Multicentre study of acute alcohol use and non-fatal injuries: data from the WHO collaborative study on alcohol and injuries

Abstract

Objectives 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. Methods 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. Findings 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. Conclusion 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.

Consumo de bebidas alcoólicas e direção de veículos nas capitais brasileiras e no Distrito Federal, segundo dois inquéritos nacionais de saúde

“…The concentration of alcohol in blood produces several neuromotor changes even at low doses, since there is a reduction of attention, false perception of speed, euphoria and difficulty in perceiving different luminosities 10 . Policies and legal restriction actions on alcohol consumption and driving, as the control of alcohol ads, the ban on sales to minors and laws that regulate the operation of alcohol outlets are important to reduce risk and, especially, to save lives 1,2,4,10 . The literature shows significant reductions in the number of deaths and injuries in countries that have adopted strict laws for alcohol consumption and driving, including the United States 20 , Cali, Colombia, among others 2 .…”

“…In the Americas, alcohol consumption has been considered the most important risk factor for diseases 2,3 . The problems caused by alcohol intake can affect not only the consumer, but their family and social circle, as in cases of domestic violence, marital conflict, child abuse 4 . Alcohol consumption can result in social and health consequences, including reduced productivity at work, violent behavior, sports and leisure injuries, traffic deaths and injuries 4,5 , unsafe sex and use of other psychoactive substances 6 .…”

“…The problems caused by alcohol intake can affect not only the consumer, but their family and social circle, as in cases of domestic violence, marital conflict, child abuse 4 . Alcohol consumption can result in social and health consequences, including reduced productivity at work, violent behavior, sports and leisure injuries, traffic deaths and injuries 4,5 , unsafe sex and use of other psychoactive substances 6 . Even in small amounts, alcohol increases the risk of involvement in traffic accidents for both drivers and pedestrians, for it changes judgment capacity, vision, reaction time and motor coordination 7 .…”

Musings on New Australian Guidelines for Reducing the Risk From Single Occasion Drinking

“…In fact, the single-occasion drinking guideline relied heavily on the World Health Organization (WHO) international case-cross-over study of emergency department admissions for injury in 10 different countries [5] which asked about drinking in the 6 hours prior to injury (i.e. not blood alcohol concentration-based).…”

“…How often can one present with a RSDO before one qualifies for heavy episodic drinking? A European project which has just finished, the SMART project (Standardizing Measurement of Alcohol Related Troubles) [5] will soon provide data that show not only important inter-country variabilities, but also the difficulties in setting a clear limit on the frequency of RSDO in order not to consider them under the heavy drinking umbrella.…”