Dataset Information

Life-threatening alcohol-related traffic crashes in adverse weather: a double-matched case-control analysis from Canada.

ABSTRACT:

Importance

Drunk driving is a major cause of death in North America, yet physicians rarely counsel patients on the risks of drinking and driving.

Objective

To test whether the risks of a life-threatening alcohol-related traffic crash were further accentuated by adverse weather.

Design

Double matched case-control analysis of hospitalised patients.

Setting

Canada's largest trauma centre between 1 January 1995 and 1 January 2015.

Participants

Patients hospitalised due to a life-threatening alcohol-related traffic crash.

Exposure

Relative risk of a crash associated with adverse weather estimated by evaluating the weather at the place and time of the crash (cases) compared with the weather at the same place and time a week earlier and a week later (controls).

Results

A total of 2088 patients were included, of whom the majority were drivers injured at night. Adverse weather prevailed among 312 alcohol-related crashes and was significantly more frequent compared with control circumstances. The relative risk of a life-threatening alcohol-related traffic crash was 19% higher during adverse weather compared with normal weather (95% CI: 5 to 35, p=0.006). The absolute increase in risk amounted to 43 additional crashes, extended to diverse groups of patients, applied during night-time and daytime, contributed to about 793 additional patient-days in hospital and was distinct from the risks for drivers who were negative for alcohol.

Conclusions

Adverse weather was associated with an increased risk of a life-threatening alcohol-related traffic crash. An awareness of this risk might inform warnings to patients about traffic safety and counselling alternatives to drinking and driving.

SUBMITTER: Redelmeier DA

PROVIDER: S-EPMC6429889 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

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Publications

Life-threatening alcohol-related traffic crashes in adverse weather: a double-matched case-control analysis from Canada.

Redelmeier Donald A DA Manzoor Fizza F

BMJ open 20190314 3

<h4>Importance</h4>Drunk driving is a major cause of death in North America, yet physicians rarely counsel patients on the risks of drinking and driving.<h4>Objective</h4>To test whether the risks of a life-threatening alcohol-related traffic crash were further accentuated by adverse weather.<h4>Design</h4>Double matched case-control analysis of hospitalised patients.<h4>Setting</h4>Canada's largest trauma centre between 1 January 1995 and 1 January 2015.<h4>Participants</h4>Patients hospitalise ...[more]

PMID: 30872544

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Project description: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.

Project description:ImportanceCataracts are the most common cause of impaired vision worldwide and may increase a driver's risk of a serious traffic crash. The potential benefits of cataract surgery for reducing a patient's subsequent risk of traffic crash are uncertain.ObjectiveTo conduct a comprehensive longitudinal analysis testing whether cataract surgery is associated with a reduction in serious traffic crashes where the patient was the driver.Design, setting, and participantsPopulation-based individual-patient self-matching exposure-crossover design in Ontario, Canada, between April 1, 2006, and March 31, 2016. Consecutive patients 65 years and older undergoing cataract surgery (n = 559 546).InterventionsFirst eye cataract extraction surgery (most patients received second eye soon after).Main outcomes and measuresEmergency department visit for a traffic crash as a driver.ResultsOf the 559 546 patients, mean (SD) age was 76 (6) years, 58% were women (n = 326 065), and 86% lived in a city (n = 481 847). A total of 4680 traffic crashes (2.36 per 1000 patient-years) accrued during the 3.5-year baseline interval and 1200 traffic crashes (2.14 per 1000 patient-years) during the 1-year subsequent interval, representing 0.22 fewer crashes per 1000 patient-years following cataract surgery (odds ratio [OR], 0.91; 95% CI, 0.84-0.97; P = .004). The relative reduction included patients with diverse characteristics. No significant reduction was observed in other outcomes, such as traffic crashes where the patient was a passenger (OR, 1.03; 95% CI, 0.96-1.12) or pedestrian (OR, 1.02; 95% CI, 0.88-1.17), nor in other unrelated serious medical emergencies. Patients with younger age (OR, 1.27; 95% CI, 1.13-1.14), male sex (OR, 1.64; 95% CI, 1.46-1.85), a history of crash (baseline OR, 2.79; 95% CI, 1.94-4.02; induction OR, 4.26; 95% CI, 2.01-9.03), more emergency visits (OR, 1.34; 95% CI, 1.19-1.52), and frequent outpatient physician visits (OR, 1.17; 95% CI, 1.01-1.36) had higher risk of subsequent traffic crashes (multivariable model).Conclusions and relevanceThis study suggests that cataract surgery is associated with a modest decrease in a patient's subsequent risk of a serious traffic crash as a driver, which has potential implications for mortality, morbidity, and costs to society.

Dataset Information

Life-threatening alcohol-related traffic crashes in adverse weather: a double-matched case-control analysis from Canada.

Importance

Objective

Design

Setting

Participants

Exposure

Results

Conclusions

Publications

Life-threatening alcohol-related traffic crashes in adverse weather: a double-matched case-control analysis from Canada.

Similar Datasets

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