higher than in a similar study 14 years earlier. This finding indicates that alcohol and drugs merit more attention in future traffic safety work.

Place, publisher, year, edition, pages
Elsevier, 2009
Keyword
Driver; Alcohol; Drugs; Road traffic; Injury
National Category
Forensic Science
Identifiers
urn:nbn:se:umu:diva-22359 (URN)10.1016/j.aap.2008.10.002 (DOI)19114147 (PubMedID)
Available from: 2009-05-06 Created: 2009-05-06 Last updated: 2017-12-13Bibliographically approved
3. Drowning deaths in Sweden with emphasis on the presence of alcohol and drugs: a retrospective study, 1992-2009
Open this publication in new window or tab >>Drowning deaths in Sweden with emphasis on the presence of alcohol and drugs: a retrospective study, 1992-2009
2013 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 13, 216- p.Article in journal (Refereed) Published
Abstract [en]

Background: Drowning deaths constitute a significant proportion of unnatural deaths globally. In Sweden and other high-income countries, drowning deaths have decreased. This study investigates the epidemiology and current trends of unintentional, intentional, and undetermined drowning deaths with emphasis on the presence of alcohol and other drugs.

Methods: During an 18-years period, 5,125 drowning deaths were autopsied in Sweden. Data on cases including toxicological analysis on alcohol, pharmaceutical drugs, and illicit drugs were obtained from the National Board of Forensic Medicine.

Results: During the study period, the annual incidence of drowning deaths in Sweden was 3.1/100,000 inhabitants and decreased on average by about 2% each year (p<0.001). The highest incidence was found among males and in middle/older age groups. The incidence increased 3% for each year of age. Children/adolescents (<= 18 years) constituted 5% of all drowning deaths. Of all drowned females in the study, 55% (847/1,547) committed suicide, which was a significantly higher proportion compared with males (21%, 763/3,578) (p<0.001). In total, 38% (1,656/4,377) of tested drowned persons had alcohol in their blood and the mean concentration was 1.8 g/l. In the unintentional drowning group, intentional drowning group, and the undetermined group, the proportion of alcohol positive was 44%, 24%, and 45%, respectively. One or several psychoactive drugs were present in the blood in 40% (1,688/4,181) of all tested persons and in 69% (965/1,394) of tested persons who died from suicidal drowning. The most common drug was benzodiazepines (21%, 891/4,181). Illicit drugs were detected in 10% (82/854) of tested persons.

Conclusion: Presence of alcohol and drugs were frequent and may have contributed to the drowning deaths. The incidence of drowning deaths significantly decreased during the study period. Males and the middle/older age groups had a higher incidence compared to females and children. Suicidal drowning was common especially among women. Alcohol and drugs are significant contributors in drowning deaths in Sweden and should be considered as part of a comprehensive prevention program.

Place, publisher, year, edition, pages
BioMed Central, 2013
Keyword
Alcohol, Drowning, Illicit drugs, Pharmaceutical drugs, Suicide
National Category
Substance Abuse Forensic Science
Identifiers
urn:nbn:se:umu:diva-70348 (URN)10.1186/1471-2458-13-216 (DOI)000317115800002 ()23497055 (PubMedID)
Available from: 2013-06-27 Created: 2013-05-14 Last updated: 2017-12-06Bibliographically approved
4. Suicidal drowning deaths in Northern Sweden 1992-2009
Open this publication in new window or tab >>Suicidal drowning deaths in Northern Sweden 1992-2009
(English)Manuscript (preprint) (Other academic)
National Category
Forensic Science
Identifiers
urn:nbn:se:umu:diva-91519 (URN)
Note

Submitted

Available from: 2014-08-11 Created: 2014-08-11 Last updated: 2014-09-08Bibliographically approved

Open Access in DiVA

Traffic and drowning incidents with emphasis on the presence of alcohol and drugs(592 kB)668 downloads
File information
File name FULLTEXT01.pdfFile size 592 kBChecksum SHA-512
825373f74e529f42db3855c4133e3b20db22958f5e9628d1bd8032ef3eef5287c96eb199bc2c4d8c78cf23668c5521a0da62bbee83dee04c37c3d341d635800c
Type fulltextMimetype application/pdf
spikblad Ahlm(20 kB)117 downloads
File information
File name FULLTEXT02.pdfFile size 20 kBChecksum SHA-512
0ddf161f68846c84b76b3403d01dbb0241db0d1db03cfb44b81e0711a523278683dcb1031e758ae5f03325279b756a3c3d2e0850453998d06a37d6d1c6cbd76c
Type spikbladMimetype application/pdf

Search in DiVA

By author/editor
Ahlm, Kristin
By organisation
Forensic Medicine
Forensic Science

Search outside of DiVA

GoogleGoogle Scholar
Total: 785 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

isbn
urn-nbn

Altmetric score

isbn
urn-nbn
Total: 467 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf