[Time course of breath and blood alcohol concentration in disorders of lung function]. / Zeitlicher Verlauf der Atem- und Blutalkoholkonzentration bei Störungen der Lungenfunktion.

In order to examine the course of breath and blood alcohol concentration under the influence of disorders of pulmonary functions, tests were carried out on eight of each of the following groups: people without lung diseases, people with restrictive or obstructive lung diseases and people with lung over-flatulence. The oral ethanol intake consisted of 0.5 g/kg body weight in half an hour. The development of breath and blood alcohol concentration was determined by measurements over a period of three hours. During the absorption phase the breath alcohol concentration is greater than the blood alcohol concentration. This situation is reversed during the elimination phase. During the period of inflow, there is a higher alcohol concentration in the pulmonary circulation than in the peripheral-venous blood system. This is due to the distribution of ethanol. During the elimination phase the situation is reversed as the breakdown of alcohol occurs in the liver and this blood flows into the pulmonary system first. Within the framework of the given research conditions our examination results showed that there is no significant difference between directly and indirectly established blood alcohol concentration with regards to pulmonary disorders. By indirectly achieved measurements we mean measurements through breath alcohol. Given the relatively small number of test persons in our examinations further studies of the influence of pulmonary disorders seem necessary. These experiments would have to be carried out with a greater number of people or, alternatively with a higher alcohol intake in order not to overlook any possible, slight divergence from the rule.

[Alcohol and traffic safety--study of epidemiology (II. 1990/1991 status]. / Alkohol und Strassenverkehrssicherheit--Untersuchung zur Epidemiologie (II. Mitteilung, Stand 1990/1991).

With the co-operation of a further 13 institutes and as a continuation of our own epidemiological-statistical survey, we recorded the total and relative distribution (frequency profile) of the blood alcohol concentration of car drivers for the 3rd quarter 1990 and the 1st quarter 1991. The participating institutes recorded almost 27,000 blood samples and compared them with results of the first part of the study (1989). The survey dealt separately with sex-, age- and time of day-distribution of drivers involved and not involved in road accidents. One of our repeatedly presented field research into the problem of "alcohol and road safety", once again, provided to be a useful method in the run-up to the unprejudiced alcohol test which we are striving for. We noticed characteristic changes in the frequency profiles of the old and the new counties (Bundesländer) in Germany in the 1st (1989) and the 2nd (1990/91) report of the study. The results of Police supervisory operations in the administrative district of Cologne have basically given useful indications as to their epidemiological-statistical value as evidence.

[Alcohol and safety in street traffic--investigations in epidemiology and the approximation of traffic laws in Europe]. / Alkohol und Strassenverkehrssicherheit--Untersuchungen zur Epidemiologie und verkehrsrechtlichen Angleichung in Europa.

After an introductory presentation of the problem-complex, "Alcohol and Road Traffic Safety", and the past history of a danger-limiting value of 0.5%, the paper gives an extensive overview of the meaning, the development and the possibilities of an epidemiology (with statistics) of alcohol delinquency in road traffic. The various measures employed in different European countries for the combatting and punishment of "Alcohol in Road Traffic" as a cause of accidents will be thoroughly considered, and the necessary steps to be taken in the area of legislation, intensity of prosecution and penal sanctions will be pointed out. Our own epidemiological-statistical investigations with the cooperation of 28 further European institutes record the total distribution and the relative distribution of the blood alcohol concentration of listed road users and those listed who had been drinking, for the 2nd halve of 1989, in the institutes, governments and governmental groups taking part in the study. Thereby result characteristic frequency profiles with an assured tendency, and relative estimated numbers of unknown cases (beneath a BAC of 1%) as definite evidence of differing limiting value- and traffic surveillance-efficiency in various regions of Europe. The final conclusion will be drawn that the height of the limiting value alone is not able to make decisive contribution to an improvement in road traffic safety if the highly variable relativity of limiting value-efficiency is not considered at the same time, and complex, closely connected accompanying measures as an adjunct to legislation and the administration of justice are not carried out. Recommendations will be formulated concerning this matter. Further epidemiological-statistical analyses of the problem "Alcohol and Road Traffic Safety" are being prepared in cooperation with 16 European institutes and will be put together in a 2nd part of this multicenter study for T 92 (The 12th Conference of the International Committee on Alcohol, Drugs and Road-Safety in Cologne, 28. September-2. October 1992).

[Blood alcohol concentration and effect, traffic medicine characteristics and legal traffic relevance of alcohol limit values in road traffic]. / Blutalkoholkonzentration und -wirkung, verkehrsmedizinische Charakterisierung und verkehrsrechtliche Relevanz von Alkoholgrenzwerten im Strassenverkehr.

Since the expert report of the Federal Health Office (FHO) in 1966 (also compare FHO expert report 1977) numerous papers about the influence of small doses of alcohol on driving ability have been published (see Blood Alcohol, Alcohol, Drugs and Behavior). These papers emphasise the possibility to prove an acute influence on the central nervous system of man with characteristic consequences for his readiness to perform and his general effectiveness with regard to the safe conduct of a vehicle above a concentration of blood alcohol from 0.2 to 0.3% upwards. This experimentally observed increase in knowledge which conforms with jurisdiction i.e. assuming the possibility of alcohol-effected reduced driving ability above 0.3% in individual cases, -however, does not include a regular capability to detect a reduced driving ability for a range in blood alcohol concentration of 0.3% to 1.0% (see opinion of the directors and boards in the German Society for Legal Medicin, 1984). From All presentations the following conclusions may be drawn regarding the level and traffic medicals als well as psychophysical relevance and the forensic importance of alcohol threshold values in road traffic: 1. The 0.0% would be consistent. Each trace of blood alcohol can influence driving ability. Such a limit would, however, be linked to an intolerable cover-up-level. 2. The threshold level to prove the effect of alcohol lies at 0.3% to 0.4% as a basic value (jurisdiction = 0.3%). This level must definitely be regarded as preventing traffic accidents. FREUDENBERG, 1966: At 0.4% the relative probability to become involved a lethal traffic accident is 2.1 times higher than the sober value. BORKENSTEIN, 1964/74: At 0.4% the relative probability to cause an accident is not significantly higher than the sober value. A blood alcohol concentration of 0.4% may be proven by an analytical average value of 0.5% (safety margin: 0.1%). From legal and traffic medical viewpoint nothing contradicts the intention to establish an abstract danger ceiling at 0.4 + 0.1% = 0.5% linked to unlawful behaviour and the prohibition to drive. 3. The danger ceiling presently in operation contains a basic value of 0.6 to 0.7% and a safety margin of 0.15% = 0.8%. At 0.6 to 0.7% the majority of drivers are unable to participate in the traffic. FREUDENBERG, 1966: At 0.7% the relative possibility to become involved in an traffic accident is 3.7 times higher als compared to the sober value. BORKENSTEIN: At 0.7% the relative probability to cause an accident in increased 2.7 times.(ABSTRACT TRUNCATED AT 400 WORDS)

[Possibilities of quality assurance (accuracy, precision) in forensic blood alcohol determination in compliance with the reduced safety increase of 0.1 g promille]. / Möglichkeiten einer Qualitätssicherung (Richtigkeit, Präzision) in der forensischen Blutalkoholuntersuchung bei Einhaltung des reduzierten Sicherheitszuschlags von 0,1 g Promille.

A lowering of thresholds in blood alcohol determination can be realized by critical reflection on efficiency of the techniques of measurement including calibration and internal and external quality control. A threshold value can be controlled by a technique of measurement if the prognosis interval of this technique is equal or smaller than the control interval. From date 1/7/1990 we measure blood probes like described. Blood measurement before this date must be proofed for accuracy. In cases of non compliance the old threshold value should be used.

[Alcohol and street traffic (critical comments from the legal and traffic medicine viewpoint)]. / Alkohol und Strassenverkehr (Kritische Erörterungen aus rechts- und verkehrsmedizinischer Sicht).

1. Our official traffic statistics in general and in regard to the problem "alcohol and road traffic security" is not reliable enough. It contains too many unaccounted factors, so that an objective reorganisation and supplement is badly needed. The present statistics is not suited to show the real dimension and the actual danger of the effects of "alcohol in traffic", especially in connection with relatively low blood-alcohol-concentration. 2. In connection with the problem "alcohol and road traffic" the Federal Republic of Germany is able to develop, by way of law, significant epidemiological research, which, so far, has been neglected. 3. Danger and frequency of low and high blood-alcohol-concentration in road traffic participants are collectively in inverse ratio: The larger group of the less dangerous road traffic participants with low blood-alcohol-concentration does not necessarily cause less damage, than the smaller group of the more dangerous ones with high blood-alcohol-concentration. 4. From the legal and traffic medical point of view the reaching and exceeding of the abstract promille limit of 0.8 shoudl be considered a violation within the meaning of penal law and should be connected with the loss of the driver's license. This was put up for discussion by Spiegel (1989). Such a legal measure would lead to a consequent and successful general and specific prevention. There should be initiated supportive side effects as for example discrimination of the drunken driver and permanent education concerning the effects of alcohol on traffic safety. 5. It seems reasonable to set the limit as low as possible, however, only if there is an sufficient police control to make it effective. 6. The concept "absolute driving incapability" has an extreme confidential value and will surely not result in any disadvantages, however, its preventive reaction is not sufficient. There is no need for this concept any more, if an abstract danger limit is connected with appropriate sanctions for an offense and with the withdrawal of the driver's license. 7. In many cases it is not without problem to assess evidence for characterizing a precise (relative) driving incapability. The valuation of driving incapability could be restricted to a blood-alcohol-concentration range between the threshold of 0.3 promille and the danger limit of 0.8 promille, if point 4. were put into action. The fact that low blood-alcohol-concentration leads to an increased frequency of minor mistakes, while relative high blood-alcohol-concentration is characterized by typical kinds of mistakes, makes the judgement of driving incapability more difficult.