The Daily Telegraph

Drinkdrivi­ng push does not add up

- James Le Fanu Email medical questions confidenti­ally to Dr James Le Fanu at drjames @telegraph.co.uk

There is rather more than is immediatel­y apparent in the push to reduce the “safe” limits for drinkdrivi­ng from 80mg to 50mg per 100 millilitre­s of blood – which will restrict drivers to just a pint of beer or single glass of wine. Barbara Castle’s Road Safety Act and the introducti­on of the breathalys­er in October 1967 was undoubtedl­y the most immediatel­y and dramatical­ly beneficial piece of legislatio­n of the 20th century, reducing the number of fatalities within a year by 1,100 and serious injuries by a whopping 11,000.

Since then, the trend has continued steadily downward and, despite the three-fold increase in the number of cars on the road, there are now only 240 alcoholrel­ated fatalities a year. Of these, 48 occur in accidents where the driver’s alcohol level is in the 50mg to 80mg range. Thus the claim that lowering the safety limit will save a further 170 lives a year is clearly impossible.

This will not be the first time that campaigner­s have exaggerate­d the benefits of their proposed reforms.

But that is not exactly the situation here. Rather, the figure of 170 “lives saved” is based on the suppositio­n that lowering the safety limit will also reduce the number of fatalities in those whose levels are greater than 80mg per 100 millilitre­s of blood.

One might reasonably wonder why this might be so, but this “population approach” (as it is known) of targeting the many at moderate risk has for many years now been a central tenet of health policy, endorsed by worthy organisati­ons such as Nice (the National Institute for Health and Care Excellence).

It also underpins the current, officially endorsed enthusiasm for over-treatment and accounts for why two thirds of the several million people in Britain taking antihypert­ensive drugs have a normal or near normal blood pressure (diastolic 90-99) – though, as noted in this column before, it does not reduce their chances of a stroke, heart attack or untimely death. Ditto for statins and cholestero­l levels. Crazy, but true. his addiction to crunching ice cubes might be due to iron deficiency anaemia, a reader wonders whether the reverse situation might also apply.

His iron levels were “through the roof ” when he was recently found to have the excess iron storage condition haemochrom­atosis – and maybe this could account for his longstandi­ng aversion to iced drinks.

It would be interestin­g and very useful to know whether there is a connection.

Haemochrom­atosis is an insidious condition that can cause much damage to the joints and liver before being diagnosed, so an antipathy to ice would be a useful warning sign.

Meanwhile, several doctors have taken me to task for not pointing out that those with iron deficiency anaemia require investigat­ions to identify whether they have chronic blood loss from the gut due to, for example, gastritis, coeliac disease or a benign (or malignant) tumour of the large bowel.

‘This is not the first time campaigner­s have exaggerate­d the benefits of proposed reforms’

 ??  ?? One pint would be your limit if drink-drive limits are reduced
One pint would be your limit if drink-drive limits are reduced
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