Trauma Surgeons Find A Significant Number Of Moped Crashes Involve Intoxicated Drivers

Main Category: Alcohol / Addiction / Illegal Drugs
Also Included In: Public Health
Article Date: 14 Oct 2008 - 0:00 PDT

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In a study presented at the 2008 Clinical Congress of the American College of Surgeons, trauma surgeons reported a high association between moped driver injuries and positive alcohol levels greater than 0.05 mg/dL. In fact, 39 percent of moped operators were driving under the influence of alcohol, which is more than one-and-a-half times more moped operators who were using alcohol and driving a motor vehicle than operators of motorcycles or automobiles, according to Ashley B. Christmas, MD, F. H. Sammy Ross Trauma Center, Carolinas Medical Center, Charlotte, NC.

"Upon questioning, we learned that many of these individuals had previously had their drivers' licenses revoked," according to Dr. Christmas, attending surgeon for trauma, critical care, and acute care injury at the medical center. "These patients were very in tune to the fact that a moped was defined as a motorized vehicle with an engine less than 50 cubic centimeters, so they knew they could still drive this vehicle without a license. We suspect that many moped operators are repeat offenders, whose licenses were previously revoked."

Dr. Christmas said that moped laws vary from state to state with regard to the minimum age of the operator and whether or not helmets, registration, inspection, and insurance are required. In North Carolina, for example, no license is required to drive a moped. Across the state line in South Carolina, however, moped drivers must have a license. Yet, getting that license does not depend on the status of any other driver's license. In other words, a driver can have a license revoked for an automobile or truck, but still get a moped license, he explained.

"It is a kind of a flaw in the system. I think the Department of Motor Vehicles needs to take a closer look at the definition of motorized vehicle. If a person loses his or her driver's license, it should roll over into not operating a moped on an open road," he said.

To more closely examine the influence of alcohol on moped crashes, Dr. Christmas and his colleagues conducted a retrospective review of adult moped injuries at their medical center from 1995 though 2006.

In total, there were 8,272 admissions to the F. H. Sammy Ross Trauma Center during the period of this study that involved some type of motor vehicle collision. Crashes involving mopeds were compared with crashes involving motorcycles and crashes of major motor vehicles such as automobiles and trucks. Among other things, the severity of injury, mortality, and serum alcohol levels were recorded.

For example, moped and motorcycle crashes numbered 113 and 973 admissions respectively, while major motor vehicles crashes accounted for 7,186 admissions. Not sur-prisingly, the severity of injuries for both moped and motorcycle drivers were higher than for automobile drivers. The Injury Severity Score (ISS), an established medical score to assess the severity of trauma, assigned a score of 15.8 for moped injuries, 16.3 for motorcycle injuries, and 13.7 for automobile injuries.

Dr. Christmas was surprised, however, that despite appearing to be "less" injured than motorcycle drivers, according to the ISS, and riding at a lower rate of speed, moped operators still had a higher rate of death. The difference in the rate of mortality was not statistically significant, he said, but the trend is clear. These results raise some questions, of course. Were these moped drivers more likely to be chronic alcoholics with more medical problems? Or did these drivers suffer worse traumatic brain injuries? These are questions he hopes to explore in future analyses.

The increased association of alcohol consumption with moped crashes, however, was statistically significant. Study findings show that 39 percent of moped drivers (44 individuals) had a blood serum alcohol level of greater than 0.05 mg/dL, in comparison with 24.8 percent of motorcycle drivers (241 individuals) and 23.4 percent of automobile drivers (1,681 individuals).

"When you do a breakdown over this study period, you see that moped accidents accounted for only 1 percent of all motor vehicle collisions, but alcohol was very significant in these crashes," Dr. Christmas said. "If people are going to continue to drink and drive motorized vehicles on the road--especially those who have had a license revoked--then they can affect crashes involving other motor vehicles, which clearly is the case. We need to find a way to revise the current laws."

Dr. Christmas would like to see a larger, multi-institutional study on mopeds to understand whether and how his findings relate to other geographic areas beyond the region around Charlotte, NC, where his medical center is located. He and his colleagues are currently working with the Department of Motor Vehicles (DMV) in an effort to learn exactly how many of the moped drivers admitted to their trauma center were driving with a suspended driver's license. This work has been delayed due to lack of funding, because of DMV charges associated with accumulating data and accessing its database. If he is unable to find an external source of funding, Dr. Christmas hopes to apply for a grant through a Health Sciences Foundation at his medical center.

Rita A. Brintzenhoff, MD; Thomas M. Schmelzer, MD; Karen Head, RN, BSN; and Ronald F. Sing, DO, FACS, assisted Dr. Christmas with this research.

American College of Surgeons
http://www.facs.org

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