Drink driving policy and road safety in the Netherlands: a retrospective analysis

In 1970, SWOV started periodic nationwide roadside surveys aimed at assessing the BAC distribution of Dutch motorists during weekend nights. The goal of these surveys was to get an insight in drink driving patterns, thus enabling policy makers to take drink driving countermeasures and to evaluate their effects. Between 1970 and 2000, the percentage of drivers with an illegal BAC (>0.5 g/l) dropped from 15% to 4.5%. The most important factor of influence was deemed to be the introduction of random breath testing in the mid-1980s. Also, a recent case-control study indicated that approximately 25% of serious road injuries in the Netherlands was associated with the use of alcohol. Drivers with a BAC above 1.3 g/l, who formed only 0.3% of all drivers and 20% of drivers with an illegal BAC, caused more than 80% of these injuries. Young male drivers, aged 18-24 years, were another high-risk group. While forming less than 5% of the Dutch population, they caused nearly a quarter of all alcohol-related serious road injuries. Existing legislation and programs were neither very effective in further decreasing the number of hardcore drinking drivers nor in improving the drink driving habits of young males. Therefore, the Dutch Ministry of Transport is preparing to introduce a 0.2 g/l BAC-limit for novice drivers and alcolock (alcohol interlocks) programs for hardcore drinking drivers.Drunk-driving Legislation Enforcement Education Sanctions

Is law enforcement of drug-impaired driving cost-efficient? An explorative study of a methodology for cost-benefit analysis

Background Road users driving under the influence of psychoactive substances may be at much higher relative risk (RR) in road traffic than the average driver. Legislation banning blood alcohol concentrations above certain threshold levels combined with roadside breath-testing of alcohol have been in lieu for decades in many countries, but new legislation and testing of drivers for drug use have recently been implemented in some countries. Methods In this article we present a methodology for cost–benefit analysis (CBA) of increased law enforcement of roadside drug screening. This is an analysis of the profitability for society, where costs of control are weighed against the reduction in injuries expected from fewer drugged drivers on the roads. We specify assumptions regarding costs and the effect of the specificity of the drug screening device, and quantify a deterrence effect related to sensitivity of the device yielding the benefit estimates. Results Three European countries with different current enforcement levels were studied, yielding benefit–cost ratios in the approximate range of 0.5–5 for a tripling of current levels of enforcement, with costs of about 4000 EUR per convicted and in the range of 1.5 and 13 million EUR per prevented fatality. Conclusions The applied methodology for CBA has involved a simplistic behavioural response to enforcement increase and control efficiency. Although this methodology should be developed further, it is clearly indicated that the cost-efficiency of increased law enforcement of drug driving offences is dependent on the baseline situation of drug-use in traffic and on the current level of enforcement, as well as the RR and prevalence of drugs in road traffic

Comparison of urine and oral fluid as matrices for screening of thirty-three benzodiazepines and benzodiazepine-like substances using immunoassay and LC-MS(-MS)

Benzodiazepines are the most frequently detected medicinal drugs in drivers. The use of benzodiazepines is associated with an increased road accident risk. In this study, the presence of benzodiazepines detected by liquid chromatography-(tandem) mass spectrometry [LC-MS(-MS)] in oral fluid and urine samples obtained from drivers stopped during a roadside survey was compared. In addition, the sensitivity and selectivity of enzyme multiplied immunoassay technique (EMIT | II Plus) relative to LC-MS(-MS) was determined for both matrices. A total number of 1011 urine samples were collected and screened for benzodiazepines using immunoassay (IA) (EMIT II Plus; cutoff 300 ng/mL). In the IA-positive (n = 25) and a group of randomly selected negative urine samples (n = 79), the presence or absence of benzodiazepines was confirme

Psychoactive substance use and the risk of motor vehicle accidents

The driving performance is easily impaired as a consequence of the use of alcohol and/or licit and illicit drugs. However, the role of drugs other than alcohol in motor vehicle accidents has not been well established. The objective of this study was to estimate the association between psychoactive drug use and motor vehicle accidents requiring hospitalisation. A prospective observational case-control study was conducted in the Tilburg region of The Netherlands from May 2000 to August 2001. Cases were car or van drivers involved in road crashes needing hospitalisation. Demographic and trauma related data was collected from hospital and ambulance records. Urine and/or blood samples were collected on admission. Controls were drivers recruited at random while driving on public roads. Sampling was conducted by researchers, in close collaboration with the Tilburg police, covering different days of the week and times of the day. Respondents were interviewed and asked for a urine sample. If no urine sample could be collected, a blood sample was requested. All blood and urine samples were tested for alcohol and a number of licit and illicit drugs. The main outcome measures were odds ratios (OR) for injury crash associated with single or multiple use of several drugs by drivers. The risk for road trauma was increased for single use of benzodiazepines (adjusted OR 5.1 (95% Cl: 1.8-14.0)) and alcohol (blood alcohol concentrations of 0.50-0.79 g/l, adjusted OR 5.5 (95% Cl: 1.3-23.2) and >or=0.8 g/l, adjusted OR 15.5 (95% Cl: 7.1-33.9)). High relative risks were estimated for drivers using combinations of drugs (adjusted OR 6.1 (95% Cl: 2.6-14.1)) and those using a combination of drugs and alcohol (OR 112.2 (95% Cl: 14.1-892)). Increased risks, although not statistically significantly, were assessed for drivers using amphetamines, cocaine, or opiates. No increased risk for road trauma was found for drivers exposed to cannabis. The study concludes that drug use, especially alcohol, benzodiazepines and multiple drug use and drug-alcohol combinations, among vehicle drivers increases the risk for a road trauma accident requiring hospitalisation

Prevention of alcohol problems in Dutch youth - Missed opportunities and ew developments

Contains fulltext : 72915.pdf (publisher's version ) (Closed access)Binge drinking among young people is a problem in the Netherlands. This article outlines the current Dutch approach to alcohol prevention in this target group. It is argued that well-enforced evidence-based control measures are lacking despite renewed political interest in them. Politicians often favor alcohol education, but to increase the effectiveness of alcohol prevention, a combined approach of policy measures, enforcement, and education is needed. Translation of education and policy-based measures is discussed