Investigation And Analysis Of Drink Driving Status And Correlated Factors In Jiangsu Province

Objective:Alcohol consumption and vehicle volume have been increasing recent years in China, which however, makes drink driving an increasingly important impact on traffic safety. The drink driving behavior is influenced by individual factors (physical, psychological and genetic) and environmental factors. Therefore, it is particularly important to analyze the reasons for drink driving, and find out risk factors of drink driving so as to explore a targeted prevention measures. The research aims:1. To determine the drink driving incidence of vehicle drivers and the distribution characteristics of drink driving behavior in Jiangsu province, China, a roadside survey and self-reported survey included.2. To learn about the public knowledge, attitude and practice on drink driving.3. To explore risk factors on drink driving.4. To explored preliminarily the relationship between gene polymorphism of COMT (rs4680), RASGRF2 (rs26907), ALDH2 (rs671) and the behavior of drink driving.Methods:A random roadside survey and a questionnaire were carried out to obtain the corresponding rate of drink driving and the public knowledge, attitude and behavior of drink driving. Peripheral blood samples were collected from some drink drivers for testing related genes polymorphism.1. The roadside survey:A multi-stage stratified random sampling and cross-sectional epidemiological study design was applied in the random roadside survey. Five representative areas were selected as target locations according to geographic location and economic development level:Three urban areas (Wuxi, Yangzhou and Huai’an) and two rural areas (Donghai, a county-level city of Lianyungang city and Dantu, a district of Zhenjiang city) included. In order to obtain representative data of drink driving, a multiple-step procedure was developed to select survey locations in each area that had reasonable traffic volume during the proposed hours of the survey. Traffic police stopped the car and tested the driver’s breath alcohol testing concentration. Then investigators recorded data and carried out drink driving questionnaire.2. Investigation to the public. Areas and checkpoints chosen were consistent with roadside survey and then local residents aged 18 to 69 were interviewed. A PDA with questionnaire was used to collect information on history of drinking, driving, related knowledge, attitudes and drink driving behavior.3. Gene polymorphism analysis of metabolic enzyme. Some drivers whose blood alcohol concentration were equal to or greater than 20 mg/100 ml were chosen, and DNA was isolated from peripheral blood samples from the subjects, amplified by LDR-PCR technology to determine genetic polymorphisms of COMT (rs4680), RASGRF2 (rs26907) and ALDH2 (rs671), then compared with HapMap database or others relative studies.Results:1. A total of 7381 drivers were stopped and 7236 valid response were returned, the response rate was 98.03% and the effective rate was 100%.(1) Among the tested drivers,129 (1.78%) were positive for BAC (>0 mg/100ml), of which 49 (0.67%) had a BAC above the legal limit (20 mg/100ml). The drink driving rate of Wuxi.Yangzhou, Huai’an, Donghai, Dantu were 1.10%、1.78%、1.38%、1.92%、2.87%, respectively. There was no statistical difference in drink driving rate among three urban areas with a p value of 0.269 and there was no statistical difference in drink driving rate between two rural areas with a p value of 0.108. The drink driving rate of urban areas and rural areas was 1.42% abd 2.39%, respectively, and the difference was statistically significant with a p value of 0.003.(2) Multi-factor logistic regression analysis showed risk factors of drink driving were rural areas (compared with urban areas, OR=1.739,95%CI=95%CI=1.211-2.495), midnight (compared with afternoon, OR=2.580,95%CI=1.587-4.195), male drivers (compared with female drivers, OR=2.486,95%CI=0.998-6.189), motorcycle drivers (compared with other types of vehicles, OR=4.137,95%CI=1.742-9.826), local license tags (compared with non-local ones, OR=1.893,95%CI= 1.034-3.464), non-commerical drivers (compared with commercial drivers, OR=2.827,95%CI=1.543-5.177), drinking frequency of 3 times or less per week (OR=3.879,95%CI=2.608-5.770) and drinking frequency of more than 3 times per week(OR= 5.010,95%CI=2.178 11.523) compared with whose who never drank in the past six months.2. A total of 4392 local residents accepted the interview and 4270 valid response were returned, the response rate was 97.22% and the effective rate was 100%.(1) Awareness rate of the legal limit of blood alcohol concentration of drinking-driving and drunk-driving, "how many years the license of a non-commercial drunk driver would be revoked for", "how many years the license of a commercial drunk driver would be revoked for", the influence of alcohol on driving, "what criminal punishments people will be subjected to for drunk-driving" were 28.64%,17.63%,12.37%,6.91%,47.03% and 7.61%, respectively. Male, a higher degree of education, the married, a higher income, people with a driver liscense had a higher awareness of of drink driving.(2) 90.37% local residents believed they didn’t have abilty to drive after drinking, and 95.88% residents objected against drink driving.63.79% of the public thought penalties for drink driving and 48.71% of the public considered the propaganda for drink driving were not enough.(3) Over the past six months, self-reported drink-driving incidence of the general population was 2.46%(105/4270), and the self-reported rate of motor vehicle drivers was 8.02% (105/1309). Multi-factor logistic regression analysis showed risk factors of self-reported drink driving were male drivers (compared with female drivers, OR=2.196,95%CI=1.029-4.689), young drivers aged from 18 to 34 (compared with drivers aged from 50 to 69, OR=3.348, 95%CI= 1.583-7.080), drivers who believed (OR=4.475,95%CI= 2.457-8.152), or had no idea whether they had drink driving ability or not (OR=3.035,95%CI=1.528-6.027) compared with whose who think they were not capable of driving after drinking, drivers whose attitudes towards drink driving were supportive (OR=4.964,95%CI= 1.279-19.264) or neutral(OR=3.750,95%CI=1.501-9.372) compared with whose who were against drink driving, drivers who did not wear a seatbelt (compare with drivers wearing a seltbelt, OR=0.350,95%CI=0.198-0.619) while driving, drinking frequency of 2 to 4 times a month (OR=7.643,95%CI=4.143-14.101),2 to 3 times a week (OR=6.985,95%CI=3.373-14.463),4 to 6 times a week (OR=19.626,95%CI=8.297-46.421), once or more times a day (OR=12.601, 95%CI=5.412-29.340) compared with the frequency of less than once a week. And the protective factors was driving frequency of 1 to 2 times a week (OR=0.259, 95%CI=0.095-0.702).3. There was no statistical difference between study subjects of COMT (rs4680), RASGRF2 (rs26907), ALDH2 (rs671) and related database and other reports on distribution of genotype frequency and allele frequency. For the study subjects, there were no statistical differences between drinking frequencies/alcohol consumption and COMT (rs4680), RASGRF2 (rs26907), ALDH2 (rs671) on distribution of genotype frequency. There were no statistical differences between drinking drink driving frequencies and COMT (rs4680) and RASGRF2 (rs26907) on distribution of genotype frequency. However, the mutation genotype (G/A+A/A) frequency of ALDH2 was higher for higher frequency of drink drving, accouting for 55.6% compared with lower frequency of drink drving(29.5%), and the p value was 0.042.Conclusions:Drink driving incident of roadside survey in Jiangsu Province is relatively lower compared with the previous domestic research and its associated factors are drivers of rural areas, driving at midnight, male drivers, motorcycle drivers, local license tags, non-commercial drivers, drinking frequency of equal to or less than 3 times a week and drinking frequency of more than 3 times a week. The public awareness of drinking-driving and related knowledge should be improved, and different groups of people had different awareness. The vast majority of the public are against drink driving, most of them believe that propaganda against drink driving and investigation and punishment on drink driving are not enough.Self-reported drink driving rate was far higher than roadside survey rate, which showed us when exploring the effective disposal method, the strength and frequency would be needed. The influencing factors of self-reported drink driving behavior were males drivers, drivers aged 18 to 34, believing in himself/ herself or having no idea of whether having ability to drink driving, attitude to drink driving is positive or neutral, driving without wearing a seatbelt. The drink driving behavior can be related to the genetic polymorphisms of ALDH2. Target interventions such as propaganda education and law enforcement can be carried out according to former influence factors.