Multicentre 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: 5.11). 07/2006; 84(6):453-60. DOI: 10.2471/BLT.05.027466
Source: PubMed

ABSTRACT 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
  • 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
    • "Worldwide, tobacco use continues to be the leading cause of preventable death (World Health Organization 2011c), and almost 4% of deaths are attributed to the harmful use of alcohol (Rehm et al. 2007; World Health Organization 2011c). Alcohol use is a causal factor in 60 types of disease and injury, a contributory factor to 200 other diseases (such as cancers, liver cirrhosis, hypertension and pancreatitis) and is associated with violence, suicides, child abuse/neglect and workplace absenteeism (Corrao et al. 2004; Borges et al. 2006; Lau et al. 2008; World Health Organization 2011c). People with alcohol-associated diseases smoke more than people with non-alcoholrelated disease, suggesting a synergism between alcoholrelated harm and cigarette smoking (Lau et al. 2008). "
    [Show abstract] [Hide abstract]
    ABSTRACT: OBJECTIVES: To describe the prevalence of smoking and alcohol use and abuse in an impoverished rural region of western Kenya. METHODS: Picked from a population-based longitudinal database of demographic and health census data, 72 292 adults (≥18 years) were asked to self-report their recent (within the past 30 days) and lifetime use of tobacco and alcohol and frequency of recent 'drunkenness'. RESULTS: Overall prevalence of ever smoking was 11.2% (11.0-11.5) and of ever drinking, 20.7% (20.4-21.0). The prevalence of current smoking was 6.3% (6.1-6.5); 5.7% (5.5-5.9) smoked daily. 7.3% (7.1-7.5) reported drinking alcohol within the past 30 days. Of these, 60.3% (58.9-61.6) reported being drunk on half or more of all drinking occasions. The percentage of current smokers rose with the number of drinking days in a month (P < 0.0001). Tobacco and alcohol use increased with decreasing socio-economic status and amongst women in the oldest age group (P < 0.0001). CONCLUSIONS: Tobacco and alcohol use are prevalent in this rural region of Kenya. Abuse of alcohol is common and likely influenced by the availability of cheap, home-manufactured alcohol. Appropriate evidence-based policies to reduce alcohol and tobacco use should be widely implemented and complemented by public health efforts to increase awareness of their harmful effects.
    Tropical Medicine & International Health 04/2013; 18(4):506-515. DOI:10.1111/tmi.12066 · 2.30 Impact Factor
  • Source
    • "Very high relative risk estimates have also been derived using the case-crossover method, with one pooled analysis generating a relative risk of 14 (Borges et al., 2006), which translates to about 93% for the " assigned proportion. " In both this case-crossover study and the earlier case-control study, relative risk estimates failed to control for important confounding variables such as environmental factors. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Alcohol can result in harm (including injury) not only to the drinker but also to others; however, little research exists on the additional proportion of violence-related injuries that can be attributed to the perpetrator. Data are reported from emergency department studies in 14 countries on the prevalence of patients' self-report of drinking within the 6 hours before the violence-related injury event, patients' belief that the event would not have happened if they had not been drinking at the time, and patients' perception that the perpetrator had been drinking. Alcohol-attributable fraction was calculated based on the patients' perception that their own drinking was causally related to the event and on their perception that the perpetrator had been drinking. Across all countries, 62.9% of the violence-related injuries involved alcohol use on the part of the victim, the perpetrator, or both. Rates of others definitely drinking, as perceived by the victim, ranged from 14% to 73% across countries and was positively associated with patients' own drinking in the event and with attributing a causal association between their drinking and the event. Estimates of alcohol-attributable fraction were 38.8% when the victim and perpetrator were considered together compared with 23.9% when only the patient was considered and varied by country-level drinking pattern. These findings suggest adjustments that could be made to global burden of disease estimates because of violence-related injury morbidity to better reflect alcohol-attributable fraction when drinking by others and country-level drinking patterns are taken into account.
    Journal of studies on alcohol and drugs 03/2012; 73(2):277-84. · 2.27 Impact Factor
Show more


1 Download
Available from