Worldwide Risk of Death in Road Crashes Caused by Drinking is Higher for Men, Younger People, Motorcyclists, and Europeans

Men, young adults, motorcyclists, and people in European and other reasonably well-developed countries are more likely to die in road crashes caused by drinking, according to a novel review of global data. Researchers found that the risk of dying in a road crash attributed to alcohol consumption varied markedly around the world and across population groups. The new review may be the first to provide detailed information on the rate of fatal injury in traffic crashes caused by alcohol use and its variation by location, the sex and age of victims, or transit circumstances. The World Health Organization estimates that in 2018, one in four road deaths worldwide were attributable to drinking. For the review in Alcoholism: Clinical & Experimental Research, investigators in Mexico explored how these fatalities are distributed, geographically and demographically. This more granular information can potentially help target prevention resources at locations and communities where they may most effectively reduce injuries and deaths relating to driving under the influence of alcohol.

Researchers used global data on road injury deaths and injuries attributed to drinking, along with countries’ socioeconomic status, alcohol exposure across populations, and the probability of road injuries caused by alcohol in specific population groups and locations. They used statistical analysis to calculate attributable risks relating to road deaths among motor vehicle drivers, pedestrians, motorcyclists, cyclists, and others. In this context, attributable risk or fraction expresses the amount (percentage) of road injury deaths that are due (attributable) to alcohol. They also calculated attributable risks by location, countries’ socioeconomic development, the age and sex of those who died, and the year (from 1990 to 2019).

In 2019, 1,200,000 road injury deaths were recorded globally, of which 6% were attributed to alcohol use — a slight increase since 1990. The 2019 data showed large variations. Motorcyclists had the highest alcohol-attributable risk of death (in Estonia, one in five such fatalities were caused by drinking), especially among young men. Pedestrians had the lowest. Eight percent of road injury deaths were caused by men’s drinking and 2 percent by women’s drinking. Age was also influential. Adults aged 20–34 were the most likely to die in traffic crashes attributed to alcohol use. Men were at highest risk in their late 20s, women in their early 20s (although women’s risk peaked well below men’s). Adults aged 50–69 were the least likely to die in this way. The risk of road deaths caused by drinking was most severe in countries of a high-middle socio-demographic status, reflecting their relatively high consumption of alcohol. The countries of greatest concern were Czechia, Estonia, Australia, New Zealand, Canada, Paraguay, and Argentina. The lowest risk was in Africa and the Arabian Peninsula. In nearly three decades covered by the data, the alcohol-attributable fraction rose among children aged 10–14, men under 39, and women under 19. People in middle-adulthood and the elderly became less likely to die in alcohol-attributed crashes.

The findings are innovative and can potentially inform prevention policies and strategies aimed at reducing alcohol-impaired driving. These include taxing alcohol, restricting alcohol advertising, revoking driving licenses, lowering speed limits, and infrastructural investments. The researchers cautioned that because of data limitations, the review findings likely underestimate the true risks. They emphasized the need for more detailed information on types of road injuries, and the role of other substances.

Global estimates of the attributable risk of alcohol consumption on road injuries. G. Borges, J. A. Garcia, I. Familiar-Lopez (pp xx).

ACER-21-4839.R2