Blood alcohol content and death from fatal injury: a study in the metropolitan area of São Paulo, Brazil

Characteristics of deaths by suicide in postmortem studies in Brazil: A systematic review and meta-analysis

INTRODUCTION

Suicide is one of the leading causes of death, with a trend for its increase in Brazil in past decades. This study aimed to review the characteristics of suicides in Brazilian postmortem studies.

METHODS

Studies investigating suicide deaths in Brazil, and based on autopsy or psychological autopsy were included. Proportions were pooled across studies with the use of random and fixed effects models.

RESULTS

6777 references were retrieved from six databases (searches up to January, 2023), and 45 studies included. In autopsy studies (k = 37, n = 16,231), substance use at toxicological analysis was found in 36.42% of cases (95% CI: 30.05-43.32), previous suicide attempts in 23.92% (95% CI: 6.73-57.78). In psychological autopsy studies (k = 8, n = 139), previous suicide attempts were reported in 28.09% (95% CI: 19.74-38.28), psychiatric conditions/symptoms in 90.67% (95% CI: 67.79-97.82), family history of suicidality in 21.33% (95% CI: 13.5-32.03). Most suicide deaths were reported in males and took place at the victim's home, hanging was the most frequent suicide method. Included studies presented significant limitations in quality assessment.

CONCLUSION

Future studies should present more robust methodology, including bigger samples, the use of controls, and validated methodology.

[Toxicology of suicide cases in the state of Rio Grande do Sul, Brazil, 2017 to 2019Perfil toxicológico de los casos de suicidio en Rio Grande do Sul (Brasil), 2017-2019]

Objetivo.

Descrever o perfil toxicológico de todas as vítimas de suicídio no Rio Grande do Sul, Brasil, de 2017 a 2019.

Métodos.

Neste estudo descritivo e transversal, foram consultados todos os laudos periciais e as ocorrências policiais relacionados aos óbitos por suicídio no estado. Foram realizadas análises de correspondência múltipla e construídos modelos independentes de regressão logística, tendo como variáveis dependentes o etanol, os ansiolíticos, os antidepressivos, as substâncias ilícitas e os agentes tóxicos não medicamentosos.

Resultados.

Foram realizados 2 978 exames de alcoolemia, com resultado positivo em 28,5%. A chance de resultados positivos para alcoolemia foi 0,5 (IC95%: 1,1 a 2,2) vez maior para suicídio durante a noite, 1,0 (IC95%: 1,4 a 2,9) vez maior para suicídio aos finais de semana e 0,9 (IC95%: 1,3 a 2,7) vez maior na presença de antecedentes criminais. A pesquisa de psicotrópicos (2 900 amostras) detectou algum medicamento em 30,4%. Os ansiolíticos foram a classe mais frequente, com chance 1,5 (IC95%: 1,6 a 4,1) vez maior em mulheres e 0,8 (IC95%: 1,2 a 2,7) vez maior para suicídios ocorridos no outono-inverno. As substâncias ilícitas (n = 338) tiveram chance 4,1 (IC95%: 1,9 a 14,4) vezes maior de detecção na macrorregião de Pelotas em relação à de Passo Fundo e 1,2 (IC95%: 1,3 a 3,6) vez maior em pessoas com resultados positivos para etanol. Não houve diferença significativa entre adolescentes e adultos.

Conclusões.

Embora sem evidência de causalidade, os resultados mostram um vínculo entre o suicídio e diversos psicoativos. Os médicos legistas devem ser orientados quanto à necessidade de realização de exames toxicológicos em todos os casos de suicídio.

[Synthesis of evidence: Guidance for the diagnosis and treatment of Chagas diseaseSíntese de evidências: Guia de diagnóstico e tratamento da doença de Chagas]

Introducción.

La enfermedad de Chagas o tripanosomiasis americana es causada por el protozoo flagelado Trypanosoma cruzi, transmitido principalmente por insectos vectores (denominados popularmente en las diferentes zonas de la Región de las Américas “vinchucas”, “pitos”, “chinches”, “chirimachas” o “kissing bugs”). El parásito es transmitido por vía transplacentaria, transfusiones y, menos frecuentemente, por vía oral o trasplante de órganos. La implementación de políticas públicas y el manejo de la condición clínica requiere ser fortalecido debido a las dificultades diagnósticas y terapéuticas que presenta esta parasitosis sistémica. Para contribuir con ello, la Organización Panamericana de la Salud (OPS) desarrolló una guía para el manejo de la tripanosomiasis americana.

Objetivos.

Sintetizar las recomendaciones incluidas en la Guía para el diagnóstico y el tratamiento de la enfermedad de Chagas, publicada por la Organización Panamericana de la Salud en 2018, con el fin de presentar el adecuado diagnóstico y tratamiento de la enfermedad de Chagas y abordar aspectos sobre su implementación.

Métodos.

Se llevó a cabo una síntesis de la guía y sus recomendaciones. Adicionalmente, se realizó una búsqueda sistemática en PubMed, Lilacs, Health Systems Evidence, Epistemonikos y literatura gris de estudios desarrollados en las Américas con el fin de identificar barreras, facilitadores y estrategias de implementación.

Resultados.

Se presentan 10 recomendaciones aplicables a pacientes adultos y pediátricos con sospecha de enfermedad de Chagas, exposición a T. cruzi y diagnóstico confirmado de enfermedad de Chagas aguda, crónica y congénita. Se identificaron reportes que abordaron aspectos de implementación.

Conclusiones.

Las recomendaciones buscan proveer estrategias para el diagnóstico y tratamiento oportunos de la enfermedad de Chagas, así como consideraciones para su implementación.

Alcohol use, aquatic injury, and unintentional drowning: A systematic literature review

ISSUES

Drowning is a global public health issue, and there is a strong association between alcohol and risk of drowning. No previous systematic review known to date has identified factors associated with alcohol use and engagement in aquatic activities resulting in injury or drowning (fatal and non-fatal).

APPROACH

Literature published from inception until 31 January 2017 was reviewed. Included articles were divided into three categories: (i) prevalence and/or risk factors for alcohol-related fatal and non-fatal drowning and aquatic injury, (ii) understanding alcohol use and aquatic activities, and (iii) prevention strategies. Methodological quality of studies was assessed using National Health and Medical Research Council (NHMRC) Level of Evidence and risk of bias was assessed using the Newcastle-Ottawa Quality Assessment Scales.

KEY FINDINGS

In total, 74 studies were included (57 on prevalence and/or risk factors, 15 on understanding alcohol use, and two on prevention strategies). Prevalence rates for alcohol involvement in fatal and non-fatal drowning varied greatly. Males, boating, not wearing lifejackets, and swimming alone (at night, and at locations without lifeguards) were risk factors for alcohol-related drowning. No specific age groups were consistently identified as being at risk. Study quality was consistently low, and risk of bias was consistently high across studies. Only two studies evaluated prevention strategies.

IMPLICATIONS

There is a need for higher quality studies and behavioural basic and applied research to better understand and change this risky behaviour.

CONCLUSION

On average, 49.46% and 34.87% of fatal and non-fatal drownings, respectively, involved alcohol, with large variations among studies observed.

Alcohol intake among adolescent students and association with social capital and socioeconomic status

The aim was to evaluate the prevalence of alcohol consumption, binge drinking and their association with social capital and socioeconomic factors among Brazilian adolescents students. A cross-sectional study was carried out with a randomly selected representative sample of 936 adolescents aged 15 to 19 years. Information on alcohol consumption, social capital and socioeconomic status was collected using the Alcohol Use Disorders Identification Test, the Integrated Questionnaire for the Measurement of Social Capital and Social Vulnerability Index, respectively. The prevalence of alcohol consumption was 50.3% and binge drinking 36% the last year. Adolescents who reported believing that people in their community could help solve a collective problem (with the water supply) and those classified as having high social vulnerability had lower likelihood of binge drinking (PR = 0.776 [95%CI:0.620 to 0.971] and PR = 0.660 [95%CI:0.542 to 0.803], respectively). The prevalence of alcohol consumption and binge drinking the last year is high among participants. Those with higher socioeconomic status as well as lower perceptions of community capital social are more likely to display binge-drinking behavior.

Alcohol consumption and driving in Brazilian capitals and Federal District according to two national health surveys

OBJECTIVE

To present the results of indicators of alcohol consumption and driving for Brazilian capitals based on two population surveys performed in Brazil in 2013.

METHODS

Cross sectional study with data from adults (≥ 18 years) participants of the Telephone Survey on Risk and Protective Factors for Chronic Diseases (Vigitel) and the National Health Survey (NHS). Prevalence for indicators of alcohol consumption and driving was then calculated.

RESULTS

The proportion of adult drivers who drove soon after drinking was significantly higher among males (29.3% - Vigitel and 24.4% - NHS), the young aging 18 to 29 years (31.6% - Vigitel and 24.1% - NHS) and among residents of the capitals of the Midwest (33.7% - Vigitel and 28.3% - NHS). The proportion of adults who reported drinking and driving was higher among males (9.4% - Vigitel and 7.4% - NHS) in the 18 to 29 age group (7.1% - Vigitel; 4.5% - NHS), and among residents of the capitals of the Midwest (7.9% - Vigitel and 6.1% - NHS).

CONCLUSION

The study estimated the prevalence of the habit of driving after alcohol consumption among drivers and in the general population. There was consistency between the results from two nationwide surveys.

Drinking and driving in southeastern Brazil: results from a roadside survey study

OBJECTIVE

The objective of this study is to present data from a roadside survey study on drinking and driving and alcohol consumption in southeastern Brazil.

METHODS

A cross-sectional roadside survey study using a questionnaire and breathalyzer data is the method used to determine the prevalence of drinking and driving and to examine whether socio-demographic characteristics and drivers' behavior, attitude and alcohol consumption predicted positive blood alcohol content (BAC). The data were gathered from 2005 to 2007 through roadside surveys conducted on high volume public roads in four cities in southeastern Brazil. A total of 4182 randomly selected drivers took part in the research. Of these drivers, 3488 (83.4%) completed the questionnaire and agreed to take a breath test.

RESULTS

Overall, 24.6% of drivers had a detectable blood alcohol concentration (BAC) and 15.9% had a BAC above the legal limit (0.6g/l) at the time of the study. Logistic regression controlling for locale (city), sex, age and marital status was used to predict whether each driver would present a positive breath test. Socio-demographic characteristics, driving behaviors and attitudes, and alcohol consumption patterns were included as predictors. These analyses indicated that those who believed drinking and driving was a serious offense were about two-thirds as likely to have a positive breath test, and that drivers reporting a pattern of regular alcohol use were three times as likely to have a positive breath test.

CONCLUSIONS

These findings indicate that drinking and driving is relatively common in Brazil, and that it occurs considerably more frequently than similar surveys suggest, is the case in other countries.

Addiction research centres and the nurturing of creativity. National institute on alcohol and drugs policies, Brazil

The National Institute of Public Policy for Alcohol and Other Drugs (INPAD) is based at the Federal University of São Paulo, Brazil, and was created to collect scientific evidence regarding epidemiology, develop new therapeutic approaches, study health economics and provide education to subsidize the proper measures to change the Brazilian scenario of alcohol and drug consumption. Policies directed towards the control of alcohol and drugs in Brazil are fragmented, poorly enforced and therefore ineffective. The unregulated market of alcohol in Brazil has contributed to the worsening health of the Brazilian population. Since 1994, INPAD has participated actively in academic debates and discussions about alcohol and drug policies and their effects on the political welfare of the country. Many scientific papers and books have been published on this subject, and the internet and other media have provided excellent opportunities for the dissemination of specialized information to the general population.

Headache is associated with lower alcohol consumption among medical students

The aim of this study was to investigate the association between headache and alcohol consumption among medical students. 480 medical students were submitted to a questionnaire about headaches and drinking alcohol. Headache was assessed by ID-Migraine and functional disability was evaluated with MIDAS. The evaluation of alcohol consumption was assessed with Alcohol Use Disorders Identification Test (AUDIT). There was significantly lower proportion of students with drinking problem among students with headache. This occurred both among students classified as having migraine and among those who had non-migrainous headache. There was not a correlation between functional disability of headache and AUDIT score. Our data suggest that having headache leads to a reduction in alcohol consumption among medical students regardless the degree of headache functional impact.

Ingestão alcoólica em vítimas de causas externas atendidas em um hospital geral universitário

OBJETIVO: Estimar a freqüência de ingestão alcoólica em vítimas de causas externas atendidas em hospital. MÉTODOS: Estudo realizado com vítimas atendidas em um hospital geral universitário em Uberlândia (MG), de fevereiro a agosto de 2004. A alcoolemia foi determinada em 85 pacientes no pronto-socorro e entrevistaram-se outros 301 internados nas enfermarias sobre possível ingestão alcoólica previamente ao trauma; em ambos os grupos foi aplicado o questionário Cut-down, Annoyed by criticism, Guilty and Eye-opener (CAGE). Para as comparações das freqüências foi utilizado o teste exato de Fisher. RESULTADOS: A alcoolemia foi positiva em 31,8% dos pacientes testados, os quais mais freqüentemente necessitaram de internação (70,4% versus 37,9%; p<0,05). Proporcionalmente, alcoolemia positiva foi mais freqüente (p<0,05) entre as vítimas de agressão física (57,1%) do que as de queda (18,2%) ou de acidente de trânsito (29,3%). Nas enfermarias, 29,9% dos pacientes referiram ingestão alcoólica, proporcionalmente mais freqüente (p<0,01) entre as vítimas de agressão física (67,4%) do que entre as de acidente de trânsito (27,8%) ou queda (19,3%). Entre aqueles que ingeriram álcool, abordados no pronto-socorro e nas enfermarias, observou-se, respectivamente: que a maioria era homens (85,2% e 80,4%), a ocorrência de trauma foi maior (p<0,05) nos finais de semana (63% e 57,8%) e no período noturno (59,3% e 57,8%), e o questionário CAGE foi positivo em 81,5% e 82,2%. CONCLUSÕES: Cerca de um terço dos pacientes ingeriu bebidas alcoólicas previamente ao trauma e, entre eles, a maioria era homens. Proporcionalmente, a ingestão prévia de bebidas alcoólicas foi mais freqüente entre os pacientes vítimas de violência. Os resultados da aplicação do CAGE mostra que a maioria dos pacientes vítimas de causas externas após ingestão etílica não era alcoolista ocasional, e sim provável usuário crônico ou dependente de álcool.

Álcool e adolescentes: estudo para implementar políticas municipais

OBJETIVO: Traçar um perfil de estudantes em relação ao consumo de álcool e comportamentos de risco. MÉTODOS: Participaram do estudo 1.990 alunos, com idade entre 11 e 21 anos, de ambos os sexos, matriculados em escolas públicas e privadas de Paulínia, SP, 2004. Um questionário de auto-preenchimento foi respondido em sala de aula, sem a presença do professor. Analisou-se a percepção da disponibilidade e facilidade de acesso às bebidas alcoólicas, contexto do beber e conseqüências do consumo. RESULTADOS: A prevalência de uso de álcool na vida foi de 62,2%. Em relação aos últimos 30 dias, 17,3% dos alunos relataram pelo menos um episódio de abuso agudo. Os adolescentes reportaram que adquiram facilmente bebidas alcoólicas de estabelecimentos comerciais e também em contextos sociais com parentes e amigos. Apenas 1% dos menores de idade relatou que tentou, mas não conseguiu comprar bebida alcoólica. Como conseqüências negativas do consumo nos últimos 12 meses, os estudantes relataram ter passado mal por ter bebido (17,9%), arrependimento por algo que fizeram sob o efeito do álcool (11%), blackout (9,8%) e ter brigado após beber (5%). Mais da metade (55%) dos estudantes conhecia alguém que sofreu acidente de trânsito provocado por motorista embriagado. CONCLUSÕES: Os dados revelaram alta prevalência de consumo de álcool entre os adolescentes estudados e fácil acesso às bebidas alcoólicas, inclusive por menores de idade. Os jovens se colocaram em risco e apresentaram conseqüências negativas do consumo de álcool. Há necessidade de ações imediatas em relação às políticas públicas para o consumo de álcool no Brasil.

Álcool, drogas e crime

OBJETIVO: Este artigo descreve duas situações complexas e duplamente preocupantes em termos de saúde pública, seja, por sua alta prevalência e/ou por suas conseqüências. Trata-se dos transtornos do uso de substâncias psicoativas e a criminalidade. Será relatada a forma como diversos pesquisadores as associam, bem como a situação das perícias de usuários e dependentes de álcool e drogas. MÉTODO: Realizou-se uma revisão das publicações sobre o tema, utilizando-se, como bancos de dados, o Medline e o Lilacs, cobrindo o período de 1986 a 2006. Os descritores usados foram: "alcoholism", "drug dependence", "drug abuse" e "crime". Resumos de congressos, artigos e livros relevantes sobre o tema, publicados por diferentes autoridades no assunto, em diversas fases de pesquisa, foram consultados e incluídos. CONCLUSÃO: As diversas pesquisas coincidem na afirmação de uma associação entre transtornos do uso de substâncias psicoativas e criminalidade. O que é possível constatar é a alta proporção de atos violentos quando o álcool ou as drogas ilícitas estão presentes entre agressores, suas vítimas ou em ambos. Quando se realiza um exame pericial em autores que alegam alguma relação do ato praticado com consumo de álcool/drogas, esta perícia deve levar em consideração a substância em uso, o quadro clínico por ela causado, bem como verificar a presença de um diagnóstico, a existência de nexo causal e possíveis alterações na capacidade de entendimento e/ou determinação do agente.

Disposição e alternativas ao dirigir alcoolizado entre jovens paulistanos

No novo código de trânsito brasileiro, a infração de dirigir sob efeito do álcool passou a ser considerada um crime de trânsito. Um modelo do comportamento de saúde dos jovens sugere que muito do seu comportamento "arriscado" não é planejado e que questões que examinam a disposição de dirigir alcoolizado são úteis em pesquisas sobre o assunto. Pela importância da questão do dirigir alcoolizado como assunto na saúde pública nacional, esse estudo utilizou-se do modelo de protótipo/disposição para analisar esse comportamento em jovens prestes a obter carteiras de habilitação em São Paulo. MÉTODOS: O estudo foi realizado no DETRAN-SP (Departamento de Trânsito de São Paulo), em 1998, entre 2.166 jovens de 18 a 25 anos de idade. Examinou-se desde medidas de consumo de bebidas alcoólicas a disposição e alternativas ao dirigir alcoolizado no ano seguinte. RESULTADOS: A maioria dos sujeitos admitia disposição tanto para o comportamento de risco (dirigir alcoolizado) quanto para o comportamento seguro (alternativas como pegar taxi e pedir carona). Foram efetuadas análises de regressão linear com a divisão da amostra em três grupos. De maneira geral, as várias diferenças com significado estatístico encontradas sugeriam que as atitudes e comportamentos seguem uma trajetória crescente de mais seguros a mais arriscados do grupo 1 ao grupo 3. CONCLUSÃO: Os achados sugerem, entre outras coisas, que campanhas de prevenção apresentando uma variedade de alternativas ao dirigir alcoolizado e o aumento da fiscalização desse comportamento seriam dois adendos básicos para a eficácia das leis mais severas do código de trânsito de 1998.

Acute alcohol use and suicidal behavior: a review of the literature

BACKGROUND

Both acute and chronic use of alcohol are associated with suicidal behavior. However, the differing relationship of each component of alcohol use and possible causal mechanisms remain unclear.

METHODS

This article reviews and summarizes associations between acute alcohol consumption (with and without intoxication) and suicidal behavior (both completed suicide and suicide attempts) among adults 19 years and older, as presented in literature published between 1991 and 2001. Possible mechanisms and methodologic challenges for evaluating the association are also discussed. An application of a research design (the case-crossover study) that has the potential for addressing the effects of acute alcohol use over and above usual or chronic use is presented.

RESULTS

The majority of articles reviewed were restricted to descriptive studies that documented the prevalence of suicide completers or attempters who tested positive for alcohol use. A wide range of alcohol-positive cases were found for both completed suicide (10-69%) and suicide attempts (10-73%). Common methodologic limitations included the lack of control groups (for evaluating risk conferred by alcohol use), selection and ascertainment bias, and small sample sizes. The results of the case-crossover pilot study indicated substantially higher risk of suicide during or shortly after use of alcohol compared with alcohol-free periods.

CONCLUSIONS

Although there is a substantial literature of published studies on acute alcohol use and suicidal behavior, the majority of studies focus on completed suicide and report prevalence estimates. Findings from such studies are subject to several possible sources of bias and have not advanced our knowledge of mechanisms in the association between acute alcohol use and suicidal behavior. The case-crossover design may help to overcome some limitations of these studies and facilitate evaluation of associations and possible causal mechanisms by which acute alcohol use is linked to suicidal behavior.

Evidence for an early onset of endogenous alcohol production in bodies recovered from the water: implications for studying alcohol and drowning

Endogenous alcohol production can increase the blood alcohol concentration (BAC) of drowning victims following submersion and confound epidemiological studies of the role of alcohol. This study seeks to determine how soon after a drowning death a victim's BAC is influenced by post-mortem alcohol production. The drop in mean lung weight that occurs over time in the water was hypothesized to serve as a proxy for the time course of decomposition, and thus provide an empirical measure to determine how soon after death to first suspect endogenous alcohol. The autopsy lung weights of 562 previously healthy males who drowned were compared across six submersion time groups (0-11.9, 12-23.9, 24-47.9, 48-95.9, 96-167.9 and >or=168 h) and two times of year (winter and non-winter). The hypothesis that a drop in lung weight is sensitive to the time course of decomposition was supported by (1). a statistically significant drop in mean lung weight that occurred 12-23.9 h post-submersion in the non-winter months, but not until 96-167.9 h in the colder winter months; and (2). a significant drop in lung weight was not observed in the group of cases with zero BAC. With a parallel finding that an increase in the proportion of cases with a positive BAC first occurred at the 12-23.9 h submersion group during the warmer non-winter months, we concluded that production of alcohol can occur in bodies recovered from the water as early as 12 h after death. Because excluding drownings with submersion durations greater than 12 h would exclude almost half of our cases from epidemiological studies of alcohol and drowning, additional evidence from the forensic literature was used to develop an adjustment procedure to account for endogenous alcohol production for submersion times of up to 1 week.

Drinking practices and other health-related behaviors among adolescents of São Paulo City, Brazil

PURPOSE

(a) detect possible demographic and behavioral differences among young episodic heavy drinkers and other young drinkers; (b) investigate the association of youth drinking patterns with other health-compromising behaviors.

METHODS

The data presented are part of a health behavior survey, which used a modified version of the Youth Health Risk Behavior Survey (YHRBS) questionnaire. Students from public (n = 993) and private schools (n = 815), from 7th to 11th grades were investigated in São Paulo city. Multivariate logistic regression analyses were employed to investigate the association among different drinking practices and the various health-compromising behaviors, controlling for age group, gender, and school system. Odds Ratios (OR) and their 95% Confidence Intervals (CI) were calculated. Episodic Heavy Drinking was defined as having five or more drinks in a 2-hour interval, at least once in the last 30 days.

RESULTS

Episodic Heavy Drinkers (EHDs) tend to be older and males and prefer to drink with friends at commercial facilities instead of drinking with their relatives at home. EHDs also reported higher percentages of adverse consequences, such as physical fights, accidents, and school absenteism after drinking. EHDs are more likely to engage in other high-risk behaviors. In the public schools, they were more likely to carry guns (OR = 17.0; CI = 3.9-74.8), get involved in physical fights (OR = 8.9; CI = 4.4-18.0), attempt suicide (OR = 4.2; CI = 2.0-8.7), and use inhalants (OR = 2.7; CI = 1.3-5.7) than abstainers. They are also more likely to use marijuana (OR = 4.7; CI = 2.2-9.9) and smoke cigarettes (OR = 5.3; CI = 2.7-10.4) than moderate drinkers. The results were similar for private schools, with even higher ratios of inhalant use (OR = 15.2; CI = 6.2-37.1), when EHDs were compared with abstainers and cigarette (OR = 64.5; CI = 8.6-481.0) and marijuana use (OR = 6.5; CI = 4.3-9.7), when EHDs were compared with moderate drinkers.

CONCLUSIONS

EHDs display different drinking habits than other adolescents who drink. Also, they are at increased risk for a range of health-compromising behaviors, when compared with both abstainers and moderate drinkers.

[Blood alcohol content prevalence among trauma patients seen at a level 1 trauma center]

OBJECTIVE

To investigate the prevalence of blood alcohol content (BAC) among patients seen at a level 1 trauma center.

METHODS

A cross-sectional study was carried out and patients were randomly selected at the emergency room of a level I trauma center in the city of São Paulo, Brazil, throughout a year (August 1998 to August 1999). Blood samples were drawn and data was collected using an adapted version of a questionnaire developed by the Medical Research Institute of San Francisco - Alcohol Research Group.

RESULTS

A population sample of 464 patients was analyzed. Most of them were males (73.7%) and the median age was 29 years old. Positive BAC was found in 28.9% of the cases (CI95% 24.8 - 33.2) and in 84.3% BAC was =0.10%. Type of injury, gender, age group, marital status and outcome showed statistically significant associations with BAC with the highest BAC prevalence observed among assault victims (46.2%), males (33.9%), 25 to 44 years old (37.6%), singles (33.0%), and patients admitted in the hospital (41.4%).

CONCLUSIONS

The results reinforce the relationship of alcohol and trauma. Preventive actions at different levels focusing on higher risk groups for alcohol-related injuries should be considered as part of prevention programs to both reduce injuries and curb recurrent events.

Drinking and driving: pre-driving attitudes and perceptions among Brazilian youth

The aim of this study was to investigate driving under the influence of alcohol (DUI) risk profiles and predictors in a sample of pre-driving Brazilian youth, in the context of Brazil's new Traffic Code. Data were obtained in the Traffic Department in São Paulo from a sample of 2166 individuals. Subjects displayed a low level of knowledge about the laws and few believed the penalties would actually be enforced for those engaging in DUI. Findings suggest that changes in DUI laws in Brazil and elsewhere should be accompanied by enforcement and education in order to enhance levels of knowledge and credibility of the sanctions.