Drink driving figures are thought to be seriously underestimated, with alcohol rarely included as a cause of death on traffic accident death certificates. 

Figures from the U.S. National Highway Traffic Safety Administration's Fatality Analysis Reporting System take note of blood alcohol levels of those who die in vehicular accidents, though this data is more often than not left out of the formal cause of death on death certificates. Researchers found that just over three percent of death certificates registered between 1999 and 2009 attributed the deaths to alcohol- related crashes, whereas data from the National Highway Traffic Safety Administration notes that around 21 percent of traffic deaths occurred in people over the legal limit to drive. However, it should be noted that not all traffic accident victims who die as a result of their injuries are subject to the blood testing - the number caps at around 70 percent. 

The numbers are particularly crucial as injuries are the leading cause of death among people under the age of 45. Of these injuries, traffic accidents are arguably the best document, and thus easiest from which data can be extracted. 

"Alcohol misuse is the fourth leading cause of death in the United States, it accounts for 89,000 deaths annually and of those, 49,500 are acute causes - they are injuries or poisonings," said the study's lead author Ralph Hingson to FoxNews.com. "The one area we've made enormous progress in over the last 30 years is reducing alcohol involvement in traffic deaths and alcohol-related traffic deaths per 100,000 people in the U.S. have been more than cut in half."

Interestingly, it also found that discrepancies in the inclusion of alcohol as a cause of death varied between states, with Maryland, Nevada, New Hampshire, and New Jersey reporting a dearth of alcohol-related traffic incidents. Conversely, states including Delaware, Iowa, Kansas, and Minnesota were more forthcoming with this information. The authors noted that the reason for the difference remains unknown, though may have something to do with the relative speed of processing death certificates compared to the lag often experienced in receiving toxicology reports.

The study was published in the Journal of Studies on Alcohol and Drugs. 

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