Alcohol and road traffic injuries in Latin America and the Caribbean: a case-crossover study
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 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 (country range 8.6%-24.1%). The likelihood of a RTI with any drinking prior (compared to not drinking) was 5 times higher (country range OR 2.50-15.00) 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 one-two 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=2.25-5.45), passengers (OR=8.12; 95%CI=4.22-15.61) and pedestrians (OR=6.30; 95%CI=3.14-12.64) 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 non-drivers…
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