Multicenter study of acute alcohol use and non-fatal injuries: data from the WHO Collaborative Study on Alcohol and Injuries

Instituto Nacional de Psiquiatria & Universidad Autónoma Metropolitana-Xochimilco, Calzada Mexico Xochimilco No. 101, Col. San Lorenzo Huipulco, Mexico DF 14370. .
Bulletin of the World Health Organisation (Impact Factor: 5.09). 07/2006; 84(6):453-60. DOI: 10.2471/BLT.05.027466
Source: PubMed


To study the risk of non-fatal injury at low levels and moderate levels of alcohol consumption as well as the differences in risk across modes of injury and differences among alcoholics.
Data are from patients aged 18 years and older collected in 2001-02 by the WHO collaborative study on alcohol and injuries from 10 emergency departments around the world (n = 4320). We used a case-crossover method to compare the use of alcohol during the 6 hours prior to the injury with the use of alcohol during same day of the week in the previous week.
The risk of injury increased with consumption of a single drink (odds ratio (OR) = 3.3; 95% confidence interval = 1.9-5.7), and there was a 10-fold increase for participants who had consumed six or more drinks during the previous 6 hours. Participants who had sustained intentional injuries were at a higher risk than participants who had sustained unintentional injuries. Patients who had no symptoms of alcohol dependence had a higher OR.
Since low levels of drinking were associated with an increased risk of sustaining a non-fatal injury, and patients who are not dependent on alcohol may be at higher risk of becoming injured, comprehensive strategies for reducing harm should be implemented for all drinkers seen in emergency departments.

1 Follower
6 Reads
  • Source
    • "Studies using the matched-interval approach compare drinking within 6 hours prior to the injury event with drinking during a predetermined control period, such as the same 6-hour period during the previous day or previous week. Such studies have reported ORs ranging from 3.2 (based on any drinking at the same time the previous day) (Vinson et al. 2003) to 5.7 in a 10-country study (based on any drinking at the same time the previous week) (Borges et al. 2006b). Both studies demonstrated a dose-response relationship. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Hospital emergency departments (EDs) see many patients with alcohol-related injuries and therefore frequently are used to assess the relationship between alcohol consumption and injury risk. These studies typically use either case-control or case-crossover designs. Case-control studies, which compare injured ED patients with either medical ED patients or the general population, found an increased risk of injury after alcohol consumption, but differences between the case and control subjects partly may account for this effect. Case-crossover designs, which avoid this potential confounding factor by using the injured patients as their own control subjects, also found elevated rates of injury risk after alcohol consumption. However, the degree to which risk is increased can vary depending on the study design used. Other factors influencing injury risk include concurrent use of other drugs and drinking patterns. Additional studies have evaluated cross-country variation in injury risk as well as the risk by type (i.e., intentional vs. unintentional) and cause of the injury. Finally, ED studies have helped determine the alcohol-attributable fraction of injuries, the causal attribution of injuries to drinking, and the impact of others' drinking. Although these studies have some limitations, they have provided valuable insight into the association between drinking and injury risk.
    Alcohol research : current reviews 11/2013; 35(2):150-4.
  • Source
    • "Our results reinforce existing efforts in many high-income countries to reduce rates of driving under the influence of cannabis and improve road safety, through policy, education, and enforcement. From the perspective of public health, increasing access to and utilization of medical marijuana in many jurisdictions, coupled with a high general prevalence of cannabis use, suggests that concerns about driving under the influence of cannabis, and associated collision risk, will persist (Hall and Degenhardt 2009; Borges et al. 2006; Saunders et al. 1993; Adamson and Sellman 2003). "
    [Show abstract] [Hide abstract]
    ABSTRACT: This study examined whether acute cannabis use leads to an increased collision risk. Participants were 860 drivers presenting to emergency departments in Toronto and Halifax, Canada, with an injury from a traffic collision, between April 2009 and July 2011. Cannabis and other drug use were identified either through blood sample or self-report. A case-crossover design was employed with two control conditions: a fixed condition measuring substance use during last time driving, and whether the driver typically uses cannabis prior to driving. Collision risk was assessed through conditional fixed-effects logistic regression models. Results revealed that 98 (11 %; 95 % CI: 9.0-13.1) drivers reported using cannabis prior to the collision. Regression results measuring exposure with blood and self-report data indicated that cannabis use alone was associated with a fourfold increased (OR 4.11; 95 % CI: 1.98-8.52) odds of a collision; a regression relying on self-report measures only found no significant association. Main findings confirmed that cannabis use increases collision risk and reinforces existing policy and educational efforts, in many high-income countries, aimed at reducing driving under the influence of cannabis.
    International Journal of Public Health 09/2013; 59(2). DOI:10.1007/s00038-013-0512-z · 2.70 Impact Factor
  • Source
    • "It represents, however, alcohol consumption levels approximately at the 90th percentile in our sample. The choice of cut-off is supported by a current WHO study on alcohol use and injuries in young adults that applied a categorization of weekly drinking frequencies of zero, one, 2–3, 4–5 and 6 or more glasses of alcoholic beverages [63]. In that study, a weekly consumption of 4–5 glasses already accounted for a significant increase in the likelihood of non-fatal injuries. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Research examining mental health in violence-affected youth in representative samples is rare. Using data from the nationally representative German Health Interview and Examination Survey for Children and Adolescents (KiGGS) this study reports on gender-specific prevalence rates and associations of a broad range of internalizing and externalizing mental health problems: emotional problems, conduct problems, ADHD, disordered eating, somatic pain and substance use in youth variously affected by violence. While internalizing is generally more common in girls and externalizing in boys, observations of prior non-normative studies suggest reverse associations once an individual is affected by violence. The occurrence of such "gender cross-over effects" is therefore examined in a representative sample. The sample consisted of 6,813 adolescents aged 11 to 17 from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS): Applying multivariate logistic regression analyses, associations between each type of violence history and mental health indicator were determined for perpetrators, victims, and perpetrating victims of youth violence. Moderating effects of gender were examined by using product term interaction. Victim status was associated primarily with internalizing problems, while perpetrators were more prone to externalizing problems. Perpetrating victims stood out with respect to the number and strength of risk associations with all investigated mental health indicators. However, the risk profiles of all violence-affected youth included both internalizing and externalizing mental health problems. Gender cross-over effects were found for girls and boys: despite lower overall prevalence, girls affected by violence were at far higher risk for conduct problems and illicit drug use; by contrast, somatic pain, although generally lower in males, was positively associated with perpetrator status and perpetrating victim status in boys. All violence-affected youth exhibited significantly higher rates of cumulative mental health problems. The results highlight the importance of violence for the mental health of youth. They reveal a particular vulnerability as a function of gender. Implications for policy making, clinical practice and research are discussed.
    BMC Public Health 07/2013; 13(1):628. DOI:10.1186/1471-2458-13-628 · 2.26 Impact Factor
Show more


6 Reads
Available from