Alcohol and road traffic injuries in Latin America and the Caribbean: a case-crossover study
Research 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 & Tobago.
Case-crossover analysis, pair-matching the number of standard alcoholic 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.
The likelihood of a RTI with any alcohol use prior (compared to no alcohol intake) was 5 times higher and the more alcohol a person consumes the higher the risk.
Every drink (12.8 g alcohol) increased the risk of an RTI by 13%, even one-two alcoholic drinks were associated with a sizable increase in risk of an RTI and a dose-response was found.
Differences in ORs for drivers, passengers and pedestrians 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.
Summary
This is one of the largest studies ever conducted on acute alcohol use and RTI with data coming from a large sample of patients from several countries of LAC.
To summarize, 1 in every 5 injury patients in EDs in LAC presented with a RTI, and 1 in every 6 RTI patients were positive for alcohol 6 hours prior to the event.
The likelihood of an RTI after any alcohol use was 5 times higher (compared to not consuming alcohol) and the more alcohol a person consumed the higher the risk. For each alcoholic drink there was a 13% increased risk, and alcohol use prior to RTI was responsible for 14% of all RTIs, varying from 7% for females to 19% for being injured as a passenger.
Measures to prevent and reduce alcohol consumption among drivers, passengers and pedestrians involved in RTI, within the scope of global and local strategies to reduce alcohol consumption shouldn’t be postponed in LAC.