Over the years, I have written many letters to the Times of Malta about road safety. I have written about the utility of strategically placed crash barriers to prevent deaths and injuries due to roadside obstacles, notably trees and electricity poles. I have written about the fourfold increased risk of injury or death for two-wheeled as against four-wheeled vehicles, with such risk being even greater when the rider is involved in a solo accident. 

I have factually disproved the outright lie that local road death rates are high, or are increasing over time. I have questioned interventions to reduce our speed limits, already the lowest in the world, and to introduce similar measures without hard evidence and studies of effectiveness.

I also dared to question the effect of a reduction of the blood alcohol limit from 0.8g/l to 0.5 g/l. Should there not be enough evidence that a significant number of road deaths were being caused by drivers with a blood alcohol level less than 0.8g/l, then such an intervention would be likely be ineffective. 

Different studies have shown different results. Compton et al (2002) and Moskovitz et al (2002) found that road deaths doubled with a blood alcohol concentration of 0.7g/l as compared to zero, but only started to increase above 0.4g/l.

However, older studies in 1964 and 1966 by Borkenstein et al and Allsop, respectively showed a doubling of road deaths at 0.9g/l and a sharp increase thereafter. As such, a blood alcohol level of approximately 0.8g/l seems to be an important milestone which is associated with increased risk.

 However, let us note that the WHO recommends a level of 0.5 g/l. Maltese law does not distinguish between those found to have a level of 0.5g/l or above and 0.8d/l or above. In my opinion, this is a major flaw. I would penalise those with a level over 0.8g/l and caution or fine those with a level between 0.5g/l and 0.8g/l, based on the above evidence.

No-one can be sure that the new alcohol limit has not been effective, because we have not observed road deaths for long enough to do so

Recently, Adrian Galea of the Malta Insurers Association was reported by the Times of Malta saying that the new alcohol limits “ha[d] no positive impact”. How does he know that? 

The average annual road death rate in Malta is 16 (between 2000 and 2017) with a standard deviation of 3.56. To exclude that the new limit has not resulted in a change in road deaths of at least 10 per cent would require the observation of over 2,000 deaths (95 per cent confidence and 80 per cent power). That would require over 100 years of observation! 

And that would also assume that the new law was the only variable affecting road deaths. Mr Galea is a very nice and well-intentioned man. I met him recently and advised him to check his statistics before making such statements. 

No one can be sure that the new alcohol limit has not been effective, because we have not observed road deaths for long enough to do so.

Mr Galea should consider other measures to reduce road deaths. The contribution of two-wheeled vehicles to road deaths in Malta has recently risen dramatically, as have fatal accidents involving roadside trees. 

I am sorry to say that my comments of years ago seem to have been spot on. The sooner we stop ignoring the facts, the sooner we will find effective solutions to our problems.

Jean Karl Soler is a medical doctor and researcher with an interest in road safety.

This is a Times of Malta print opinion piece


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