Ignition Interlock

Ignition Interlock- What is it?

Ignition interlock, also known as a handheld breathalyzer, is a device that is installed directly in to a vehicle. These devices prevent individuals from starting their car while intoxicated. The use of these guarantees continued sobriety from the driver through their trip behind the wheel.
Anyone with an ignition interlock installed on their vehicle will be required to provide a breath sample into the mouthpiece in order to start their vehicle. States' generally restrict the Blood Alcohol Content (BAC) level to below 0.02. Technology in these devices utilizes fuel cells to measure user's breath. If the driver blows above the limit set by the state, the vehicle will not start. However, if blowing below the state set limit, the vehicle will start.

Why is Ignition Interlock Important?

According to the Insurance Institute for Highway Safety (IIHS), 2017 saw 34,439 fatal motor vehicle crashes that resulted in a total of 37,461 deaths in the United States. This equates to 11.6 deaths per 100,000. The Centers for Disease Control and Prevention (CDC) show that in 2016, 10,497 people died in alcohol-impaired driving crashes, making up nearly one-third of all traffic-related deaths in the U.S. One million drivers were arrested in 2016 for driving under the influence (DUI) or narcotics, while 111 million self-reported episodes of their alcohol-impaired driving, accounting for only one-percent. Drivers with BAC levels of 0.08 or higher involved in fatal crashes were 4.5 times more likely to have a prior conviction for DUI than those with no alcohol in their system. It's important to understand these numbers and how they impact everyone. A significant portion of insurance rate costs are passed on to general consumers through incremental premium increases. In addition, taxes are raised due to increased cost for law enforcement, housing in jails and prisons, judicial and administrative court costs, and repairs to roads and street maintenance (Real Cost of Drunk Driving, 2012).

What are the Current Policies Regarding Ignition Interlock?

Currently, according to data from the National Conference of State Legislatures (2018), all 50 states have some form of ignition interlock law in place. However, only 28 states have mandatory provisions for all offenses (Ignition Interlock Laws, 2018). States such as Colorado and Maine do not make it mandatory for the first conviction. Other states do not require interlocks for first offenders unless they have a BAC higher then 0.15. One state does not even have a policy, where only a judge can order an ignition interlock installation if he or she deems it necessary. Massachusetts has absolutely no first offense policy even if the offender has a BAC level that is four times the legal limit.
For some states that do have mandatory ignition interlock policies in place, they take it a step further for when you fail to provide a breath below the state mandated limit. Some will allow you submit an additional breath sample after a shot waiting period, while others will lock you out after multiple failed samples. Other states will allow you to keep blowing into the device until you provide a passing breath sample. In addition to providing a passing breath sample, some states also require random samples throughout the duration of your trip to ensure the driver does not have a sober person start their vehicle for them to allow them to drive. Tests here are given at random, but drivers are allowed a 4 to 6minute grace period to retest, allowing them ample time to pull over or take necessary precautionary measures in heavy traffic (Intoxalock Ignition Interlock, n.d.). Overall, each state mandates its own policies, protocols, and complexity for the law as they deem suitable, with no federally established guidelines or mandated minimum requirements.

How does this Impact Healthcare?

For starters, there are large upfront costs associated with Emergency Medical Services (EMS) and their response to the accident scene, involving labor, training, readiness, and equipment. One particular instance was noted in a vehicle accident in New York City where a two-mile transport to a hospital cost $2,691.50, while the patient was responsible for $770.30 of this after insurance coverage (Digangi, 2017). In addition to these fees, there are societal costs for alcohol-involved crashes. In 2010, these amounted to $125 billion; $117 billion of which was associated with BAC's greater than 0.08 (Zaloshnja et al., 2013). Diving further in to the data, we find there are $758 million in victim mental health treatment, $149 million in lost productivity due to offenders being incarcerated, and a whopping $5.85 billion in medical costs.

In regards to police-reported alcohol-involved crashes, these costs in 2010 dollars (Zaloshnja et al., 2013) amounted to $54,311 per person for serious injury, $16,273 for evident injury, $12,164 for possible injury, and $4,646 for uninjured, among other factors (See Appendix A). A separate CDC study (2018) found that drinking costs totaled over $223.5 billion, with 72 percent of costs being associated with workplace productivity, 11 percent for healthcare treatment expenses, 10 percent for criminal justice expense, and 5 percent for motor vehicles.

What can be Done to Improve our Current Policies?

Currently, only 29 states have mandatory ignition interlock provisions (National Conference of State Legislatures, 2018). Multiple studies have been conducted that prove the benefit of ignition interlock policies. McGinty et al. (2016) conducted one notable study based upon data collected between 1982 and 2013 revolving around alcohol-involved crashes in all 50 states. At the time of the study, only 18 states had implemented ignition interlock policies, however data showcased a 7 percent decrease in the rate of fatal crashes with BAC levels of less than 0.08, in addition to an 8 percent decrease in the rate for those with BAC's less than 0.15. McGinty et al. estimates this prevented 1,250 crashes.

A separate study was also conducted utilizing data from the National Highway Traffic Safety Administration (NHTSA) from 1993 to 2013. As was in the previous study, 18 states had made interlock devices mandatory for all those convicted for drunk driving offenses between 2004 and 2013. The results here showed the policy impact was apparent after only three years of implementation (Kaufman and Wiebe, 2016). Ignition interlocks resulted in 15 percent fewer alcohol-involved crash deaths compared to states with less stringent requirements (see Appendix B).
Based on the data above, mandatory ignition interlock devices should be made in to a standard policy nationwide. As previously stated, the CDC cites that 10,497 people died as a result of alcohol-impaired driving crashes, making up nearly one-third of all traffic related deaths in the United States. If ignition interlocks resulted in 15 percent fewer alcohol-involved crashes (Kaufmen and Wiebe, 2016), this could theoretically save approximately 2,000 lives annually.

Taking this a step further, there is potential for making ignition interlock devices standard on all vehicles. A study was conducted by the University of Michigan Injury Center in conjunction with the University of Michigan Transportation Research Institute, published in The American Journal of Public Health. Based upon data from the Fatality Analysis Reporting System and the National Automotive Sampling System, the study looked to analyze the impact of installing ignition interlock devices on all new vehicles for the next 15 years. Based on the data, the United States could avoid 85 percent of crash deaths attributable to alcohol-involved motor vehicle crashes during this 15year implementation period. This would prevent over 59,000 deaths, as well as 1.25million non-fatal injuries; a reduction of approximately 84-89 percent (Researchers Explore Impact of Installing Alcohol Ignition Interlock Devices, 2015). In terms of healthcare and societal costs, we would be able to save $343billion over 15 years, while recuperating the costs of ignition interlock installation in only three years. The data shows most prevalent to those closest to the drinking age; those 21-29 account for 481,103 deaths and injuries prevented, making up 35 percent of all age groups. Those under 21 would benefit as well with reduced deaths and injuries by 193,886. Although an extremely ambitious policy, established studies of current and future data as depicted above prove beneficial to the American public.

Conclusion

Overall, the majority of states have taken strides to make ignition interlock a mandatory policy for first-time offenders. Results shown by both Kaufman and Wiebe (2016) as well as McGinty et al. (2016) depict large reductions in fatal alcohol-related automotive accidents. The University of Michigan takes this data a step further showcasing that we can save 59,000 lives and prevent 1.25million non-fatal injuries, saving $343billion over 15years by implementing mandatory ignition interlock devices in all new vehicles. While this particular policy is extremely ambitious, one thing is certain; a stronger push is needed amongst states with mandatory ignition interlock policies. In addition, those states with more flexible policies must create more stringent laws to improve the safety and wellbeing of the American society and the impact these devices have on the lives on individuals, and the costs associated to an ever-inflating American Healthcare system.

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