Blood alcohol content and death from fatal injury: a study in the metropolitan area of São Paulo, Brazil.

This study analyzed 5,690 toxicological screenings carried out on blood and viscera of fatally injured victims at the Institute of Forensic Medicine in the Metropolitan area of São Paulo during 1994. The screenings analyzed correspond to 39.5% of all deaths due to injury in this metropolitan area during the same period. Almost half of the victims (48.3%) presented a positive blood alcohol content (BAC). The exact proportion however, varied according to the cause of death with 64.1% of victims of drowning testing positive for alcohol, 52.3% of homicides, 32.2% of suicides and 50.6% of motor vehicle accidents. Blood alcohol concentration was also found to vary, with suicide victims presenting low concentrations and 70% of pedestrians hit by cars presenting high concentrations (0.2% or greater). Few cases tested positive for drugs other than alcohol, and of those who did, the majority were positive for cocaine. However, it should be emphasized that the methods used for the detection of substances other than alcohol were only accurate enough to detect cases of overdose. These findings highlight the need to improve surveillance of alcohol-related fatalities in Brazil and suggest an important link between alcohol intoxication and fatal injury.