SAMMENDRAGBilkj?ring stiller store krav til f?rernes sansing, oppmerksomhet, informasjonsbearbeiding og evne til ?reagere. F?rere som er under innflytelse av sentralnerv?st aktive stoffer, vil derfor v?re en potensiell fare itrafikken. I perioden 1.8–31.12. 1993 identifiserte Statens rettstoksikologiske institutt (SRI) 394 ulykkesf?reresom politiet hadde rekvirert analyser av med hensyn p? narkotiske stoff/sentralnerv?st aktive medikamenter(andre rusmidler) og/eller alkohol. Blodpr?ver fra disse f?rerne ble analysert med hensyn p? alkohol og etutvidet repertoar av andre rusmidler ved SRI. Da polititjenestemenn og medtrafikanter ofte ikke vil oppdagep?virkning av andre rusmidler enn alkohol, dels pga. manglende alkohollukt, vil andre rusmidler som ulykkes?rsakv?re noe underrepresentert i dette materialet sammenliknet med alkohol. Hos 299 av ulykkesf?rerneble det p?vist alkohol og/eller andre rusmidler. 44 f?rere hadde tatt inn b?de alkohol og andre rusmidler, mensalkohol og andre rusmidler ble p?vist alene i henholdsvis 204 og 51 saker. Totalt ble benzodiazepiner,cannabis, opiater og amfetamin p?vist i henholdsvis 54, 30, 17 og 16 saker. Av de 95 som hadde tatt inn andrerusmidler, hadde 34 tatt inn mer enn ett rusmiddel (alkohol ikke medregnet) og i 72 av tilfellene ble analysefunnenevurdert (AB og JM) til sannsynligvis ? ha gitt sentralnerv?s p?virkning. Risiko?kningen for trafikkulykkeved nylig bruk av cannabisstoffer og diazepam i h?ydose ble estimert til ? kunne tilsvare en blodalkoholkonsentrasjonp? 1-1,5 promille. Alkohol er det rusmiddel som oftest p?vises hos ulykkesf?rere, menforekomsten av benzodiazepiner, cannabis og amfetamin er s?vidt h?y blant ulykkesf?rere at disse stoffenem? anses ? v?re et alvorlig trafikksikkerhetsproblem.Bj?rneboe A, Beylich K-M, Christophersen AS, Fosser S, Glad A, M?rland J.Prevalence of alcohol and other intoxicants in blood samples from drivers involved in road trafficaccidents. ENGLISH SUMMARYIllegal and some legal drugs affect the central nervous system and drivers who use such drugs may represent ahazard in the road traffic. The prevalence of such drugs among drivers involved in accidents depends on theincrease of the accident risk due to the drug and on the prevalence of the drugs among drivers on the road. Inthis study we have examined blood samples from 394 drivers involved in road traffic accidents during theperiod August–December 1993, to determine the prevalence of alcohol and drugs among drivers involved inaccidents. Most of the drivers enrolled in the study were suspected by the police of driving under the influenceof alcohol or drugs. The data are, however, probably somewhat biased, because drivers influenced by alcoholor drugs will, if possible, avoid contact with the police. Furthermore, the police's ability to detect driversinfluenced by drugs is limited. Accordingly, the proportion of influenced drivers and especially drivers influencedby drugs could be too low compared with the proportion among all drivers involved in traffic accidents.In about 2/3 of the blood samples examined, alcohol was found either alone or together with other drugs,and in 1/4 of the cases drugs were found either alone or together with alcohol. The most prevalent drugs werebenzodiazepines (13.7%), cannabis (7.5%), opiates (4.3%) and amphetamine (4.1%). In about 3/4 of the drugpositive cases the drug concentration was so high that it was considered likely or very likely that the driverwas influenced by the drug(s). The bias due to the police's inability to detect all drivers influenced by drugs50A. BJ?RNEBOE OG MEDARBEIDEREwas estimated. After correction for this bias it was estimated that at least 2.7% of drivers involved in injuryaccidents will have significant concentrations of drugs in the blood and at least 4.4% will have significantblood alcohol concentrations.Based on various sources of drug use in Norway we arrived at rough estimates of increase in risk of beinginvolved in road traffic accidents after different drug intakes. Driving a car the first few hours after cannabisintake may increase the risk for an accident comparable to the risk involved when driving with a bloodalcohol concentration in the range 1.0 - 1.5 per mill. High doses of diazepam intake will most likely increasethe risk of an accident in the same order of magnitude.We conclude that drunken drivers still constitute the main problem with regard to influenced driving onNorwegian roads. Nevertheless, the relatively high frequency of drivers influenced by drugs among thoseinvolved in accidents, demonstrates that these drivers are a serious safety problem.Nor J Epidemiol 1996; 6 (1): 49-56.
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