Trauma Surgeons Find A Significant Number Of Moped Crashes Involve Intoxicated Drivers

In a study presented
at the 2008 Clinical Congress of the American College of Surgeons, trauma
surgeons reported a high association between moped driver injuries and
positive alcohol levels greater than 0.05 mg/dL. In fact, 39 percent of
moped operators were driving under the influence of alcohol, which is more
than one-and-a-half times more moped operators who were using alcohol and
driving a motor vehicle than operators of motorcycles or automobiles,
according to Ashley B. Christmas, MD, F. H. Sammy Ross Trauma Center,
Carolinas Medical Center, Charlotte, NC.



"Upon questioning, we learned that many of these individuals had
previously had their drivers' licenses revoked," according to Dr.
Christmas, attending surgeon for trauma, critical care, and acute care
injury at the medical center. "These patients were very in tune to the fact
that a moped was defined as a motorized vehicle with an engine less than 50
cubic centimeters, so they knew they could still drive this vehicle without
a license. We suspect that many moped operators are repeat offenders, whose
licenses were previously revoked."



Dr. Christmas said that moped laws vary from state to state with regard
to the minimum age of the operator and whether or not helmets,
registration, inspection, and insurance are required. In North Carolina,
for example, no license is required to drive a moped. Across the state line
in South Carolina, however, moped drivers must have a license. Yet, getting
that license does not depend on the status of any other driver's license.
In other words, a driver can have a license revoked for an automobile or
truck, but still get a moped license, he explained.



"It is a kind of a flaw in the system. I think the Department of Motor
Vehicles needs to take a closer look at the definition of motorized
vehicle. If a person loses his or her driver's license, it should roll over
into not operating a moped on an open road," he said.



To more closely examine the influence of alcohol on moped crashes, Dr.
Christmas and his colleagues conducted a retrospective review of adult
moped injuries at their medical center from 1995 though 2006.



In total, there were 8,272 admissions to the F. H. Sammy Ross Trauma
Center during the period of this study that involved some type of motor
vehicle collision. Crashes involving mopeds were compared with crashes
involving motorcycles and crashes of major motor vehicles such as
automobiles and trucks. Among other things, the severity of injury,
mortality, and serum alcohol levels were recorded.



For example, moped and motorcycle crashes numbered 113 and 973
admissions respectively, while major motor vehicles crashes accounted for
7,186 admissions. Not sur-prisingly, the severity of injuries for both
moped and motorcycle drivers were higher than for automobile drivers. The
Injury Severity Score (ISS), an established medical score to assess the
severity of trauma, assigned a score of 15.8 for moped injuries, 16.3 for
motorcycle injuries, and 13.7 for automobile injuries.
















Dr. Christmas was surprised, however, that despite appearing to be
"less" injured than motorcycle drivers, according to the ISS, and riding at
a lower rate of speed, moped operators still had a higher rate of death.
The difference in the rate of mortality was not statistically significant,
he said, but the trend is clear. These results raise some questions, of
course. Were these moped drivers more likely to be chronic alcoholics with
more medical problems? Or did these drivers suffer worse traumatic brain
injuries? These are questions he hopes to explore in future analyses.



The increased association of alcohol consumption with moped crashes,
however, was statistically significant. Study findings show that 39 percent
of moped drivers (44 individuals) had a blood serum alcohol level of
greater than 0.05 mg/dL, in comparison with 24.8 percent of motorcycle
drivers (241 individuals) and 23.4 percent of automobile drivers (1,681
individuals).



"When you do a breakdown over this study period, you see that moped
accidents accounted for only 1 percent of all motor vehicle collisions, but
alcohol was very significant in these crashes," Dr. Christmas said. "If
people are going to continue to drink and drive motorized vehicles on the
road--especially those who have had a license revoked--then they can affect
crashes involving other motor vehicles, which clearly is the case. We need
to find a way to revise the current laws."



Dr. Christmas would like to see a larger, multi-institutional study on
mopeds to understand whether and how his findings relate to other
geographic areas beyond the region around Charlotte, NC, where his medical
center is located. He and his colleagues are currently working with the
Department of Motor Vehicles (DMV) in an effort to learn exactly how many
of the moped drivers admitted to their trauma center were driving with a
suspended driver's license. This work has been delayed due to lack of
funding, because of DMV charges associated with accumulating data and
accessing its database. If he is unable to find an external source of
funding, Dr. Christmas hopes to apply for a grant through a Health Sciences
Foundation at his medical center.



Rita A. Brintzenhoff, MD; Thomas M. Schmelzer, MD; Karen Head, RN, BSN;
and Ronald F. Sing, DO, FACS, assisted Dr. Christmas with this research.


American College of Surgeons

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