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Conde K, Peltzer RI, Gimenez PV, Salomón T, Suarez G, Monteiro M, Cherpitel CJ, Cremonte M. Road traffic injury risk from alcohol and cannabis use among emergency department patients in Argentina. Rev Panam Salud Publica 2022; 46:e116. [PMID: 36060199 PMCID: PMC9426949 DOI: 10.26633/rpsp.2022.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 06/07/2022] [Indexed: 11/24/2022] Open
Abstract
Objective To report the risk from alcohol, cannabis, and their combined use for non-fatal road traffic injuries for drivers, passengers, and pedestrians. Methods Risk was estimated using the case-crossover method. Participants (N= 306) were injured patients from an emergency department in Mar del Plata, Argentina. Results Alcohol use (OR= 6.78, CI 95% 3.75-12.25) as well as combined alcohol and cannabis use (OR= 7.05, CI 95% 1.16-42.73) significantly increased the risk of a road traffic injuries. Alcohol use increased the risk in both, women (OR= 8.87, CI 95% 2.69-29.21) and men (OR= 6.16, CI 95% 3.10-12.23); in those >30 years old (OR= 6.01, CI 95% 2.09-17.24) and those <30 years old (OR= 7.15, CI 95% 3.49-14.65). This last group also had an increased risk after combined alcohol and cannabis use (OR= 7.05, CI 95% 1.16-42.75). Both drivers (OR= 6.40, CI 95% 3.23-12.69) and passengers (OR= 13.83, CI 95% 2.87-66.42) had an increased risk after alcohol consumption. Conclusions To our knowledge, these are the first estimates of the risk of having a road traffic injury after alcohol and cannabis consumption in one of the countries of the Southern Cone (Argentina, Chile, and Uruguay). These results highlight the urgent need to implement and enforce comprehensive alcohol control measures. Furthermore, given the global trend towards legalizing cannabis for recreational use, our results could also inform policymakers to enact or amend impaired driving laws.
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Affiliation(s)
- Karina Conde
- Universidad Nacional de Mar del PlataMar del PlataArgentinaUniversidad Nacional de Mar del Plata, Mar del Plata, Argentina.
| | - Raquel Inés Peltzer
- Universidad Nacional de Mar del PlataMar del PlataArgentinaUniversidad Nacional de Mar del Plata, Mar del Plata, Argentina.
| | - Paula Victoria Gimenez
- Universidad Nacional de Mar del PlataMar del PlataArgentinaUniversidad Nacional de Mar del Plata, Mar del Plata, Argentina.
| | - Tomás Salomón
- Universidad Nacional de Mar del PlataMar del PlataArgentinaUniversidad Nacional de Mar del Plata, Mar del Plata, Argentina.
| | - Gabriel Suarez
- Hospital Interzonal General de Agudos “Dr. Oscar Alende”Mar del PlataArgentinaHospital Interzonal General de Agudos “Dr. Oscar Alende”, Mar del Plata, Argentina
| | - Maristela Monteiro
- Pan American Health OrganizationWashington, D.C.United States of AmericaPan American Health Organization, Washington, D.C., United States of America
| | - Cheryl J Cherpitel
- Public Health InstituteEmeryvilleUnited States of AmericaPublic Health Institute, Emeryville, United States of America
| | - Mariana Cremonte
- Universidad Nacional de Mar del PlataMar del PlataArgentinaUniversidad Nacional de Mar del Plata, Mar del Plata, Argentina.
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Tonellato DJ, Ransohoff JR, Nash C, Melanson SEF, Petrides AK, Tolan NV, Goldberg SA, Boyer EW, Chai PR, Erickson TB. Traumatic pedestrian and bicyclist injuries associated with intoxication. Am J Emerg Med 2021; 45:192-195. [PMID: 33046308 PMCID: PMC7884480 DOI: 10.1016/j.ajem.2020.08.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 08/06/2020] [Accepted: 08/10/2020] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND Drug and alcohol use are risk factors for trauma among operators of motor vehicles and contribute to trauma in pedestrians and bicyclists. We describe the prevalence of drug and alcohol use and clinical consequences in a cohort of pedestrians and bicyclists with trauma. METHODS We analyzed a 25-month data set of 916 trauma team activations from January 2017-January 2019 at an urban, level I trauma center. Blood ethanol levels and urine toxicology screens were obtained in 94 pedestrian and bicyclist trauma activations. We compared pedestrians or bicyclists with a positive urine or blood screen (n = 69) to those with negative screens (n = 25). We conducted a retrospective chart review to determine mechanism of injury, injury pattern, and disposition from the emergency department (ED). RESULTS Overall, 38 (55%) of injured patients with positive screen were pedestrians and 31 (45%) were bicyclists. Fentanyl was the most commonly detected drug (n = 38; 40%), followed by opiates (n = 27; 29%), and tetrahydrocannabiol (THC) (n = 23; 25%). Twenty-one patients were positive for ethanol. Pedestrians and bicyclists with positive toxicology screens were significantly more likely to sustain fractures (p < .01), require an operative procedure (p < .05), or intensive care unit admission (p < .05). CONCLUSION Our study builds on previous literature which suggests that intoxicated bicyclists and pedestrians suffer frequent and more severe injury than their sober counterparts. Public health campaigns should educate bicyclists and pedestrians about the risks of cycling or walking in areas of road traffic while under the influence of alcohol or illicit drugs.
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Affiliation(s)
- D J Tonellato
- Department of Emergency Medicine, Division of Medical Toxicology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States of America.
| | - J R Ransohoff
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States of America
| | - C Nash
- Department of Emergency Medicine, Division of Medical Toxicology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States of America
| | - S E F Melanson
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States of America
| | - A K Petrides
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States of America
| | - N V Tolan
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States of America
| | - S A Goldberg
- Department of Emergency Medicine, Division of Medical Toxicology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States of America
| | - E W Boyer
- Department of Emergency Medicine, Division of Medical Toxicology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States of America; The Fenway Institute, Boston, MA, United States of America
| | - P R Chai
- Department of Emergency Medicine, Division of Medical Toxicology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States of America; The Fenway Institute, Boston, MA, United States of America; Koch Institute for Integrated Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, United States of America; Department of Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, MA, United States of America
| | - T B Erickson
- Department of Emergency Medicine, Division of Medical Toxicology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States of America; Harvard Humanitarian Initiative, Harvard University, Cambridge, MA, United States of America
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Dashpuntsag K, Chandaga U, Tserennadmid N, Bat-Ochir U, Mukhtar Y, Altankhuyag GE, Gombodorj N, Dulamsuren O, Jaalkhorol M. Awareness and Attitudes of Mongolian Adolescents and Youth toward Alcohol Consumption and Alcohol-related Harm. ADDICTION & HEALTH 2021; 13:185-193. [PMID: 35140896 PMCID: PMC8730445 DOI: 10.22122/ahj.v13i3.1250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 04/18/2021] [Indexed: 01/05/2023]
Abstract
BACKGROUND This study aimed to examine alcohol consumption among Mongolian adolescents and youth, as well as their awareness and attitudes toward alcohol-related consequences. METHODS We analyzed cross-sectional data collected from students in secondary schools, colleges, and universities in Ulaanbaatar, Mongolia, using descriptive analysis methods. FINDINGS More than half of respondents had tried alcohol in the past, and 15.9% of high school students and 58.8% of university students had consumed alcohol in the last month (P = 0.0001). In total, 70.0% of respondents celebrated holidays with alcohol, 23.4% had economic problems due to alcohol consumption, 7.8% had health problems 1-2 times in the last 30 days, and roughly 36.0% had negative attitudes toward alcohol. Approximately, 15.0% of adolescents and young people had an insufficient understanding of anti-alcohol measures and laws. CONCLUSION Our findings suggest that Mongolian adolescents and youth have a high level of alcohol consumption and insufficient awareness and attitude regarding alcohol-related harm.
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Affiliation(s)
- Khishigtogtokh Dashpuntsag
- Department of Preventive Medicine, School of Public Health, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Unurtsetseg Chandaga
- Department of Preventive Medicine, School of Public Health, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Nyamsuren Tserennadmid
- Department of Philosophy and Religious Studies, School of Sciences, National University of Mongolia, Ulaanbaatar, Mongolia
| | - Udvaltsesteg Bat-Ochir
- Department of Preventive Medicine, School of Public Health, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Yerkyebulan Mukhtar
- Department of Epidemiology and Biostatistics, School of Public Health, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Gan Erdene Altankhuyag
- Department of Health Social Work and Social Sciences, School of Public Health, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Nadmidtseren Gombodorj
- Department of Health Social Work and Social Sciences, School of Public Health, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Oyunbileg Dulamsuren
- Department of Health Social Work and Social Sciences, School of Public Health, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Myadagmaa Jaalkhorol
- Department of Preventive Medicine, School of Public Health, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
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Petersen Williams P, Morojele N, Londani M, Harker Burnhams N, Parry CDH. Alcohol Advertising, Affordability and Availability, and the Effect on Adult Heavy Drinking and Symptoms of Alcohol Problems: International Alcohol Control Study (South Africa). Subst Use Misuse 2019; 54:1751-1762. [PMID: 31076000 DOI: 10.1080/10826084.2019.1609987] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background: Alcohol harm is a major contributor to the burden of disease in South Africa. This study aimed to identify the extent of heavy drinking and symptoms of alcohol problems among adult drinkers and associated demographic and other risk factors in the Tshwane Metropole of South Africa. Methods: A household survey was conducted using multi-stage stratified cluster random sampling. Heavy drinking was defined as consuming at least 120 mL for men and at least 90 mL for women of absolute alcohol on one occasion at least monthly while symptoms of alcohol problems were measured using the Rapid Alcohol Problems Screen 4 (RAPS4). Stata 14.0 was used for the analysis. Results: Just over half (52%) of the sample reported heavy drinking, and half (50%) reported symptoms of alcohol problems. Gender race/ethnicity, marital status, mode of transport used to purchase alcohol, perceptions of alcohol availability and exposure to alcohol promotions and advertising through SMS and free offers when buying alcohol all impacted heavy drinking. Gender, age, personal income and exposure to alcohol promotions and advertising in magazines and newspapers all impacted symptoms of alcohol problems. Conclusion: The study raises important questions about various policy related mechanisms to curtail heavy drinking and highlights the need for more extensive research to assess the nature and extent of heavy drinking and alcohol problems in South Africa.
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Affiliation(s)
- Petal Petersen Williams
- a Alcohol, Tobacco and Other Drug Research Unit , South African Medical Research Council , Cape Town , South Africa.,d Department of Psychiatry and Mental Health , University of Cape Town , Cape Town , South Africa
| | - Neo Morojele
- a Alcohol, Tobacco and Other Drug Research Unit , South African Medical Research Council , Cape Town , South Africa.,b School of Public Health and Family Medicine , University of Cape Town , Cape Town , South Africa.,c School of Public Health , University of the Witwatersrand , Johannesburg , South Africa
| | - Mukhethwa Londani
- a Alcohol, Tobacco and Other Drug Research Unit , South African Medical Research Council , Cape Town , South Africa
| | - Nadine Harker Burnhams
- a Alcohol, Tobacco and Other Drug Research Unit , South African Medical Research Council , Cape Town , South Africa.,b School of Public Health and Family Medicine , University of Cape Town , Cape Town , South Africa
| | - Charles D H Parry
- a Alcohol, Tobacco and Other Drug Research Unit , South African Medical Research Council , Cape Town , South Africa.,e Department of Psychiatry , Stellenbosch University , Cape Town , South Africa
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