The pedestrian fraction of traffic related deaths in Cape Town, South Africa has reached catastrophic proportions, accounting for 68% of all fatalities. Alcohol appears to be a causative factor in many of these fatalities. Blood alcohol concentration (BAC) estimation was carried out on 227 non-fatally and fatally injured pedestrians who were involved in motor vehicle collisions in Cape Town.

BACs were positive in 62.1 % of pedestrians - 59.5% had BACs at or above 0.08 g/dl. Pedestrians who were intoxicated sustained more severe injuries, more frequently required surgical interventions, required longer hospital admissions and were left with more severe disabilities than their sober counterparts. Alcohol intoxication is a major problem in pedestrian trauma in Cape Town and should be addressed by education, legislation and law enforcement.