David Cliff


Deaths and injuries caused by road traffic crashes are a major public health problem and a leading cause of death and injury around the world. Each year more than 1.3 million people are killed on the world’s roads, and millions more are injured, often with life-changing consequences.

Together with the devastating social costs suffered by individuals, families and communities, injuries and deaths from road traffic crashes place an enormous burden on health services and economies. On average, the cost to countries is estimated at 3% of Gross Domestic Product (GDP).

As motorization continues to increase at an exponential rate, road traffic crashes are a fast-growing problem, particularly in low- and middle-income countries where the burden of road crashes is most profound.
For any individual using the roads, there are a number of risk factors that influence the underlying probability of being involved in a crash, the presence of alcohol is one of the more common. Mr Dave Cliff, Chief Executive Officer of the Global Road Safety Partnership (GRSP) in Geneva, Switzerland speaks about the links between alcohol and road crash death and injury.

Q. What is the magnitude of crashes involving drinking and driving?

Decades of research have shown that the risk of being involved in a road crash is significantly higher when alcohol has been consumed. Even at moderate levels of blood alcohol concentration (BAC) the risk is higher, and this risk increases dramatically as BAC levels rise.

In most high-income countries, around 20% of drivers killed in road crashes have a BAC in excess of the legal limit. What is more worrying though, is that studies in low- and middle-income countries have shown that between 33% and 69% of fatally injured drivers and between 8% and 29% of non-fatally injured drivers had consumed alcohol before being involved in a road crash[1].

Q. Why is it that drinking and driving is such a problem?

In most countries alcoholic beverages are a very common part of people`s lifestyles, whether it is having a beer with friends or a glass of wine over dinner with family. Alcohol is part of many cultures and even has religious connotations in some parts of the world.

Unfortunately, it is often neglected that alcohol is first and foremost a drug that causes dangerous intoxication. It is essential for us to remind everyone that, regardless the amount consumed, alcohol will impair a person`s ability to handle themselves safely on the road. Through poorer judgement, decreased vision, increased reaction time and many more dangerous consequences of being under the influence, if you drink you are putting yourself, and other road users, at risk of serious injuries and even death.

Q. Who is considered to be at the highest risk?

Those with a very high level of BAC are the highest risk group, regardless of age, sex, occupation or other indicators. Though if we are looking to produce a profile, multiple studies do provide insight into common characteristics of a drink-driver.

We know that men are most likely to offend, particularly young men aged 18 to 24. Other characteristics identified in the studies include inexperienced drivers, those who are single or divorced, people with low self-esteem and those from lower socio-economic or educational groupings.

Having said that, it is important not to generalise and to remember that any driver or rider with any level of blood alcohol greater than zero is at higher risk of being involved in a crash than one with zero BAC.

Q. How should the drink-driving issue be tackled in order to reduce crashes related to alcohol?

The good news is that over the past decades, many countries have been successful in reducing the number of crashes caused by drink-drivers. In saying that, we recognize that the best practice solutions that worked well in New Zealand or Sweden can`t always be directly applied in other countries. However, this does not mean that the lessons learnt can`t be adapted to local conditions and then be implemented with positive results.

The starting point is a strong political will to address the problem. A clear legislative stance must follow. With this in place, a strict and continued enforcement must be carried out penalising those who are in breach of the law. As with other major risk factors, enforcement should be complemented by a well-planned public education campaign aimed at changing attitudes towards drink-driving.

Effective anti-drink drive legislation should include general BAC limits of no more than 0.05% and lower maximum levels for young and commercial drivers and allow random or compulsory breath testing.

Professor Ross Homel, a leader in developing the general deterrence model that proved so successful across Australasia, advocated for an enforcement effort that was sustained over time, rigorously enforced, highly visible and well publicised. Having police focussed upon maximising breath testing at times and days of the week when drink driving is most prevalent, setting breath testing targets and carrying out enforcement operations that are difficult for drink drivers to avoid, have proven highly effective at reducing alcohol related road trauma.


[1] Drinking and Driving; A road safety manual for decision makers and practitioners. WHO