A cross cultural perspective of acute alcohol use and the risk of injury

BORGES, GUILHERME; CHERPITEL, CHERYL; MACDONALD, SCOTT; STOCKWELL, TIM; GIESBRECHT, NORMAN; CREMONTE, MARIANA; BOND, JASON; YE, YU

Simposio; Alcohol, Tabacco and other drugs Symposium from the American Public Health Asociation; 2003

Background:To determine the relative risk (RR) of non-fatal injury associated with alcoholconsumption in a series of Emergency Departments (EDs), possible effectmodifiers and the impact of contextual variables on differences across sites. Methods:Data are from the Emergency Room Collaborative Alcohol Analysis Project(ERCAAP) and the WHO Collaborative Study on Alcohol and Injuries that includedprobability samples of 11 536 injured patients attending 28 EDs studies across16 countries (1984-2002). The case-crossover method was used to obtain RRestimates of alcohol on non-fatal injuries. Meta-analysis was used to evaluatethe consistency and magnitude of RR estimates across sites, and the extent towhich contextual variables explain differences in effect sizes. Results:The majority of the sample was male (65%) and >=30 years old (53%). Drinkingwithin six hours prior to the injury was reported by 21% of the sample. Theestimated (random) pooled relative risk for patients who reported alcohol usewithin six hours prior to injury was 5.69 (95% Confidence Interval =4.04-8.00), ranging from 1.05 in WHO-Canada to 35.00 in WHO-South Africa.Effect size was not homogeneous across studies as societies with riskier consumptionpatterns had a higher relative risk for injury. Heavier drinkers showed lower RRwhen compared to patients with low levels of chronic alcohol use. Conclusions:Acute alcohol was a risk factor for non-fatal injuries in most sites and publicmeasures addressed to all population is recommended, especially in societieswith riskier consumption patterns.