{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T05:57:25Z","timestamp":1790575045477,"version":"4.1.0"},"reference-count":49,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Alcohol can impair driving performance, and drunk driving is associated with traffic crashes and injuries. However, there is a lack of evidence regarding the driver-related, vehicle-related and environmental risk factors for major trauma in drunk driving crashes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed crash-level data from the National Health Insurance Research Database (NHIRD) and Traffic Accident Data (TAD) from 2012 to 2019. Data from all the drunk-driving violations from this period were extracted, and we categorized these violations based on whether they resulted in major trauma to any involved party (including drivers, passengers, and pedestrians). Due to the lack of fault-attribution in the TAD, detailed person-level data was not included in the analysis. The risk factors for major trauma in drunk-driving traffic crashes (i.e., driver-related factors, vehicle-related factors, and environmental factors) were identified via multivariable logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We retrieved data from 96,860 drunk-driving traffic crashes during the study period. Registered major trauma from the NHIRD was reported in 9.7% of the crashes. The crash-level driver-related risk factor for major trauma in drunk-driving crashes was heavy drinking (blood alcohol concentration \u22650.55\u202fmg\/L; odds ratio\u202f=\u202f1.58, 95% confidence interval 1.45\u20131.72). The vehicle-related risk factors for major trauma in drunk-driving crashes included heavy vehicles, powered two wheelers, and other vehicles. The environmental risk factors for major trauma in drunk-driving crashes included less urbanized regions, late-night crashes, mist, freeways and highways.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Driver-related factors, vehicle-related factors, and environmental factors could all affect the risk of major trauma in drunk driving crashes. A multidisciplinary approach could be taken to further improve the outcomes of drunk driving crashes. The identification of risk factors for trauma could provide guidance for future policy interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1733604","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T05:45:49Z","timestamp":1790574349000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Driver, vehicle, and environmental risk factors for crash-level major trauma in drunk driving collisions: a national registry linkage study"],"prefix":"10.3389","volume":"14","author":[{"given":"Ling-Wei","family":"Kuo","sequence":"first","affiliation":[{"name":"Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Linkou Medical Center","place":["Taoyuan City, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chien-An","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Linkou Medical Center","place":["Taoyuan City, Taiwan"]},{"name":"Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University","place":["Taipei City, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi-Tung","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Linkou Medical Center","place":["Taoyuan City, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chien-Hung","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Linkou Medical Center","place":["Taoyuan City, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih-Po","family":"Hsu","sequence":"additional","affiliation":[{"name":"Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Linkou Medical Center","place":["Taoyuan City, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih-Yuan","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Linkou Medical Center","place":["Taoyuan City, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Shiang","family":"Yang","sequence":"additional","affiliation":[{"name":"New Taipei City Police Department","place":["New Taipei City, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jen-Fu","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Linkou Medical Center","place":["Taoyuan City, Taiwan"]},{"name":"Division of Trauma and Emergency Surgery, Department of General Surgery, Jen-Ai Hospital, Dali Branch","place":["Taichung, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1007\/s00213-008-1443-x","article-title":"Novice drivers\u2019 performance after different alcohol dosages and placebo in the divided-attention steering simulator (DASS)","volume":"204","author":"Verster","year":"2009","journal-title":"Psychopharmacology"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1983","DOI":"10.1016\/j.aap.2010.06.005","article-title":"Alcohol-related impairment in the lane change task","volume":"42","author":"Huemer","year":"2010","journal-title":"Accid Anal Prev"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"481","DOI":"10.1038\/257481a0","article-title":"Alcohol prolongs time course of glare 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