The relationship between blood alcohol concentration (BAC), age, and crash risk

J Safety Res. 2008;39(3):311-9. doi: 10.1016/j.jsr.2008.02.030. Epub 2008 May 16.


Problem: The role of age (youth and driving inexperience) and alcohol as major risk factors in traffic crash causation has been firmly established by numerous studies over the past 50 years. Less well established is how the two variables interrelate to influence crash risk. Some investigations have hypothesized an interactive or synergistic effect in which young drivers with less experience and a greater tendency to take risks are more adversely affected at lower blood alcohol concentrations (BACs) than are older drivers. The evidence for this hypothesis is mixed. Resolution of this issue has important implication for developing countermeasures directed at the young driver crash problem.

Method: Case control data previously collected in Long Beach and Fort Lauderdale were reanalyzed using a more sensitive method for detecting interaction effects than used in the original analysis. A conditional logistic regression analyses found a highly significant agexBAC interaction (P<.0001) involving differences between drivers under 21 and those 21 and older.

Discussion: The results clearly indicate that positive BACs in drivers under 21 are associated with higher relative crash risks than would be predicted from the additive effect of BAC and age. It is likely that two mechanisms are operating to cause the interaction. First, it seems likely that the crash avoidance skill of young novice drivers would be more adversely affected by alcohol due to their driving inexperience, immaturity, and less experience with alcohol. Second, drivers under 21 who choose to drink and to drive after drinking probably have pre-existing characteristics that predisposed them to risk taking and crash involvement apart from any increased vulnerability to alcohol impairment.

Impact on industry: The results support increased enforcement of zero-tolerance BAC laws for minors.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Accidents, Traffic*
  • Adolescent
  • Adult
  • Age Factors
  • Alcohol Drinking / adverse effects*
  • Alcohol Drinking / blood
  • Alcoholic Intoxication / blood
  • Alcoholic Intoxication / complications*
  • California
  • Case-Control Studies
  • Ethanol / blood*
  • Female
  • Florida
  • Humans
  • Male
  • Middle Aged
  • Risk


  • Ethanol