The effect of ethyl alcohol on the severity of injuries in fatal pedestrian victims of traffic crashes

Lasota, Dorota; Goniewicz, Mariusz; Kosson, Dariusz; Ochal, Andrzej; Krajewski, Paweł; Tarka, Sylwia; Goniewicz, Krzysztof; Mirowska‐Guzel, Dagmara

doi:10.1371/journal.pone.0221749

Cited by 16 publications

(8 citation statements)

References 25 publications

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“…However, the analyses using hospital length of stay and ISS are broadly similar. Lastly, we cannot rule out the possibility of residual confounding, such as the effect of alcohol [ 36 , 37 ], despite our best attempts to collect and control for various factors including socioeconomic and injury related factors.…”

Section: Discussionmentioning

confidence: 99%

Impacts of injury severity on long-term outcomes following motor vehicle crashes

Hung

Kifley²,

Brown

et al. 2021

BMC Public Health

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Background There is growing evidence that a range of pre-injury, injury related and post-injury factors influence social and health outcomes across the injury severity spectrum. This paper documents health related outcomes for people with mild, moderate and severe injury after motor vehicle crash (MVC) injuries in New South Wales, Australia. Methods This inception cohort study followed 2019 people injured in MVCs, for 6 and 12 months post-injury. We categorised moderate injury as hospital length-of-stay (LOS) of 2–6 days and Injury Severity Score (ISS) of 4–11, while severe injury as LOS ≥7 days or ISS ≥ 12. We examined differences in paid work status, 12-Item Short Form Survey (SF12), EQ-5D and World Health Organisation Disability Assessment Schedule II (WHODAS) outcomes longitudinally from baseline to 12 months between levels of injury severity using linear mixed models for repeated measures. We first considered minimally sufficient adjustment factors (age, sex, crash role, perceived danger in crash, pre-injury health, pre-injury EQ-5D, recruitment source), and then more extensive adjustments including post-injury factors. The presence of mediating pathways for SF-12 Physical Component Summary (PCS) and Mental Component Summary (MCS) via post-injury factors was evaluated. Results Based on hospital length of stay (LOS), 25 and 10% of participants sustained moderate and severe injuries, respectively, while 43 and 4% had these injuries based on ISS. Twelve months post-injury LOS ≥7 days versus ≤1 day was associated with an estimated 9 units lower mean SF12 PCS using a minimally sufficient adjustment model, and LOS ≥ 7 days was associated with a 3 units lower mean SF12 MCS score. Mediation analyses (LOS ≥ 7 days vs ≤1 day) found for SF12 MCS outcomes, effects of injury severity were small and mostly indirect (direct effect − 0.03, indirect effect − 0.22). Whereas for SF12 PCS outcomes the effect of having a more severe injury rather than mild were both direct and indirect (direct effect − 0.50, indirect effect − 0.38). Conclusions Individuals with severe injuries (those with LOS ≥ 7 days and ISS 12+) had poorer recovery 12 months after the injury. In addition, post-injury mediators have an important role in influencing long-term health outcomes. Trial registration Australia New Zealand Clinical trial registry identification number - ACTRN12613000889752.

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Section: Discussionmentioning

confidence: 99%

Impacts of injury severity on long-term outcomes following motor vehicle crashes

Hung

Kifley²,

Brown

et al. 2021

BMC Public Health

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“…According to legal standards in Poland, when the blood alcohol content is or nears a concentration of 0.2% to 0.5% (or the presence of 0.1 mg to 0.25 mg of alcohol in 1 dm 3 in exhaled air), this is considered a state after alcohol consumption [22]. When the blood alcohol level is or nears a blood alcohol level above 0.5% (and there is more than 0.25 mg in 1 dm 3 in the exhaled air), we are talking about a state of intoxication [29][30][31][32]. Unfortunately, in the presented analysis, the above-mentioned limits were significantly exceeded in pedestrians (0.2-4.40% ).…”

Section: Discussionmentioning

confidence: 99%

Alcohol and Road Accidents Involving Pedestrians as Unprotected Road Users

Lasota

Al-Wathinani

Krajewski

et al. 2020

IJERPH

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According to the World Health Organization (WHO), more than half of all road fatalities involve vulnerable road users, i.e., pedestrians, cyclists, and motorcyclists. Poland is classified as one of the European Union (EU) countries marked by low road safety, with a higher frequency of accidents involving pedestrians compared to other EU countries (31% of all fatalities). Among unprotected road users, a significant group of victims are pedestrians, who are often under the influence of alcohol. This study aims to analyze the impact of alcohol on the risk of occurrence and consequences of road accidents among pedestrians. The source of data was the medical documentation of the Department of Forensic Medicine of the Medical University of Warsaw. In more than half of pedestrian deaths, the presence of alcohol was found; regardless of the place of the event and the place of death, among the victims under the influence of alcohol, males dominated; the average age of the victims under the influence of alcohol was significantly lower compared to the average age of sober victims, with younger victims being significantly more likely to die at the scene of the accident, especially in rural areas; significantly higher alcohol concentrations were found in males, in victims who died at the scene of the accident, and with victims of accidents in rural areas. Among pedestrian traffic accident fatalities, the most numerous group comprised young men under the influence of alcohol. In rural areas, a higher percentage of pedestrian victims died at the scene as a result of excessive alcohol consumption. These areas should be subject to intensive preventive measures to increase the safety of pedestrians as unprotected road users.

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“…Studies by Lasota et al on the impact of ethanol on the severity of injuries in fatal road traffic accidents involving pedestrian victims, demonstrated that the effect of ethanol on injury severity cannot be mentioned without taking into account the gender and age of the victims [6,7].…”

Section: Methodsmentioning

confidence: 99%

Ethanol as a stimulus to risky and auto-aggressive behaviour

Lasota¹,

Pawłowski²,

Mirowska‐Guzel³

et al. 2021

Ann Agric Environ Med.

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According to the World Health Organization (WHO), ethyl alcohol occupies the third place among health risks for the general population, causing damage to health as well as social damage. Ethanol is also considered the greatest risk factor in injuries. Both alcohol and its main metabolite, acetaldehyde, are directly toxic to tissues and lead to several systemic pathologies. Alcohol abuse may also lead to mental health disorders. Although one-in-eight adult Poles abstains from drinking alkohol, 10-20% of adult Poles drink alcohol regularly. It is estimated that this group includes about 900,000 addicts, and over 2,000,000 people who drink alcohol at a risky or harmful level. It affects their occurrence and their consequences Drinkdriving is one of the problems most often raised, although alcohol is a documented risk factor in pedestrian accidents. It is also an important risk factor for suicidal behaviour with people under the influence of alcohol choosing more radical and effective methods of committing suicide, such as hanging or 'throwing themselves under a moving vehicle.' Only properly selected and consistently taken preventive actions can improve the tragic statistics related to ethanol stimulating risky and auto-aggressive behaviours. It is also necessary to improve the system for reporting such events because only reliable statistics enable proper assessment of the scale of the problem, and the effectiveness of these activities.

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The effect of ethyl alcohol on the severity of injuries in fatal pedestrian victims of traffic crashes

Cited by 16 publications

References 25 publications

Impacts of injury severity on long-term outcomes following motor vehicle crashes

Impacts of injury severity on long-term outcomes following motor vehicle crashes

Alcohol and Road Accidents Involving Pedestrians as Unprotected Road Users

Ethanol as a stimulus to risky and auto-aggressive behaviour

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