The more you drink, the harder you fall: A systematic review and meta-analysis of how acute alcohol consumption and injury or collision risk increase together

Abstract

Alcohol consumption causes injury in a dose-response manner. The most common mode of sustaining an alcohol-attributable injury is from a single occasion of acute alcohol consumption, but much of the injury literature employs usual consumption habits to assess risk instead. An analysis of the acute dose-response relationship between alcohol and injury is warranted to generate single occasion- and dose-specific relative risks. A systematic literature review and meta-analysis was conducted to fill this gap. Linear and best-fit first-order model were used to model the data. Usual tests of heterogeneity and publication bias were run. Separate meta-analyses were run for motor vehicle and non motor vehicle injuries, as well as case-control and case-crossover studies. The risk of injury increases non-linearly with increasing alcohol consumption. For motor vehicle accidents, the odds ratio increases by 1.24 (95% CI: 1.18–1.31) per 10-gram in pure alcohol increase to 52.0 (95% CI: 34.50 – 78.28) at 120 grams. For non-motor vehicle injury, the OR increases by 1.30 (95% CI: 1.26–1.34) to an OR of 24.2 at 140 grams (95% CI: 16.2 – 36.2). Case-crossover studies of non-MVA injury result in overall higher risks than case-control studies and the per-drink increase in odds of injury was highest for intentional injury, at 1.38 (95% CI: 1.22 – 1.55). Efforts to reduce drinking both on an individual level and a population level are important. No level of consumption is safe when driving and less than 2 drinks per occasion should be encouraged to reduce the risk of injury.

The Dynamic Risk of Heavy Episodic Drinking on Interpersonal Assault in Young Adolescence and Early Adulthood

“…The headline result reported above suggests the risk of committing an assault offence increases monotonically with increased heavy episodic drinking frequency (for both genders) and confirms findings from an earlier study using logistic regression models (XXXX 2011). This finding resembles that identified in a metaanalysis by Lipsey et al (1997) and also the finding that increases in alcohol consumption are associated with a monotonic increased risk of injury, as established by Taylor et al (2010).…”

The relationship between different dimensions of alcohol use and the burden of disease—an update

“…In addition, as already mentioned above, judgement about risk‐taking and other behavioural actions is impacted by alcohol use, again dose‐dependent. The dose–response relationship between acute alcohol use, measured through the blood alcohol concentration and injury, seem exponential for all injury types, albeit varying slightly by type of injury 311, 312, 313.…”

The influence of groups and alcohol consumption on individual risk-taking

“…Study 2 and 3 supported the importance of targeting not only alcohol consumption, but also contexts in which harmful alcohol behaviours occur. As identified in Chapter 1, recent statistics point to a reduction in alcohol consumption over recent years (HSCIC, 2017), however this does not appear to be mirrored in an associated decrease in alcohol-related harms (such as risk-related injuries; Taylor et al, 2010). Studies 2 to 4, may offer some insight in this regard, and aid current intervention efforts in reducing alcohol-related risk.…”