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

Moskowitz, H; Robinson, Cyril D.; SRA Technologies, Inc. · 2007 · OpenAlex-citations

DOI: 10.21949/1525245

archive: archived pipeline: cataloged verified

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Summary

This literature review, conducted by the National Highway Traffic Safety Administration, addresses the specific blood alcohol concentration (BAC) levels at which impairment of driving-related skills first appears. The study was motivated by the need to inform public policy decisions regarding legal BAC limits, particularly as standards shifted from 0.15% to 0.10% and lower. The authors sought to determine if a minimum threshold exists below which alcohol does not impair driving performance, analyzing experimental evidence rather than epidemiological data. The methodology involved a comprehensive review of 557 citations identified through computer searches and reference checks. After excluding studies due to irrelevance, lack of methodological detail, or inability to compute BACs, 177 studies were included in the final analysis. A key methodological feature was the independent calculation of BACs for each study based on reported dosages, subject gender, and body weight, using a conservative metabolism rate of 15 mg/100 ml per hour. This approach ensured uniformity and provided conservative estimates that likely overestimated actual BACs, thereby strengthening the validity of findings regarding low-dose impairment. The studies were categorized into nine behavioral domains: reaction time, tracking, concentrated attention, divided attention, information processing, visual functions, perception, psychomotor skills, and driving performance. The results indicated that 158 of the 177 studies reported impairment in at least one skill area, with 35 studies finding impairment at BACs of 0.04% or less. Impairment was found to be significant by BACs of 0.05% across most areas, with initial effects appearing in many domains at BACs of 0.02% to 0.03%. Divided attention performance was the most sensitive area, showing impairment at BACs below 0.02%, followed closely by tracking performance. In contrast, concentrated attention was the least sensitive, with no impairment found below 0.05%. Complex reaction time was impaired at lower BACs than simple reaction time, while visual functions like glare recovery and acuity showed little impairment at low levels when tested in isolation. The study concludes that there is no lower threshold for alcohol impairment of driving-related skills; impairment begins at very low BAC levels, particularly affecting divided attention and tracking. The authors assert that scientific evidence suggests no safe lower limit can be placed on alcohol impairment for driving. These findings support the trend toward lowering legal BAC limits, as they demonstrate that cognitive and perceptual skills critical for driving are compromised well below traditional legal limits of 0.10% or 0.08%.

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• alcohol