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Borges G, Orozco R, Pérez-Núñez R, Pechansky F. Substance use and type of Road Traffic Injury in Mexico City. JOURNAL OF PREVENTION (2022) 2024; 45:323-337. [PMID: 38353804 DOI: 10.1007/s10935-024-00769-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/31/2024] [Indexed: 04/02/2024]
Abstract
Limited data are available in Mexico on the prevalence of alcohol and drug use and the possible differences in their effects on types of road traffic injury (RTI), such as those involving pedestrians, drivers or passengers of motorcycles or other motor vehicles, and the association between substance use and driving behaviors, for preventive purposes. The sample comprised 433 adult RTI patients, admitted to the emergency department (ED) of a public hospital in Mexico City (January to April 2022). Breath Alcohol Concentration (BAC) was measured using a breath tester, and six types of drugs (amphetamines, barbiturates, benzodiazepines, cannabis, cocaine, and methamphetamine) were assessed using a saliva screen test. RTI patients also self-reported their alcohol and drug use in the six hours prior to the accident. Approximately 62% of respondents had been involved in a motorcycle crash. One in three patients self-reported or had traces of a substance in their saliva or breath. The most common substance was alcohol (23.6%), followed by cannabis and stimulants (10.9%). One in five patients reported having used a cell phone ten minutes before the injury. One in three had not been using any safety device, the only behavior exacerbated by substance use. We found a high prevalence of substance use in the sample of RTI patients admitted to the ED, regardless of the type of the RTI, together with high cell phone rates. Motorcycle passengers under the influence were particularly likely not to have been wearing a helmet.
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Affiliation(s)
- Guilherme Borges
- Instituto Nacional de Psiquiatría, Calzada México Xochimilco 101. Col. San Lorenzo Huipulco C.P., Tlalpan, 14370, CDMX, México.
| | - Ricardo Orozco
- Instituto Nacional de Psiquiatría, Calzada México Xochimilco 101. Col. San Lorenzo Huipulco C.P., Tlalpan, 14370, CDMX, México
| | | | - Flavio Pechansky
- Universidade Federal do Rio Grande do Sul / Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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Goel R, Tiwari G, Varghese M, Bhalla K, Agrawal G, Saini G, Jha A, John D, Saran A, White H, Mohan D. Effectiveness of road safety interventions: An evidence and gap map. CAMPBELL SYSTEMATIC REVIEWS 2024; 20:e1367. [PMID: 38188231 PMCID: PMC10765170 DOI: 10.1002/cl2.1367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
Background Road Traffic injuries (RTI) are among the top ten leading causes of death in the world resulting in 1.35 million deaths every year, about 93% of which occur in low- and middle-income countries (LMICs). Despite several global resolutions to reduce traffic injuries, they have continued to grow in many countries. Many high-income countries have successfully reduced RTI by using a public health approach and implementing evidence-based interventions. As many LMICs develop their highway infrastructure, adopting a similar scientific approach towards road safety is crucial. The evidence also needs to be evaluated to assess external validity because measures that have worked in high-income countries may not translate equally well to other contexts. An evidence gap map for RTI is the first step towards understanding what evidence is available, from where, and the key gaps in knowledge. Objectives The objective of this evidence gap map (EGM) is to identify existing evidence from all effectiveness studies and systematic reviews related to road safety interventions. In addition, the EGM identifies gaps in evidence where new primary studies and systematic reviews could add value. This will help direct future research and discussions based on systematic evidence towards the approaches and interventions which are most effective in the road safety sector. This could enable the generation of evidence for informing policy at global, regional or national levels. Search Methods The EGM includes systematic reviews and impact evaluations assessing the effect of interventions for RTI reported in academic databases, organization websites, and grey literature sources. The studies were searched up to December 2019. Selection Criteria The interventions were divided into five broad categories: (a) human factors (e.g., enforcement or road user education), (b) road design, infrastructure and traffic control, (c) legal and institutional framework, (d) post-crash pre-hospital care, and (e) vehicle factors (except car design for occupant protection) and protective devices. Included studies reported two primary outcomes: fatal crashes and non-fatal injury crashes; and four intermediate outcomes: change in use of seat belts, change in use of helmets, change in speed, and change in alcohol/drug use. Studies were excluded if they did not report injury or fatality as one of the outcomes. Data Collection and Analysis The EGM is presented in the form of a matrix with two primary dimensions: interventions (rows) and outcomes (columns). Additional dimensions are country income groups, region, quality level for systematic reviews, type of study design used (e.g., case-control), type of road user studied (e.g., pedestrian, cyclists), age groups, and road type. The EGM is available online where the matrix of interventions and outcomes can be filtered by one or more dimensions. The webpage includes a bibliography of the selected studies and titles and abstracts available for preview. Quality appraisal for systematic reviews was conducted using a critical appraisal tool for systematic reviews, AMSTAR 2. Main Results The EGM identified 1859 studies of which 322 were systematic reviews, 7 were protocol studies and 1530 were impact evaluations. Some studies included more than one intervention, outcome, study method, or study region. The studies were distributed among intervention categories as: human factors (n = 771), road design, infrastructure and traffic control (n = 661), legal and institutional framework (n = 424), post-crash pre-hospital care (n = 118) and vehicle factors and protective devices (n = 111). Fatal crashes as outcomes were reported in 1414 records and non-fatal injury crashes in 1252 records. Among the four intermediate outcomes, speed was most commonly reported (n = 298) followed by alcohol (n = 206), use of seatbelts (n = 167), and use of helmets (n = 66). Ninety-six percent of the studies were reported from high-income countries (HIC), 4.5% from upper-middle-income countries, and only 1.4% from lower-middle and low-income countries. There were 25 systematic reviews of high quality, 4 of moderate quality, and 293 of low quality. Authors' Conclusions The EGM shows that the distribution of available road safety evidence is skewed across the world. A vast majority of the literature is from HICs. In contrast, only a small fraction of the literature reports on the many LMICs that are fast expanding their road infrastructure, experiencing rapid changes in traffic patterns, and witnessing growth in road injuries. This bias in literature explains why many interventions that are of high importance in the context of LMICs remain poorly studied. Besides, many interventions that have been tested only in HICs may not work equally effectively in LMICs. Another important finding was that a large majority of systematic reviews are of low quality. The scarcity of evidence on many important interventions and lack of good quality evidence-synthesis have significant implications for future road safety research and practice in LMICs. The EGM presented here will help identify priority areas for researchers, while directing practitioners and policy makers towards proven interventions.
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Affiliation(s)
- Rahul Goel
- Transportation Research and Injury Prevention CentreIndian Institute of Technology DelhiNew DelhiIndia
| | - Geetam Tiwari
- Transportation Research and Injury Prevention CentreIndian Institute of Technology DelhiNew DelhiIndia
| | | | - Kavi Bhalla
- Department of Public Health SciencesUniversity of ChicagoChicagoIllinoisUSA
| | - Girish Agrawal
- Transportation Research and Injury Prevention CentreIndian Institute of Technology DelhiNew DelhiIndia
| | | | - Abhaya Jha
- Transportation Research and Injury Prevention CentreIndian Institute of Technology DelhiNew DelhiIndia
| | - Denny John
- Faculty of Life and Allied Health SciencesM S Ramaiah University of Applied Sciences, BangaloreKarnatakaIndia
| | | | | | - Dinesh Mohan
- Transportation Research and Injury Prevention CentreIndian Institute of Technology DelhiNew DelhiIndia
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Daldegan-Bueno D, Lindner SR, Kovaleski D, Fischer B. Cannabis use, risk behaviours and harms in Brazil: A comprehensive review of available data indicators. Drug Alcohol Rev 2023; 42:318-336. [PMID: 36443987 DOI: 10.1111/dar.13571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 10/19/2022] [Accepted: 10/22/2022] [Indexed: 12/02/2022]
Abstract
ISSUES Cannabis use and related health/social outcome indicator data for Brazil-where non-medical cannabis is generally illegal-are limited. APPROACH Towards a comprehensive overview of relevant indicators, we searched primary databases by combining MeSH-index terms related to cannabis, geographic location and subtopic terms (e.g., use, health, mortality) focusing on cannabis use and key outcome indicators in Brazil since 2010. In addition, relevant 'grey literature' (e.g., survey reports) was identified. Key indicator data were mainly narratively summarised. KEY FINDINGS Overall, cannabis use has increased somewhat since pre-2010, with (past-year) use rates measured at 2-3% for general population adults, yet 5% or higher among youth and/or (e.g., post-secondary) student populations. For key risk behaviours, the presence of tetrahydrocannabinol-positivity among motor-vehicle drivers has been measured at <2%. While the prevalence of cannabis use disorder appears to have decreased, the relative proportion of treatment provided for cannabis-related problems increased. National- and local-based studies indicated an association of cannabis use with mental health harms, including depression and suicidality. Although some non-representative and/or local studies contain information, other monitoring data, including cannabis-related risks and harms (e.g., cannabis-related driving, mortality, hospitalisations), are limited in availability. IMPLICATIONS AND CONCLUSION The prevalence of cannabis use in Brazil is comparably low (e.g., relative to elsewhere in the Americas). Data on numerous key cannabis-related indicators is absent, or limited in scope for Brazil. Considering ongoing evolutions in cannabis control and its status as the most common illicit drug, more comprehensive surveillance of cannabis use and related outcomes is advised.
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Affiliation(s)
- Dimitri Daldegan-Bueno
- Centre for Applied Research in Mental Health and Addiction, Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada
| | - Sheila R Lindner
- Department of Public Health, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Douglas Kovaleski
- Department of Public Health, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Benedikt Fischer
- Centre for Applied Research in Mental Health and Addiction, Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
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Alcohol, drugs, and road traffic injuries in an emergency department in Mexico City. Injury 2023; 54:481-489. [PMID: 36588032 DOI: 10.1016/j.injury.2022.12.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 12/15/2022] [Accepted: 12/18/2022] [Indexed: 12/24/2022]
Abstract
There have been no studies reporting on the use of biological specimens in Mexico to analyze the prevalence of alcohol and drug use among Emergency Department (ED) patients with a road traffic injury (RTI). We report here on a sample of 304 adult patients, admitted to the ED of a public hospital in Mexico City from January to April 2022, after being involved in an RTI. Patients gave informed consent for a breath test measuring breath alcohol concentration (BAC) and a saliva screening test for six classes of drugs (amphetamines, barbiturates, benzodiazepines, cannabis, cocaine, and methamphetamine). We found that at least one in every four patients (27.6%) had traces of alcohol or drugs in their body upon arrival in the ED. The breath test found a positive BAC in 16.1% of the sample; the most common substances detected in saliva were amphetamines or methamphetamine (8.6%), followed by cocaine (7.0%) and cannabis (6.9%). Only a few variables differentiated those with positive BAC from those with negative BAC (male, arriving on a weekend day or night, and arriving by ambulance), and even fewer variables differentiated those testing positives for drugs than those testing negative (less than 13 years of education and drivers of cars, bicycles, or other vehicles). While alcohol continues to be the single most used substance, our findings indicate that stimulants are of great concern. Since those testing positives for alcohol or drugs are so similar in their demographic pattern to those testing negative, the introduction of biological testing as a routine practice in the ED is highly recommended. Routine testing makes it possible to provide the patient with the best treatment and is also the best way to assess substance use.
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Bombana HS, Bogstrand ST, Gjerde H, Jamt REG, Carvalho HBD, Andreuccetti G, Bernini CDO, Muñoz DR, Leyton V, Greve JMD. Use of alcohol and illicit drugs by trauma patients in Sao Paulo, Brazil. Injury 2022; 53:30-36. [PMID: 34749908 DOI: 10.1016/j.injury.2021.10.032] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 10/07/2021] [Accepted: 10/28/2021] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Alcohol and illicit drugs impair cognitive and psychomotor skills and may thereby increase the risk of involvement in a road traffic crash and other types of injuries. However, the knowledge on the use of psychoactive substances among injured patients presenting to emergency departments in low and middle-income countries remains limited. AIMS To estimate the prevalence of alcohol and illicit drug use among patients with traumatic injuries admitted to an emergency department in Sao Paulo, Brazil. METHODS Blood samples from injured patients requiring hospitalization for more than 24 h due to road traffic crashes, falls, or violence, were collected from July 2018 to June 2019. The samples were analyzed for alcohol and illicit drugs. RESULTS A total of 376 patients were included in this study; the median age was 36 years and 80% of patients were male. The majority (56%) of injuries resulted from road traffic crashes, with approximately half of them being motorcyclists. Alcohol, drugs, or both were detected in 32% of samples. The proportion that tested positive was highest for males (35%), for the age group 18-39 years (41%), for singles (43%), and for patients injured at nighttime (44%). Patients injured due to violence had the highest prevalence of alcohol or drugs in their blood samples (44%). Alcohol was most prevalent (23%), followed by cocaine (12%) and cannabis (5%). CONCLUSION The use of alcohol and illicit drugs was common among injured patients in Sao Paulo; it was likely a contributing factor in a third of the injurious accidents. Alcohol was the most prevalent substance followed by cocaine and cannabis.
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Affiliation(s)
- Henrique Silva Bombana
- Department of Legal Medicine, University of Sao Paulo Medical School, Av. Dr. Arnaldo, 455 - Cerqueira César, São Paulo SP 01246-903, Brazil.
| | - Stig Tore Bogstrand
- Department of Forensic Sciences, Oslo University Hospital, Oslo, P.O. Box 4950 Nydalen, NO-0424, Norway
| | - Hallvard Gjerde
- Department of Forensic Sciences, Oslo University Hospital, Oslo, P.O. Box 4950 Nydalen, NO-0424, Norway
| | - Ragnhild Elén Gjulem Jamt
- Department of Forensic Sciences, Oslo University Hospital, Oslo, P.O. Box 4950 Nydalen, NO-0424, Norway
| | - Heráclito Barbosa de Carvalho
- Department of Preventive Medicine, University of Sao Paulo Medical School, Av. Dr. Arnaldo, 455 - Cerqueira César, São Paulo SP 01246-903, Brazil
| | - Gabriel Andreuccetti
- Department of Legal Medicine, University of Sao Paulo Medical School, Av. Dr. Arnaldo, 455 - Cerqueira César, São Paulo SP 01246-903, Brazil
| | - Celso de Oliveira Bernini
- Department of Surgery, Clinical Hospital of the University of Sao Paulo Medical School, Av. Dr. Enéas Carvalho de Aguiar, 255 - Cerqueira César, São Paulo SP 05403-000, Brazil
| | - Daniel Romero Muñoz
- Department of Legal Medicine, University of Sao Paulo Medical School, Av. Dr. Arnaldo, 455 - Cerqueira César, São Paulo SP 01246-903, Brazil
| | - Vilma Leyton
- Department of Legal Medicine, University of Sao Paulo Medical School, Av. Dr. Arnaldo, 455 - Cerqueira César, São Paulo SP 01246-903, Brazil
| | - Julia Maria D'Andréa Greve
- Department of Traumatology and Orthopedics, Clinical Hospital of the University of Sao Paulo Medical School, R. Dr. Ovídio Pires de Campos, 333 - Cerqueira César, São Paulo SP 05403-010, Brazil
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Chen S, Shao H, Ji X. Insights into Factors Affecting Traffic Accident Severity of Novice and Experienced Drivers: A Machine Learning Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312725. [PMID: 34886451 PMCID: PMC8656871 DOI: 10.3390/ijerph182312725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/24/2021] [Accepted: 11/30/2021] [Indexed: 11/16/2022]
Abstract
Traffic accidents have significant financial and social impacts. Reducing the losses caused by traffic accidents has always been one of the most important issues. This paper presents an effort to investigate the factors affecting the accident severity of drivers with different driving experience. Special focus was placed on the combined effect of driving experience and age. Based on our dataset (traffic accidents that occurred between 2005 and 2021 in Shaanxi, China), CatBoost model was applied to deal with categorical feature, and SHAP (Shapley Additive exPlanations) model was used to interpret the output. Results show that accident cause, age, visibility, light condition, season, road alignment, and terrain are the key factors affecting accident severity for both novice and experienced drivers. Age has the opposite impact on fatal accident for novice and experienced drivers. Novice drivers younger than 30 or older than 55 are prone to suffer fatal accident, but for experienced drivers, the risk of fatal accident decreases when they are young and increases when they are old. These findings fill the research gap of the combined effect of driving experience and age on accident severity. Meanwhile, it can provide useful insights for practitioners to improve traffic safety for novice and experienced drivers.
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Gioldasis C, Christoforou Z, Seidowsky R. Risk-taking behaviors of e-scooter users: A survey in Paris. ACCIDENT; ANALYSIS AND PREVENTION 2021; 163:106427. [PMID: 34628268 DOI: 10.1016/j.aap.2021.106427] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 07/23/2021] [Accepted: 09/24/2021] [Indexed: 06/13/2023]
Abstract
Risk-taking behavior is often held responsible for increased crash involvement. We designed and undertook a face-to-face road survey (N = 459) in order to explore incident involvement history, driving attitudes and perceived risk among e-scooter users is Paris, France. Three risk factors were specifically explored: (i) riding after having consumed alcohol, (ii) riding after having consumed drugs, and (iii) using the smartphone while riding. The relationship between these factors and user attributes (such as age and gender) and travel behavior (such as frequency of e-scooter usage and trip duration) was examined using logit and mixed logit specifications and a structural equation model. Empirical evidence suggests that it is more likely for young and male riders to develop risky behaviors. Longer trip durations seem to be associated with risk-taking behaviors.
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Affiliation(s)
- Christos Gioldasis
- COSYS-GRETTIA, Univ Gustave Eiffel, IFSTTAR, F-77447 Marne-la-Vallée, France; University of Patras, Department of Civil Engineering, Panepistimioupoli Patron 265 04, Patras, Greece.
| | - Zoi Christoforou
- COSYS-GRETTIA, Univ Gustave Eiffel, IFSTTAR, F-77447 Marne-la-Vallée, France; University of Patras, Department of Civil Engineering, Panepistimioupoli Patron 265 04, Patras, Greece
| | - Régine Seidowsky
- COSYS-GRETTIA, Univ Gustave Eiffel, IFSTTAR, F-77447 Marne-la-Vallée, France
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Lasota D, Al-Wathinani A, Krajewski P, Goniewicz K, Pawłowski W. Alcohol and Road Accidents Involving Pedestrians as Unprotected Road Users. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8995. [PMID: 33276696 PMCID: PMC7729452 DOI: 10.3390/ijerph17238995] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/29/2020] [Accepted: 12/01/2020] [Indexed: 11/16/2022]
Abstract
According to the World Health Organization (WHO), more than half of all road fatalities involve vulnerable road users, i.e., pedestrians, cyclists, and motorcyclists. Poland is classified as one of the European Union (EU) countries marked by low road safety, with a higher frequency of accidents involving pedestrians compared to other EU countries (31% of all fatalities). Among unprotected road users, a significant group of victims are pedestrians, who are often under the influence of alcohol. This study aims to analyze the impact of alcohol on the risk of occurrence and consequences of road accidents among pedestrians. The source of data was the medical documentation of the Department of Forensic Medicine of the Medical University of Warsaw. In more than half of pedestrian deaths, the presence of alcohol was found; regardless of the place of the event and the place of death, among the victims under the influence of alcohol, males dominated; the average age of the victims under the influence of alcohol was significantly lower compared to the average age of sober victims, with younger victims being significantly more likely to die at the scene of the accident, especially in rural areas; significantly higher alcohol concentrations were found in males, in victims who died at the scene of the accident, and with victims of accidents in rural areas. Among pedestrian traffic accident fatalities, the most numerous group comprised young men under the influence of alcohol. In rural areas, a higher percentage of pedestrian victims died at the scene as a result of excessive alcohol consumption. These areas should be subject to intensive preventive measures to increase the safety of pedestrians as unprotected road users.
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Affiliation(s)
- Dorota Lasota
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, 02-097 Warsaw, Poland;
| | - Ahmed Al-Wathinani
- Department of Emergency Medical Services, Prince Sultan Bin Abdulaziz College for Emergency Medical Services, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Paweł Krajewski
- Department of Forensic Medicine, Medical University of Warsaw, 00-001 Warsaw, Poland;
| | - Krzysztof Goniewicz
- Department of Aviation Security, Military University of Aviation, 08-521 Dęblin, Poland;
| | - Witold Pawłowski
- Department of Emergency Medicine, Medical University of Lublin, 20-081 Lublin, Poland
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Benlagha N, Charfeddine L. Risk factors of road accident severity and the development of a new system for prevention: New insights from China. ACCIDENT; ANALYSIS AND PREVENTION 2020; 136:105411. [PMID: 31911400 DOI: 10.1016/j.aap.2019.105411] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 10/11/2019] [Accepted: 12/21/2019] [Indexed: 06/10/2023]
Abstract
Road accident fatalities and accident severity costs have become top priorities and concerns for Chinese policymakers. Understanding the principal factors that explain accident severity is considered to be the first step towards the adequate design of an accident prevention strategy. In this paper, we examine the contribution of various types of factors (vehicle, driver and others) in explaining accident severity in China. Unlike previous studies, the analysis gives a particular focus on fatal accidents. Using a large sample of 405,177 observations for 4-wheeled vehicles in the year 2017 and various statistical and econometrics approaches (e.g., OLS, quantile regression and extreme value theory), the results show that the factors explaining the severity of accidents differs significantly between normal and extreme severity accidents, e.g. across quantiles. Interestingly, we find that the gender factor is only significant for fatal accidents. In particular, the analysis shows that male drivers have an increased likelihood of extreme risk taking. On the basis of these empirical findings, a new ratemaking approach that aims to improve road safety and prevention is discussed and proposed.
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Affiliation(s)
- Noureddine Benlagha
- Department of Finance and Economics, College of Business and Economics, Qatar University. P.O.X 2713, Doha, Qatar.
| | - Lanouar Charfeddine
- Department of Finance and Economics, College of Business and Economics, Qatar University. P.O.X 2713, Doha, Qatar.
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Thomas M, Williams T, Jones J. The epidemiology of pedestrian fatalities and substance use in Georgia, United States, 2007-2016. ACCIDENT; ANALYSIS AND PREVENTION 2020; 134:105329. [PMID: 31704642 DOI: 10.1016/j.aap.2019.105329] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 06/30/2019] [Accepted: 10/15/2019] [Indexed: 06/10/2023]
Abstract
Though U.S. motor vehicle crashes as a whole have decreased over the past few years, fatalities among vulnerable road users have increased. Pedestrian deaths rose nationally by 27% between 2007 and 2016 accounting for 16% of all motor vehicle fatalities. This increase continues to burden transportation specialists, public health professionals, and community stakeholders. Potential risk factors include characteristics of the built environment, distractions, and pedestrians' use of alcohol and drugs. Pedestrian deaths in Georgia, United States, increased 40% between 2014 and 2016 while drug overdose deaths have increased by 18% during the same period. Concurrent increases in mortality due to pedestrian fatalities and drug overdoses make Georgia a natural environment in which to describe the proximity of drugs among pedestrian fatalities, a topic largely overlooked by the literature. This study explores the epidemiology of pedestrian fatalities in Georgia over a 10-year period with an emphasis on reported substance use among cases. The study employed 10-year data from the Fatality Analysis Reporting System (FARS) administered by the National Highway Traffic Safety Administration. Descriptive methods were used to explore drug screens by person, place, and time. We also examined trends in total drug screens over the examination period. Between 2007 and 2016, 1781 pedestrian crashes were reported to FARS; the fatality rate for this period was 94.5%. Of these, most were male with Blacks and Whites equally represented. Ages 15-64 accounted for 81.1% of cases with most occurring in the Atlanta Metropolitan area. When adjusted for population, one finds higher rates in more rural areas of the state. Data revealed that testing for the presence of drugs occurred among half of reported cases. Of those testing positive, five drug categories emerged; stimulants (45.8%), cannabinoids (21.5%), narcotics (including opioids) (14.1%), depressants (12.1%), and "Other Drugs" (6.3%). Positive drug screens across all drug classifications increased by 178.1% between 2007 and 2016. These findings suggest the need for state-wide policies designed to promote more consistent screening among pedestrians involved in motor vehicle crashes as well as diligence in understanding the role played by drugs among this population. Additional investigation should be conducted to tease out the presence of category-specific drugs among pedestrians. Understanding the epidemiology of pedestrian fatalities in the state, especially in relation to substance use, serves as a first step toward implementing localized preventive efforts.
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Affiliation(s)
- McKinley Thomas
- Department of Health Sciences and Kinesiology, Waters College of Health Professions, Georgia Southern University, 11935 Abercorn St., Savannah, GA, 31419, United States.
| | - TimMarie Williams
- Department of Health Sciences and Kinesiology, Waters College of Health Professions, Georgia Southern University, 11935 Abercorn St., Savannah, GA, 31419, United States.
| | - Jeffery Jones
- Department of Health Policy and Community Health, Jiann-Ping Hsu College of Public Health, Georgia Southern University, PO Box 8015, Statesboro, GA, 30460, United States.
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Thomas M, Riemann B, Jones J. Epidemiology of alcohol and drug screening among pedestrian fatalities in the United States, 2014-2016. TRAFFIC INJURY PREVENTION 2019; 20:557-562. [PMID: 31225741 DOI: 10.1080/15389588.2019.1622006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 05/16/2019] [Accepted: 05/17/2019] [Indexed: 06/09/2023]
Abstract
Objective: U.S. pedestrian fatalities increased by 25% between 2010 and 2015. Risk factors include distractions, the built environment, urbanization, economic variables, and weather conditions. Of interest is the role of alcohol and drugs in premature death among pedestrians. This study sought to explore the prevalence of substance use screenings among pedestrian fatalities in the United States between 2014 and 2016. Methods: Data were collected from the Fatality Analysis Reporting System provided by the NHTSA. Pedestrian crash variables included demographics as well as information regarding alcohol or drug testing status. Frequency and cross-tabulation tables were constructed to assess the prevalence of screening by person, place, and time. Log-linear analyses were completed to explore age, race, and sex differences. A 3-year examination period was used to control for yearly fluctuations and to incorporate an increasing trend in cases. Results: Pedestrian fatalities accounted for 84% of all deaths among vulnerable road users during the examination period. Those most at risk were white males between the ages of 45 and 64. Over all states, 74.7% of fatalities were tested for alcohol and 67.1% were tested for drugs; further, 66.5% of cases were tested for both alcohol and drugs and 24.8% were tested for neither substance. Cases screened for both alcohol and drugs ranged from 2.9% in North Carolina to 95.7% in Nevada and those testing for neither substance ranged from a high of 68.9% in Indiana to a low of 1.1% in Maryland. Log-linear regression revealed significant differences in alcohol screening by age and race but not by sex. Differences in drug screening were not identified for any demographic variable. Fatalities tested for alcohol were significantly more likely to be tested for drugs; only 8.2% were screened solely for alcohol and 0.05% were screened for drugs alone. Conclusions: Preventive strategies become more important as pedestrian crashes and fatalities increase. Risk reduction in the form of policy change, alterations to the built environment, or interdisciplinary approaches to injury prevention is dependent upon best evidence supported in part by more deliberate and consistent screening.
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Affiliation(s)
- McKinley Thomas
- a Department of Health Sciences and Kinesiology, Waters College of Health Professions, Georgia Southern University , Savannah , Georgia
| | - Bryan Riemann
- a Department of Health Sciences and Kinesiology, Waters College of Health Professions, Georgia Southern University , Savannah , Georgia
| | - Jeffery Jones
- b Department of Health Policy and Community Health, Jiann-Ping Hsu College of Public Health, Georgia Southern University , Statesboro , Georgia
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Pan M, Wang X, Zhao Y, Liu W, Xiang P. A retrospective analysis of data from forensic toxicology at the Academy of Forensic Science in 2017. Forensic Sci Int 2019; 298:39-47. [DOI: 10.1016/j.forsciint.2019.02.039] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 02/18/2019] [Accepted: 02/23/2019] [Indexed: 12/28/2022]
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Pawłowski W, Lasota D, Goniewicz M, Rzońca P, Goniewicz K, Krajewski P. The Effect of Ethyl Alcohol upon Pedestrian Trauma Sustained in Traffic Crashes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16081471. [PMID: 31027255 PMCID: PMC6517985 DOI: 10.3390/ijerph16081471] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 03/28/2019] [Accepted: 04/23/2019] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Every year more than 1.2 million people worldwide die due to trauma sustained in road crashes, with an additional number of people injured exceeding 50 million. To a large extent, this applies to so called "unprotected road users", including pedestrians. The risk involved in a traffic crash for pedestrians can result from many factors, one of which is participation in road traffic when under the influence of alcohol. The aim of this study was to analyze the impact of alcohol use among pedestrians as unprotected road traffic participants, and the consequences of them being struck by motor vehicles. MATERIAL AND METHODS The source of data was the medical documentation of the Department of Forensic Medicine at the Medical University of Warsaw. The sample for this research consisted of 313 pedestrians who were victims of fatal road crashes resulting from a collision with a mechanical vehicle. The obtained results were subjected to statistical analysis using the STATISTICA version 12.5 program (StatSoft Polska, Cracow, Poland). RESULTS Male fatalities constituted the majority of the study sample. Nearly half of the fatal pedestrian victims were found to be under the influence of alcohol. The statistical analysis demonstrated a significant relationship between the gender and age of the victims, as well as between the place of the event, the place of death, the mechanism of the event, and the presence of alcohol in pedestrians. CONCLUSIONS Among pedestrians, victims of road crashes who were under the influence of alcohol were predominantly drunk young males. Victims under the influence of alcohol were more likely to become fatalities in crashes where the mechanism of the incident was being struck by a passenger car, and when the place of the incident was a rural area, in these cases the rates of death directly at the scene were much more frequent. The eradication of alcohol consumption by all road users should be the overriding objective of all measures aimed at reducing the number of road crashes.
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Affiliation(s)
- Witold Pawłowski
- Department of Disaster Medicine, Medical University of Warsaw, 02-091 Warszawa, Poland.
| | - Dorota Lasota
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, 02-091 Warszawa, Poland.
| | - Mariusz Goniewicz
- Department of Emergency Medicine, Medical University of Lublin, 20-059 Lublin, Poland.
| | - Patryk Rzońca
- Department of Emergency Medicine, Medical University of Lublin, 20-059 Lublin, Poland.
| | - Krzysztof Goniewicz
- Department of Security Studies, Polish Air Force Academy, 08-521 Dęblin, Poland.
| | - Paweł Krajewski
- Department of Forensic Medicine, Medical University of Warsaw, 02-091 Warszawa, Poland.
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Jacob L, Pizzol D, Veronese N, Stubbs B, Koyanagi A. Physical injury and depression in six low- and middle-income countries: A nationally representative study. J Affect Disord 2019; 248:99-107. [PMID: 30721800 DOI: 10.1016/j.jad.2019.01.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 01/14/2019] [Accepted: 01/19/2019] [Indexed: 01/05/2023]
Abstract
BACKGROUND Studies on the association between physical injury and depression in low- and middle-income countries (LMICs) are scarce. Therefore, our goal was to analyze the association between physical injury and depression using nationally representative data from six LMICs. METHODS Cross-sectional data from the Study on Global Ageing and Adult Health (SAGE) survey (2007-2010) were analyzed (N = 42,489). Questions based on the World Mental Health Survey version of the Composite International Diagnostic Interview were used for the endorsement of past 12-month DSM-IV depression. Any injury in our analysis referred to having experienced traffic injury or other injury in the past 12 months. Multivariable logistic regression analysis and meta-analyses were used to assess associations. RESULTS Overall, the prevalence of depression was higher among those who had any injury compared to those without injuries (9.0% vs. 3.7%). Compared to having no injury, any injury without disability was associated with a 1.72 (95%CI=1.18-2.50) times higher odds for depression, while the odds for injury with disability was much higher (OR =3.81; 95%CI=2.16-6.73). The pooled estimate (OR) for the association between any injury and depression based on a meta-analysis using country-wise estimates was 3.28 (95%CI = 1.71-6.31) and a moderate level of between-country heterogeneity was observed (I2 = 63.1%). LIMITATIONS Causality or temporal associations cannot be established due to the cross-sectional nature of the study. CONCLUSIONS Personalized mental health care to victims of physical injury may reduce risk for depression. Treating disability as the result of injuries may also be effective in the prevention of depressive disorders.
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Affiliation(s)
- Louis Jacob
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, 2 avenue de la Source de la Bièvre, Montigny-le-Bretonneux 78180, France.
| | - Damiano Pizzol
- Operational Research Unit, Doctors with Africa, Mozambique
| | - Nicola Veronese
- Aging Branch National Research Council, Neuroscience Institute, Padova, Italy
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, United Kingdom
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, Madrid 28029, Spain
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Carfora A, Campobasso CP, Cassandro P, Petrella R, Borriello R. Alcohol and drugs use among drivers injured in road accidents in Campania (Italy): A 8-years retrospective analysis. Forensic Sci Int 2018; 288:291-296. [DOI: 10.1016/j.forsciint.2018.05.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 03/30/2018] [Accepted: 05/02/2018] [Indexed: 11/16/2022]
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Miller TR, Levy DT, Swedler DI. Lives saved by laws and regulations that resulted from the Bloomberg road safety program. ACCIDENT; ANALYSIS AND PREVENTION 2018; 113:131-136. [PMID: 29407660 DOI: 10.1016/j.aap.2018.01.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 10/26/2017] [Accepted: 01/11/2018] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To estimate lives saved during 2008-2023 by traffic safety laws passed in six developing countries while participating in the Bloomberg Road Safety Program (BRSP). METHODS BRSP-funded local staff identified relevant laws and described enforcement to the study team. We analyzed road crash death estimates for 2004-2013 from the Global Burden of Disease and projected estimates absent intervention forward to 2023. We amalgamated developing country and US literature to estimate crash death reductions by country resulting from laws governing drink driving, motorcycle helmets, safety belt use, and traffic fines. RESULTS BRSP helped win approval of traffic safety laws in Brazil, China, Kenya, Mexico, Turkey, and Vietnam. In 2008-2013, those laws saved an estimated 19,000 lives. Many laws only took effect in 2014. The laws will save an estimated 90,000 lives in 2014-2023. Of the 109,000 lives saved, drink driving laws will account for 84%, increased motorcyclist protection for 13%, increased fines and penalty points for 2%, and safety belt usage mandates for 1%. Drink driving reductions in China will account for 56% of the savings and reduced drink driving and motorcycling deaths in Vietnam for 35%. The savings in China will result from a narrow intervention with just 4% estimated effectiveness against drink driving deaths. As a percentage of deaths anticipated without BRSP effort, the largest reductions will be 11% in Vietnam and 5% in Kenya. CONCLUSIONS Viewed as a public health measure, improving traffic safety provided large health gains in developing nations.
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Affiliation(s)
- Ted R Miller
- Pacific Institute for Research and Evaluation, Calverton, MD, USA; Curtin University School of Public Health, Perth, Australia.
| | | | - David I Swedler
- Pacific Institute for Research and Evaluation, Calverton, MD, USA
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Hostiuc S, Moldoveanu A, Negoi I, Drima E. The Association of Unfavorable Traffic Events and Cannabis Usage: A Meta-Analysis. Front Pharmacol 2018; 9:99. [PMID: 29487531 PMCID: PMC5816577 DOI: 10.3389/fphar.2018.00099] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 01/29/2018] [Indexed: 01/07/2023] Open
Abstract
Background: In the last years were published many epidemiological articles aiming to link driving under the influence of cannabis (DUIC) with the risk of various unfavorable traffic events (UTEs), with sometimes contradictory results. Aim: The primary objective of this study was to analyze whether there is a significant association between DUIC and UTEs. Materials and Methods: We used two meta-analytical methods to assess the statistical significance of the effect size: random-effects model and inverse variance heterogeneity model. Results: Twenty-four studies were included in the meta-analysis. We obtained significant increases in the effect size for DUIC tested through blood analysis, with an odds ratio (OR) of 1.97 and a confidence interval (CI) between 1.35 and 2.87; death as an outcome, with an OR of 1.56 and a CI between 1.16 and 2.09; and case–control as the type of study, with an OR of 1.99 and a CI between 1.05 and 3.80. Publication bias was very high. Conclusion: Our analysis suggests that the overall effect size for DUIC on UTEs is not statistically significant, but there are significant differences obtained through subgroup analysis. This result might be caused by either methodological flaws (which are often encountered in articles on this topic), the indiscriminate employment of the term “cannabis use,” or an actual absence of an adverse effect. When a driver is found, in traffic, with a positive reaction suggesting cannabis use, the result should be corroborated by either objective data regarding marijuana usage (like blood analyses, with clear cut-off values), or a clinical assessment of the impairment, before establishing his/her fitness to drive.
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Affiliation(s)
- Sorin Hostiuc
- Department of Legal Medicine and Bioethics, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Alin Moldoveanu
- Faculty of Automatic Control and Computers, Polytechnic University of Bucharest, Bucharest, Romania
| | - Ionuţ Negoi
- Department of Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Eduard Drima
- Clinical-Medical Department, Faculty of Medicine and Pharmacy, University Dunǎrea de Jos, Galaţi, Romania.,Galai Psychiatry Hospital, Galaţi, Romania
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Volpe FM, Ladeira RM, Fantoni R. Evaluating the Brazilian zero tolerance drinking and driving law: Time series analyses of traffic-related mortality in three major cities. TRAFFIC INJURY PREVENTION 2017; 18:337-343. [PMID: 27588457 DOI: 10.1080/15389588.2016.1214869] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 07/15/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE A zero tolerance alcohol restriction law was adopted in Brazil in 2008. In order to assess the effectiveness of this intervention, the present study compares specific mortality in 2 time series: 1980-2007 and 2008-2013. METHODS Data on mortality and population were gathered from official Brazilian Ministry of Health information systems. Segmented regression analyses were carried out separately for 3 major Brazilian capitals: Belo Horizonte, Rio de Janeiro, and São Paulo. RESULTS In 2 cities (Belo Horizonte and Rio de Janeiro) there were no significant changes in mortality rate trends in 2 periods, 1980 to 2007 and 2008 to 2013, where the observed rates did not differ significantly from predicted rates. In São Paulo, a decreasing trend until 2007 unexpectedly assumed higher levels after implementation of the law. CONCLUSION There is no evidence of reduced traffic-related mortality in the 3 major Brazilian capitals 5.5 years after the zero tolerance drinking and driving law was adopted.
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Affiliation(s)
- Fernando Madalena Volpe
- a Hospital Foundation of Minas Gerais , Belo Horizonte , Brazil
- b Health Promotion & Violence Prevention Postgraduate Program, Federal University of Minas Gerais , Belo Horizonte , Brazil
| | | | - Rosely Fantoni
- b Health Promotion & Violence Prevention Postgraduate Program, Federal University of Minas Gerais , Belo Horizonte , Brazil
- c Road and Traffic Department of Minas Gerais , Belo Horizonte , Brazil
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de Carvalho HB, Andreuccetti G, Rezende MR, Bernini C, Silva JS, Leyton V, D'Andréa Greve JM. Alcohol and drug involvement in motorcycle driver injuries in the city of Sao Paulo, Brazil: Analysis of crash culpability and other associated factors. Drug Alcohol Depend 2016; 162:199-205. [PMID: 27036936 DOI: 10.1016/j.drugalcdep.2016.03.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 03/09/2016] [Accepted: 03/10/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND Earlier studies have already identified that a greater proportion of injured drivers are under the effects of illicit drugs than alcohol in Brazil, but the crash risk attributable to each substance is still unknown. METHODS Injured motorcycle drivers who were involved in traffic accidents in the West Zone of the city of Sao Paulo were recruited for a cross-sectional study based on crash culpability analysis. Alcohol and drug positivity among drivers was evaluated according to their responsibility for the crash. Culpability ratios were generated based on the proportion of drivers who were deemed culpable in relation to those considered not culpable according to the use of drugs and alcohol. RESULTS Of the 273 drivers recruited, 10.6% tested positive for alcohol. Among those who were also tested for drugs (n=232), 20.3% had consumed either alcohol and/or other drugs, 15.5% of whom were positive only for drugs other than alcohol, specifically cannabis and cocaine. Drivers who tested positive for alcohol were significantly less likely to possess a valid driver's license and to report driving professionally, whereas those who had consumed only drugs were more likely to drive professionally. The culpability ratio estimated for alcohol-positive drivers was three times higher than that for alcohol-free drivers, showing a superior ratio than drivers who had consumed only drugs other than alcohol, who presented a 1.7 times higher culpability ratio than drug-free drivers. CONCLUSION Substance use was overrepresented among culpable motorcycle drivers, with alcohol showing a greater contribution to crash culpability than other drugs.
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Affiliation(s)
| | - Gabriel Andreuccetti
- Department of Preventive Medicine, University of Sao Paulo Medical School, Sao Paulo 01246-903, Brazil.
| | - Marcelo Rosa Rezende
- Department of Traumatology and Orthopaedics, University of Sao Paulo Medical School, Sao Paulo 05403-010, Brazil.
| | - Celso Bernini
- Department of Surgery, University of Sao Paulo Medical School, Sao Paulo 01246-903, Brazil.
| | - Jorge Santos Silva
- Department of Surgery, University of Sao Paulo Medical School, Sao Paulo 01246-903, Brazil.
| | - Vilma Leyton
- Department of Legal Medicine, University of Sao Paulo Medical School, Sao Paulo 01246-903, Brazil.
| | - Julia Maria D'Andréa Greve
- Department of Traumatology and Orthopaedics, University of Sao Paulo Medical School, Sao Paulo 05403-010, Brazil.
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d'Avila S, Barbosa KGN, Bernardino ÍDM, da Nóbrega LM, Bento PM, E Ferreira EF. Facial trauma among victims of terrestrial transport accidents. Braz J Otorhinolaryngol 2015; 82:314-20. [PMID: 26614044 PMCID: PMC9444685 DOI: 10.1016/j.bjorl.2015.10.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 05/15/2015] [Indexed: 12/01/2022] Open
Abstract
Introduction In developing countries, terrestrial transport accidents – TTA, especially those involving automobiles and motorcycles – are a major cause of facial trauma, surpassing urban violence. Objective This cross-sectional census study attempted to determine facial trauma occurrence with terrestrial transport accidents etiology, involving cars, motorcycles, or accidents with pedestrians in the northeastern region of Brazil, and examine victims’ socio-demographic characteristics. Methods Morbidity data from forensic service reports of victims who sought care from January to December 2012 were analyzed. Results Altogether, 2379 reports were evaluated, of which 673 were related to terrestrial transport accidents and 103 involved facial trauma. Three previously trained and calibrated researchers collected data using a specific form. Facial trauma occurrence rate was 15.3% (n = 103). The most affected age group was 20–29 years (48.3%), and more men than women were affected (2.81:1). Motorcycles were involved in the majority of accidents resulting in facial trauma (66.3%). Conclusion The occurrence of facial trauma in terrestrial transport accident victims tends to affect a greater proportion of young and male subjects, and the most prevalent accidents involve motorcycles.
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Affiliation(s)
- Sérgio d'Avila
- Universidade Estadual da Paraíba (UEPB), Campina Grande, PB, Brazil.
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Cannabinoids determination in oral fluid by SPME-GC/MS and UHPLC-MS/MS and its application on suspected drivers. Sci Justice 2014; 54:421-6. [PMID: 25498928 DOI: 10.1016/j.scijus.2014.08.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Revised: 08/17/2014] [Accepted: 08/26/2014] [Indexed: 11/22/2022]
Abstract
The confirmation of Δ9-tetrahydrocannabinol (THC) in oral fluid (OF) is an important issue for assessing Driving Under the Influence of Drugs (DUID). The aim of this research was to develop a highly sensitive method with minimal sample pre-treatment suitable for the analysis of small OF volumes (100 μL) for the confirmation of cannabinoids in DUID cases. Two methods were compared for the confirmation of THC in residual OF samples, obtained from a preliminary on-site screening with commercial devices. An ultra high performance LC-MS (UHPLC-MS/MS) method and an SPME-GC/MS method were hence developed. 100 μL of the residual mixture OF/preservative buffer or neat OF was simply added to 10 μL of THC-D3 (1 μg/mL) and submitted to the two different analyses: A - direct injection of 10 μL in UHPLC-MS/MS in positive electrospray ionisation (ESI) mode and B - sampling for 30 min with SPME (100 μm polydimethylsiloxane or PDMS fibre) and direct injection by desorption of the fibre in the GC injection port. The lowest limit of detection (LLOD) of THC was 2 ng/mL in UHPLC-MS/MS and 0.5 ng/mL in SPME-GC/MS. In addition, cannabidiol (CBD) and cannabinol (CBN) could be detected in GC/MS equipment at 2 ng/mL, whilst in UHPLC-MS/MS the LLOD was 20 ng/mL. Both methods were applied to 70 samples coming from roadside tests. By SPME-GC/MS analysis, THC was confirmed in 42 samples, whilst CBD was detected in 21 of them, along with CBN in 14 samples. THC concentrations ranged from traces below the lowest limit of quantification or LLOQ (2 ng/mL) up to 690 ng/mL.
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de Castro DS, Sanchez ZM, Zaleski M, Palhares Alves HN, Pinsky I, Caetano R, Laranjeira RR. Binge drinking among Brazilians: Higher drinking frequency increases related problems. J Addict Dis 2014:0. [PMID: 24829095 DOI: 10.1080/10550887.2014.909692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Abstract Aims: To correlate binge drinking (BD) with alcohol-related problems (ARP) in the Brazilian population. Methods: A representative cross-sectional survey was conducted in 143 Brazilian cities. Associations between the frequencies of BD and ARP were gathered using an ordered logit regression model. Results: Higher BD frequencies significantly increased the chance of injury in accidents, job loss, and involvement in intense arguments and assaults over the year. High frequency in BD increases the odds of all ARP. Conclusion: There is a dose-response association between the frequency BD and ARP and is therefore a possible target for public prevention policies.
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Affiliation(s)
- Daniel Sócrates de Castro
- a Alcohol and Drugs Research Unit (Unidade de Pesquisa em Álcool e Outras Drogas; UNIAD), Department of Psychiatry , Universidade Federal de São Paulo (UNIFESP) , São Paulo , SP , Brazil
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de Oliveira MH, Carlos G, Bergold AM, Pechansky F, Limberger RP, Fröehlich PE. Determination of mazindol in human oral fluid by high performance liquid chromatography-electrospray ionization mass spectrometry. Biomed Chromatogr 2014; 28:1064-9. [DOI: 10.1002/bmc.3120] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 10/27/2013] [Accepted: 12/02/2013] [Indexed: 11/11/2022]
Affiliation(s)
- Marcella Herbstrith de Oliveira
- Program of Postgraduation in Pharmaceutical Sciences, College of Pharmacy; Federal University of Rio Grande do Sul; 2752 Ipiranga Avenue, Santana 90610-000 Porto Alegre Rio Grande do Sul Brazil
| | - Graciela Carlos
- Program of Postgraduation in Pharmaceutical Sciences, College of Pharmacy; Federal University of Rio Grande do Sul; 2752 Ipiranga Avenue, Santana 90610-000 Porto Alegre Rio Grande do Sul Brazil
| | - Ana Maria Bergold
- Program of Postgraduation in Pharmaceutical Sciences, College of Pharmacy; Federal University of Rio Grande do Sul; 2752 Ipiranga Avenue, Santana 90610-000 Porto Alegre Rio Grande do Sul Brazil
| | - Flavio Pechansky
- Research Center on Alcohol and Drugs; Federal University of Rio Grande do Sul; 400, Álvaro Alvim Street 90420-020 Porto Alegre Rio Grande do Sul Brazil
| | - Renata Pereira Limberger
- Program of Postgraduation in Pharmaceutical Sciences, College of Pharmacy; Federal University of Rio Grande do Sul; 2752 Ipiranga Avenue, Santana 90610-000 Porto Alegre Rio Grande do Sul Brazil
| | - Pedro Eduardo Fröehlich
- Program of Postgraduation in Pharmaceutical Sciences, College of Pharmacy; Federal University of Rio Grande do Sul; 2752 Ipiranga Avenue, Santana 90610-000 Porto Alegre Rio Grande do Sul Brazil
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De Boni RB, Bastos FI, de Vasconcellos M, Oliveira F, Limberger RP, Pechansky F. Drug use among drivers who drank on alcohol outlets from Porto Alegre, Brazil. ACCIDENT; ANALYSIS AND PREVENTION 2014; 62:137-142. [PMID: 24148905 DOI: 10.1016/j.aap.2013.09.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Revised: 08/31/2013] [Accepted: 09/23/2013] [Indexed: 06/02/2023]
Abstract
BACKGROUND Driving under the influence of multiple substances is a public health concern, but there is little epidemiological data about their combined use and putative impact on driving in low and middle-income countries where traffic crashes have been clustering in recent years. The aim of this study is to estimate the prevalence of alcohol and drug use - as well as their associated factors - among drivers in the context of alcohol outlets (AOs). METHODS A probability three-stage sample survey was conducted in Porto Alegre, Brazil. Individuals who were leaving AO were screened, with the selection of 683 drivers who met the inclusion criteria. Drivers answered a structured interview, were breathalyzed, and had their saliva collected for drug screening. Prevalences were assessed using domain estimation and logistic regression models assessed covariates associated with substance use. FINDINGS Benzodiazepines 3.9% (SE 2.13) and cocaine 3.8% (SE 1.3) were the most frequently detected drugs in saliva. Among drivers who were going to drive, 11% had at least one drug identified by the saliva drug screening, 0.4% two, and 0.1% three drugs in addition to alcohol. In multivariable analyses, having a blood alcohol concentration (BAC)>0.06% was found to be associated with a 3.64 times (CI 95% 1.79-7.39) higher chance of drug detection, compared with interviewees with lower BACs. CONCLUSIONS To drive under the influence of multiple substances is likely to be found in this setting, highlighting an association between harmful patterns of consume of alcohol and the misuse of other substances.
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Affiliation(s)
- Raquel B De Boni
- Department of Health Information, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
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Regional differences associated with drinking and driving in Brazil. BRAZILIAN JOURNAL OF PSYCHIATRY 2013; 34:306-13. [PMID: 23429776 DOI: 10.1016/j.rbp.2012.02.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2011] [Accepted: 02/03/2012] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To evaluate regional differences and similarities associated with drinking and driving (DUI) in the five Brazilian macro-regions. METHOD A roadside survey was conducted in the 27 Brazilian state capitals. A total of 3,398 drivers were randomly selected and given a structured interview and a breathalyzer test. To determine the predictors of positive blood alcohol concentration (BAC) in each region, a MANOVA was performed, and 3 groups were used as follows: 1) North and Northeast, 2) South and Midwest, and 3) Southeast. A Poisson robust regression model was performed to assess the variables associated with positive BAC in each group. RESULTS Of all surveyed drivers, 2,410 had consumed alcohol in the previous 12 months. Most were male, with a median age of 36. Leisure as the reason for travel was associated with positive BAC in all 3 groups. Low schooling, being older than 30, driving cars or motorcycles and having been given a breathalyzer test at least once in their lives predicted DUI in at least two different groups. CONCLUSIONS Factors , especially low schooling and leisure as a reason for travel, associated with drinking and driving were similar among regions, although certain region-specific features were observed. This information is important for aiming to reduce DUI in the country.
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Takitane J, Oliveira LGD, Endo LG, Oliveira KCBGD, Muñoz DR, Yonamine M, Leyton V. Uso de anfetaminas por motoristas de caminhão em rodovias do Estado de São Paulo: um risco à ocorrência de acidentes de trânsito? CIENCIA & SAUDE COLETIVA 2013. [DOI: 10.1590/s1413-81232013000500009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
No Brasil, é comum o uso de anfetaminas por motoristas de caminhão, o que pode culminar na ocorrência de acidentes de trânsito. O objetivo deste artigo é estimar a prevalência do uso de anfetaminas entre caminhoneiros. Motoristas (N = 134) foram abordados em duas rodovias do Estado de São Paulo e solicitados a responder um questionário, assim como a fornecer uma amostra de urina para realização de análises toxicológicas. Todos os dados foram analisados em Stata 8.0. Todos os participantes eram do sexo masculino, de idade média de 40,8 anos e de baixa escolaridade. A presença de anfetaminas foi detectada em 10,8% das amostras de urina, cujo uso foi justificado para manter a vigília durante o trabalho. O uso de anfetaminas foi detectado entre caminhoneiros em rodovias de São Paulo. Cessado o efeito estimulante, a sonolência advinda de uma possível privação de sono diminui a atenção e o bom desempenho na direção, predispondo o condutor aos acidentes de trânsito e seus custos relacionados.
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De Boni R, Cruz OG, Weber E, Hasenack H, Lucatelli L, Duarte P, Gracie R, Pechansky F, Bastos FI. Traffic crashes and alcohol outlets in a Brazilian state capital. TRAFFIC INJURY PREVENTION 2013; 14:86-91. [PMID: 23259523 DOI: 10.1080/15389588.2012.690164] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE Restricting alcohol outlets is being considered as a measure for preventing alcohol-related crashes. However, in many developing countries, alcohol availability is not regulated and its influence on motor vehicle traffic crashes is unknown. This study explores the association between traffic crashes and alcohol outlets in a Brazilian city. METHOD Data were geocoded and exploratory analysis was conducted using the kernel density estimator. Two generalized additive models (GAMs) were implemented to predict the factors associated with alcohol-related crashes. RESULTS For 78 percent of the 3840 traffic crashes where the driver was a victim, there was at least one bar located within a 300-m radius. The median distances between an outlet were 124.4 and 130.7 m for a non-alcohol- and alcohol-related crashes, respectively (P =.13). The GAMs did not make evident any significant association between the outlet locations and alcohol-related crashes: the presence of at least one outlet was associated with alcohol-related crashes with an odds ratio (OR) of 0.94 (95% confidence interval [CI] = 0.75-1.17). Alcohol crashes are more likely to be observed among males (OR = 1.58; 95% CI = 1.21-2.06), young drivers vs. those aged 50 years+ (OR = 3.4; 95% CI = 1.79-6.43), and crashes with fatalities (OR = 1.73; 95% CI = 0.98-3.04). CONCLUSIONS Density of alcohol outlets was high all over the city and both alcohol- and non-alcohol-related crashes occurred near an outlet. The study helps to better understand the relationship between alcohol availability and traffic crashes in a middle-income country where licensing/zoning is absent and suggests that measures for restricting the physical availability of alcohol are necessary, even though further studies are still needed.
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Affiliation(s)
- Raquel De Boni
- Center for Drug and Alcohol Research, Federal University of Rio Grande do Sul and Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil.
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De Boni R, Pechansky F, Silva PLDN, de Vasconcellos MTL, Bastos FI. Is the Prevalence of Driving After Drinking Higher in Entertainment Areas? Alcohol Alcohol 2012. [DOI: 10.1093/alcalc/ags126] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Zancanaro I, Limberger RP, Bohel PO, dos Santos MK, De Boni RB, Pechansky F, Caldas ED. Prescription and illicit psychoactive drugs in oral fluid—LC–MS/MS method development and analysis of samples from Brazilian drivers. Forensic Sci Int 2012; 223:208-16. [DOI: 10.1016/j.forsciint.2012.08.048] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2012] [Revised: 08/24/2012] [Accepted: 08/28/2012] [Indexed: 11/29/2022]
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Strano-Rossi S, Anzillotti L, Castrignanò E, Romolo FS, Chiarotti M. Ultra high performance liquid chromatography–electrospray ionization–tandem mass spectrometry screening method for direct analysis of designer drugs, “spice” and stimulants in oral fluid. J Chromatogr A 2012; 1258:37-42. [DOI: 10.1016/j.chroma.2012.07.098] [Citation(s) in RCA: 89] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2012] [Revised: 07/30/2012] [Accepted: 07/31/2012] [Indexed: 11/26/2022]
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Strano-Rossi S, Castrignanò E, Anzillotti L, Serpelloni G, Mollica R, Tagliaro F, Pascali JP, di Stefano D, Sgalla R, Chiarotti M. Evaluation of four oral fluid devices (DDS®, Drugtest 5000®, Drugwipe 5+® and RapidSTAT®) for on-site monitoring drugged driving in comparison with UHPLC–MS/MS analysis. Forensic Sci Int 2012; 221:70-6. [DOI: 10.1016/j.forsciint.2012.04.003] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2012] [Revised: 03/27/2012] [Accepted: 04/07/2012] [Indexed: 11/28/2022]
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da Silva DW, de Andrade SM, Soares DFPDP, Mathias TADF, Matsuo T, de Souza RKT. Factors associated with road accidents among Brazilian motorcycle couriers. ScientificWorldJournal 2012; 2012:605480. [PMID: 22629158 PMCID: PMC3354443 DOI: 10.1100/2012/605480] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2011] [Accepted: 12/21/2011] [Indexed: 11/18/2022] Open
Abstract
The objective of the study was to identify factors associated with reports of road accidents, among motorcycle couriers in two medium-sized municipalities in southern Brazil. A self-administered questionnaire was answered by motorcycle couriers that had worked for at least 12 months in this profession. The outcomes analyzed were reports on accidents and serious accidents over the 12 months prior to the survey. Bivariate and multivariate analyses by means of logistic regression were carried out to investigate factors that were independently associated with the outcomes. Seven hundred and fifty motorcycle couriers, of mean age 29.5 years (standard deviation = 8.1
), were included in the study. Young age (18 to 24 years compared to ≥25 years, odds ratio [OR] = 1.77) speeding (OR = 1.48), and use of cell phones while driving (OR = 1.43) were factors independently associated with reports of accidents. For serious accidents, there was an association with alternation of work shifts (OR = 1.91) and speeding (OR = 1.67). The characteristics associated with accidents—personal (young age), behavioral (use of cell phones while driving and speeding), and professional (speeding and alternation of work shifts)—reveal the need to adopt wide-ranging strategies to reduce these accidents, including better work conditions for these motorcyclists.
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Affiliation(s)
- Daniela Wosiack da Silva
- Postgraduate Program on Public Health, Department of Physiotherapy, State University of Londrina, 86038-350 Londrina, PR, Brazil
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Reaching the hard-to-reach: a probability sampling method for assessing prevalence of driving under the influence after drinking in alcohol outlets. PLoS One 2012; 7:e34104. [PMID: 22514620 PMCID: PMC3325972 DOI: 10.1371/journal.pone.0034104] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2011] [Accepted: 02/22/2012] [Indexed: 12/05/2022] Open
Abstract
Drinking alcoholic beverages in places such as bars and clubs may be associated with harmful consequences such as violence and impaired driving. However, methods for obtaining probabilistic samples of drivers who drink at these places remain a challenge – since there is no a priori information on this mobile population – and must be continually improved. This paper describes the procedures adopted in the selection of a population-based sample of drivers who drank at alcohol selling outlets in Porto Alegre, Brazil, which we used to estimate the prevalence of intention to drive under the influence of alcohol. The sampling strategy comprises a stratified three-stage cluster sampling: 1) census enumeration areas (CEA) were stratified by alcohol outlets (AO) density and sampled with probability proportional to the number of AOs in each CEA; 2) combinations of outlets and shifts (COS) were stratified by prevalence of alcohol-related traffic crashes and sampled with probability proportional to their squared duration in hours; and, 3) drivers who drank at the selected COS were stratified by their intention to drive and sampled using inverse sampling. Sample weights were calibrated using a post-stratification estimator. 3,118 individuals were approached and 683 drivers interviewed, leading to an estimate that 56.3% (SE = 3,5%) of the drivers intended to drive after drinking in less than one hour after the interview. Prevalence was also estimated by sex and broad age groups. The combined use of stratification and inverse sampling enabled a good trade-off between resource and time allocation, while preserving the ability to generalize the findings. The current strategy can be viewed as a step forward in the efforts to improve surveys and estimation for hard-to-reach, mobile populations.
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Silveira CM, Siu ER, Wang YP, Viana MC, Andrade AGD, Andrade LH. Gender differences in drinking patterns and alcohol-related problems in a community sample in São Paulo, Brazil. Clinics (Sao Paulo) 2012; 67:205-12. [PMID: 22473399 PMCID: PMC3297027 DOI: 10.6061/clinics/2012(03)01] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2011] [Revised: 10/20/2011] [Accepted: 10/25/2011] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To investigate drinking patterns and gender differences in alcohol-related problems in a Brazilian population, with an emphasis on the frequency of heavy drinking. METHODS A cross-sectional study was conducted with a probability adult household sample (n = 1,464) in the city of São Paulo, Brazil. Alcohol intake and ICD-10 psychopathology diagnoses were assessed with the Composite International Diagnostic Interview 1.1. The analyses focused on the prevalence and determinants of 12-month non-heavy drinking, heavy episodic drinking (4-5 drinks per occasion), and heavy and frequent drinking (heavy drinking at least 3 times/week), as well as associated alcohol-related problems according to drinking patterns and gender. RESULTS Nearly 22% (32.4% women, 8.7% men) of the subjects were lifetime abstainers, 60.3% were non-heavy drinkers, and 17.5% reported heavy drinking in a 12-month period (26.3% men, 10.9% women). Subjects with the highest frequency of heavy drinking reported the most problems. Among subjects who did not engage in heavy drinking, men reported more problems than did women. A gender convergence in the amount of problems was observed when considering heavy drinking patterns. Heavy and frequent drinkers were twice as likely as abstainers to present lifetime depressive disorders. Lifetime nicotine dependence was associated with all drinking patterns. Heavy and frequent drinking was not restricted to young ages. CONCLUSIONS Heavy and frequent episodic drinking was strongly associated with problems in a community sample from the largest city in Latin America. Prevention policies should target this drinking pattern, independent of age or gender. These findings warrant continued research on risky drinking behavior, particularly among persistent heavy drinkers at the non-dependent level.
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