A comparison of maxillofacial trauma before and after implementation of lockout laws in Sydney

Abstract

Background: Lockout reforms were introduced in February 2014 by the New South Wales government in an attempt to curb alcohol-related violence in Sydney, following a number of fatalities. Changes include 1.30 a.m. venue lockouts and the 3 a.m. cessation of alcohol service. This study aims to assess the results of these reforms through analysis of departmental treatment data. All maxillofacial fractures that required operative management at St Vincent’s Hospital, Sydney, over a two-year period pre and post reforms were analysed.Methods: Medical information, from multiple sources, of patients that required operative management for maxillofacial fractures over a 2-year period (2012-2014) were compared to those between (2014-2016). Data collected included age, gender, demographics, mechanism of injury, pattern of injury, treatment required, association with alcohol, time and place of injury, and long-term complications.Results: 145 maxillofacial fractures were operatively treated prior to the reforms compared to only 58 (p<0.001) post. Reported incidents occurring in the city significantly fell from 54 to 15 (p<0.001), with no change in peripheral locations. The operated cases associated with alcohol dropped post reforms (102/145 (70%) vs 33/58 (57%). The number of assaults related to ‘king hits’ significantly reduced from 30 (33%) to just 5 (19.2%).Conclusion: This study demonstrates a clear correlation with the reduction in maxillofacial trauma, alcohol and violence in a localised region of Sydney since the arrival of the lockout reforms. As such, it can provide guidance to other regions in Australia into the effects of such laws and its repercussions on patient care and service.

COVID-19 social-distancing measures altered the epidemiology of facial injury: a United Kingdom-Australia comparative study

“…The association between facial trauma and alcohol related interpersonal violence (IPV) has been well established in the literature with early lockouts and strict liquor licensing laws leading to a decrease in facial trauma presentations. Not surprisingly, the closure of licenced pubs, clubs, bars and hotels during the COVID social distancing period similarly reduced the sale and consumption of alcohol, which we believe directly lead to a reduction in IPV [8] , [9] , [10] .…”

The Frequency and Characteristics of Facial Injury Following COVID-19 Social Distancing Laws: Newcastle, (Australia) Observations

“…These episodes are often associated with the consumption of alcohol. [6][7][8] Our study showed that the increase in presentation of facial injury (during devolution of social distancing) occurred in twice as many males as females, with half of these aged between 11 and 40 years. Although small in number, there were demonstrable increases in presentations due to interpersonal violence, motor vehicle accidents, and sporting activities.…”

The impact of high profile restrictions on support for alcohol control policies

“…These findings suggest that opponents of the restrictions have been relatively successful at changing the minds of the public. In spite of consistent evidence that the Sydney restrictions have dramatically reduced violence in the targeted areas (with only minimal displacement elsewhere) , a significant proportion of the public were less supportive of these policies in 2016 than they were before their introduction. In a recent analysis of the media coverage that preceded and followed the introduction of the Sydney restrictions, Dwyer et al note that even while the number of newspaper articles emphasising negative impacts of the restrictions increased sharply after the end of 2014, there were still more articles reporting on the positive impacts right through until the end of 2016.…”

“…These interventions received significant media attention and generated major public debate. Despite repeated evidence from Sydney that the interventions had markedly reduced violence , they remained hugely controversial due to their effects on businesses and nightlife , the exemption granted to the state's casino and their displacement of some problems to neighbouring areas . Dwyer et al have examined the media coverage of these debates and their work provides some helpful context for the current study.…”