title: Alcohol violations and aviation accidents: findings from the U.S. mandatory alcohol testing program.
abstract: BACKGROUND
  Mandatory alcohol testing has been implemented in the U.S. aviation industry since 1995. This study documents the prevalence of alcohol violations and the association between alcohol violations and aviation accidents among aviation employees with safety-sensitive functions.
  
  
  METHODS
  Data from the random alcohol testing and post-accident alcohol testing programs reported by major airlines to the Federal Aviation Administration for the years 1995 through 2002 were analyzed. A violation was defined as an alcohol level of > or = 0.04% or a refusal to submit to testing. Relative and attributable risks of accident involvement associated with alcohol violations were estimated using the case-control method.
  
  
  RESULTS
  During the study period, random alcohol testing yielded a total of 440 violations, with an overall prevalence rate of 0.09% and a prevalence rate of 0.03% for flight crews. Alcohol violations were associated with an increased yet not statistically significant risk of accident involvement (odds ratio 2.56, 95% confidence interval 0.81-7.08) and were attributed to 0.13% of aviation accidents.
  
  
  CONCLUSIONS
  Alcohol violations among U.S. major airline employees with safety-sensitive functions are rare and play a negligible role in aviation accidents.
authors.affiliation: Department of Emergency Medicine, Johns Hopkins University School of Medicine, 5801 Smith Avenue, Davis Building, Suite 3220, Baltimore, MD 21209, USA. ghli@jhmi.edu
authors.forename: Guohua
authors.initials: G
authors.lastname: Li
authors.forename: Susan P
authors.initials: SP
authors.lastname: Baker
authors.forename: Yandong
authors.initials: Y
authors.lastname: Qiang
authors.forename: George W
authors.initials: GW
authors.lastname: Rebok
authors.forename: Melissa L
authors.initials: ML
authors.lastname: McCarthy
mesh_terms: D000060:Accidents, Aviation / Q000517:prevention & control / Q000706:statistics & numerical data*; D000428:Alcohol Drinking / Q000097:blood*; D001359:Aviation / Q000331:legislation & jurisprudence*; D016021:Epidemiologic Studies; D000431:Ethanol / Q000009:adverse effects* / Q000097:blood; D006801:Humans; D037141:Mandatory Programs; D015995:Prevalence; D012306:Risk; D018570:Risk Assessment; D012307:Risk Factors; D012309:Risk-Taking; D012449:Safety / Q000331:legislation & jurisprudence*; D014481:United States / Q000453:epidemiology
chemical_list: D000431:Ethanol