Risk Of Death Due To Alcohol-Related
Crashes For Children
Context The overall percentage of motor vehicle deaths associated with alcohol
consumption declined between 1991 and 1996, but the risk of death due to alcohol-related
crashes for children warrants analysis.
Objective To examine the association between alcohol use by drivers and mortality
of children who were passengers, pedestrians, and bicyclists.
Design and Setting Analysis of data from the Fatality Analysis Reporting System, a nationwide
US registry of motor vehicle deaths, for 1991-1996.
Subjects A total of 16,676 children younger than 16 years who were passengers,
pedestrians, or bicyclists and whose death was due to a motor vehicle crash.
Main Outcome Measure Alcohol use by drivers involved in crashes in which children died, assessed
by age and sex of the child and driver and type of crash.
Results A total of 3310 deaths (19.9%) involved alcohol-related crashes. The
percentage declined from 21.6% in 1991 to 17.8% in 1996. Considering only
crashes in which the alcohol-use status of the child's driver was relevant,
the decline was less marked, from 18.8% in 1991 to 15.1% in 1995, with an
increase to 16.4% in 1996. Among crashes involving alcohol, the child's own
driver had been drinking in 66.3% of cases, varying from 58.0% to 70.7% over
time. Drivers younger than the legal drinking age of 21 years who had been
drinking alcohol accounted for 30.3% of alcohol-related passenger deaths among
Conclusion While the overall percentage of alcohol-related motor vehicle deaths
for children declined between 1991 and 1996, experiences for passengers, pedestrians,
and bicyclists differ. Selected characteristics of children and drivers that
elevate the risk of an alcohol-related motor vehicle death point to the need
for further policy and clinical interventions.
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Characteristics Of Crashes Involving Child Passenger - Deaths And Injuries Associated With Drinking Drivers
Context Motor vehiclerelated injury is the leading cause of death for
children and young adults aged 1 to 24 years in the United States. Approximately
24% of child traffic deaths involve alcohol.
Objective To examine characteristics of crashes involving child passenger deaths
and injuries associated with drinking drivers to identify opportunities for
Design, Setting, and Participants Descriptive epidemiological analysis of 1985-1996 data from the Fatality
Analysis Reporting System on deaths among US child passengers (aged 0-14 years)
and 1988-1996 data from the General Estimates System on nonfatal injuries.
Main Outcome Measures Child passenger death or injury by driver characteristics (eg, driver
age, blood alcohol concentration, and driving history).
Results In 1985-1996, there were 5555 child passenger deaths involving a drinking
driver. Of these deaths, 3556 (64.0%) occurred while the child was riding
with a drinking driver; 67.0% of these drinking drivers were old enough to
be the parent or caregiver of the child. Of all drivers transporting a child
who died, drinking drivers were more likely than nondrinking drivers to have
had a previous license suspension (17.1% vs 7.1%) or conviction for driving
while intoxicated (7.9% vs 1.2%). Child restraint use decreased as both the
child's age and the blood alcohol concentration of the child's driver increased.
In 1988-1996, an estimated 149,000 child passengers were nonfatally injured
in crashes involving a drinking driver. Of these, 58,000 (38.9%) were riding
with a drinking driver when injured in the crash.
Conclusions These data indicate that the majority of drinking driverrelated
child passenger deaths in the United States involve a child riding unrestrained
in the same vehicle with a drinking driver. Typically, the drinking driver
transporting the child is old enough to be the child's parent or caregiver.
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Consensus Statement : Plague As A Biological Weapon
Objective The Working Group on Civilian Biodefense has developed consensus-based
recommendations for measures to be taken by medical and public health professionals
following the use of plague as a biological weapon against a civilian population.
Participants The working group included 25 representatives from major academic medical
centers and research, government, military, public health, and emergency management
institutions and agencies.
Evidence MEDLINE databases were searched from January 1966 to June 1998 for the
Medical Subject Headings plague, Yersinia pestis, biological weapon, biological terrorism, biological warfare, and biowarfare. Review of the bibliographies
of the references identified by this search led to subsequent identification
of relevant references published prior to 1966. In addition, participants
identified other unpublished references and sources. Additional MEDLINE searches
were conducted through January 2000.
Consensus Process The first draft of the consensus statement was a synthesis of information
obtained in the formal evidence-gathering process. The working group was convened
to review drafts of the document in October 1998 and May 1999. The final statement
incorporates all relevant evidence obtained by the literature search in conjunction
with final consensus recommendations supported by all working group members.
Conclusions An aerosolized plague weapon could cause fever, cough, chest pain, and
hemoptysis with signs consistent with severe pneumonia 1 to 6 days after exposure.
Rapid evolution of disease would occur in the 2 to 4 days after symptom onset
and would lead to septic shock with high mortality without early treatment.
Early treatment and prophylaxis with streptomycin or gentamicin or the tetracycline
or fluoroquinolone classes of antimicrobials would be advised.
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