In the estimates for the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010), alcohol is the fifth leading risk factor for Latin America and the Caribbean (LAC) (1). Injuries constitute one-third of alcohol-attributable disability-adjusted life years (DALYs) in the LAC region (versus 42% in the Americas), and 12% of them are from intentional interpersonal violence (versus 19.5% in the Americas) (1, 2).Relative risk (RR) of injury from alcohol consumption is an important factor to consider when estimating the alcohol-attributable fraction (AAF) of injury. Risk is usually derived from 1) mortality data (rather than morbidity data) and 2) measures of chronic consumption of alcohol (rather than acute consumption) (3), with the latter measure more relevant when the research interest is the immediate effect of drinking on an event, such as injury (4). In addition, most risk estimates do not examine the dose-response relationship. Finally, risk estimates typically assume uniform risk across different alcohol consumption levels, gender and age groups, causes of injury, and countries or regions, so most research on the AAF of injury derived from RR estimates does not consider the effects of these potentially important moderating variables.
ABSTRACT
Objective. To determine the relative risk (RR) and societal burden of injury related to alcohol-attributable intentional interpersonal violence (alcohol-attributable fraction or AAF), and the dose-response relationship, in Latin America and the Caribbean (LAC), where both the RR and AAF for violence-related injuries are believed to be particularly high.
Methods. A probability sample of 1 024 emergency department patients from 10 LAC countries who reported an intentional interpersonal violence-related injury (IVRI) was analyzed using case-crossover fractional polynomial analysis of the number of drinks consumed prior to the event.
Results. A dose-response relationship with a sixfold increase in risk (