County of San Diego Division of Emergency Medical Services EMS Child Passengers Injured in Alcohol-Related Crashes in San Diego County Alan M. Smith Janace A. Pierce Leslie Upledger Ray Patricia A. Murrin County of San Diego Health and Human Services Agency Division of Emergency Medical Services

County of San Diego Division of Emergency Medical Services EMS Background San Diego County: –Motor vehicle crashes are the leading cause of death and serious injury to children younger than 15. National Studies (Quinlan et al): –24% of motor vehicle-related deaths in children younger than 15 report alcohol involvement. –64% of children who died and 39% of children who were injured in alcohol-related crashes were passengers of an intoxicated driver. JAMA May 3; 283(17):

County of San Diego Division of Emergency Medical Services EMS Research Questions How many children are injured while riding with an intoxicated driver? How does driver impairment impact restraint use of child passengers ? How does driver impairment impact the severity of injury to child passengers? At what time of day are child passengers injured or killed by impaired drivers?

County of San Diego Division of Emergency Medical Services EMS Study Design Retrospective study of alcohol/drug-related motor vehicle occupant (MVO) crashes with injuries to children under age 15. Setting: San Diego County,

County of San Diego Division of Emergency Medical Services EMS Data Source Statewide Integrated Traffic Records System (SWITRS) –Motor Vehicle Occupant (MVO) Crashes –Injury or death of passenger under age 15 reported in crash –DUI crashes – Cause = alcohol or drug impairment, and Party at fault impaired by alcohol or drugs. –Time Period: 1996 through SWITRS data for San Diego County are maintained by the California Highway Patrol –Additional coding, geolocating performed by San Diego County EMS

County of San Diego Division of Emergency Medical Services EMS VICTIMS

County of San Diego Division of Emergency Medical Services EMS Child Victims in Traffic Crashes, 1996 to 1999 All Crashes DUI-Related Crashes Total Victims 0-14 Years MVO6256 (69%)348 (94%) MVO Passenger 6202 (69%)341 (92%)

Victims Age 0-14 Years by Type of Crash Source: County of San Diego, Health and Human Services Agency, Division of Emergency Medical Services. SWITRS databases CY 1996 to 1999

County of San Diego Division of Emergency Medical Services EMS Child MVO Passenger Victims by DUI Status of Driver at Fault Source: County of San Diego, Health and Human Services Agency, Division of Emergency Medical Services. SWITRS databases CY 1996 to 1999

County of San Diego Division of Emergency Medical Services EMS Age Group of Victim by Party at Fault Source: County of San Diego, Health and Human Services Agency, Division of Emergency Medical Services. SWITRS databases CY 1996 to 1999

County of San Diego Division of Emergency Medical Services EMS Child Victim Restraint Use in DUI MVO Crashes by Party at Fault Source: County of San Diego, Health and Human Services Agency, Division of Emergency Medical Services. SWITRS databases CY 1996 to 1999.

County of San Diego Division of Emergency Medical Services EMS Child Passenger Victims in DUI MVO Crashes: Injury Severity by Party at Fault Source: County of San Diego, Health and Human Services Agency, Division of Emergency Medical Services. SWITRS databases CY 1996 to 1999.

County of San Diego Division of Emergency Medical Services EMS CRASHES

County of San Diego Division of Emergency Medical Services EMS Age of Party at Fault by DUI Status and Presence of Child Passengers Source: County of San Diego, Health and Human Services Agency, Division of Emergency Medical Services. SWITRS databases CY 1996 to 1999.

County of San Diego Division of Emergency Medical Services EMS Gender of Party at Fault by DUI Status and Presence of Child Passengers Source: County of San Diego, Health and Human Services Agency, Division of Emergency Medical Services. SWITRS databases CY 1996 to 1999.

County of San Diego Division of Emergency Medical Services EMS Collision Type by DUI Status and Presence of Child Passengers Source: County of San Diego, Health and Human Services Agency, Division of Emergency Medical Services. SWITRS databases CY 1996 to 1999.

County of San Diego Division of Emergency Medical Services EMS Hour When DUI MVO Crashes Occurred Source: County of San Diego, Health and Human Services Agency, Division of Emergency Medical Services. SWITRS databases CY 1996 to 1999.

County of San Diego Division of Emergency Medical Services EMS Child Victims in DUI Crashes Versus Child Victims in All Crashes Six of every 100 children injured or killed in traffic crashes were injured in DUI crashes. 92 percent of children injured or killed in DUI crashes were passengers in motor vehicle occupant crashes. 69 percent of children injured or killed in all crashes were passengers in motor vehicle occupant crashes.

County of San Diego Division of Emergency Medical Services EMS Findings: Child Passenger DUI Victims One-third of child passenger victims in DUI MVO crashes were passengers of the impaired driver. Child victims injured as passengers of the impaired driver were younger than those whose drivers were not impaired. Child passengers of impaired drivers were significantly (p=.03) less likely to wear active restraints than passengers in crashes where the other driver was at fault.

County of San Diego Division of Emergency Medical Services EMS Findings (Continued) Child passengers in the DUI driver’s car suffered more severe injuries than child passengers whose drivers were not under the influence. In contrast to DUI crashes overall, which peaked between 1:00 and 2:00 in the morning, DUI crashes involving children had their highest point between 6:00 and 7:00 in the evening.

County of San Diego Division of Emergency Medical Services EMS Conclusions These findings emphasize the need to educate parents about the danger, not only to themselves, but also to their passengers, of driving under the influence of alcohol or drugs. Drivers who drive under the influence of alcohol or drugs also use bad judgement by carrying children in their car and by not ensuring that the children are properly restrained.

County of San Diego Division of Emergency Medical Services EMS Acknowledgements The data collection efforts of the police and sheriffs throughout the County are gratefully acknowledged, as is the cooperation of State staff for providing the SWITRS data to San Diego County.

County of San Diego Division of Emergency Medical Services EMS Contact Information Alan M. Smith County of San Diego Health and Human Services Agency Emergency Medical Services 6255 Mission Gorge Road San Diego, CA (619) phone (619) fax