Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/28446
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dc.contributor.authorHaghpanahan, Houraen_UK
dc.contributor.authorLewsey, Jimen_UK
dc.contributor.authorMackay, Danielen_UK
dc.contributor.authorMcIntosh, Emmaen_UK
dc.contributor.authorPell, Jillen_UK
dc.contributor.authorJones, Andyen_UK
dc.contributor.authorFitzgerald, Niamhen_UK
dc.contributor.authorRobinson, Marken_UK
dc.date.accessioned2018-12-22T01:04:28Z-
dc.date.available2018-12-22T01:04:28Z-
dc.date.issued2019-01en_UK
dc.identifier.urihttp://hdl.handle.net/1893/28446-
dc.description.abstractBackground Drink driving is an important risk factor for road traffic accidents (RTAs), which cause high levels of morbidity and mortality globally. Lowering the permitted blood alcohol concentration (BAC) for drivers is a common public health intervention that is enacted in countries and jurisdictions across the world. In Scotland, on Dec 5, 2014, the BAC limit for drivers was reduced from 0·08 g/dL to 0·05 g/dL. We therefore aimed to evaluate the effects of this change on RTAs and alcohol consumption. Methods In this natural experiment, we used an observational, comparative interrupted time-series design by use of data on RTAs and alcohol consumption in Scotland (the interventional group) and England and Wales (the control group). We obtained weekly counts of RTAs from police accident records and we estimated weekly off-trade (eg, in supermarkets and convenience stores) and 4-weekly on-trade (eg, in bars and restaurants) alcohol consumption from market research data. We also used data from automated traffic counters as denominators to calculate RTA rates. We estimated the effect of the intervention on RTAs by use of negative binomial panel regression and on alcohol consumption outcomes by use of seasonal autoregressive integrated moving average models. Our primary outcome was weekly rates of RTAs in Scotland, England, and Wales. This study is registered with ISRCTN, number ISRCTN38602189. Findings We assessed the weekly rate of RTAs and alcohol consumption between Jan 1, 2013, and Dec 31, 2016, before and after the BAC limit came into effect on Dec 5, 2014. After the reduction in BAC limits for drivers in Scotland, we found no significant change in weekly RTA rates after adjustment for seasonality and underlying temporal trend (rate ratio 1·01, 95% CI 0·94–1·08; p=0.77) or after adjustment for seasonality, the underlying temporal trend, and the driver characteristics of age, sex, and socioeconomic deprivation (1·00, 0·96–1·06; p=0·73). Relative to RTAs in England and Wales, where the reduction in BAC limit for drivers did not occur, we found a 7% increase in weekly RTA rates in Scotland after this reduction in BAC limit for drivers (1·07, 1·02–1·13; p=0·007 in the fully-adjusted model). Similar findings were observed for serious or fatal RTAs and single-vehicle night-time RTAs. The change in legislation in Scotland was associated with no change in alcohol consumption, measured by per-capita off-trade sales (−0·3%, −1·7 to 1·1; p=0·71), but a 0·7% decrease in alcohol consumption measured by per-capita on-trade sales (−0·7%, −0·8 to −0·5; pen_UK
dc.language.isoenen_UK
dc.publisherElsevieren_UK
dc.relationHaghpanahan H, Lewsey J, Mackay D, McIntosh E, Pell J, Jones A, Fitzgerald N & Robinson M (2019) An evaluation of the effects of lowering blood alcohol concentration limits for drivers on the rates of road traffic accidents and alcohol consumption: a natural experiment. Lancet, 393 (10169), pp. 321-329. https://doi.org/10.1016/s0140-6736%2818%2932850-2en_UK
dc.rightsThis article is available under the terms of the Creative Commons Attribution License (CC BY). You may copy and distribute the article, create extracts, abstracts and new works from the article, alter and revise the article, text or data mine the article and otherwise reuse the article commercially (including reuse and/or resale of the article) without permission from Elsevier. You must give appropriate credit to the original work, together with a link to the formal publication through the relevant DOI and a link to the Creative Commons user license above. You must indicate if any changes are made but not in any way that suggests the licensor endorses you or your use of the work.en_UK
dc.titleAn evaluation of the effects of lowering blood alcohol concentration limits for drivers on the rates of road traffic accidents and alcohol consumption: a natural experimenten_UK
dc.typeJournal Articleen_UK
dc.identifier.doi10.1016/s0140-6736(18)32850-2en_UK
dc.identifier.pmid30553498en_UK
dc.citation.jtitleLanceten_UK
dc.citation.issn1474-547Xen_UK
dc.citation.issn0140-6736en_UK
dc.citation.volume393en_UK
dc.citation.issue10169en_UK
dc.citation.spage321en_UK
dc.citation.epage329en_UK
dc.citation.publicationstatusPublisheden_UK
dc.citation.peerreviewedRefereeden_UK
dc.type.statusVoR - Version of Recorden_UK
dc.contributor.funderNational Institute for Health Researchen_UK
dc.citation.date12/12/2018en_UK
dc.contributor.affiliationUniversity of Glasgowen_UK
dc.contributor.affiliationUniversity of Glasgowen_UK
dc.contributor.affiliationUniversity of Glasgowen_UK
dc.contributor.affiliationUniversity of Glasgowen_UK
dc.contributor.affiliationUniversity of Glasgowen_UK
dc.contributor.affiliationUniversity of East Angliaen_UK
dc.contributor.affiliationInstitute for Social Marketingen_UK
dc.contributor.affiliationNHS Health Scotlanden_UK
dc.identifier.isiWOS:000456808200023en_UK
dc.identifier.wtid1078997en_UK
dc.contributor.orcid0000-0002-3643-8165en_UK
dc.date.accepted2018-12-12en_UK
dc.description.refREF Compliant by Deposit in Stirling's Repositoryen_UK
dc.date.filedepositdate2018-12-20en_UK
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