Alcohol and Road Traffic Injuries in Latin America and the Caribbean: A Case-Crossover Study

Abstract

Background This study reports dose-response estimates for the odds ratio (OR) and population attributable risk of acute alcohol use and road traffic injury (RTI). Methods Data were analyzed on 1,119 RTI patients arriving at 16 emergency departments (EDs) in Argentina, Brazil, Costa Rica, Dominican Republic, Guatemala, Guyana, Mexico, Nicaragua, Panama and Trinidad & Tobago. Case-crossover analysis, pair-matching the number of standard drinks consumed within the six hours prior to the RTI with two control periods (prior day/week) was performed using fractional polynomial analysis for dose-response. Results About 1 in 6 RTI patients in EDs were positive for self-reported alcohol 6 hours prior to the injury (country range 8.6%-24.1%). The likelihood of a RTI with any drinking prior (compared to not drinking) was 5 times higher (country range OR 2.50-15.00) and the more a person drinks the higher the risk. Every drink (12.8 g alcohol) increased the risk of an RTI by 13%, even one-two drinks were associated with a sizable increase in risk of an RTI and a dose-response was found. Differences in ORs for drivers (OR=3.51; 95%CI=2.25-5.45), passengers (OR=8.12; 95%CI=4.22-15.61) and pedestrians (OR=6.30; 95%CI=3.14-12.64) and attributable fractions were noted. Acute use of alcohol was attributable to 14% of all RTIs, varying from 7% for females to 19% for being injured as a passenger. Conclusions: The finding that the presence of alcohol increases risk among drivers and non-drivers alike may further help to drive interventions targeting passengers and pedestrians. Routine screening and brief interventions in all health services could also have a beneficial impact in decreasing rates of RTIs. Higher priority should be given to alcohol as a risk factor for RTIs, particularly in Latin America and the Caribbean.

Estimating the drink driving attributable fraction of road traffic deaths in Mexico

“…In this sense, there are few data on differences of BAC levels among drivers and passengers in the literature. Recent evidence shows that, even though ORs seem to be higher in passengers compared to drivers, there are no statistical differences that might provide evidence of potential bias on this regard [29]. In addition, not having the time when the collision occurred and the time when the necropsy was conducted made it impossible to identify whether those car occupants classified as negative for alcohol were not actually under the influence at the moment of the collision.…”

Ethnopharmacological Applications Targeting Alcohol Abuse: Overview and Outlook

“…Similarly, Borges and co-worker reported dose-response estimates for the odds ratio (OR) and population attributable risk of acute alcohol consumption and road traffic injury (RTI) (Borges et al, 2017). In this study the data was obtained and analyzed from 1,119 RTI patients who reached 16 emergency departments in countries like Trinidad and Tobago, Dominican Republic, Brazil, Guatemala, Costa Rica, Guyana, Nicaragua, Panama, Mexico, and Argentina.…”

“…Applying local and global measures immediately in areas like Latin America and the Caribbean to decrease consumption of alcohol can reduce usage of alcohol among pedestrians, drivers, and passengers involved in RTI (WHO, 2010;Borges et al, 2017).…”

Relative risk of injury due to alcohol consumption in car and motorcycle drivers

“…Despite improved hospital care, mortality from RTAs is the second leading public health problem in the Islamic Republic of Iran (2). There is strong evidence that a substantial number of fatal as well as nonfatal injuries results from alcohol consumption and abuse (3); therefore, it can be argued that alcohol consumption is one of the most well-known risk factors for RTAs (4,5). High alcohol consumption was attributed to 14% of all road traffic injuries and the rate of alcohol consumption in RTAs has been reported to vary from 14% to 26% (4,6).…”

“…There is strong evidence that a substantial number of fatal as well as nonfatal injuries results from alcohol consumption and abuse (3); therefore, it can be argued that alcohol consumption is one of the most well-known risk factors for RTAs (4,5). High alcohol consumption was attributed to 14% of all road traffic injuries and the rate of alcohol consumption in RTAs has been reported to vary from 14% to 26% (4,6). It is reported that the chance of an accident after alcohol consumption is 6.1 times higher than without alcohol consumption (7).…”