Fatally injured pedestrians and bicyclists in the United States with high blood alcohol concentrations

June 2018

Objective: Little research has focused on the problem of alcohol impairment among pedestrians and bicyclists in the United States. The aim of the current study was to investigate the prevalence, trends, and characteristics of alcohol-impaired fatally injured pedestrians and bicyclists. Methods: Data from the Fatality Analysis Reporting System (FARS) were analyzed for fatally injured passenger vehicle drivers, pedestrians, and bicyclists 16 and older during 1982-2014. Personal, roadway, and crash characteristics were examined for pedestrians and bicyclists killed in crashes during 1982-86 and 2010-14, and logistic regression models examined which characteristics were associated with high blood alcohol concentrations (BACs) among these road users. Results: The percentage of fatally injured pedestrians with high BACs (=0.08 g/dL) declined from 45 percent in 1982 to 35 percent in 2014. The percentage of fatally injured bicyclists with high BACs declined from 28 percent in 1982 to 21 percent in 2014. By comparison, the percentage of fatally injured passenger vehicle drivers with high BACs declined from 51 percent in 1982 to 32 percent in 2014. During the study periods, the largest reductions in alcohol impairment among fatally injured pedestrians and bicyclists were found among ages 16-20. During the most recent study period (2010-14), fatally injured pedestrians and bicyclists ages 40-49 had the highest odds of having a high BAC, compared with other age groups. Discussion: A substantial proportion of fatally injured pedestrians and bicyclists have high BACs, and this proportion has declined less dramatically than for fatally injured passenger vehicle drivers during the past three decades. Most countermeasures used to address alcohol-impaired driving may have only limited effectiveness in reducing fatalities among alcohol-impaired pedestrians and bicyclists. Efforts should increase public awareness of the risk of walking or bicycling when impaired, and further research should evaluate the effectiveness of potential countermeasures directed at alcohol-impaired pedestrians and bicyclists.