U.S. Department of Defense


Date of this Version



Pediatrics 2014;133:966–972 doi:10.1542/peds.2013-2318


This article is a U.S. government work, and is not subject to copyright in the United States.


BACKGROUND AND OBJECTIVE: Approximately 1 in 5 child passenger deaths in the United States involves an alcohol-impaired driver, most commonly the child’s own driver. The objective of this study was to document recent trends and state-specific rates of these deaths. METHODS: A descriptive analysis of 2001–2010 Fatality Analysis Reporting System data for child passengers aged ,15 years killed in alcoholimpaired driving crashes. Driver impairment was defined as a blood alcohol concentration of ≥ 0.08 g/dL. RESULTS: During 2001–2010, 2344 children ,15 years were killed in crashes involving at least 1 alcohol-impaired driver. Of these children, 1515 (65%) were riding with an impaired driver. Annual deaths among children riding with an alcohol-impaired driver decreased by 41% over the decade. Among the 37 states included in the state-level analysis, Texas (272) and California (135) had the most children killed while riding with an impaired driver and South Dakota (0.98) and New Mexico (0.86) had the highest annualized child passenger death rates (per 100 000 children). Most (61%) child passengers of impaired drivers were unrestrained at the time of the crash. Onethird of the impaired drivers did not have a valid driver’s license. CONCLUSIONS: Alcohol-impaired driving remains a substantial threat to the safety of child passengers in the United States, and typically involves children being driven by impaired drivers. This risk varies meaningfully among states. To make further progress, states and communities could consider increased use of effective interventions and efforts aimed specifically at protecting child passengers from impaired drivers.