Traumatic pedestrian and bicyclist injuries associated with intoxication

Tonellato, Daniel; Ransohoff, Jaime R; Nash, Carol C.; Melanson, Stacy E.F.; Petrides, Athena K.; Tolan, Nicole V.; Goldberg, Scott A; Boyer, Edward W.; Chai, Peter R.; Erickson, Timothy

doi:10.1016/j.ajem.2020.08.024

Cited by 6 publications

(3 citation statements)

References 21 publications

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“…Furthermore, the dangers of public substance use extends beyond just the cyclists themselves. Tonellato et al 21 concluded from a series of 94 patients that intoxicated cyclists and associated pedestrians suffer more serious injuries than their sober counterparts, including more fractures and have subsequent intensive care unit admission. Though these studies have implicated alcohol and/ or drug use in cycling crashes, injuries, and hospital stays, our study is the first to provide a large, population-based data on the specific risk of alcohol and drug use while cycling, and it represents a natural extension of the previous work.…”

Section: Discussionmentioning

confidence: 99%

Alcohol and Drug Use While Cycling Significantly Increases the Likelihood of Facial Fractures

Sorenson¹,

Rich

Hagstrom³

et al. 2021

Journal of Craniofacial Surgery

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Purpose: Substance use, including alcohol and drugs,has beenfound to amplify the risks associated with cycling. Our purpose was to determine the relationship between alcohol or drug use and facial injuries in a nationwide population of patients experiencing cycling trauma. Methods: Theauthorsreportacross-sectionalstudyofpatientsreported to the National Electronic Injury Surveillance System from January 1, 2019 to December 31, 2019, in the United States. Patients were included in our study if they were evaluated in the emergency department for a cycling-related injury. Primary outcome was facial injury. Results: There were a total of 6499 adult patients who experience an injury after cycling trauma reported by the National Electronic Injury Surveillance System-participating emergency departments during the study period. A total of 553 (553/6499; 8.5%) patients had a facial injury and 82 patients with facial injuries had alcohol/ drug use recorded (82/553; 14.8%). The proportion of males with facial injuries was higher in the alcohol/drug group than the no alcohol/drug group (86.6% versus 76.4%, respectively; P ¼ 0.04). Injured cyclists in the alcohol/drug group experienced greater odds of sustaining a facial injury (odds ratio: 2.21, 95% confidence interval: 1.71-2.84, P < 0.0001) and a facial fracture (odds ratio: 2.75, 95% confidence interval: 1.83-4.13, P < 0.0001) than injured cyclists in the no alcohol/drug group. Conclusions: Substance use while cycling is not safe and significantly increases the likelihood of a facial injury and of facial fractures. This prevalence of injuries would suggest that cycling under the influence should always be illegal, and the law strictly enforced.

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Section: Discussionmentioning

confidence: 99%

Alcohol and Drug Use While Cycling Significantly Increases the Likelihood of Facial Fractures

Sorenson¹,

Rich

Hagstrom³

et al. 2021

Journal of Craniofacial Surgery

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“…In the Recommendations for Toxicological investigation of DUID fatalities, due to an increased prevalence of FENT registered by different laboratories, FENT was included in the mandatory substances to test, with a confirmation cut-off in the blood of 0.5 ng/mL [ 26 ]. Fentanyl was the most commonly detected drug (around 40%) of pedestrian/bicycle traumas in 2017-2019 [ 27 ] and in the USA FENT positive-DUID cases rose from 1% in 2014 to 5% in 2018, being 3% in 2019 [ 28 ]. An increase was also reported most recently, by the NMS Lab, that, by reviewing DUID cases over 11 years, revealed that 4.4% were positive for FENT, with a rise from 0.6% in 2010 to 12% in 2020 [ 29 ].…”

Section: Psychomotor Performances In Humans - Literature Reviewmentioning

confidence: 99%

Sensorimotor Alterations Induced by Novel Fentanyl Analogs in Mice: Possible Impact on Human Driving Performances

Marti

Bilel

Giorgetti

et al. 2023

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Operating a vehicle is a complex task that requires multiple cognitive functions and psychomotor skills to cooperate. Driving might be impaired by licit or illicit drugs, including novel psychoactive substances (NPS) and novel synthetic opioids (NSO), the effects of which are still yet to be elucidated in humans. In the present work, a revision of the literature regarding the psychomotor impairing effects of Fentanyl (FENT) and three analogues (Acrylfentanyl, Ocfentanyl and Furanylfentanyl) is presented, as emerged by experimental studies on humans, driving under the influence of a drug (DUID) and intoxication cases. An experimental study on a mouse model evaluated the sensorimotor alterations induced by FENT and the three fentalogs. Acute systemic administration of the four opioids (0.01-15 mg/kg i.p.) dose-dependently decreased the visual object and placing tests, the acoustic and the tactile responses of mice. The preclinical data are in accordance with the data that emerged from the revision of the literature regarding experimental data on humans, driving under the influence of drugs and intoxication cases, suggesting that novel synthetic opioids might affect the psychomotor performances on daily human tasks with a particular focus on driving.

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“…Research on EDs has usually relied on exposure data (alcohol and drugs) prior to the RTI collected through biological specimens (blood, saliva, urine and breath) and/or self-reported data through standardised questionnaires 16. While biological specimens have been used to describe exposure in samples of patients prior to RTI,17 18 most research draws on self-reported data to calculate relative risks, usually by means of ORs from case–control19 20 or case–crossover21–24 studies. Few studies have investigated differences in relative risk estimates when using biological samples or self-reported exposure data (see Asbridge et al for alcohol and cannabis) (see Khanjani, Mousavi, Dehghanian, et al 2017, for cannabis) and only one study used a combination of information from both sources 11 25.…”

Section: Introductionmentioning

confidence: 99%

Alcohol and cannabis use in traffic-related injuries in Mexico City

Borges

Orozco

2022

Inj Prev

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BacterkgroundThere is debate on whether cannabis affects road traffic injuries (RTIs) separately from the effects of alcohol. Our goals are to report the possible increase in risk of an RTI among alcohol and cannabis users by type of exposure (biological, self-reported and combined) and the possible interaction of alcohol and cannabis in patients with an RTI in an emergency department in Mexico City.MethodsA case–crossover study with 433 cases of RTI (as a pedestrian, driver or passenger) during the period January–April 2022. A breath sample, an oral sample for cannabis detection and self-reported alcohol and cannabis use 6 hours prior to the RTI and in two control periods were used. We report ORs and 95% CIs from conditional logistic regressions for the case–crossover estimates.ResultsAlcohol alone increased the risk of an RTI (OR=6.02, 95% CI 3.29 to 10.99) for most RTIs, regardless of whether we used information from self-reports or a breath sample in the hazard period. Conversely, cannabis only increased the RTI when we added information in the hazard period from self-reports or oral samples. Nevertheless, this increase in risk disappeared (OR=2.06, 95% CI 0.90 to 4.70) among those who only used cannabis. We also found no evidence of interaction between alcohol and cannabis in the risk of an RTI.ConclusionsAlcohol is the most commonly used substance in Mexico and a high-risk factor for RTI in Mexico City. Although cannabis alone was not associated with an RTI, continuous monitoring of its effects is required.

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Traumatic pedestrian and bicyclist injuries associated with intoxication

Cited by 6 publications

References 21 publications

Alcohol and Drug Use While Cycling Significantly Increases the Likelihood of Facial Fractures

Alcohol and Drug Use While Cycling Significantly Increases the Likelihood of Facial Fractures

Sensorimotor Alterations Induced by Novel Fentanyl Analogs in Mice: Possible Impact on Human Driving Performances

Alcohol and cannabis use in traffic-related injuries in Mexico City

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