Alcohol in aviation-related fatalities: North Carolina, 1985-1994

Background: Previous studies examining the role of alcohol in aviation safety have been limited to pilots and the estimated degree of alcohol involvement in fatal aviation crashes was susceptible to selection bias because alcohol testing was not conducted on a routine basis. This study examines the magnitude of and factors related to alcohol involvement in both pilot and non-pilot aviation fatalities. Methods: We analyzed medical examiner data on all victims who died in civilian aircraft crashes in North Carolina during 1985-94, complemented by crash investigation data from the National Transportation Safety Board. Results: During the 10-yr study period, the North Carolina Medical Examiner information System recorded 337 aviation- related fatalities including 111 pilots. Alcohol testing was performed on 91% of the pilots and 72% of the non-pilot occupants. Of the victims who were tested for alcohol, 12% (7% of the pilots and 15% of non-pilot occupants) had positive blood alcohol concentrations (BACs), ranging from 0.02 to 0.14%. All four victims with BACs greater than 0.10% were pilots aged 20-29 yr who were fatally injured in nighttime general aviation crashes. In crashes of commercial flights, none of the pilots tested positive for alcohol, whereas 20% of the non-pilot occupants had positive BACs. Conclusions: Intoxicated flying, particularly among young general aviation pilots, is still a valid concern. The aviation safety implications of alcohol use by passengers of commercial flights should be further examined.