Alcohol and road use: a single outcome

In a previous article, we outlined one of South Africa's biggest road safety challenges: alcohol. With over half our traffic fatalities under the influence, the situation has been at crisis proportions for some time now, but what is it about alcohol which makes it such a road safety problem? What changes occur in a driver or pedestrian to so dramatically increase risk? In this second article of three on the alcohol and road use issue, we will look at this issue more closely..

 In 1992, a local traffic criminologist, Dr Lawrence Barit, conducted the most comprehensive study ever undertaken in South Africa into the effects of alcohol on driving. Dozens of participants took part in Project RID (Remove Intoxicated Drivers) which tracked the way driving ability changed as Blood Alcohol Concentration increased. Participants were divided into groups, with each group having drinkers and non-drinking controls. Special attention was paid to fatigue, with one group of drivers who had not slept the previous night.

 The massive experiment took place at Kyalami. The AA's driver training arm designed a series of simple, low-speed driving skills tests of judgment and driving ability. The Kyalami skidpan was used for the wet road tests, and the dry road tests were conducted in a large, isolated car park well away from the public while the media and authorities looked on. Close supervision was ensured by traffic police and an army of organisers and researchers, and a fleet of designated drivers ensured the dozens of intoxicated drivers were able to get home safely afterwards. With free liquor at their disposal, the drinkers were encouraged to indulge in their favourite tipple at their pleasure, and nurses and doctors were on hand to assess participants' physical condition and draw blood and take breathalyser readings every two hours. Having familiarised themselves with the driving skills tests before drinking commenced, the participants - both drinkers and non-drinkers - re-did the tests regularly throughout the day.

 The results were unequivocal - the performance of the non-drinkers gradually improved as they repeated the tests. The drinkers got progressively worse until some had to be physically restrained from driving the test vehicles due to the danger they posed. One driver, only moderately intoxicated according to the breathalyser readings, bumped every obstacle in the 'garage' parking test, and another  forgot about the current test altogether and drove aimlessly around the test area until organisers intervened.

 The fatigue group's performance while under the influence deteriorated so rapidly that the group's experiment was terminated early for safety reasons. By the end of the day, the evidence from the score sheets made it clear beyond doubt that, notwithstanding variations between individuals, alcohol reduces driving ability from the very first drink.

 Reduction in driving ability as intoxication increases is not the only danger on the roads.. At high blood alcohol concentrations, loss of consciousness can occur, making crashes almost inevitable among very heavily intoxicated drivers. An accident victim who is under the influence also presents a challenge to medical staff at the crash scene, complicating treatment - the effects of alcohol may mask symptoms or interfere with the individual's ability to communicate with medical staff. And the presence of alcohol may restrict treatment options over concern about interactions between alcohol and other medications. These medical aspects, which are rarely raised in the media, raise the interesting question of whether one should travel by road at all after drinking alcohol, even if only as a passenger.

 Project RID did not specifically investigate the effects of alcohol on pedestrians, but the conclusions drawn from the condition of the drivers cannot be ignored - a few heavily intoxicated drivers were unable to communicate coherently, walk, or even stand, and some were visibly un-coordinated after just a few drinks. Studies before and since Project RID have shown that South African pedestrians have high drinking rates, and when combined with the high drinking rates of drivers, the effect on road safety is likely to be significant enough to account for a good proportion of the roughly 40% of traffic fatalities which are pedestrians.

 An important finding of research into alcohol and driving is that there is a single outcome for everyone: the decline in performance with increased intoxication may be slower in some than in others, but eventually all drivers start to commit major driving errors. The driving public's acceptance of this reality was slower back in 1991 when driving after drinking was commonplace. But with Project RID now more than two decades in the past, and a new generation which has grown up with decreasing acceptance of alcohol and driving, why then has alcohol use on our roads reached epidemic proportions?

 The AA's view is that there must be many drivers and pedestrians who have escaped the net. The message about alcohol and road use has either not reached them, or they are not heeding it. In a future article to conclude this series on alcohol, we will speculate about who they may be, and how (and indeed, if) they can be persuaded to keep road use and alcohol separate.

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