Risk factors associated with recurrent DUI offenses in Brazil

Background: Alcohol in blood is a major factor for traffic accidents; high blood alcohol concentrations (BAC) increase the risk of involvement in offenses, and it is hypothesized that traffic injuries and casualty rates are partly attributed to recurrent offending behavior. Aim: To analyze and compare risk and protective factors among Brazilian repeat DUI offenders in 2009/2010. Methods: Cross-sectional study with 12,204 DUI offenders from the State Traffic Department, using descriptive statistics and Poisson regression analysis. Drivers, age, sex, education level, time license to drive and license category were assessed. Drivers were considered repeat offenders if convicted of DUI more than once among 2009/2010. Results: 538 drivers (4.41%) were repeat offenders. The risk factors with the highest rates were age between 41 and 50 (PR=3.41), being licensed for 12 years or more (PR=1.86), having a motorcycle/car/truck license (PR=1.36), having a restricted license for psychological reasons (PR=1.33), and driving a truck or similar at the moment of notification (PR=1.08). Protective factors were female sex (PR=0.64), professional driver (PR=0.95), and high levels of education (PR=0.68). Discussion and conclusion: Age as a risk factor may be linked to licensure duration, as well as to the implementation of a new traffic law whereby driving after drinking is a crime. License restriction based on psychological issues as a risk factor reinforces the need for new assessments before license renewal. Protective factors corroborate previous findings. An inverse relation was observed between repeat offending and education level, suggesting that mass media dissemination of the new law is not reaching the lowest education strata. As for professional drivers, the fear of losing a job may be an influence on driving behavior. Internationally reported rates of one-time and repeat DUI offenses are higher than here reported, probably as a result of the poor law enforcement in Brazil. Introduction: For decades, studies have warned against the combination of drinking and driving, mainly because of the resulting increase in the risk of accidents, severe injuries, and mortality (Ahlm, 2009). Alcohol consumption impairs the abilities required for driving a vehicle: reflexes, perception of speed and obstacles, ability to control the vehicle, and visual acuity. Other effects include impaired judgment and more impulsive and aggressive behaviors (Kelly,2004). No Brazilian study so far attempted to describe the profile of repeat offenders convicted of drinking and driving Method: We conducted a cross-sectional study with all drivers licensed in the state of Rio Grande do Sul (RS), southern Brazil. Data provided by the RS State Traffic Department for 3,949,693 licensed drivers were analyzed from January 2009 to December 2010 to identify DUI offenders. Drivers convicted of DUI more than once over a period of 24 months were considered recidivists. Results: Of all the 3,949,693 drivers licensed in the state of Rio Grande do Sul, 12,204 (0.3%) had been convicted of DUI in the past two years (approximately 3 per 1,000 drivers). Of these, 11,666 (95.59%) had committed one violation, and 538 (4.41%) were recidivists. Our findings revealed that the main characteristics of DUI recidivists were being male, aged 41 to 50 years, licensed for over 12 years, having a low education level, and considered able to drive with psychological restrictions. The results of the psychological assessment with restrictions are applied when the driver has a psychological disorder, but it is temporarily under control. In this case, the driver is submitted to another psychological assessment after a determined period (from 1-5 years).(See Table 1) Table 1-Sociodemographic characteristics of recidivist and non-recidivist in the state of Rio Grande do Sul Years 2009-2010 Recidivist PR Adjusted PR** Yes No n=538 n=11,666 N % N % Sex Male 529 98 11,360 97 1 Female 9 2 306 3 0.64 Age range (years) 18 to 20 12 2 643 6 1 21 to 30 111 21 3,769 32 1.56 31 to 40 138 26 2,691 23 2.66 41 to 50 177 33 2,657 23 3.41 51 to 60 79 15 1,449 12 2.82 ≥ 61 21 4 457 4 2.40 Mean age* 41 (11.2) 37 (12.5) Education level Elementary school 361 68 6,609 57 1 High school 140 26 4,124 35 0.63 Under graduate 33 6 899 8 0.68 N/A 4 34 License duration (years) ≤ 2 70 13 2,196 19 1 1 3 to 5 49 9 1,681 14 0.92 0.96 6 to 8 55 10 1,328 11 1.29 1.33 9 to 12 58 11 1,446 12 1.25 1.28 > 12 306 57 5,015 43 1.86 1.81 Mean license duration 16 (10.7) 13 (10.9) Type of vehicle driven upon notification Car/utility 435 82 9,438 82 1 1 Motorcycle/motor scooter/moped 62 12 1,369 12 0.98 0.93 Pickup/van/truck/motor home/semitrailer/tractor 31 6 655 6 1.03 0.96 Bus/minibus 1 0.03 38 1.9 0.58 0.54 N/A 9 166 Professional driver Yes 137 0.25 3,087 26 0.95 0.91 No 401 0.75 8,579 73 1 1 Psychological assessment***(N= 8,646) Able to drive 301 91 7,762 93 1 1 Able to drive with psychological restriction 29 9 554 7 1.33 1.23 Reference categories have prevalence ratio (PR) = 1 ** Variables represented by the mean (SD) * PR adjusted for age, sex and education ***Missing data PR values for license category ranged from 0.76 for E category (trucks weighing ≥ 6,500 kg) to 1.36 for AC category (motorcycles and trucks between 3,500 and 6,000 kg) (reference category: B). A Category (motorcycles) showed a PR of 0.92, and C category (midsized trucks), of 1.14; individual categories showed lower PRs when compared with combined categories. When comparing psychological assessment results and professional driver status among recidivist, both professional and non-professional drivers showed a similar distribution of psychological assessment outcomes (able or able with psychological restrictions). Among nonrecidivist, the number of professional drivers considered able to drive with psychological restrictions was 8% higher than the number of drivers able to drive (See Figure 1). Figure 1 Comparison between professional (n = 3,224) and non-professional (n = 8,978) drivers in relation to psychological assessment results among recividist (n = 330) and non-recidivist (n = 8,315).