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Some medical and biological aspects in the interlock programs for the non offender

Some medical and biological aspects in the interlock programs for the non offender. C.Mercier-Guyon *, M.Mallaret *,  *:C.E.R.M.T. BP 132, 74004, Annecy Cedex, France. The history of breath alcohol detection. First equipments were settled for control of offenders’ BAC: less discussion:

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Some medical and biological aspects in the interlock programs for the non offender

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  1. Some medical and biological aspects in the interlock programs for the non offender • C.Mercier-Guyon *, M.Mallaret *, •  *:C.E.R.M.T. BP 132, 74004, Annecy Cedex, France

  2. The history of breath alcohol detection • First equipments were settled for control of offenders’ BAC: less discussion: • Simple issues : guilty or not guilty • Priority: to avoid circumvention (volume, hum, negative pression) • Alternative blood sampling at the beginning or still possible today in certain countries • In other countries: no blow means refusal and sanction • Evolution to ignition interlock devices: many people keep the same «strong» point of view in term of medical fitness: “if he is not fit to blow, he is not fit to drive!”

  3. What is a non offender use ? 1/Medical examination for driving fitness: • Personal history of alcohol related problems without any previous offence • Special categories of vehicles 2/Parents choice 3/Insurance cost issues

  4. What is a non offender use ? (2) 4/ Administration: • Driving licences administration managing offenders after « justice time », only in term of fitness • Regulation for special categories of drivers (public transport, dangerous goods,etc)

  5. Who face problems to blow? • Obstructive problems: • Asthma, Chronic bronchitis • Restrictive problems: • Kyphosis, scoliosis, neuro-muscular problems, surgery, paraplegia, obesity, little size or little weight • Combination: • Amyotrophic diseases, age

  6. A LACK OF STUDIES • Most of the studies where led in normal subjects 20 years ago • No recent studies in different categories of patients, elderly people, extreme sizes or weights, handicaps • No recent studies about reduced flow and reliability • No recents studies about interfering substances

  7. RESPIRATORY INSUFFICIENCY

  8. Flow and volumes Normal

  9. A normal subject can blow 80% of is pulmonary volume (3 lit to give 2,4 lit) • A subject with a light restrictive disease will give only 70% (3,4 lit to give 2,4 lit) IRV IC VC TC ERV RFC RV

  10. Minimum size for a capacity of 3 liters

  11. SAAQ exemption for WR2

  12. SAAQ exemption for WR3

  13. Interfering substances • From the body (acetone, 2-Propanol, Methane, etc) • From medicines (Isoprene, Methyl terbutyl ether, etc) • From food (Dimethyl sulfide, Methyl mercaptan, etc)

  14. Many substances can interfere with alcohol detection

  15. The technical issues in non offender programs • False negative means problem for the driver and for the manager in term of responsibility • False positive means lack of confidence in the equipment, time lost = money lost • Out of “family use”, there is a need of reliable equipments able to face • legal consequences • Confidence of customers, especially with business issues

  16. The medical issues • « Integrative » or « selective » model of society • More and more people must work and drive despite a handicap • Disabled people have also to be controlled but cannot always give a sufficient breath sample

  17. The « selective » model is weakening in most of the countries (old drivers, disabled people, speed limits) • The « moral » aspect of alcohol consumption has to be left, due to the low legal limits in many countries, for a « fitness » model which does not allow the same « strong » point of view

  18. Offenders or similar Certified medical exemption based on medical advice and certified tests Or special setting (reduced flow) Specific medical and biological follow up to « compensate » like biological markers: less volume, more controls Training and procedures for interfering substances Commercial or private Simple medical exemption based on medical advice and tests ++ Special setting regarding to the context ?? Alternative procedures for employees unable to give a full sample Information and prevention for interfering substances Two different contexts

  19. CONCLUSIONS • A lack of studies about « new customers » with physical problems or characteristics • A lack of studies about interfering substances • A remaining « offender’s program's point of view which cannot be applied in term of driving fitness or commercial and private issues • A need for more training and information around the programs

  20. Thank you for your attention INTERLOCK PROGRAM SELECTION

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