Context The overall percentage of motor vehicle deaths associated with alcohol
consumption declined between 1991 and 1996, but the risk of death due to alcohol-related
crashes for children warrants analysis.
Objective To examine the association between alcohol use by drivers and mortality
of children who were passengers, pedestrians, and bicyclists.
Design and Setting Analysis of data from the Fatality Analysis Reporting System, a nationwide
US registry of motor vehicle deaths, for 1991-1996.
Subjects A total of 16,676 children younger than 16 years who were passengers,
pedestrians, or bicyclists and whose death was due to a motor vehicle crash.
Main Outcome Measure Alcohol use by drivers involved in crashes in which children died, assessed
by age and sex of the child and driver and type of crash.
Results A total of 3310 deaths (19.9%) involved alcohol-related crashes. The
percentage declined from 21.6% in 1991 to 17.8% in 1996. Considering only
crashes in which the alcohol-use status of the child's driver was relevant,
the decline was less marked, from 18.8% in 1991 to 15.1% in 1995, with an
increase to 16.4% in 1996. Among crashes involving alcohol, the child's own
driver had been drinking in 66.3% of cases, varying from 58.0% to 70.7% over
time. Drivers younger than the legal drinking age of 21 years who had been
drinking alcohol accounted for 30.3% of alcohol-related passenger deaths among
Conclusion While the overall percentage of alcohol-related motor vehicle deaths
for children declined between 1991 and 1996, experiences for passengers, pedestrians,
and bicyclists differ. Selected characteristics of children and drivers that
elevate the risk of an alcohol-related motor vehicle death point to the need
for further policy and clinical interventions.