Alcohol and road traffic injuries in Latin America and the Caribbean: A case-crossover study

Journal article

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.

Authors: Borges, G; Monteiro, M; Cherpitel, C; Orozco, R; Ye, Y

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Wiley
• Journal: Alcoholism, Clinical and Experimental Research
• Volume: 41
• Issue: 10
• Pages: 1731-1737
• Publication date: 2017-09-13
• Acceptance date: 2017-07-31
• DOI: 10.1111/acer.13467
• EISSN: 1530-0277
• ISSN: 0145-6008
• Pmid: 28905388
• Language: English
• Keywords: case-crossover; accidents, traffic; risk; emergency service, hospital; risk factors; cross-over studies; case-control studies; road traffic injury; Latin America; emergency department; alcohol; alcohol drinking; Caribbean region