Alcohol and road traffic injuries in Latin America and the Caribbean: a case-crossover study
Author(s)
Type
Journal Article
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 and Tobago. Case-crossover analysis, pair-matching the number of standard drinks consumed within the 6 hours prior to the RTI with 2 control periods (prior d/wk), 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 to 24.1%). The likelihood of an RTI with any drinking prior (compared to not drinking) was 5 times higher (country range OR 2.50 to 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 1 to 2 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 to 5.45), passengers (OR = 8.12; 95% CI = 4.22 to 15.61), and pedestrians (OR = 6.30; 95% CI = 3.14 to 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 nondrivers alike may further help to urge 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.
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 and Tobago. Case-crossover analysis, pair-matching the number of standard drinks consumed within the 6 hours prior to the RTI with 2 control periods (prior d/wk), 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 to 24.1%). The likelihood of an RTI with any drinking prior (compared to not drinking) was 5 times higher (country range OR 2.50 to 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 1 to 2 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 to 5.45), passengers (OR = 8.12; 95% CI = 4.22 to 15.61), and pedestrians (OR = 6.30; 95% CI = 3.14 to 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 nondrivers alike may further help to urge 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.
Date Issued
2017-10
Date Acceptance
2017-07-31
Citation
Alcoholism: Clinical and Experimental Research, 2017, 41 (10), pp.1731-1737
ISSN
0145-6008
Publisher
Wiley
Start Page
1731
End Page
1737
Journal / Book Title
Alcoholism: Clinical and Experimental Research
Volume
41
Issue
10
Copyright Statement
Copyright © 2017 by the Research Society on Alcoholism
This is the peer reviewed version of the following article: Borges, G., Monteiro, M., Cherpitel, C.J., Orozco, R., Ye, Y., Poznyak, V., Peden, M., Pechansky, F., Cremonte, M., Reid, S.D. and Mendez, J. (2017), Alcohol and Road Traffic Injuries in Latin America and the Caribbean: A Case-Crossover Study. Alcohol Clin Exp Res, 41: 1731-1737., which has been published in final form at https://doi.org/10.1111/acer.13467. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.
This is the peer reviewed version of the following article: Borges, G., Monteiro, M., Cherpitel, C.J., Orozco, R., Ye, Y., Poznyak, V., Peden, M., Pechansky, F., Cremonte, M., Reid, S.D. and Mendez, J. (2017), Alcohol and Road Traffic Injuries in Latin America and the Caribbean: A Case-Crossover Study. Alcohol Clin Exp Res, 41: 1731-1737., which has been published in final form at https://doi.org/10.1111/acer.13467. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.
Identifier
https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000412107700008&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=a2bf6146997ec60c407a63945d4e92bb
Subjects
Alcohol
Case-Crossover
CONSUMPTION
DESIGN
DOSE-RESPONSE RELATIONSHIP
DRINKING
Emergency Department
EMERGENCY-DEPARTMENT DATA
Life Sciences & Biomedicine
RECALL BIAS
Risk
RISK
Road Traffic Injury
ROOM
Science & Technology
Substance Abuse
Publication Status
Published
Date Publish Online
2017-09-13