A Swedish alcohol ignition interlock programme for drink-drivers: effects on hospital care utilization and sick leave.
OBJECTIVE
This project evaluates health outcomes following an alcohol ignition interlock programme (AIIP) by assessing hospital care utilization and sick-leave register data relative to controls with revoked licences, but with no comparable opportunity to participate in an AIIP.


METHODS
In Sweden, driving while impaired (DWI) offenders can now select voluntarily a 2-year AIIP in lieu of 12 months' licence revocation. The AIIP includes regular medical check-ups designed to alter alcohol use.


METHODS
The study is a quasi-experimental intent-to-treat design; accordingly, the intervention group includes 48% of the participants who were dismissed from the AIIP before completion.


RESULTS
The control group (865 individuals) showed increased hospital care and sick leave after licence revocation following the DWI. Among the 1266 people in the AIIP, however, significantly fewer needed hospital care relative to controls, and relative to their own care utilization before the DWI offence. This occurred whether care reflected all diagnosis or only alcohol-related diagnosis. Also, sick-leave data showed significantly fewer AIIP group individuals using sick leave relative to the control group, and relative to their own pre-treatment period. These significant health benefits disappear in the post-treatment period. However, among those who actually do complete the entire AIIP, sustained positive health effects are observed 3 and 4 years after the DWI offence.


CONCLUSIONS
Voluntary participation in an AIIP has favourable effects with less need for hospital care or sick leave. This is probably linked to reduced alcohol consumption during the programme and to the ability to continue driving.
Bjerre
Bo
B
Traffic Medicine, Swedish Road Administration, Borlänge, Sweden. bo.bjerre@vv.se
Marques
Paul
P
Selén
Jan
J
Thorsson
Ulf
U
D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000331:legislation & jurisprudence*; D001334:Automobile Driving; D016022:Case-Control Studies; D005260:Female; D006300:Health Services Misuse / Q000706:statistics & numerical data*; D006801:Humans; D008004:Licensure / Q000331:legislation & jurisprudence*; D008297:Male; D008875:Middle Aged; D018582:Sick Leave / Q000706:statistics & numerical data; D013548:Sweden