Category Archives: Impairment

Drink or Drive—Pick One

By Member Jennifer Homendy

The United States continues to be one of the world’s leaders in drunk-driving deaths. One of the reasons for this shameful distinction is that US drivers are allowed to operate motor vehicles with more alcohol in their system than is permitted in most other countries.

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One state in the nation is an exception to this rule: Utah, which became the first state to lower the threshold for drunk driving from .08 percent blood alcohol concentration (BAC) to .05 percent BAC, joining more than 100 countries that have a limit of .05 percent or lower. In 1983, Utah was also the first state to lead the nation in lowering the threshold from .10 percent to .08 percent BAC.

Currently, California and Michigan legislators are considering whether to adopt a .05‑percent law that will save hundreds of lives and prevent thousands of life-altering injuries over the coming years. On April 3, NTSB Safety Advocate Leah Walton added her voice to the growing chorus calling for a lower BAC limit in California, for the same reasons that I spoke in favor of a similar law in Michigan on March 20, and for the same reasons that the NTSB advocated in support of Utah’s .05 law, which went into effect December 30, 2018. (New York is also considering such a move.) All three laws satisfy our 2013 safety recommendation to lower the legal BAC limit to .05 percent or lower. All three laws will separate drinking from driving, and, by doing so, all three laws will save lives.

Our .05-percent BAC limit safety recommendation was adopted in our safety study, Reaching Zero: Actions to Eliminate Alcohol-Impaired Driving. Numerous other studies, including a recent study by the National Academy of Sciences, have reached the same conclusion: .05‑percent limits save lives.

Let me be clear: we aren’t trying to stop people from drinking; we’re working to stop people from drinking and driving. Our goal is to save lives, and our concerns are justified. In the past 10 years, more than 100,000 people have died in alcohol-involved crashes in the United States.  According to the National Highway Traffic Safety Administration, 10,874 people died in driving-under-the-influence crashes in 2017, the last full year on record. Clearly, .08-percent limits just aren’t working.

Reducing the legal BAC limit for driving is a broad deterrent that lowers the incidence of crashes and crash deaths at all BAC levels, not just those in the narrow range between .05 and .079 percent. It’s estimated that lowering the legal BAC limit in every state would likely reduce the number of fatal alcohol-related crashes by 11 percent, potentially saving up to 1,790 lives a year.

Other safety organizations have done their own great work in support of a .05-percent or lower BAC limit. The World Health Organization; the National Academies of Sciences, Engineering and Medicine; Advocates for Auto and Highway Safety; the National Safety Council; and Mothers Against Drunk Driving have all supported our safety recommendation. A .05-percent BAC limit is also supported by a majority of US motorists—63 percent, in fact, according to the AAA 2015 Traffic Safety Culture Index.

It’s noteworthy that even countries with higher alcohol consumption per capita than the United States set their BAC limits at .05 percent or lower. It’s not that people in these countries don’t drink; they just don’t drink and drive.

Growing up, my parents taught me not to drink and drive. It was just that simple. I never once heard anyone tell me it was OK to “only drive a little drunk.” My parents never lectured me that I could drink and drive as long as I kept my BAC below a certain limit.

And that’s the goal of the .05-percent movement—separating drinking from driving. You can drink responsibly. You can drive responsibly. But no one can responsibly drink and drive.

Our goal is not to propose a new target number of drinks to have before driving; rather, it’s for people to plan to either drink or drive. But never to do both.

 

Don’t Rely on the Luck of the Irish for a Safe Ride Home

By: Member Jennifer Homendy

St. Patrick’s Day is a big deal in our house. “Leprechauns” sneak in the night before to raid our kitchen cabinets. Sometimes they write things in green paint on our walls; other times they leave gold coins. And my daughter always tries to catch one in her latest handmade trap (spoiler alert: it’s never happened). This is also one of the busiest weekends of the year for us. My daughter is an Irish dancer, and over St. Patrick’s Day weekend, our schedule is jam packed with parades and multiple performances at local pubs where there’s lots of dancing, drinking, and good ole reveling in Irish culture. What always concerns me, though, is the number of people who walk out of those pubs right into their cars after an afternoon of drinking.

Did you know that nearly 29 people die each day in the United States in alcohol-impaired driving crashes? That’s one person every 50 minutes, or more than 10,000 people a year. Alcohol-impaired driving crashes are 100% preventable. It’s simple. Choose one: drink or drive. Don’t do both.

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This Sunday, you may be tempted to think: well, it’s just one drink, or it’s just two. Although the current legal definition of alcohol impairment in 49 states is a blood alcohol concentration of 0.08% (0.05% in Utah, thanks to the efforts of the NTSB), research shows that impairment begins at much lower levels; even small amounts of alcohol affect the brain and human performance behind the wheel.

So, this St. Patrick’s Day, we want you to have fun. And the best way to do that is to have a plan in place before you start to celebrate. Leave the driving to someone who’s sober or take transit, call a cab or a rideshare service, but please don’t drink and drive.

Add a Day of Remembrance for a Balanced Holiday Season

By Chairman Robert L. Sumwalt

Every year, I hear that the holiday season has gotten too long—that holiday music, commercials, and sales begin too early. Traditionally, the season starts on Thanksgiving, the fourth Thursday of November.

 

I think the season should actually start even earlier this year—on the third Sunday in November, World Day of Remembrance for Road Traffic Victims. Why? Because to truly give thanks for what we have, we have to imagine losing it. Around the world, about 1.3 million people lose their lives in automobile crashes every year; 20 to 50 million more survive a crash with injuries, many of which are life-altering. Here in the United States, annual traffic deaths number around 37,000—more than 100 a day—and a motor vehicle crash is the single most likely way for a teen to die.

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If you’ve lost somebody to a crash, you probably need no special reminder. Your loved one will be missed at the holiday dinner table, on the way to the home of a friend or out-of-town relative, and throughout the holidays. But for the rest of us, the Day of Remembrance is a time to think of those needlessly lost on our roads.

I encourage us all to go beyond remembering those lost in highway crashes, to thinking of victims of transportation accidents in all modes who won’t be joining family and friends this holiday season. Before we give thanks next Thursday, let’s take a moment to remember those who have been lost, and then take steps to make our own holiday travel safer.

By Car

Fatigue, impairment by alcohol and other drugs, and distraction continue to play major roles in highway crashes. Here’s what you can do to keep yourself and those around you safe on the road.

  • If your holiday celebrations involve alcohol, ask a friend or family member to be your designated driver, or call a taxi or ridesharing service.
  • In a crash, seat belts (and proper child restraints) are your best protection. Always make sure that you and all of your passengers are buckled up or buckled in!
  • Make sure to use the right restraint for child passengers, and be sure it’s installed correctly. If you have doubts, ask a Certified Child Passenger Safety Technician.
  • Make sure you’re well rested! A fatigued driver is just as dangerous as one impaired by alcohol or other drugs.
  • Avoid distractions. In this video, survivor-advocates share their stories of personal loss—and the changes they’re working for now.
  • Don’t take or make calls while driving, even using a hands-free device. Set your navigation system before you start driving. If you’re traveling with others, ask them to navigate.

By Bus or Train

We’ve made recommendations to regulators and industry to improve passenger rail and motorcoach operations and vehicle crashworthiness, but travelers should know what to do in an emergency.

  • Pay attention to safety briefings and know where the nearest emergency exit is. If it’s a window or roof hatch, make sure you know how to use it.
  • If you’re unsure of where the exits are or how to use them, or if you didn’t receive a safety briefing, ask your driver or train conductor to brief you.
  • Always use restraints when they’re available!

By Air or Sea

Airline and water travel have become incredibly safe, but these tips can help keep you and your loved ones safe in an emergency.

  • When flying, make sure that you and your traveling companions have your own seats—even children under age 2.
  • Don’t forget your child’s car seat. The label will usually tell you whether your child car seat is certified for airplane use; the owner’s manual always has this information.
  • If you don’t know the rules for using a child’s car seat on your flight, call the airline and ask what you need to know.
  • Pay close attention to the safety briefing! Airline and marine accidents have become very rare, but you and your family can be safer by being prepared.
  • Whether you’re on an airplane or a boat, know where to find the nearest flotation device.

This holiday season, no matter how you plan to get where you’re going, remember that, for many, this time of year is a time of loss. Honor survivors and remember traffic crash victims by doing your best to make sure you—and those around you—make only happy memories on your holiday travels.

Observing an Impaired Driving Enforcement Training

By Member T. Bella Dinh-Zarr, PhD, MPH

This summer, I had the opportunity to observe men and women training to be law enforcement officers. Part of their training included 40 hours focused specifically on executing a standardized field sobriety test (SFST).

The SFST is a series of assessments an officer performs during a traffic stop to determine if a driver is impaired. I was surprised to learn how the SFST also helps officers detect drivers who are impaired by drugs other than alcohol.  When an officer encounters a subject who he believes to be impaired, his first response will be to evaluate his physical condition by administering a SFST.  Although all the clues for impairment which are analyzed in the SFST are for alcohol, there are similarities in impairment by some of the 7 different drug classes.  Additionally, the presence of some impairment clues and the absence of others can be a strong indicator of drug impairment.  For instance, a subject who displays nystagmus (uncontrollable twitching of the eyes) from alcohol impairment will also present an inability to maintain balance.  With some drug classes, there will be a high degree of nystagmus, but their balance may not be affected to the same degree.  The same goes with the strong odor of alcohol.  If a subject is obviously impaired but has no odor of alcohol about their breath, drug impairment may have an influence.  When officers administer an SFST to a suspected drug-impaired driver, the results often identify the need for a drug recognition expert (DRE) to evaluate the driver for physical signs of drug impairment.

Trainees learn about the effects of alcohol on the body and the visual cues to look for when they suspect a driver is impaired, as well as how to determine the likelihood of impairment so they have probable cause to administer an impairment test. In addition to the SFST training, officers spend hours learning how to document impaired driving arrests and how to present evidence of such arrests in court.

To effectively practice these skills, trainees conduct the SFST on live subjects who have consumed varying amounts of alcohol in a controlled environment (a law-enforcement training facility; subjects are driven home by law enforcement officers afterward). Volunteers are given measured amounts of alcohol over the course of 4 hours prior to the mock SFST, and then are given a breath test to document their breath alcohol concentration (BrAC) as the evaluation begins. SFST instructors observe trainees as they evaluate subjects and offer real-time feedback and suggestions for improvement. By using live subjects, trainees witness how variably alcohol consumption can present in individuals.

A law enforcement trainee conducts the SFST on a live subject that has consumed alcohol.
A law enforcement trainee conducts the SFST on a live subject that has consumed alcohol

I spent some time with the live subjects, all of whom were impaired, before their evaluations. All subjects had a BrAC of 0.08 percent or higher and, had they been behind the wheel, would have been subject to arrest. The SFST instructor showed me the documented BAC levels of the subjects. While all of the subjects were at or above 0.08, they were each keenly aware that they were in no condition to drive. They were unsteady on their feet, reacted slowly to orders, and struggled to follow directions given by the trainees. I couldn’t tell which subjects had higher BACs than others, but just knowing that some were close to or just above the “legal limit,” I would not be comfortable sharing the road with any of them.

When the evaluations started, I got to be one of the (sober) subjects evaluated by the trainees. I received the same set of questions and was given the same tests as the impaired subjects. The SFST is incredibly thorough, and officers determine the likelihood of impairment by scoring the elements of the test based on how the subject performs. I was asked questions such as, “Where are you coming from?” “Have you had anything to drink tonight?” “Are you on any medications or do you have any medical conditions that I should be aware of?” From there, I was asked to walk a certain number of steps, heel to toe, counting each step out loud; to stand on one foot with my arms at my sides and balance, and to track a pen that the trainee moved in front of my face from side to side. The test is designed to evaluate a person’s ability to complete simultaneous tasks—an ability that is hindered by impairment. What I learned later is that each part of the test helps the officer gather data about the subject—slurred speech, an alcohol odor, impaired coordination, and atypical eye movement are all signs of impairment. Subjects who score in or above a certain range on the test are considered to have a positive likelihood of impairment.

Member Dinh-Zarr undergoes the SFST
Member Dinh-Zarr undergoes the SFST

I learned two things through this test. First, I struggle with balancing on one foot, even when I’m sober! Second, the trainees are taught this protocol very thoroughly; they are instructed to take their time and not rush any element of the test. They need to be very deliberate because officers cannot administer a breath test unless they positively detect impairment.

End Alcohol and Other Drug Impairment in Transportation is on our Most Wanted List of transportation safety improvements. Specifically, we recommend that all states lower their per se BAC limit from 0.08 percent to 0.05 percent or lower. Observing this SFST training exercise reaffirms my belief in the NTSB’s position on this recommendation. A 0.08 percent BAC illegal limit is far too high. At .05, drivers have difficulty with vision, coordination, and steering, even if they may not realize it.  In fact, in 2016, approximately 1,400 people were killed by drivers with a BAC of 0.01­–0.07 percent.

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Driver BAC’s from fatal crashes in 2016. Drivers are not considered legally impaired before 0.08 BAC, but 1,400 people were killed by drivers that had between 0.01 and 0.07 BAC in 2016.

In addition to calling on states to lower their legal BAC limit, we also recommend increased high-visibility enforcement, such as sobriety checkpoints, which allow law enforcement officers to screen a high number of drivers in a short amount of time for potential impairment. All of these safety recommendations are not intended to increase arrests.  In fact. they may decrease the number of arrests because they deter many impaired people from even getting behind the wheel in the first place.  That is true prevention!

Our 2013 report, “Reaching Zero: Actions to Eliminate Alcohol-Impaired Driving” includes a series of recommendations to combat impaired driving. We believe that implementing a combination of a lower BAC legal limit, increased or high-visibility enforcement, and mandatory ignition interlock devices for all DUI offenders can reduce the number of impaired drivers on our roadways. Our goal is to eliminate impaired driving by convincing people to separate drinking or drugging from driving.

I’d like to thank all law enforcement officers who conduct SFSTs and remove alcohol-impaired drivers from our roadways. It may not seem as glamourous as other aspects of their job, but they are making our nation safer with this important work. These trained professionals help keep our roads safe and prevent families from losing a loved one to an impaired driving crash. It’s up to the rest of us to do our part to reach zero.

Working for Safety

By Robert L. Sumwalt, Chairman

 Labor Day and Memorial Day both have specific relevance that can be lost in seasonal associations. The meaning of Memorial Day as a time to honor those lost in our nation’s wars can be eclipsed by its unofficial role as the “kickoff day” for summer. Similarly, all too often, we think of Labor Day only as summer’s end rather than as a commemoration of the contributions of the nation’s working men and women.

This Labor Day, I’d like to take a moment to express my appreciation for the men and women who work every day in transportation, doing everything right so that there’s not an accident for the NTSB to investigate.

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From owner-operators of long-haul trucks to employees of the biggest trucking companies; from captains of small fishing boats to employees of the biggest cruise lines and marine cargo companies; from air-tour operators to airline pilots and cabin crews; and throughout railroad and pipeline transportation, safe transportation depends on the dedication and hard work of the people on the front lines: individual transportation workers.

At the NTSB, we investigate what goes wrong in transportation. In each accident, we look at the human, the machine, and the environment. When we find a lapse in any of those areas, we look for ways to eliminate the opportunity for error. Meanwhile, day in and day out, good men and women go to work every day and do everything right. We don’t investigate the truck that stayed on the road because its conscientious drivers got plenty of sleep, or the ship that didn’t run aground because its captain and crew were well-trained and attentive. We’ll never hold a Board meeting to discuss one of the millions of safe airline flights every year, or to talk about the pipeline operators and railroad employees who found the safety defect among thousands of miles of rail or pipe before it caused an accident.

Although technology and design innovations have greatly improved transportation safety, we haven’t yet managed to eliminate everything that can go wrong in transportation. That’s why we depend so heavily on the nation’s transportation workers, who face rigorous rules and laws, to ensure safety. Commercial truckers and pilots log their rest and duty time to prevent fatigue. While the general driving public is subjected to a .08-percent blood alcohol content (BAC) legal limit, for commercial drivers, the limit is already .04 percent. And then there are all the safety procedures these professionals are required to know—and follow—throughout their commercial transportation careers.

The majority of our nation’s transportation professionals meet these high standards and are intent on preventing transportation tragedies. As Chairman of the NTSB and a member of the traveling public, I want to express my appreciation for all those transportation workers who are quietly doing things right, day in and day out.

Professor James Reason once said that safety professionals live with a “chronic unease.” Safety is a matter of constantly searching out the unassessed hazard, the unmitigated risk. Transportation operators at every level embrace this difficult challenge every day. On this Labor Day, I gratefully tip my hat to each one of you who takes safety seriously.

 

Two Years and Counting . . . Still no FAA Action

By Chairman Robert L. Sumwalt

Saturday, July 30, 2016.

The day started like most summer days in central Texas—hot and muggy, with the Lockhart Blog.jpgchance of foggy and cloudy conditions around daybreak. I can only imagine the feelings of excitement—perhaps even a few fleeting moments of apprehension—as the pilot and his 15 passengers climbed into the basket of the enormous hot air balloon. The large smiley face that adorned the side of the balloon was emblematic of what the day’s flight was supposed to be for these paying passengers, who were celebrating birthdays, anniversaries, and even, belatedly, Mother’s Day. Tragically, about 45 minutes after lifting off, the balloon careened into high-tension powerlines that crisscrossed the Texas countryside. The balloon plunged to the ground, claiming all 16 lives on board.

This was the deadliest balloon crash in U.S. history. Furthermore, it was the deadliest U.S. aviation accident in more than 7 years.

We determined the probable cause of the crash was “the pilot’s pattern of poor decision-making that led to the initial launch, continued flight in fog and above clouds, and descent near or through clouds that decreased the pilot’s ability to see and avoid obstacles.” Further, we pointed out that “contributing to the accident were (1) the pilot’s impairing medical conditions and medications and (2) the Federal Aviation Administration’s [FAA’s] policy to not require a medical certificate for commercial balloon pilots.”

Our investigation revealed that the pilot had several medical conditions that would have precluded his legal ability to operate any aircraft, including a balloon. He was also taking medications prohibited when piloting. He had been arrested on four occasions for driving under the influence. Any of these conditions or circumstances would have barred his ability to obtain an FAA medical certificate.

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Post accident photo of the basket

But, here’s the odd thing: unlike commercial airplane and helicopter air tour pilots, commercial air tour balloon pilots are not required to have an FAA medical certificate. Our accident investigation report made clear: “The [FAA’s] exemption of balloon pilots from medical certification requirements eliminated the potential for (1) an aviation medical examiner to identify the pilot’s potentially impairing medical conditions and medications and/or (2) FAA awareness of his history of drug-and alcohol-related offenses, which could have led to [his pilot certificate being revoked or suspended] until satisfactorily resolved.” To close this loophole, we recommended a logical solution—that the FAA begin requiring medical certificates for commercial balloon pilots (Safety Recommendation A-17-34). “Require Medical Fitness” has been a focus of our Most Wanted List of critical transportation safety improvements since 2015.

As we wrapped up the Board meeting we held to deliberate this tragedy, I expressed my optimism that “today’s recommendations, if acted upon, will help to bring the safety standards and oversight of commercial passenger balloon operations closer to those that apply to powered flight.”

Sadly, it appears that optimism was misplaced. Two years after the Lockhart tragedy, and nearly 10 months after we issued this recommendation, we still haven’t received any indication that the FAA plans to require commercial balloon pilots to hold valid medical certificates.

The FAA should act. The victims of this horrible accident and their families deserve nothing less, and future balloon passengers deserve better.

Back-to-School Safety Series: Zero Tolerance Starts at Home

By Leah Walton, NTSB Safety Advocate

As teen drivers head back to school—and all the daily exposure to peer influence that implies—remember that you have influence, too. That’s especially important when the subject is impaired driving.

You already know that driving impaired is dangerous, but underage drinking and driving is especially deadly. In the United States, 19% of drivers age 15 to 20 involved in fatal motor vehicle crashes had a BAC of at least 0.08%.

Chart of effects of BAC levels from .01 to .10Impairment begins with the first drink or the moment a mind- or mood-altering substance is ingested, inhaled, or injected. Teenagers drive under the influence of drugs other than alcohol in astonishing numbers; among the 62.6% of students nationwide who drove during the 30 days before a 2017 survey, 5.5% had driven a car or other vehicle one or more times when they had been drinking alcohol, and 16.5% had ridden one or more times in a vehicle driven by someone who had been drinking. Another survey showed that 19-year-old drivers drive under the influence of drugs at the staggering rate of 16%.

It’s important to point out that a broad range of drugs can be impairing. Illicit, prescribed, and over-the-counter drugs can all impair a driver. Whether it’s an allergy medication from the drug store or a prescription from a doctor, if the warning label reads, “do not operate heavy machinery,” that includes a car; driving should be avoided until the side effects pass.

Impairment is...

As a group, teenagers are at higher risk of experimenting with drugs or alcohol than adults. Teens’ brains are still developing and they’re less able to control their impulses than adults. It’s easy to see how teens can feel fearless in the face of tragedies they assume will “never happen to them”—until they do. The threat of injury from impaired driving crashes shouldn’t be the only deterrent. Consuming any alcohol at all under the age of 21 is illegal. All states have zero-tolerance laws for drivers under 21, meaning that driving with any or a very low BAC comes with great consequence. Teens who drive impaired can face DUI “school,” a lifelong conviction on their arrest record, and even jail time. And as more states begin to legalize marijuana, it’s a good time to remind teens that driving under the influence of drugs (DUID) is illegal and, more importantly, can be deadly.

End Alcohol and Other Drug Impairment in Transportation is on the NTSB’s Most Wanted List of transportation safety improvements, and it applies to drivers of all ages. But young drivers (ages 16­­–20) are 17 times more likely to die in a crash when they have a BAC of .08% than when they have not been drinking. Although the number of underage impaired driving crashes has decreased over the past decade, in 2016, alcohol was still a factor in 20 percent of fatal crashes involving teens.

For teenagers, the world is small, and nebulous concepts like dying in a car crash are more easily heard than taken to heart. Talk to your teen about the dangers of impaired driving—share with them a story of someone in your community who was killed or injured as the result of a drunk or drugged driver. Make clear to your teen that a poor choice, such as driving impaired, can negatively affect the rest of their life; for example, even if no one is hurt in an impaired-driving incident, a DUI, DWI, or DUID on your teen’s record can disqualify him or her from getting certain jobs as an adult.

Maybe most importantly: lead by example. Make it a household rule that driving impaired by any substance is unacceptable, and hold yourself to that rule. Choose to drink or drive, but not both. At the same time, assure your teen that if he or she does slip up and drink or do drugs, they can—and should—always call you or another trusted adult for a ride home. There may be a consequence to their choice, but it will never be as severe as what impaired driving could bring.

Be aware of the influences your teen faces at school every day, and counteract any negative ones with your own. Set the standard in your home and prep your teen up for success as the pressures of the school year go into full swing.