Use of behavioral risk factor surveys to predict alcohol-related motor vehicle events

The relationship between acute alcohol intoxication and increased risk of traffic violations, crashes, and injuries is well known. We designed this study to investigate the usefulness of behavioral risk factor surveys (BRFSs) in identifying drivers at risk for subsequent motor vehicle violations and crashes. We carried out a retrospective cohort study in a random sample of members of a health maintenance organization, who were followed for five years after ascertainment of alcohol use. Reported problem drinking behavior increased the risk of motor vehicle violations or crashes for women drivers and older drivers (older than 65 years of age) of both sexes. Women "binge drinkers" had an age-adjusted relative risk (RR) for violations of 1.7 (95% confidence interval [CI] = 1.1, 2.8) and an age-adjusted RR for crashes of 1.9 (95% CI = 1.1, 3.2). Older drivers reporting drinking and driving or multiple drinking problems had an increased risk of motor vehicle crashes (sex-adjusted RR = 2.7; 95% CI = 1.2, 5.8, and 3.0; 95% CI = 1.1, 8.4). A CAGE score of 2 or more identified older drivers at increased risk for both violations and crashes. We found no increased risk for male drivers under 65 years of age for any of the problem drinking behaviors. We conclude that BRFSs in a general population can help identify high-risk drivers among women and drivers older than 65 years of age.