A Review of the Literature on the Effects of Low Doses of Alcohol on Driving-Related Skills

Moskowitz, Herbert, 1925-; Florentino, D. · 2000 · ROSA P / United States. National Highway Traffic Safety Administration

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Summary

This report, commissioned by the National Highway Traffic Safety Administration (NHTSA), reviews scientific literature from 1981 to 1997 regarding the effects of low doses of alcohol on driving-related skills. The study aims to determine the blood alcohol concentration (BAC) thresholds at which impairment reliably occurs, addressing the need for evidence-based BAC limits. The authors analyzed 112 experimental studies that met strict inclusion criteria, including the use of placebo controls, statistical significance, and human subjects. The data were indexed by BAC and categorized into 13 behavioral domains, such as divided attention, tracking, visual functions, and cognitive tasks. The analysis revealed that alcohol impairs driving skills beginning with any significant departure from zero BAC. By a BAC of 0.05 g/dl, the majority of studies reported significant impairment, and by 0.08 g/dl, more than 94% of reviewed studies showed impairment in the skills measured. Impairment thresholds varied significantly across behavioral areas. Skills requiring divided attention, visual functions (specifically contrast sensitivity and oculomotor control), and drowsiness resistance were highly sensitive, showing impairment at BACs as low as 0.005–0.030 g/dl. In contrast, simple reaction time and finger tapping were found to be insensitive measures, often showing no impairment until higher BACs. Driving simulator studies, which better reflect the mental workload of actual driving, consistently reported impairment at low BACs, with one study detecting effects at 0.001 g/dl. The authors concluded that there is no BAC threshold below which impairment does not occur; rather, specific performance skills are differentially affected. The discrepancies in reported thresholds across studies were attributed to a lack of standardization in testing methods and instruments. The review supports the conclusion that all drivers can be expected to experience impairment in some driving-related skills at BACs of 0.08 g/dl or less. The findings reinforce earlier recommendations for lowering the legal BAC limit for driving to 0.05 g/dl, as scientific evidence indicates that significant impairment in critical driving skills, particularly those involving divided attention and complex processing, occurs well below the traditional 0.08 g/dl limit. The report emphasizes the need for standardized experimental procedures to improve the reliability of future research.

Key finding

By a BAC of 0.08 g/dl, more than 94% of the reviewed studies showed impairment in the driving-related skills they measured.

Methodology

review

Sample size: 112

Provenance

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Topics

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• alcohol
• drowsy as impairment
• polydrug
• cannabis