Pechansky & Chandran [1] have provided a thoughtful call-to-action to address drunk driving in South America. The authors provide evidence that drunk driving is a substantial and possibly increasing problem in South America, and contrast the status of the issue there with that in Canada and the United States. They then propose an insightful, three-pronged strategy to address the problem that, if implemented, promises to have a major impact on drunk driving deaths, injuries and collisions. Their recommendations take on added urgency when the projected large increases in collision-related deaths in the developing world are considered [2,3]. In the same way that we take action to avert the devastating effects of new infectious diseases, we should be preparing for concerted efforts to address the projected increases in alcohol-related and other collision deaths that can be expected in the near future. The course of action proposed by the authors for Brazil and other parts of South America would also save many lives in other parts of the world.

While it is true that in North America efforts to address the drunk driving problem are considered to be an important public health success [4–6], it is also true that those of us in North America can continue to benefit from following the general advice provided by Pechansky & Chandran [1]: to collect information on the nature of the problem, enact effective legislation and ensure that police and the legal system are prepared to enforce the legislation. Perhaps, above all, these authors underscore the need to continue to learn from each other. Thus, if Pechansky & Chandran's advice is followed in Brazil, researchers in North America and other parts of the world can soon look forward to valuable new information from our Brazilian colleagues about drunk driving and effective means to prevent it.

We can also now apply these principles in other ways. Researchers in Australia, Europe and Brazil have demonstrated the value of legal limits lower than the current criminal level for blood alcohol content (BAC) of 0.08% in Canada and the United States [7,8]. The legal limit of 0.05% in Australia and many European states is amply supported by research. At a BAC of 0.05%, skills needed for safe driving are impaired significantly, the risk of being involved in a collision is increased significantly and other jurisdictions have shown that lowering legal limits to this level will reduce alcohol-related collisions, injuries and deaths substantially [7,9]. Nevertheless, there has been substantial opposition to initiatives involving changes to the legal limit, primarily from the alcohol industry [10], and to date governments in Canada and the United States appear to have been more persuaded by industry arguments than by the substantial reductions in drunk driving collisions, injuries and fatalities that would result.

Another initiative that colleagues in Australia and Europe have shown would reduce deaths and injuries in North America is random breath testing (RBT; [11,12]). RBT permits police officers to request a breath sample without having to document reasonable suspicion that that driver is impaired by alcohol, and thus can increase substantially the ability of police to process drivers at the roadside. Substantial reductions in drunk driving collisions, injuries and deaths have been documented with RBT, and most countries in the developed world have implemented RBT provisions; North American countries are among the exceptions [13].

Drunk driving continues to be a leading cause of preventable death and injury internationally. We continue to learn about the nature of the problem and its prevention [3,14,15], and opportunities for jurisdictions to learn from each other should be embraced. Pechansky & Chandran [1] exemplify what is needed in proposing to learn from North American experience. It is also true that North America needs to learn from the rest of the world as well.


  1. Top of page
  2. Declarations of interest
  3. References
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