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Does Alcohol Kill 1,800 College Students?

By Aaron Crowe

Binge DrinkingThe number is staggering and often alarms parents of college students — 1,800 college students die every year from “alcohol-related causes.”

This often-repeated claim is frequently linked to binge drinking. But a closer look at the numbers finds that most of the deaths — three-quarters of them — are related to vehicle crashes as “alcohol-related injury deaths” where alcohol is cited as a factor.

A lot of college students aren’t just dying from binge drinking, but mostly from being involved in a car accident while drunk or when someone else is drunk. And those young adults may not necessarily be college students, according to a Washington Post review of the figures.

Where the numbers start

The number of “alcohol-related unintentional injury deaths” — 1,825 to be exact — comes from a third report on these deaths in 2005. The report was led by Ralph Hingson, director of the epidemiology and prevention research division of the National Institute on Alcohol Abuse and Alcoholism.

The first report listed the number of such deaths at 1,442 in 1998, growing to 1,647 in 2001.

A fourth report is expected to come out this year, which should show a decline in binge drinking and DUIs among college-age students, Hingson says.

The 1,825 figure of college, he says, comes from a conservative estimate that one-third of the 5,461 alcohol related deaths averaged annually from 2006-2010 for people ages 18-24 were in college.

Faulty figures?

The figure is from data from the Centers for Disease Control and Prevention. However, no deaths are directly linked to binge drinking in the calculation of the statistics, the Post reported.

One problem, according to the Post, is that the 1,800 figure is an estimate of the number of young adults who are college students. There isn’t data in the accident records about whether someone is a college student, so researchers estimated what they believed would be college students.

The increasing number of college students dying while under the influence of alcohol may simply be because more young adults are going to college: from 30 percent in 1998 to 33 percent in 2005.

Alcohol deaths in cars over-estimated?

About three-quarters of the 1,825 deaths are related to motor-vehicle crashes. The rest are from non-traffic deaths such as fires, falls, drownings and other “alcohol-related injury deaths.”

Even among the 1,825 alcohol-related deaths among college students, the data doesn’t always mean that alcohol consumption caused the crashes. The National Highway Traffic Safety Administration has said since at least 2003 that a vehicle crash is considered to be alcohol-related if at least one driver or non-occupant (such as a pedestrian or bicyclist) involved in the crash has any measurable amount of alcohol in them.

“The term ‘alcohol-related’ does not indicate that a crash or fatality was caused by the presence of alcohol,” the NHTSA wrote.

If a pedestrian was drunk and is hit by a sober driver, the fatality would be listed as “alcohol-related.” Even if alcohol didn’t cause the accident and death, anyone involved in the accident who is found to have drunk any amount of alcohol is enough evidence to list it as an alcohol-related crash.

Hingson, who wasn’t originally aware of the NHTSA warning about accident data, agrees that alcohol isn’t the only cause of these accidents.

“You can’t always say that alcohol always causes every traffic death,” Hingson says. Speeding, not wearing a seatbelt, red-light running and other transgressions could be factors, he says.

The number of college student deaths related to drinking could be under-reported, Hingson says, because his group of researchers didn’t include homicides and suicides, for example, that could be related to alcohol.

“These are estimates,” he says of the 1,825 figure.

Better reporting of alcohol deaths needed

There are a few things that could improve determining how many college students die from alcohol use, Hingson says. One is that college identifiers are needed in fatal crashes to determine if the person who died was a college student, he says.

Another is the variation among states on under-reporting alcohol involvement on death certificates. In another NIH report that Hingson was involved with, motor vehicle traffic crash fatalities where alcohol was involved was found to be under-reported.

Reasons that a physician, coroner or medical examiner might not have included alcohol as a fatal factor on a death certificate include avoiding distressing relatives or social stigma, and insufficient training in death certification.

The NHTSA reported in 2012 that alcohol-related motor vehicle deaths are underreported, and alcohol testing for surviving drivers is much lower. In a study of Blood Alcohol Concentration, or BAC, testing and reporting for drivers involved in fatal crashes from 1997 to 2009, the NHTSA found that in 2009 BACs were known for 71 percent of fatally injured drivers and only 27 percent of surviving drivers.

One reason for the low testing was that 22 states had no law requiring it and went with probable cause, while 25 states had laws requiring testing in all fatal crashes. The basic standard for a law enforcement officer to request BAC tests is that the officer has probable cause or reasonable grounds to believe the driver was breaking the state’s impaired driving law.

In 2009, states that required BAC testing by law had 13-15 percent higher testing rates than states requiring probable cause.

From 1999 to 2009, death certificates reported that alcohol was involved in 3.3 percent of traffic deaths. The federal Fatality Analysis of Reporting System, or FARS, which collects information on car accidents, reported alcohol was involved in more than 20 percent of fatal accidents.

To test as many drivers as possible, the NHTSA recommends requiring a law to test for all drivers in fatal crashes, and eliminating laws that require probable cause for a surviving driver to be tested.

Medical examiners and coroners should test all fatally injured drivers whenever possible, and law enforcement should test all surviving drivers, the report recommends.

Also, BACs from hospital records can be used my medical examiners and coroners for drivers who die after admission to hospitals. Blood test kits should also be provided as needed, and states should pay testing costs.

Reporting can be made simpler by establishing routine reporting, including electronic reporting forms, and tracking all fatalities to follow up on all missing BACs.

Gathering complete and correct statistics is probably the best way to get to the most accurate numbers and gain a better understanding of when alcohol kills college-age adults.

Until then, that 1,800 number that keeps getting thrown out as the best number for binge drinking deaths among college students may only scare them and their parents in one area and not when they get behind the wheel.